Introduction

The Frommelt Attitude Toward the Care of the Dying (FATCOD-30) is one of the most widely used psychometric instruments for assessing healthcare professionals’ attitudes toward caring for individuals at the end of life. Originally developed by Katherine H. Frommelt in 1988, the scale was designed to evaluate the beliefs, emotions, and preparedness of healthcare providers in delivering compassionate, patient-centered palliative and end-of-life care. Positive professional attitudes toward dying patients are considered essential for high-quality palliative care, effective communication, and holistic support for both patients and their families. Consequently, the FATCOD-30 has become a standard assessment tool in nursing education, medical training, palliative care research, and professional development programs worldwide.

Description

The Frommelt Attitude Toward the Care of the Dying consists of 30 self-report statements that measure attitudes toward caring for patients approaching the end of life. The instrument evaluates several important aspects of palliative care, including emotional support for dying patients, communication with patients and their families, healthcare professionals’ comfort when providing end-of-life care, and the sense of professional fulfillment associated with caring for terminally ill individuals. By examining these domains, the FATCOD-30 provides valuable insight into factors that influence the quality of palliative care and identifies educational needs that may improve professional competence and confidence.

The questionnaire contains both positively and negatively worded statements, allowing for a balanced assessment of respondents’ attitudes while reducing response bias. Because it measures attitudes rather than clinical competence, the FATCOD-30 is particularly useful for evaluating educational interventions and monitoring changes in perceptions following palliative care training.

Data Analysis and Interpretation

The Frommelt Attitude Toward the Care of the Dying generates standardized quantitative data that enable comprehensive assessment of healthcare professionals’ attitudes toward end-of-life care. Total scores provide an overall measure of positive or negative attitudes toward caring for dying patients, while individual items may also be analyzed to identify specific educational or professional development needs.

The FATCOD-30 is widely used to investigate associations between attitudes toward palliative care and variables such as professional experience, educational background, communication skills, burnout, empathy, compassion fatigue, self-efficacy, and quality of patient care. Because the instrument produces standardized psychometric data, it is suitable for descriptive statistical analyses, reliability assessment using Cronbach’s alpha, exploratory and confirmatory factor analysis (EFA and CFA), correlation analysis, multiple regression, mediation and moderation analysis, structural equation modeling (SEM), multilevel analysis, and longitudinal studies evaluating changes following educational interventions or clinical training programs.

Factor analytic studies have generally supported the theoretical dimensions underlying attitudes toward end-of-life care, and the scale demonstrates strong internal consistency. According to the available documentation, Cronbach’s alpha is typically reported as greater than 0.80, supporting the reliability and stability of the instrument across healthcare populations.

Purpose

The primary purpose of the Frommelt Attitude Toward the Care of the Dying is to evaluate healthcare professionals’ attitudes toward caring for individuals who are approaching the end of life. More specifically, the instrument assesses attitudes toward palliative and hospice care, professionals’ comfort when communicating with dying patients, emotional readiness to provide end-of-life care, perceptions regarding support for patients’ families, and the effectiveness of educational programs in palliative care. The scale is also widely employed in research investigating healthcare professionals’ attitudes, communication skills, and preparedness for delivering compassionate, person-centered end-of-life care. Systematic assessment of these attitudes supports the development of targeted educational initiatives and organizational strategies aimed at improving the quality of palliative care services.

Scoring

The FATCOD-30 consists of 30 items rated on a five-point Likert scale, ranging from Strongly Agree to Strongly Disagree. The questionnaire includes 15 positively worded items (Items 1, 2, 4, 10, 12, 16, 18, 20, 21, 22, 23, 24, 25, 27, and 30) and 15 negatively worded items, which require reverse scoring before calculating the total score. Total scores range from 30 to 150, with higher scores indicating more positive attitudes toward caring for dying patients and the provision of palliative care, whereas lower scores reflect less positive or more negative attitudes toward end-of-life care. This scoring approach enables both cross-sectional comparisons and longitudinal evaluation of educational or professional development programs.

Applications

The Frommelt Attitude Toward the Care of the Dying is extensively used in hospitals, palliative care units, oncology and hematology departments, intensive care units, home healthcare services, and hospice care, as well as in the education of nurses, physicians, allied health professionals, and healthcare students. The instrument is widely applied in palliative care research, evaluations of educational interventions, studies of professional preparedness, and investigations of attitudes toward death, dying, and end-of-life care. Its strong psychometric properties, practical administration, and broad international use make the FATCOD-30 one of the leading instruments for assessing attitudes toward palliative care. By identifying educational needs and monitoring changes in professional attitudes, the scale contributes to improving communication with patients and families, enhancing compassionate care, and promoting high-quality, person-centered healthcare during the final stages of life.