116.7: Development and translation and of the psychometric Flodén ATODAI into the Swedish version.

Abstract

Background: There is a lack of published, validated questionnaires for evaluating the attitudes toward organ donor advocacy among intensive care unit (ICU) staff. Specific behavior among ICU staff is significantly associated with if there is consent to, or decline of, organ donation. In 2011, Flodén et al. developed the questionnaire “Attitudes towards organ donor advocacy scale” (ATODAS). Through the translation and cross-cultural adaption of the ATODAS into English, the questionnaire was further developed resulting in the “Flodén ATODAI North American version” (Attitudes Toward Organ Donor Advocacy Instrument). Therefore, the Aim of this study is to develop and psychometrically evaluate the instrument Flodén ATODAI into the Swedish version, for measuring intensive and critical-care nurses’ attitudes toward organ donor advocacy. Methods: A cross-sectional study was employed as the study design. Data was collected separately for the two included studies. Study subjects were Swedish nurses who currently worked in a Swedish ICU. For the major data collection (n=715), participants were identified by the Swedish association of health professionals. For the test-retest (n=33), participants were identified at an ICU at a Swedish county hospital. The validation of the Flodén ATODAI was performed in several steps: • Construct validity with Exploratory Factor Analysis, Kaiser-Mayer-Olkin, Bartlett’s test and Scree plot • Internal validity with Discriminant and Convergent validity, Scaling success, and Cronbach’s alpha • External validity with Known-groups validation, and • Reliability testing with test-retest and Intraclass Correlation Coefficient Results: The Exploratory Factor Analysis showed that the previously used five-factor solution of the questionnaire just agreed partially, but not entirely, which motivated this study of instrument development. Internal and external validation was performed. Known-groups validation revealed significant differences between the ICU nurses with a designated role in organ donation and neuro-ICU nurses, compared to the general ICU nurses. The six factors identified of the Flodén ATODAI showed good reliability in the test-retest analysis and the Intraclass Correlation Coefficient. Conclusions: The modified Flodén ATODAI [Swedish version] may be a reliable and valid tool for measure attitudes toward organ donor advocacy among ICU nurses. Anticipated or potential outcomes of this study may include: Evaluation of baseline attitudes of ICU nurses that can lead to tailored professional development; Changes in organizational structure related to organ donation; and Increased understanding of critical care nurses and the barriers to organ donation.