The Farsi translation, reliability and validity of the Death Concern Scale

Death concern is a conscious contemplation of the reality of death combined with a negative evaluation of that reality. The Death Concern Scale (DCS) is related to thinking, and death fear or anxiety about death. The aim of the present study was to develop a Farsi version of the DCS and to explore its psychometric properties in a sample of Iranian nurses.

Methods:

A cross-sectional study was conducted to investigate the reliability, validity, and factorial structure of the Farsi version of the DCS in a convenience sample of 106 Iranian nurses in two hospitals in Tehran, Iran. The nurses completed the DCS, the Collett-Lester Fear of Death Scale (CLFDS), the Death Anxiety Scale (DAS), the Reasons for Death Fear Scale (RDFS), the Death Depression Scale (DDS), and the Death Obsession Scale (DOS).

Results:

For the DCS, Cronbach's α was 0.77, the Spearman-Brown coefficient 0.63, the Guttman split-half coefficient 0.62, and two-week test-retest reliability 0.77. The DCS correlated at 0.51 with the CLFDS, 0.52 with the DAS, 0.34 with the RDFS, 0.40 with the DDS, and 0.48 with the DOS, indicating good construct and criterion-related validity. The results of an exploratory factor analysis for the DCS identified seven factors, accounting for 64.30% of the variance and indicating considerable heterogeneity in the content of the items.

Conclusions:

The Farsi version of the DCS has good validity and reliability, and it can be used in clinical, educational, and research settings to assess death concerns in the Iranian society.

Keywords:
Death concern; death anxiety; DCS; reliability; validity; factorial structure; nurses; Iran

Variable		%
Age (years)
	20-29	26.2
	30-39	48.8
	40-49	19.0
	50+	6.0
Sex
	Women	95.0
	Men	5.0
Appointment
	Contract	61.0
	Formal	39.0
Work experience (years)
	1-5	32.6
	10+	67.4
Position
	Staff nurse	88.0
	Head nurse	12.0
Work shift
	Rotational	79.0
	Fixed	20.4
Number of patients per shift
	0-9	51.0
Care of end stage patients in the past 3 months
	0-6	58.0
Participation in reclamation operations in the past 3 months
	5+	29.9

DCS items	Mean	SD
1. I think about my own death.	2.65	0.86
2. I think about the death of loved ones.	2.66	0.93
3. I think about dying young.	2.23	0.94
4. I think about the possibility of my being killed on a city street.	2.27	1.04
5. I have fantasies of my own death.	2.02	1.00
6. I think about death just before I go to sleep.	1.95	0.99
7. I think of how I would act if I knew I were to die within a given period of time.	2.37	1.09
8. I think of how my relatives would act and feel upon my death.	2.40	0.95
9. When I am sick I think about death.	2.34	0.93
10. When I am outside during a lightning storm I think about the possibility of being struck by lightning.	1.92	0.91
11. When I am in an automobile I think about the high incidence of traffic fatalities.	2.02	0.98
12. I think people should first become concerned about death when they are old.	2.35	0.98
13. I am much more concerned about death than those around me.	2.37	0.98
14. Death hardly concerns me.	2.68	0.79
15. My general outlook just doesn't allow for morbid thoughts.	2.66	0.91
16. The prospect of my own death arouses anxiety in me.	2.45	0.87
17. The prospect of my own death depresses me.	2.61	0.88
18. The prospect of the death of my loved ones arouses anxiety in me.	2.80	0.91
19. The knowledge that I will surely die does not in any way affect the conduct of my life.	2.45	0.97
20. I envision my own death as a painful, nightmarish experience.	1.94	0.83
21. I am afraid of dying.	2.60	0.87
22. I am afraid of being dead.	2.55	0.84
23. Many people become disturbed at the sight of a new grave but it does not bother me.	2.44	0.92
24. I am disturbed when I think about the shortness of life.	2.44	0.98
25. Thinking about death is a waste of time.	2.66	0.90
26. Death should not be regarded as a tragedy if it occurs after a productive life.	2.16	1.02
27. The inevitable death of a person poses a serious challenge to the meaningfulness of human existence.	2.35	0.85
28. The death of the individual is ultimately beneficial because it facilitates change in society.	2.99	0.93
29. I have a desire to live on after death.	2.58	0.97
30. The question of whether or not there is a future life worries me considerably.	2.43	0.86

Scales	Mean (SD)	No. of items	Format	Cronbach's α
Death Concern Scale (DCS)	72.72 (10.82)	30	Likert (1-4)	0.73
Collett-Lester Fear of Death Scale (CLDFS)	99.15 (25.14)	32	Likert (1-5)	0.94
Death Anxiety Scale (DAS)	8.27 (2.71)	15	False-true (0-1)	0.60
Reasons for Death Fear Scale (RFDS)	57.70 (14.23)	18	Likert (1-5)	0.90
Death Depression Scale (DDS)	8.07 (4.34)	17	False-true (0-1)	0.84
Death Obsession Scale (DOS)	30.74 (12.35)	15	Likert (1-5)	0.95

Item	r	Item	r
1	0.23^* * Correlation significant at 0.01.	16	0.46^* * Correlation significant at 0.01.
2	-0.15	17	0.35^* * Correlation significant at 0.01.
3	0.47^* * Correlation significant at 0.01.	18	0.22^† † Correlation significant at 0.05.
4	0.09	19	0.15^† † Correlation significant at 0.05.
5	0.51^* * Correlation significant at 0.01.	20	0.27^* * Correlation significant at 0.01.
6	0.59^* * Correlation significant at 0.01.	21	0.26^* * Correlation significant at 0.01.
7	0.59^* * Correlation significant at 0.01.	22	0.41^* * Correlation significant at 0.01.
8	0.57^* * Correlation significant at 0.01.	23	0.08
9	0.52^* * Correlation significant at 0.01.	24	0.40^* * Correlation significant at 0.01.
10	0.55^* * Correlation significant at 0.01.	25	0.38^* * Correlation significant at 0.01.
11	0.64^* * Correlation significant at 0.01.	26	0.27^* * Correlation significant at 0.01.
12	0.21^† † Correlation significant at 0.05.	27	0.14
13	0.42^* * Correlation significant at 0.01.	28	0.31^* * Correlation significant at 0.01.
14	0.16	29	0.27^* * Correlation significant at 0.01.
15	0.47^* * Correlation significant at 0.01.	30	0.55^* * Correlation significant at 0.01.

Scales	r
Collett-Lester Fear of Death Scale (CLDFS)	0.51^* * Correlation significant at 0.01.
Death Anxiety Scale (DAS)	0.52^* * Correlation significant at 0.01.
Reasons for Death Fear Scale (RDFS)	0.34^* * Correlation significant at 0.01.
Death Depression Scale (DDS)	0.40^* * Correlation significant at 0.01.
Death Obsession Scale (DOS)	0.48^* * Correlation significant at 0.01.

	Component
DCS items	F1	F2	F3	F4	F5	F6	F7
1. I think about my own death.		0.691
2. I think about the death of loved ones.			-0.728
3. I think about dying young.	0.608
4. I think about the possibility of my being killed on a city street.						0.806
5. I have fantasies of my own death.
6. I think about death just before I go to sleep.	0.792
7. I think of how I would act if I knew I were to die within a given period of time.				0.548
8. I think of how my relatives would act and feel upon my death.	0.593
9. When I am sick I think about death.	0.587
10. When I am outside during a lightning storm I think about the possibility of being struck by lightning.
11. When I am in an automobile I think about the high incidence of traffic fatalities.							0.589
12. I think people should first become concerned about death when they are old.						-0.652
13. I am much more concerned about death than those around me.							0.751
14. Death hardly concerns me.
15. My general outlook just doesn't allow for morbid thoughts.				0.714
16. The prospect of my own death arouses anxiety in me.					0.603
17. The prospect of my own death depresses me.		-0.538
18. The prospect of the death of my loved ones arouses anxiety in me.
19. The knowledge that I will surely die does not in any way affect the conduct of my life.
20. I envision my own death as a painful, nightmarish experience.
21. I am afraid of dying.				0.710
22. I am afraid of being dead.					0.771
23. Many people become disturbed at the sight of a new grave but it does not bother me.
24. I am disturbed when I think about the shortness of life.
25. Thinking about death is a waste of time.			0.785
26. Death should not be regarded as a tragedy if it occurs after a productive life.
27. The inevitable death of a person poses a serious challenge to the meaningfulness of human existence.		0.696
28. The death of the individual is ultimately beneficial because it facilitates change in society.
29. I have a desire to live on after death.			0.561
30. The question of whether or not there is a future life worries me considerably.					0.537
Eigen value	5.44	2.98	2.16	1.90	1.66	1.34	1.35
% of variance	18.16	9.94	7.23	6.34	5.53	5.15	4.52
% of total variance	64.30

Associação de Psiquiatria do Rio Grande do Sul Av. Ipiranga, 5311/202, 90610-001 Porto Alegre RS/ Brasil, Tel./Fax: (55 51) 3024 4846 - Porto Alegre - RS - Brazil
E-mail: trends@aprs.org.br

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[1] Correspondence: mahboubehdadfar@yahoo.com