Validity and reliability of the Turkish version of the Patient Dignity Inventory

Palliat Support Care. 2022 Jun;20(3):389-396. doi: 10.1017/S1478951521000948.


Objective: The aim of this study was to investigate the validity and reliability of the Patient Dignity Inventory (PDI) in the Turkish society, which was developed to evaluate dignity-related distress in palliative care patients.

Methods: One hundred and twenty-seven adults with advanced cancer hospitalized in several clinics of two university hospitals were included in the study. The patients whose Palliative Performance Scale score was at least 40% were recruited to study. The data were collected with a patient demographic form, the Turkish version of Hospital Anxiety and Depression Scale (HADS-TR), and the Turkish version of the PDI (PDI-TR). The PDI-TR was finalized and back-translated after translating into Turkish and obtaining 10 expert opinions. Exploratory and confirmatory factor analysis, internal consistency, concurrent validity, and test-retest reliability analysis were performed.

Results: The Cronbach's α coefficient of PDI-TR was 0.94. Factor analysis resulted in a five-factor solution, and all items were loaded on factors. Factors were labeled as symptom distress, existential distress, self-confidence, dependency, and supportive care needs and accounted for 68.70% of the overall variance. The model's normed fit index, comparative fit index, and X2/SD were found between acceptable range (0.90, 0.93, and 2.64, respectively). A positive and strong correlation was found between subdimension scores of HADS-TR and the total score of PDI-TR (r = 0.70 for anxiety subdimension; r = 0.73 for depression subdimension). The test-retest reliability was conducted with 32 patients within the sample two weeks after the first application, and no significant difference was found between the two application scores as the result of paired-sample t-test (p > 0.05). An intraclass correlation coefficient of test-retest reliability was r = 0.855.

Significance of results: PDI-TR was found to be a valid and reliable tool in palliative care patients in Turkish society.

Keywords: Dignity; Nursing; Palliative Care; Patient Dignity Inventory; Psychometrics.

MeSH terms

  • Adult
  • Humans
  • Palliative Care
  • Psychometrics
  • Reproducibility of Results
  • Respect*
  • Surveys and Questionnaires
  • Translating*