• María Rullán, Ana Carvajal, Jorge M Núñez-Córdoba, Marina Martínez, José Miguel Carrasco, Irene García, María Arantzamendi, Alazne Belar, and Carlos Centeno.
• Department of Gastroenterology, Complejo Hospitalario de Navarra, Pamplona, Spain; ATLANTES Research Program, Institute for Culture and Society, University of Navarra, Pamplona, Spain.
• J Pain Symptom Manage. 2015 Dec 1; 50 (6): 874-81.e1.

ContextThe Patient Dignity Inventory (PDI) is an instrument to measure sources of distress related to dignity at the end of life.ObjectivesTo obtain a Spanish version of the PDI and measure psychometric aspects in patients with advanced cancer.MethodsA back-translation method was used to obtain the Spanish version. Inpatients and outpatients with advanced cancer were included. Patients completed the Spanish versions of the PDI (PDI-s), Edmonton Symptom Assessment System (ESAS), Hospital Anxiety and Depression Scale (HADS), and Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp-12) instruments. The psychometric properties evaluated were internal consistency; concurrent validity between PDI-s/ESAS, PDI-s/HADS, and PDI-s/FACIT-Sp-12; discriminant validity, test-retest reliability, and factor analysis. The usefulness of the instrument also was tested.ResultsA Spanish version of the PDI was obtained. One hundred twenty-four patients completed the study. Cronbach's alpha coefficient for the PDI-s was 0.89. The PDI-s significantly correlated with the ESAS (rs = 0.669; P < 0.001), HADS (rs = 0.788; P < 0.001), and FACIT-Sp-12 (rs = -0.442; P = 0.008). The instrument distinguished outpatients from inpatients and between patients with differing Karnofsky Performance Status scores (rs = -0.328; P < 0.001). The test-retest method indicated excellent reproducibility (intraclass correlation coefficient = 0.931). Factor analysis showed three factors accounting for 79.4% of the variance. Factors were labeled psychological and existential distress, physical symptoms and dependency, and social support. Patients had no difficulties in understanding or completing the questionnaire (mean time to complete: 7.2 minutes).ConclusionThe Spanish version of the PDI showed adequate psychometric properties when tested with advanced cancer patients. This research provides a three-factor alternative in Spanish to the PDI.Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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