• Beatrice Albanesi, Anna Marchetti, Gabriella Facchinetti, Marco Clari, Federica Dellafiore, Loredana Piervisani, Maura Lusignani, Maria Grazia De Marinis, and Michela Piredda.
• Department of Biomedicine and Prevention University of Rome 'Tor Vergata', Rome, Italy.
• Nutrition. 2020 Apr 1; 72: 110655.

ObjectivesDecision-making on artificial nutrition and hydration for patients terminally ill with cancer can be influenced by nurses' knowledge, attitudes, and behavioral intentions. A comprehensive 57-item questionnaire including six sections on the knowledge, attitudes, and behavioral intentions in providing artificial nutrition and hydration to patients terminally ill with cancer has been developed and used in Taiwan. However, the questionnaire needs further psychometric testing and adaptation for other cultures. This study aimed to cross-culturally adapt the questionnaire within the Italian cultural context and test its psychometric properties.MethodsThe questionnaire was translated into Italian and cross-culturally adapted per the recommendations by Beaton. A panel of 10 experts assessed content validity. A multicenter cross-sectional study was conducted with 411 nurses to test its psychometric properties. Dimensionality and construct validity were assessed through exploratory and confirmatory factor analyses. Reliability was estimated by composite ω and traditional methods, such as the Kuder Richardson formula-20 and Cronbach's α coefficients.ResultsThe overall content validity index was 0.85. A confirmatory factor analysis was conducted for the knowledge section and the four attitudes sections. A preliminary analysis for the behavioral intentions section yielded non acceptable results. The internal consistency of the scales was adequate (range, 0.64-0.93).ConclusionsThis study constituted a notable advancement in the psychometric testing of the tool, and provides evidence that the Italian version of the questionnaire has acceptable psychometric characteristics for the sections on knowledge and attitudes.Copyright © 2019 Elsevier Inc. All rights reserved.

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