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Death Studies
Article . 2025 . Peer-reviewed
License: CC BY
Data sources: Crossref
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Measurement invariance of the Death Literacy Index across Flemish Belgium, The Netherlands, and Sweden

Authors: Therese Johansson; Aleksandra Bujacz; Leo Kowalski; Carol Tishelman; Corine A. Nierop-van Baalen; Lars E. Eriksson; Marieke Groot; +4 Authors

Measurement invariance of the Death Literacy Index across Flemish Belgium, The Netherlands, and Sweden

Abstract

Death literacy is a construct conceptualizing experience-based knowledge and skills for end-of-life care, which is operationalized as a six-factor model in the 29-item Death Literacy Index (DLI). The DLI has gained international interest, but its validity across countries is yet unknown. This cross-sectional study therefore assessed its measurement invariance (psychometric equivalence), across Flemish Belgium, the Netherlands, and Sweden. Translated and adapted country-specific DLI versions were developed and completed by 1516 participants in total. Results from a series of multigroup confirmatory factor analyses showed that the DLI met the conditions for configural, scalar, and metric invariance. The findings demonstrate that the DLI measures death literacy in an invariant (equivalent) way across the national samples without systematic contextual bias. Our study provides support for cross-national use of the DLI. Its potential as an appropriate instrument for comparing and evaluating impact of community competence-building interventions is discussed.

Keywords

FIT INDEXES, POPULATION-LEVEL, IMPACT, END, Medicine and Health Sciences, Social Sciences, EoLC, OF-LIFE CARE, HEALTH, PALLIATIVE CARE

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
Green
hybrid