German version of the Death Attitudes Profile- Revised (DAP-GR) - translation and validation of a multidimensional measurement of attitudes towards death.

Background: In Germany, only limited data are available on attitudes towards death. Existing measurements are complex and time consuming, and data on psychometric properties are limited. The Death Attitude Profile- Revised (DAP-R) captures attitudes towards dying and death. The measure consists of 32 items, which are assigned to 5 dimensions (Fear of Death, Death Avoidance, Neutral Acceptance, Approach Acceptance, Escape Acceptance). It has been translated and tested in several countries, but no German version exists to date. This study reports the translation of the Death Attitudes Profile-Revised (DAP-R) into German (DAP-GR) using a cross-cultural adaption process methodology and its psychometric assessment.

Methods: The DAP-R was translated following guidelines for cultural adaption. A total of 216 medical students of the Heinrich Heine University Duesseldorf participated in this study. Interrater reliability was investigated by means of Kendall's W concordance coefficient. The internal consistency of the DAP-GR Scales was assessed with Cronbach's alpha coefficients. Split-half reliability was estimated using Spearman-Brown coefficients. Convergent validity was measured by Spearman's correlation coefficient. Content validity was assessed by means of confirmatory factor analysis (CFA). All statistical analyses were performed using SPSS 24 and AMOS 22.

Results: The items showed fair to good interrater reliability, with W-values ranging from .30 to .79. Internal consistency of the five subscales ranged from .61 (Neutral Acceptance) to .94 (Approach Acceptance). Split-half reliability was good, with a Spearman-Brown-coefficient of .83. The results of CFA slightly diverged from the original scale.

Conclusion: Our results suggest overall good reliability of the German version of the DAP-R. The DAP-GR promises to be a robust instrument to establish normative data on death attitudes for use in German-speaking countries.