Aim: The purpose of this study was to construct a scale that measures multidimensional attitudes regarding death in the middle-aged and elderly, using scale items for adolescents, and to examine its reliability and validity.
Methods: Twenty-nine items which were selected from the scale of Attitudes toward Death (Tange, 1999) were administered to subjects, consisting of 2,223 community-living Japanese men and women aged 40-79 years. Both exploratory factor analysis and confirmatory factor analysis were performed to examine the factor structures. The reliability and validity of the scale were examined.
Results: Exploratory factor analysis was performed to examine the factor structures of death attitudes, using the data from half of the subjects, indicated 5 factors. Confirmatory factor analysis, using the data from the remaining half, supported the goodness of fit of that model. Using this structure, the attitude toward death scale for the middle-aged and elderly (ATDS-A; five subscales) was constructed; "fear of death", "belief in existence of afterlife", "intention to live out own life", "meaning of death for life", "approval of death with dignity". For these subscales, the alpha coefficients ranged from 0.59-0.87. The validity of the subscales was suggested through the relation with the ego integration score.
Conclusions: This study suggested that the ATDS-A was reliable and valid, and was useful for the measurement of death attitudes in the middle-aged and elderly.