The Desire to Hasten Death (DHD) is a relatively frequent phenomenon in individuals in the advanced stages of disease. Previous studies carried out by WeCare have proven the distinct meanings that the WTHD can have for the patients who express it as well as its complexity and conceptual ambiguity in international literature. In these patients the DHD emerges, not as a genuine desire to die but rather a reactive phenomenon to the presence of a multidimensional suffering. It represents a means of ending suffering and a cry for help, a desire to live but not like this.
Until now, there was only one scale for the assessment of the WTHD, the Schedule of Attitudes Toward Hastened Death (SAHD). Despite covering acceptable psychometric properties, the SAHD has some significant conceptual limitations in terms of clinical application.
Conceptualise the DHD and develop an operational definition with an international consensus, in keeping with a shared conceptual framework.
Design an instrument for the detection and evaluation of DHD in accordance with accepted theories.
Determine the validity, reliability and applicability of said new instrument in the clinical context of palliative care units.
Establish a conceptual framework to be discussed by a named group of european experts and reach a consensus of an operational definition by means of the Delphi technique (30 international panelists).
Starting with the agreed theoretical principles, a bank of items will be composed and subsequently submitted to a panel of experts in order to select the most adequate items to be included in the preliminary scale. Following adjustments according to the results of the first pilot, the new instrument will be defined.
A study of the metric properties of the new instrument in order to guarantee its reliability and validity in a sample of 120 palliative care patients to be evaluated for the DHD.