{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T23:48:16Z","timestamp":1782172096562,"version":"3.54.5"},"reference-count":19,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Omega (Westport)"],"abstract":"<jats:p>This study investigated death literacy within a United States (U.S.) community using the Death Literacy Index (DLI). Aims: (1) establish benchmark DLI and subscale scores, (2) examine demographic variability, end-of-life (EOL) experience, and spirituality, (3) assess psychometric properties of DLI. A cross-sectional survey using the DLI was conducted with a community convenience sample. The sample (n = 367) was 75% White, 70% female, with a mean age of 53\u00a0years. The overall DLI score was 4.87 (scaled 0\u201310), with the highest subscale score in Support Groups (6.04) and the lowest in Doing Hands-On Care (3.75). Higher scores are associated with older age, being widowed, Medicare, EOL experience, and spirituality. Factor analysis and confirmatory factor analysis via structural equation modeling supported the 6-factor model with good fit statistics. Strong internal consistency and subscale reliability confirmed the DLI as a reliable instrument for measuring death literacy in the U.S.<\/jats:p>","DOI":"10.1177\/00302228261463029","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T14:26:22Z","timestamp":1781879182000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Death Literacy in a United States Community: A Cross-Sectional Study"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-0275-0663","authenticated-orcid":false,"given":"Karen A.","family":"Nelson","sequence":"first","affiliation":[{"name":"UCLA Joe C. Wen School of Nursing"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4895-1748","authenticated-orcid":false,"given":"Eden R.","family":"Brauer","sequence":"additional","affiliation":[{"name":"UCLA Joe C. 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Wen School of Nursing"},{"name":"UCLA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,19]]},"reference":[{"key":"e_1_3_4_2_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2015.302889"},{"key":"e_1_3_4_3_1","volume-title":"National Health Expenditures 2022 highlights","author":"Center for Medicaid and Medicare Services","year":"2022","unstructured":"Center for Medicaid and Medicare Services (2022). National Health Expenditures 2022 highlights. Retrieved July 22, 2024 from. https:\/\/cms.gov. https:\/\/www.cms.gov\/newsroom\/fact-sheets\/national-health-expenditures-2022-highlights"},{"key":"e_1_3_4_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1140475"},{"key":"e_1_3_4_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049909119836204"},{"key":"e_1_3_4_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2018.08.005"},{"key":"e_1_3_4_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-022-01032-0"},{"issue":"5","key":"e_1_3_4_8_1","first-page":"1","article-title":"Measurement invariance of the Death Literacy Index across Flemish Belgium, The Netherlands, and Sweden","volume":"50","author":"Johansson T.","year":"2025","unstructured":"Johansson T., Bujacz A., Kowalski L., Tishelman C., Nierop-van Baalen C. A., Eriksson L. E., Groot M., Olsson A., Vanderstichelen S., Cohen J., Goliath I. (2025). Measurement invariance of the Death Literacy Index across Flemish Belgium, The Netherlands, and Sweden. Death Studies, 50(5), 1\u20139. https:\/\/doi.org\/10.1080\/07481187.2025.2468162","journal-title":"Death Studies"},{"issue":"11","key":"e_1_3_4_9_1","doi-asserted-by":"crossref","first-page":"e0295141","DOI":"10.1371\/journal.pone.0295141","article-title":"Validation of a culturally adapted Swedish-language version of the Death Literacy Index","volume":"181","author":"Johansson T.","year":"2023","unstructured":"Johansson T., Olsson A., Tishelman C., Noonan K., Leonard R., Eriksson L. E., Goliath I., Cohen J. (2023). Validation of a culturally adapted Swedish-language version of the Death Literacy Index. 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