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Translation, adaptation and psychometric evaluation of the German version of the Abortion Attitude Scale - A secondary analysis of a cross-sectional study among medical students

Lindig A, Christalle E, Rutenkröger M, Zill JM, Baumgart M

PloS one, 2026

10 participants

Abstract

BACKGROUND: Unintentionally pregnant individuals in Germany seeking an abortion face challenges due to legal regulations, stigma and difficult access to abortion care. Abortion attitudes of (prospective) physicians influence the care situation. To measure these attitudes, psychometrically sound instruments like the Abortion Attitude Scale (AAS) are necessary. So far, no instruments assessing attitudes toward abortions are available in German. This study aims to translate, culturally adapt and psychometrically test the AAS.

METHODS: This is a secondary analysis of a cross-sectional study on abortion attitudes of medical students in Germany. The English 14-item AAS was translated into German and adapted using a team translation protocol. Comprehensibility was tested via cognitive interviews (n = 10 medical students). We analyzed acceptance (completion rate), factor structure (confirmatory factor analysis (CFA), model fit), item characteristics (response distribution, item difficulties, corrected item-total correlations, inter-item correlations), and reliability (McDonald's omega).

RESULTS: The translated and adapted AAS version was comprehensible. AAS data of 305 medical students could be included in analysis. Completion rate was above 98% for all items. The CFA results confirmed a one-factor structure, but a model without item 10 and correlations between item 8 and item 13 showed the best model fits. Floor or ceiling effects could be found for 7 items, item difficulties…

How strong is the evidence?

Evidence Hub reads this as a secondary / pooled analysis, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 10 participants or records.

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