Psychometric evaluation of the Danish Near-Death Experience Content (NDE-C) scale in a sample of out-of-hospital cardiac arrest survivors

Some individuals have profound and specific experiences during life-threatening events such as cardiac arrest. Such experiences, often termed near-death experiences (NDE), or recalled experiences of death, have been studied extensively internationally, but research in a Scandinavian context is almost nonexistent. No psychometrically tested questionnaire for capturing NDE phenomena exist in any Scandinavian language. This hinders prevalence, cross-cultural, and clinical care studies of NDEs in a Scandinavian context. The aim of the present study was to evaluate the psychometric properties of the Danish translation of the NDE content scale (NDE-C) among out-of-hospital cardiac arrest (OHCA) survivors. A cross-sectional survey was conducted among OHCA survivors (2016-2020) identified through the Danish Cardiac Arrest Register. Participants reporting memories from their cardiac arrest completed the 20-item Danish NDE-C. Of 2,262 invited survivors, 855 responded (37.8%) with 226 participants who completed the NDE-C. The scale demonstrated excellent internal consistency (Cronbachs = 0.92). A confirmatory factor analysis supported a five-factor structure conceptually, but global fit indices were mixed with most indices falling below predefined thresholds for a good fit (CFI = 0.858; TLI = 0.831; RMSEA = 0.093; SRMR = 0.062). Factor loadings and discriminant validity were satisfactory. The Danish NDE-C scale shows strong internal consistency and a preliminary acceptable, although not good, factor structure, indicating potential promise as a tool for assessing NDE content in clinical and research contexts. Further psychometric validation is necessary. This marks an important step in the systematic research of NDE and related spiritually transformative experiences in a Scandinavian context.