factor analysis result in a five-factor solution: factor label include symptom distress, existential distress, dependency, peace of mind, and social support, accounting for 58% of the overall variance. evidence for concurrent validity was report by way of significant associate between PDI factor and concurrent measure of distress. The PDI is a valid and reliable new instrument, which could assist clinician to routinely detect end-of-life dignity-related distress. identifying these source