Demoralization syndrome among cancer outpatients in Taiwan

Lee, Cheng-Yang; Fang, Chun-Kai; Yang, Yuh‐Cheng; Liu, Chien‐Liang; Leu, Yi-Shing; Wang, Tsang-En; Chang, Yi-Chun; Hsieh, Ruey‐Kuen; Chen, Yu-Jen; Tsai, Li‐Yun; Liu, Shen‐Ing; Chen, Hongwen

doi:10.1007/s00520-011-1332-4

Cited by 57 publications

(118 citation statements)

References 33 publications

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“…10 Among the numerous negative emotions experienced by patients with cancer, the most common two forms of psychological distress are depression and anxiety. However, most patients do not reach the level of major depressive or regulation disorders.…”

Section: Discussionmentioning

confidence: 99%

“…In each of the five studies, the correlation design was stated and five articles clearly described the representativeness of the exposed cohort. 1,2,10,18,23 Four of the five articles, thus the majority, clearly described the comparability of cohorts on the basis of the design or analysis and self-report. 2,10,18,23 One of the five studies did not clearly describe the reason for sample dropout.…”

Section: Study Qualitymentioning

confidence: 99%

“…18 Of the 5 studies, four employed the same Demoralization Scale (DS) to measure demoralization concepts. 1,2,10,23 Four studies employed a Patient Health Questionnaire (PHQ) to measure the depression concept, 1,2,10,23 whereas the fifth used the DCPR as the standard for diagnosing psychosomatic disorders in patients. 18 …”

Section: Research Participants and Measurement Outcomesmentioning

confidence: 99%

“…1.2 Because depression and demoralization syndrome in patients with cancer are closely related to suicidal behavior, the suicide risk increases when healthcare professionals fail to identify patients' suicidal ideation. 10 Their demoralized emotions may affect patients, influencing their capacity and willingness to receive treatments. If cancer patients are unable to be cared and evaluated properly, demoralization in nearly one-fourth of patients with cancer can be overlooked causing patients to exhibit social withdrawal and suicidal ideation.…”

mentioning

confidence: 99%

“…The odds ratio difference between the two groups [high demoralization (n = 49) vs. low-demoralization (n =16)] was significant (6.06 times, 95 % CI 3.14-11.72). Lee et al10 measured subjects' depression by DS-MV and indicated that 49.1 % of patients with cancer demonstrated demoralization and 27.4 % of patients demonstrated high demoralization and low depression. The odds ratio difference between the two groups [high demoralization (n = 46) vs. low-demoralization (n = 8)] was significant (9.91 times, 95 % CI 4.38-22.45).…”

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confidence: 99%

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A Systematic Review and Meta-Analysis of Demoralization and Depression in Patients With Cancer

2015

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Section: Discussionmentioning

confidence: 99%

Section: Study Qualitymentioning

confidence: 99%

Section: Research Participants and Measurement Outcomesmentioning

confidence: 99%

mentioning

confidence: 99%

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confidence: 99%

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A Systematic Review and Meta-Analysis of Demoralization and Depression in Patients With Cancer

2015

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Psychometric properties for Persian version Demoralization Scale‐24 (DS‐24) in Iranian cancer patients

Mousavi,

Piryaei,

Nooripour

et al. 2024

Brain and Behavior

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BackgroundThis study focuses on the phenomenon of demoralization, a common experience among terminally ill patients, especially those diagnosed with cancer. The primary objective is to adapt and validate a practical assessment tool for demoralization, the Demoralization Scale‐24 (DS‐24), within the context of Iranian society.MethodsIn this cross‐sectional study, we employed the DS‐24 as the principal instrument, which had been exactly translated and evaluated for its psychometric properties in 160 Persian cancer patients. The assessment included exploratory factor analysis, confirmatory factor analysis (CFA), as well as evaluations of convergent validity and internal consistency or reliability.ResultsThe CFA unveiled a five‐factor model, consistent with the original structure of the DS‐24. Moreover, statistically significant correlations were observed between the DS‐24 and both the Beck Depression and MUNSH happiness scales. Cronbach's alpha indicated high internal consistency, with a value of .92 for the total score.ConclusionIn Iran, like in other countries, the demoralization questionnaire demonstrates significant validity and reliability. This ensures the timely diagnosis of demoralization in cancer patients and the prompt initiation of therapeutic interventions.

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Refinement and revalidation of the demoralization scale: The DS‐II—external validity

Robinson

Kissane

Brooker

et al. 2016

Cancer

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BACKGROUND:The recently refined Demoralization Scale-II (DS-II) is a 16-item, self-report measure of demoralization. Its 2 factorsMeaning and Purpose and Distress and Coping Ability-demonstrate sound internal validity, including item fit, unidimensionality, internal consistency, and test-retest reliability. The convergent and discriminant validity of the DS-II with various measures is reported here. METHODS: Patients who had cancer or other progressive diseases and were receiving palliative care (n 5 211) completed a battery of questionnaires, including the DS-II and measures of symptom burden, quality of life, depression, and attitudes toward the end of life. Spearman q correlations were determined to assess convergent validity. Mann-Whitney U tests with calculated effect sizes were used to examine discriminant validity and establish the minimal clinically important difference (MCID). Cross-tabulation frequencies with chi-square analyses were used to examine discriminant validity with major depression. RESULTS: The DS-II demonstrated convergent validity with measures of psychological distress, quality of life, and attitudes toward the end of life. It also demonstrated discriminant validity, as the DS-II differentiated patients who had different functional performance levels and high/low symptoms, with a difference of 2 points between groups on the DS-II considered clinically meaningful. Furthermore, discriminant validity was demonstrated, as comorbidity with depression was not observed at moderate levels of demoralization. CONCLUSIONS: The DS-II has sound psychometric properties and is an appropriate measure of demoralization. Given its structural simplicity and brevity, it is likely to be a useful tool in meaning-centered therapies. Cancer 2016;122:2260-7. V C 2016 American Cancer Society.KEYWORDS: cancer, construct validity, convergent validity, demoralization, discriminant validity, external validity, revalidation. INTRODUCTIONThe Demoralization Scale-II (DS-II) is a recently refined and revalidated 16-item, self-report measure of demoralization. 1 Demoralization is a maladaptive coping response conceptualized as a loss of meaning and purpose, with feelings of hopelessness and helplessness. 2 It is understood to arise in response to a stressful event or situation, such as the suffering associated with the diagnosis or experience of an advanced cancer. 2 In our recent systematic 3 and conceptual 4 reviews, we provided a discussion on the differences between demoralization and depression and highlighted the finding that there is a level of overlap between these constructs. In a companion to this article in this issue of Cancer, we report the internal validity of the DS-II as a 2-factor model (comprising two 8-item factors: Meaning and Purpose and Distress and Coping Ability) that demonstrated psychometrically sound item fit, unidimensionality, and reliability in patients receiving palliative care. 1 The reduced number of items and the simplified response format make the DS-II more user-friendly in the advanced...

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Demoralization syndrome among cancer outpatients in Taiwan

Abstract: Demoralization syndrome was found to be related to psychosocial issues, different cancer types, and treatments. Further studies are recommended to better understand causes and impacts of demoralization in the quality of life and care of cancer patients.

Cited by 57 publications

References 33 publications

A Systematic Review and Meta-Analysis of Demoralization and Depression in Patients With Cancer

A Systematic Review and Meta-Analysis of Demoralization and Depression in Patients With Cancer

Psychometric properties for Persian version Demoralization Scale‐24 (DS‐24) in Iranian cancer patients

Refinement and revalidation of the demoralization scale: The DS‐II—external validity

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