Background: This article presents the development and application of a method to diagnose and measure subjective incompetence, the clinical hallmark of demoralization. Methods: The subjects (n = 112) were patients with cancer at a consultation clinic of a cancer center. They completed a questionnaire on general background information, the Brief Cope Scale, and a newly developed scale to measure subjective incompetence. The development and psychometric properties of this scale were studied. Data analysis included both univariate and bivariate statistical tests and an examination of the intercorrelations between the subjective incompetence scores and the scores on the Brief Cope Scale. Results: The scale for subjective incompetence was found to have adequate reliability and validity. Conclusions: The proposed scale will allow us to determine if the distinction between depression and demoralization has practical implications and to what extent and to further clarify the role of demoralization in the etiology and pathogenesis of both physical illnesses and mental disorders. The combined use of this scale with the existing criteria and scales for demoralization will highlight the role of subjective incompetence in converting what might have been a normal response to stress into an abnormal state requiring intervention.
Data mining of electronic databases is becoming more popular as a method for researchers to study issues in the health policy arena. The advantages of using electronic databases, such as the decreased investments in time and costs associated with subject recruitment and data collection, contribute to its appeal. Despite these features, the use of electronic databases to address health policy issues in nursing has been limited. This article discusses potential uses of secondary analysis for nursing research and outlines the steps involved in the process of data mining. Examples of health services research using samples generated from electronic databases support the discussion. The growing popularity of secondary analyses has given rise to concerns regarding the protection of patient rights and confidentiality. The authors discuss steps taken by federal agencies and institutional review boards to ensure that data are protected while preserving the research potential of this method of analysis.
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