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Katz, Roger C.; Flasher, Lydia V.; Cacciapaglia, Holly; Nelson, Sonja

doi:10.1023/a:1012939310459

Cited by 98 publications

(23 citation statements)

References 6 publications

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“…The association of demoralization with depression was comparable to what was found in cancer patients (Mehnert et al, 2011), probably due to the symptomatic overlap of those two constructs. Anxiety was also strongly associated with demoralization and consistent with findings in previous studies (Katz et al, 2001;Mehnert et al, 2011).…”

Section: Discussionsupporting

confidence: 91%

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Norm Values and Psychometric Properties of the 24-Item Demoralization Scale (DS-I) in a Representative Sample of the German General Population

et al. 2021

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Purpose: The Demoralization scale (DS-I) is a validated and frequently used instrument to assess existential distress in patients with cancer and other severe medical illness. The purpose of this study was to provide normative values derived from a representative German general population sample and to analyze the correlational structure of the DS-I.Methods: A representative sample of the adult German general population completed the DS-I (24 Items), the Emotion Thermometers (ET) measuring distress, anxiety, depression, anger, need for help, and the Functional Assessment of Chronic Illness Therapy Fatigue Scale (FACIT-fatigue).Results: The sample consists of N = 2,407 adults (mean age = 49.8; range = 18–94 years), 55.7% women). The percentages of participants above the DS-I cutoff (≥30) was 13.5%. The mean scores of the DS-I dimensions were as follows: (1) loss of meaning and purpose: M = 2.78 SD = 4.49; (2) disheartenment: M = 3.19 SD = 4.03; (3) dysphoria M = 4.51 SD = 3.20; (4) sense of failure: M = 6.24 SD = 3.40; and for the DS-I total score: M = 16.72 SD = 12.74. Women reported significantly higher levels of demoralization than men, with effect sizes between d = 0.09 (Loss of Meaning) and d = 0.21 (Dysphoria). Age was not associated with demoralization in our sample. DS-I reliability was excellent (α = 0.94) and DS-I subscales were interrelated (r between 0.31 and 0.87) and significantly correlated with ET, especially depression, anxiety, and need for help and fatigue (r between 0.14 and 0.69).Conclusions: In order to use the DS-I as a screening tool in clinical practice and research the normative values are essential for comparing the symptom burden of groups of patients within the health care system to the general population. Age and sex differences between groups of patients can be accounted for using the presented normative scores of the DS-I.

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Section: Discussionsupporting

confidence: 91%

“…As it has been repeatedly reported in previous studies (Katz et al, 2001;Mehnert et al, 2011), those who live without a partner describe higher levels of demoralization than those who live with a partner. Family, friends and partners are among the most often mentioned areas relevant to the meaning of life (Fegg et al, 2008).…”

Section: Discussionsupporting

confidence: 71%

Norm Values and Psychometric Properties of the 24-Item Demoralization Scale (DS-I) in a Representative Sample of the German General Population

et al. 2021

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“…When analyzing the marital status, a higher score in singles (15.83 SD 16.88) than married KTRs (13.01 SD 11.94) (F 2.369, p < 0.05) was found. These findings are in agreement with the reported associations of demoralization in heart transplant patients [24] and in other medical settings [49,50], confirming the role of partners' support of patients in coping with life problems.…”

Section: Discussionsupporting

confidence: 91%

The Use of Demoralization Scale in Italian Kidney Transplant Recipients

Battaglia

Zerbinati

Piazza

et al. 2020

JCM

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Demoralization is a commonly observed syndrome in medically ill patients. The risk of demoralization may increase in patients after a kidney transplant (KTRs) because of the stressful nature of renal transplantation, psychosocial challenges, and adjustment needs. No study is available on demoralization amongst KTRs. The purpose of our study was to evaluate the validity of the Italian version of the Demoralization Scale (DS-IT) and the prevalence of demoralization in KTRs. Also, we aimed at exploring the association of the DS-IT with International Classification of Diseases (ICD) psychiatric diagnoses, post-traumatic growth (PTG), psychological and physical symptoms, and daily-life problems. A total of 134 KTRs were administered the MINI International Neuropsychiatric Interview 6.0. and the Diagnostic Criteria for Psychosomatic Research–Demoralization (DCPR/D) Interview. The DS-IT, the Edmonton Symptom Assessment System (ESAS), the Canadian Problem Checklist (CPC), were used to measure demoralization, physical and psychological symptoms, and daily-life problems; also, positive psychological experience of kidney transplantation was assessed with the PTG Inventory. Routine biochemistry and sociodemographic data were collected. Exploratory factor analysis demonstrated a four-dimensional factor structure of the DS-IT, explaining 55% of the variance (loss of meaning and purpose, disheartenment, dysphoria, and sense of failure). DS-IT Cronbach alpha coefficients indicated good or acceptable level of internal consistency. The area under the Receiving Operating Characteristics (ROC) curve for DS-IT (against the DCPR/D interview as a gold standard) was 0.92. The DS-IT optimal cut-off points were ≥20 (sensitivity 0.87, specificity 0.82). By examining the level of demoralization, 14.2%, 46.3%, 24.6%, and 14.6% of our sample were classified as having no, low, moderate, and high demoralization, respectively, with differences according to the ICD psychiatric diagnoses (p < 0.001). DS-IT Total and subscales scores were positively correlated with scores of ESAS symptoms and CPC score. A correlation between DS-IT loss of meaning and purpose subscale and PTGI appreciation of life subscale (p < 0.05) was found. This study shows, for the first time, a satisfactory level of reliability of the DS-IT and a high prevalence of severe demoralization in KTRs.

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“…Some authors claim that the fighting spirit strategy contributes to patients’ ability to see positive changes their disease introduces into their lives [ 44 , 45 ]. What is more, van Laarhoven et al .…”

Section: Discussionmentioning

confidence: 99%

Assessment of pain, acceptance of illness, adjustment to life with cancer, and coping strategies in colorectal cancer patients

Czerw¹,

Religioni²,

Deptała³

et al. 2016

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IntroductionEvery year more than 15,000 newly diagnosed cases of colorectal carcinoma are recorded in Poland.AimThe objective of the study was an assessment of coping strategies and pain management, acceptance of illness, and adjustment to cancer in patients diagnosed with colorectal carcinoma. The analysis was extended to include the effect of socioeconomic variables on the above-mentioned issues.Material and methodsThe study included 238 colorectal cancer patients treated on an outpatient basis at the Centre of Oncology, the Maria Skłodowska-Curie Institute in Warsaw in the year 2013. The questionnaire interview comprised demographic questions (socioeconomic variables) and the following four psychometric tests: BPCQ (Beliefs about Pain Control Questionnaire), CSQ (Coping Strategies Questionnaire), AIS questionnaire (Acceptance of Illness Scale), and the Mini-Mac scale (Mental Adjustment to Cancer).ResultsThe source of pain control depends on the respondent's level of education. An increase in patient income was associated with a lower mean result in the “power of doctors” subscale. The coping self-statements and increased behavioural activity are the two most frequently selected strategies of coping with pain. The most commonly followed ways of mental adjustment to cancer in the study group were a fighting spirit (23.42) and positive re-evaluation (22.31).ConclusionsColorectal cancer patients believe that the greatest role in pain management is played by internal factors. The locus of pain control depends on the level of education. The study patients feature a constructive way of struggling with disease differentiated by the place of residence, professional status, and income.

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Cited by 98 publications

References 6 publications

Norm Values and Psychometric Properties of the 24-Item Demoralization Scale (DS-I) in a Representative Sample of the German General Population

Norm Values and Psychometric Properties of the 24-Item Demoralization Scale (DS-I) in a Representative Sample of the German General Population

The Use of Demoralization Scale in Italian Kidney Transplant Recipients

Assessment of pain, acceptance of illness, adjustment to life with cancer, and coping strategies in colorectal cancer patients

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