Objective: To test the psychometric properties, internal consistency, dimensional
structure, and convergent validity of the German version of the Demoralization Scale-
II (DS-II), and to examine the association between demoralization, sociodemographic,
disease- and treatment-related variables in patients with cancer.
Methods: We recruited adult patients with cancer at a Psychosocial Counseling Center
and at oncological wards. Participants completed the 16-item DS-II, Patient Health
Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder Screener-2 (GAD-2), Distress
Thermometer (DT), and Body Image Scale (BIS). We analyzed internal consistency
of the DS-II using Cronbach‘s Alpha (a). We tested the dimensional structure of the
DS-II with Confirmatory Factor Analyses (CFA). Convergent validity was expressed
through correlation coefficients with established measures of psychological distress.
The associations between demoralization, sociodemographic, disease- and treatmentrelated
variables were examined with ANOVAs.
Results: Out of 942 eligible patients, 620 participated. The average DS-II total score
was M = 5.78, SD = 6.34, the Meaning and Purpose subscale M = 2.20, SD = 3.20,
and the Distress and Coping Ability subscale M = 3.58, SD = 3.45. Internal consistency
ranged from high to excellent with a = 0.93 for the DS-II total scale, a = 0.90 for
the Meaning and Purpose subscale, and a = 0.87 for the Distress and Coping Ability
subscale. The one-factor and the two-factor model yielded similar model fits, with
CFI and TLI ranging between 0.910 and 0.933, SRMR < 0.05. The DS-II correlated
significantly with depression (PHQ-9: r = 0.69), anxiety (GAD-2: r = 0.72), mental distress
(DT: r = 0.36), and body image disturbance (BIS: r = 0.58). High levels of demoralization
were reported by patients aged between 18 and 49 years (M = 7.77, SD = 6.26), patients
who were divorced/separated (M = 7.64, SD = 7.29), lung cancer patients (M = 9.29,
SD = 8.20), and those receiving no radiotherapy (M = 7.46, SD = 6.60).
Conclusion: The DS-II has very good psychometric properties and can be
recommended as a reliable tool for assessing demoralization in patients with cancer.
The results support the implementation of a screening for demoralization in specific risk
groups due to significantly increased demoralization scores.
| Identifer | oai:union.ndltd.org:DRESDEN/oai:qucosa:de:qucosa:84476 |
| Date | 31 March 2023 |
| Creators | Koranyi, Susan, Hinz, Andreas, Hufeld, Julia M., Hartung, Tim J., Garzón, Leonhard Quintero, Fendel, Uta, Letsch, Anne, Rose, Matthias, Esser, Peter, Mehnert-Theuerkauf, Anja |
| Publisher | Frontiers Research Foundation |
| Source Sets | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Language | English |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, doc-type:article, info:eu-repo/semantics/article, doc-type:Text |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 1664-1078, 789793 |
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