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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

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 (a = 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.

Identiferoai:union.ndltd.org:DRESDEN/oai:qucosa:de:qucosa:84454
Date31 March 2023
CreatorsGarzón, Leonhard Quintero, Hinz, Andreas, Koranyi, Susan, Mehnert-Theuerkauf, Anja
PublisherFrontiers Research Foundation
Source SetsHochschulschriftenserver (HSSS) der SLUB Dresden
LanguageEnglish
Detected LanguageEnglish
Typeinfo:eu-repo/semantics/publishedVersion, doc-type:article, info:eu-repo/semantics/article, doc-type:Text
Rightsinfo:eu-repo/semantics/openAccess
Relation1664-1078, 681977

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