Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-22T02:57:14.124Z Has data issue: false hasContentIssue false
  • English
  • Français

Validation of the Demoralization Scale in an Irish advanced cancer sample

Published online by Cambridge University Press:  30 September 2009

Mary Mullane ,
Barbara Dooley ,
Eoin Tiernan  and
Ursula Bates
Mary Mullane*
Affiliation:
Psychology Department, Child and Family Centre, County Clinic, Navan, Co. Meath, Ireland
Barbara Dooley
Affiliation:
School of Psychology, University College Dublin, Dublin, Ireland
Eoin Tiernan
Affiliation:
Palliative Care Department, St. Vincent's University Hospital, Dublin, Ireland
Ursula Bates
Affiliation:
Palliative Care Department, St. Vincent's University Hospital, Dublin, Ireland
*
Address correspondence and reprint requests to: Mary Mullane, Psychology Department, Child and Family Centre, County Clinic, Navan, Co. Meath, Ireland. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

This article presents a validation study of the Demoralization Scale, a 24-item, 5-point response questionnaire developed by Kissane et al. in 2004 to assess demoralization in advanced cancer patients.

Method:

One hundred Irish inpatients with advanced palliative cancer completed the Demoralization Scale and measures of depression, hopelessness, quality of life, and personal hopefulness.

Results:

Principal component analysis of the Demoralization Scale yielded four similar factors found by Kissane et al. (2004), namely, loss of meaning, dysphoria, disheartenment, and sense of failure. A new factor, the hopelessness factor, was also found in the current study. The reliability of the five factors was good, ranging from .72 to .93. Contrary to the findings of Kissane et al.'s (2004) study, divergent validity of the Demoralization Scale was not supported. Demoralized patients were significantly more likely to be depressed than those that did not score highly on the Demoralization Scale. In addition, this study found significantly lower levels of demoralization in general compared with Kissane et al.'s (2004) study.

Significance of results:

The results of the current study show that, in an Irish palliative care context, demoralization is not differentiated from depression. Additional factor analytic studies are needed to validate the Demoralization Scale.

Keywords

DemoralizationDistressDemoralization ScaleCancerPalliative care
Type
Original Articles
Information
Palliative & Supportive Care , Volume 7 , Issue 3 , September 2009 , pp. 323 - 330
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

American Psychiatric Association. (2000). Diagnostic and Statistical Manual of the Mental Disorders (4th ed., text revision), Washington, DC: Author.Google Scholar
Beck, A.T. & Steer, R.A. (1988). Manual for the Beck Hopelessness Scale. San Antonio, TX: Psychological Corporation.Google Scholar
Beck, A.T., Steer, R.A. & Brown, G.K. (1996). Manual for the Beck Depression Inventory–II. San Antonio, TX: Psychological Corporation.Google Scholar
Cohen, S.R., Mount, B.M., Strobel, M.G., et al. (1995). The McGill Quality of Life Questionnaire: A measure of quality of life appropriate for people with advanced disease. A preliminary study of the validity and acceptability. Palliative Medicine, 9, 207–219.CrossRefGoogle ScholarPubMed
Kissane, D.W., Clarke, D.M. & Street, A. (2001). Demoralisation Syndrome: A relevant psychiatric diagnosis for palliative care. Journal of Palliative Care, 17, 12–21.CrossRefGoogle ScholarPubMed
Kissane, D.W., Wein, S., Love, A., et al. (2004). The Demoralization Scale: A report of its development and preliminary validation. Journal of Palliative Care, 20, 269–276.CrossRefGoogle Scholar
Kroenke, K., Spitzer, R.L. & Williams, J.B. (2001). The PHQ-9. Validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606–613.CrossRefGoogle ScholarPubMed
McClain, C.S., Rosenfeld, B. & Breitbart, W. (2003). Effect of spiritual well-being in end-of-life despair in terminally ill cancer patients. The Lancet, 361, 1603–1607.CrossRefGoogle ScholarPubMed
Nelson, C.J., Rosenfeld, B., Breitbart, W., et al. (2002). Spirituality, religion and depression in the terminally ill. Psychosomatics, 43, 213–220.CrossRefGoogle ScholarPubMed
Nunn, K.P., Lewin, T.J. & Walton, J.M. (1996). The construction and characteristics of an instrument to measure hopefulness. Psychological Medicine, 26, 531–545.CrossRefGoogle ScholarPubMed
Parker, M. (2004). Medicalising meaning: Demoralisation syndrome and the desire to die. Australian and New Zealand Journal of Psychiatry, 38, 765–773.CrossRefGoogle Scholar
Rosenfeld, B., Breitbart, W., Galietta, M., et al. (2000). The Schedule of Attitudes toward Hastened Death. Measuring desire for death in terminally ill cancer patients. Cancer, 88, 2868–2875.3.0.CO;2-K>CrossRefGoogle ScholarPubMed
Slavney, P.R. (1999). Diagnosing demoralisation in consultation psychiatry. Psychosomatics, 40, 325–329.CrossRefGoogle ScholarPubMed