Costantini Anna, Picardi Angelo, Brunetti Serena, Trabucchi Guido, Bersani Francesco Saverio, Minichino Amedeo, Marchetti Paolo
UOD Psiconcologia, Ospedale Sant’Andrea, Sapienza Università di Roma.
Riv Psichiatr. 2013 May-Jun;48(3):234-9. doi: 10.1708/1292.14291.
Demoralization and depressive symptoms are very common in chronic organic diseases. The aim of the present study is to evaluate reliability and psychometric properties of the Italian version of the Demoralization Scale (DS) in patients with advanced cancer.
The Italian version of DS was administered to a sample consisting of 100 patients affected by different forms of cancer. The following scales were also administered: Patient Health Questionnaire, Beck Depression Inventory (BDI), Mini-Mental Adjustment to Cancer (MAC) and Karnofsky Performance Status Scale.
The total mean score of the DS was 23.9±14.5. The study showed a good degree of stability and internal consistency of DS total score (α=0.90) and the 5 factors represented by loss of meaning and purpose (α=0.69), dysphoria (α=0.72), disheartenment (α=0.84), helplessness (α=0.50) and sense of failure (α=0.74). Significant correlations were found between DS total score and BDI (r=0.74) and between DS factors and BDI (r=0.64 for loss of meaning and purpose; r=0.55 for dysphoria; r=0.71 for disheartenment; r=0.51 for helplessness; r=0.46 for sense of failure). Good correlations were also found between DS total score and Hopelessness scale of MAC (r=0,51). According to different cut-off values, between 28 and 32 patients were seriously demoralized and 40 had moderate levels of demoralization. Between 6 and 20 patients were seriously demoralized but not clinically depressed; between 16 and 31 patients with moderate levels of demoralization had no depression.
Results provide further evidence that the DS is a valid and reliable instrument of high clinical relevance in patients with advanced cancer and confirm the hypothesis of the ontological difference between demoralization and depression.
在慢性器质性疾病中，士气低落和抑郁症状非常常见。本研究旨在评估意大利版士气低落量表（DS）在晚期癌症患者中的信度和心理测量特性。
将意大利版DS应用于由100名患有不同形式癌症的患者组成的样本。还应用了以下量表：患者健康问卷、贝克抑郁量表（BDI）、癌症心理适应简易量表（MAC）和卡氏功能状态量表。
DS的总平均分是23.9±14.5。研究表明DS总分（α=0.90）以及由意义和目标丧失（α=0.69）、烦躁不安（α=0.72）、气馁（α=0.84）、无助感（α=0.50）和失败感（α=0.74）所代表的5个因素具有良好程度的稳定性和内部一致性。发现DS总分与BDI之间存在显著相关性（r=0.74），DS各因素与BDI之间也存在显著相关性（意义和目标丧失r=0.64；烦躁不安r=0.55；气馁r=0.71；无助感r=0.51；失败感r=0.46）。DS总分与MAC绝望量表之间也存在良好相关性（r=0.51）。根据不同的临界值，28至32名患者存在严重的士气低落，40名患者存在中度士气低落。6至20名患者存在严重的士气低落但无临床抑郁；16至31名中度士气低落的患者无抑郁。
结果进一步证明DS是晚期癌症患者中具有高度临床相关性的有效且可靠的工具，并证实了士气低落和抑郁在本体论上存在差异的假设。
