III. Department of Medicine, Interdisciplinary Department of Palliative Care, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany.
Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
Support Care Cancer. 2021 Feb;29(2):965-973. doi: 10.1007/s00520-020-05555-1. Epub 2020 Jun 16.
To determine the efficacy of specifically targeted interventions in palliative care, sequential use of the Demoralization Scale (DS) could be a useful approach. This study's main objective was to evaluate the weekly use of the DS for palliative care inpatients. Secondary objectives were the analysis of the DS, self-perceived strain, and personal benefits of the assessment.
Patients admitted to 3 palliative care units (PCUs) were tested for eligibility and asked to complete the DS weekly. Self-perceived strain was rated on a numeric scale (0-10). Open questions about strain and helpfulness of the survey were asked.
Over 10 months, 568 patients were admitted to the PCUs; 193 patients were eligible. A total of 120 patients participated once, of whom only 41 (34.1%) participated at least twice. The mean self-perceived strain caused by the assessment was 1.53 at T1 (N = 117, SD = 2.27, max = 8).
While the single use of the DS in PCUs seems justified in view of the possibility to detect severe demoralization with overall low to moderate strain and self-perceived helpfulness for patients, the feasibility of the sequential use of the DS has to be regarded critically. Our study undermines the complexity of assessing changes in self-reported psychological phenomena with end-of-life patients at a PCU. The most limiting factors for participating twice were that patients were either discharged from hospital or declined further participation.
为了确定在姑息治疗中针对性干预措施的疗效，连续使用抑郁量表（DS）可能是一种有用的方法。本研究的主要目的是评估每周使用 DS 对姑息治疗住院患者的效果。次要目标是分析 DS、自我感知的压力和评估的个人获益。
将被收入 3 个姑息治疗病房（PCU）的患者进行资格测试，并要求他们每周填写 DS。自我感知的压力通过数字量表（0-10）进行评估。还询问了关于压力和调查有用性的开放性问题。
在 10 个月的时间里，共有 568 名患者被收入 PCU，其中 193 名符合条件。共有 120 名患者参加了一次评估，其中只有 41 名（34.1%）至少参加了两次。评估引起的自我感知压力平均值为 T1 时的 1.53（N=117，SD=2.27，最大值=8）。
鉴于使用 DS 有可能检测到严重的抑郁状态，同时总体压力和自我感知的帮助程度较低，因此在 PCU 中单次使用 DS 似乎是合理的，但连续使用 DS 的可行性必须受到严格审查。我们的研究破坏了在姑息治疗病房评估临终患者自我报告的心理现象变化的复杂性。两次参与的最限制因素是患者要么出院，要么拒绝进一步参与。
