Koranyi Susan, Hinz Andreas, Hufeld Julia M, Hartung Tim J, Quintero Garzón Leonhard, Fendel Uta, Letsch Anne, Rose Matthias, Esser Peter, Mehnert-Theuerkauf Anja
Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany.
Department of Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.
Front Psychol. 2021 Nov 24;12:789793. doi: 10.3389/fpsyg.2021.789793. eCollection 2021.
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. 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 (α). 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 treatment-related variables were examined with ANOVAs. Out of 942 eligible patients, 620 participated. The average DS-II total score was = 5.78, = 6.34, the subscale = 2.20, = 3.20, and the subscale = 3.58, = 3.45. Internal consistency ranged from high to excellent with α = 0.93 for the DS-II total scale, α = 0.90 for the subscale, and α = 0.87 for the 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: = 0.69), anxiety (GAD-2: = 0.72), mental distress (DT: = 0.36), and body image disturbance (BIS: = 0.58). High levels of demoralization were reported by patients aged between 18 and 49 years ( = 7.77, = 6.26), patients who were divorced/separated ( = 7.64, = 7.29), lung cancer patients ( = 9.29, = 8.20), and those receiving no radiotherapy ( = 7.46, = 6.60). 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.
为测试德语版失志量表-II（DS-II）的心理测量特性、内部一致性、维度结构和收敛效度，并检验癌症患者失志与社会人口学、疾病及治疗相关变量之间的关联。我们在一个心理社会咨询中心和肿瘤病房招募了成年癌症患者。参与者完成了16项的DS-II、患者健康问卷-9（PHQ-9）、广泛性焦虑障碍筛查量表-2（GAD-2）、痛苦温度计（DT）和身体意象量表（BIS）。我们使用克朗巴哈α系数（α）分析DS-II的内部一致性。我们用验证性因子分析（CFA）测试DS-II的维度结构。通过与既定心理困扰测量指标的相关系数来表示收敛效度。用方差分析检验失志、社会人口学、疾病及治疗相关变量之间的关联。在942名符合条件的患者中，620名参与了研究。DS-II总分的平均值为=5.78，=6.34，子量表=2.20，=3.20，子量表=3.58，=3.45。内部一致性从高到优，DS-II总量表的α=0.93，子量表的α=0.90，子量表的α=0.87。单因素和双因素模型产生了相似的模型拟合度，CFI和TLI在0.910至0.933之间，SRMR<0.05。DS-II与抑郁（PHQ-9：=0.69）、焦虑（GAD-2：=0.72）、心理困扰（DT：=0.36）和身体意象障碍（BIS：=0.58）显著相关。18至49岁的患者（=7.77，=6.26）、离婚/分居的患者（=7.64，=7.29）、肺癌患者（=9.29，=8.20）以及未接受放疗的患者（=7.46，=6.60）报告的失志水平较高。DS-II具有非常好的心理测量特性，可作为评估癌症患者失志的可靠工具推荐。由于失志得分显著升高，研究结果支持在特定风险群体中开展失志筛查。
