Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan.
School of Psychology, Chung Shan Medical University, Taichung, Taiwan.
Health Qual Life Outcomes. 2022 Apr 2;20(1):60. doi: 10.1186/s12955-022-01962-6.
Demoralization is a common problem in oral cancer patients owing to the chronic and severe nature of their affliction. However, the association between demoralization and the patient's spiritual needs, quality of life, and suicidal ideation remains unclear. This study aims to provide insights into possible links between demoralization among oral cancer patients and its effects on the patient's spiritual needs, quality of life, and suicidal ideation.
We examined 155 Taiwanese oral cancer inpatients in Taichung Veterans General Hospital, Taiwan, using the following three rating scales: (a) Demoralization Scale Mandarin Version (DS-MV), (b) Spiritual Interests Related to Illness Tool, and (c) The Taiwan Chinese versions of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire. Suicidal ideation was established if at least one of the two suicide-related items on the DS-MV scale were checked. We divided the participants into high- and low-demoralization groups, per the cutoff score of 30. We then explored group associations with sociodemographic features, quality of life, and spiritual needs. Logistic regression and receiver operating characteristic (ROC) curves were used to determine demoralization and its association between these variables.
Fifty-five (35.5%) patients were categorized as having high demoralization (DS-MV scale score > 30), with scores for DS-MV for all patients being 27.2 ± 16.8. The rates of suicidal ideation were 29.1% (16/55) in the high-demoralization group and 2% (2/100) in the low-demoralization group, with an odds ratio (95% confidence interval) of 20.10 (4.41-91.55). Logistic regression analysis revealed significant effects of spiritual needs and global health status on the DS-MV scores (p < 0.001). Multivariate analyses further confirmed that only overall quality of life scores < 62.5 and spiritual needs < 3.7 significantly predicted the occurrence of high demoralization.
High demoralization is associated with low satisfaction with spiritual needs, poor quality of life, and high risk of suicidal ideation. DS-MV may potentially be an effective tool for achieving holistic health care among oral cancer patients.
由于口腔癌患者的疾病具有慢性和严重的性质，因此他们普遍存在沮丧情绪。然而，沮丧情绪与患者的精神需求、生活质量和自杀意念之间的关系尚不清楚。本研究旨在深入了解口腔癌患者的沮丧情绪与其对患者的精神需求、生活质量和自杀意念的影响之间可能存在的联系。
我们使用以下三种评分量表对来自中国台湾台中荣民总医院的 155 名口腔癌住院患者进行了检查：（a）中文版本的 Demoralization Scale（DS-MV），（b）与疾病相关的精神兴趣工具，以及（c）欧洲癌症研究与治疗组织的生活质量问卷的台湾中文版本。如果 DS-MV 量表上至少有一个与自杀相关的项目被勾选，则认为存在自杀意念。我们根据 30 分的临界值将参与者分为高沮丧组和低沮丧组。然后，我们探讨了组与社会人口统计学特征、生活质量和精神需求之间的关联。使用逻辑回归和接收器工作特征（ROC）曲线来确定沮丧情绪及其与这些变量之间的关联。
共有 55 名（35.5%）患者被归类为存在高沮丧情绪（DS-MV 量表得分>30），所有患者的 DS-MV 评分为 27.2±16.8。高沮丧组的自杀意念发生率为 29.1%（16/55），低沮丧组为 2%（2/100），优势比（95%置信区间）为 20.10（4.41-91.55）。逻辑回归分析显示，精神需求和总体健康状况对 DS-MV 评分有显著影响（p<0.001）。多变量分析进一步证实，只有总体生活质量评分<62.5 和精神需求<3.7 显著预测高沮丧的发生。
高沮丧与精神需求满意度低、生活质量差和自杀意念风险高有关。DS-MV 可能是评估口腔癌患者整体健康状况的有效工具。
