Psychometric Evaluation of the German Version of the Demoralization Scale-II and the Association Between Demoralization, Sociodemographic, Disease- and Treatment-Related Factors in Patients With Cancer
Objective: 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 pati...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-11-01
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| Series: | Frontiers in Psychology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyg.2021.789793/full |
| _version_ | 1818743978670948352 |
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| author | Susan Koranyi Andreas Hinz Julia M. Hufeld Tim J. Hartung Tim J. Hartung Leonhard Quintero Garzón Uta Fendel Anne Letsch Anne Letsch Matthias Rose Matthias Rose Peter Esser Anja Mehnert-Theuerkauf |
| author_facet | Susan Koranyi Andreas Hinz Julia M. Hufeld Tim J. Hartung Tim J. Hartung Leonhard Quintero Garzón Uta Fendel Anne Letsch Anne Letsch Matthias Rose Matthias Rose Peter Esser Anja Mehnert-Theuerkauf |
| author_sort | Susan Koranyi |
| collection | DOAJ |
| description | Objective: 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.Methods: 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.Results: Out of 942 eligible patients, 620 participated. The average DS-II total score was M = 5.78, SD = 6.34, the Meaning and Purpose subscale M = 2.20, SD = 3.20, and the Distress and Coping Ability subscale M = 3.58, SD = 3.45. Internal consistency ranged from high to excellent with α = 0.93 for the DS-II total scale, α = 0.90 for the Meaning and Purpose subscale, and α = 0.87 for the Distress and Coping Ability 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: r = 0.69), anxiety (GAD-2: r = 0.72), mental distress (DT: r = 0.36), and body image disturbance (BIS: r = 0.58). High levels of demoralization were reported by patients aged between 18 and 49 years (M = 7.77, SD = 6.26), patients who were divorced/separated (M = 7.64, SD = 7.29), lung cancer patients (M = 9.29, SD = 8.20), and those receiving no radiotherapy (M = 7.46, SD = 6.60).Conclusion: 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. |
| first_indexed | 2024-12-18T02:37:00Z |
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| language | English |
| last_indexed | 2024-12-18T02:37:00Z |
| publishDate | 2021-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychology |
| spelling | doaj.art-adef70fc33384ca4be21cc242db415062022-12-21T21:23:46ZengFrontiers Media S.A.Frontiers in Psychology1664-10782021-11-011210.3389/fpsyg.2021.789793789793Psychometric Evaluation of the German Version of the Demoralization Scale-II and the Association Between Demoralization, Sociodemographic, Disease- and Treatment-Related Factors in Patients With CancerSusan Koranyi0Andreas Hinz1Julia M. Hufeld2Tim J. Hartung3Tim J. Hartung4Leonhard Quintero Garzón5Uta Fendel6Anne Letsch7Anne Letsch8Matthias Rose9Matthias Rose10Peter Esser11Anja Mehnert-Theuerkauf12Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, GermanyDepartment of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, GermanyDepartment of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, GermanyDepartment of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, GermanyDepartment of Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, GermanyDepartment of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Hematology and Oncology, Campus Benjamin Franklin, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, GermanyDepartment of Medicine II, Hematology and Oncology, University Hospital Schleswig-Holstein, Kiel, GermanyDepartment of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Quantitative Health Sciences, Medical School, University of Massachusetts, Amherst, MA, United StatesDepartment of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, GermanyDepartment of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, GermanyObjective: 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.Methods: 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.Results: Out of 942 eligible patients, 620 participated. The average DS-II total score was M = 5.78, SD = 6.34, the Meaning and Purpose subscale M = 2.20, SD = 3.20, and the Distress and Coping Ability subscale M = 3.58, SD = 3.45. Internal consistency ranged from high to excellent with α = 0.93 for the DS-II total scale, α = 0.90 for the Meaning and Purpose subscale, and α = 0.87 for the Distress and Coping Ability 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: r = 0.69), anxiety (GAD-2: r = 0.72), mental distress (DT: r = 0.36), and body image disturbance (BIS: r = 0.58). High levels of demoralization were reported by patients aged between 18 and 49 years (M = 7.77, SD = 6.26), patients who were divorced/separated (M = 7.64, SD = 7.29), lung cancer patients (M = 9.29, SD = 8.20), and those receiving no radiotherapy (M = 7.46, SD = 6.60).Conclusion: 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.https://www.frontiersin.org/articles/10.3389/fpsyg.2021.789793/fullpsychometricsvalidation studyconfirmatory factor analysisdemoralizationneoplasm |
| spellingShingle | Susan Koranyi Andreas Hinz Julia M. Hufeld Tim J. Hartung Tim J. Hartung Leonhard Quintero Garzón Uta Fendel Anne Letsch Anne Letsch Matthias Rose Matthias Rose Peter Esser Anja Mehnert-Theuerkauf Psychometric Evaluation of the German Version of the Demoralization Scale-II and the Association Between Demoralization, Sociodemographic, Disease- and Treatment-Related Factors in Patients With Cancer Frontiers in Psychology psychometrics validation study confirmatory factor analysis demoralization neoplasm |
| title | Psychometric Evaluation of the German Version of the Demoralization Scale-II and the Association Between Demoralization, Sociodemographic, Disease- and Treatment-Related Factors in Patients With Cancer |
| title_full | Psychometric Evaluation of the German Version of the Demoralization Scale-II and the Association Between Demoralization, Sociodemographic, Disease- and Treatment-Related Factors in Patients With Cancer |
| title_fullStr | Psychometric Evaluation of the German Version of the Demoralization Scale-II and the Association Between Demoralization, Sociodemographic, Disease- and Treatment-Related Factors in Patients With Cancer |
| title_full_unstemmed | Psychometric Evaluation of the German Version of the Demoralization Scale-II and the Association Between Demoralization, Sociodemographic, Disease- and Treatment-Related Factors in Patients With Cancer |
| title_short | Psychometric Evaluation of the German Version of the Demoralization Scale-II and the Association Between Demoralization, Sociodemographic, Disease- and Treatment-Related Factors in Patients With Cancer |
| title_sort | psychometric evaluation of the german version of the demoralization scale ii and the association between demoralization sociodemographic disease and treatment related factors in patients with cancer |
| topic | psychometrics validation study confirmatory factor analysis demoralization neoplasm |
| url | https://www.frontiersin.org/articles/10.3389/fpsyg.2021.789793/full |
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