Supervisors info:
Μυστακίδου Κυριακή, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Ζυγογιάννη Άννα, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Κατσαραγάκης Στυλιανός, Επίκουρος Καθηγητής, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Summary:
Introduction: The concept of demoralization is used to describe situations of existential distress and self-perceived inability to effectively deal with stressors or a combination of mental pain and feelings of subjective incompetence seen in patients with chronic illnesses and advanced diseases such as cancer. The Kissane and Clarke (2002) Demoralization Scale is the most well-known and widely used method of assessing and diagnosing demoralization syndrome. The psychometric properties of DS have been translated and studied in various countries, in patient samples with advanced cancer and in palliative care. The DS II tool is a short and modified version of the original DS that measures the level of demoralization in patients.
Objective: The present study’s main objective is to evaluate the psychometric properties of the Greek version of the demoralization scale in a population of oncology patients. The importance of this study lies in the emergence of a valid and reliable tool for the recognition of emotional and cognitive states of existential distress and demoralization.
Methodology: The main tool used in the prospective cross-sectional observational study was the DS II GR demoralization scale, which was translated and evaluated for its psychometric properties in a sample of 150 oncology patients during the period from 03/04/2019 till 18/09/2019 during their arrival at Aretaio Hospital and the Palliative Care Unit. The sample of the study was asked to complete the Greek version of the demoralization scale as well as the questionnaire of the Hospital Anxiety and Depression Scale. The statistical package SPSS v 21.0 was used for the statistical data analysis.
Results: According to the confirmatory factor analysis, a two-factor model of the authentic DS-II scale emerged, which was marginally characterized by unacceptable global adjustment indicators. Subsequently, two factors also emerged, but of different conceptual content and grouping than those of the original scale. The correlation coefficients between DS-II GR and HAD anxiety for factor 1 were (r = 0.602, p <0.001), for factor 2 (r = 0.519, p <0.001), and for the total score (r = -0.628, p <0.001). The correlation coefficients between DS-II GR and HAD depression for factor 1 were (r = 0.701, p <0.001), for factor 2 (r = 0.456, p <0.001), and for the total score (r = -0.667, p <0.001). The above results indicate a high correlation which satisfies the convergent validity. The internal consistency of DS-II GR for factor 1, factor 2, and total score were measured with Cronbach’s alpha and calculated to be 0.906, 0.810, and 0.913, respectively. These values indicate excellent internal consistency for the total score and for the subscales.
Conclusion: The Greek version of the demoralization scale is a reliable and valid tool for its widespread use in the Greek population in order to evaluate demoralization among Greek cancer patients. The use of this tool is expected to contribute substantially to the collection of necessary information and knowledge to assess the psychosocial needs of cancer patients in Greece.
Keywords:
Demoralization, Demoralization scale, Oncology patients, Palliative care, Depression
