Demoralization Scale--13-Item Version

2020 ◽  
Author(s):  
Martino Belvederi Murri ◽  
Luigi Zerbinati ◽  
Heifa Ounalli ◽  
David Kissane ◽  
Beatrice Casoni ◽  
...  
Keyword(s):  
Author(s):  
Chuan-Yung Huang ◽  
Yi-Chun Hung ◽  
Chee-Seng Tan ◽  
Siew-May Cheng ◽  
Shun-Hao Hu

AbstractThe impact of demoralization among the general population has received little attention due to the lack of an appropriate measurement. Three studies involving 1,143 high school and undergraduate students in Taiwan were thus conducted to develop and validate a tool to assess demoralization. A pool of 50 items was first developed and administered to high school students. Exploratory factor analysis results supported a 5-factor solution with 15 items (Study 1). Study 2 compared the potential models using confirmatory factor analysis and found the 5-factor second-order model with 15 items the best fit model. The 15-item Mandarin version of Demoralization Scale (DS-M-15) was also found to have good internal consistency, test–retest reliability, and (concurrent and predictive) validity in a sample of undergraduate students (Study 3). Taken together, the converging findings show that the DS-M-15 is a promising tool for assessing demoralization among Chinese adolescents and emerging adults.


2020 ◽  
Vol 9 (7) ◽  
pp. 2119 ◽  
Author(s):  
Yuri Battaglia ◽  
Luigi Zerbinati ◽  
Giulia Piazza ◽  
Elena Martino ◽  
Sara Massarenti ◽  
...  

Demoralization is a commonly observed syndrome in medically ill patients. The risk of demoralization may increase in patients after a kidney transplant (KTRs) because of the stressful nature of renal transplantation, psychosocial challenges, and adjustment needs. No study is available on demoralization amongst KTRs. The purpose of our study was to evaluate the validity of the Italian version of the Demoralization Scale (DS-IT) and the prevalence of demoralization in KTRs. Also, we aimed at exploring the association of the DS-IT with International Classification of Diseases (ICD) psychiatric diagnoses, post-traumatic growth (PTG), psychological and physical symptoms, and daily-life problems. A total of 134 KTRs were administered the MINI International Neuropsychiatric Interview 6.0. and the Diagnostic Criteria for Psychosomatic Research–Demoralization (DCPR/D) Interview. The DS-IT, the Edmonton Symptom Assessment System (ESAS), the Canadian Problem Checklist (CPC), were used to measure demoralization, physical and psychological symptoms, and daily-life problems; also, positive psychological experience of kidney transplantation was assessed with the PTG Inventory. Routine biochemistry and sociodemographic data were collected. Exploratory factor analysis demonstrated a four-dimensional factor structure of the DS-IT, explaining 55% of the variance (loss of meaning and purpose, disheartenment, dysphoria, and sense of failure). DS-IT Cronbach alpha coefficients indicated good or acceptable level of internal consistency. The area under the Receiving Operating Characteristics (ROC) curve for DS-IT (against the DCPR/D interview as a gold standard) was 0.92. The DS-IT optimal cut-off points were ≥20 (sensitivity 0.87, specificity 0.82). By examining the level of demoralization, 14.2%, 46.3%, 24.6%, and 14.6% of our sample were classified as having no, low, moderate, and high demoralization, respectively, with differences according to the ICD psychiatric diagnoses (p < 0.001). DS-IT Total and subscales scores were positively correlated with scores of ESAS symptoms and CPC score. A correlation between DS-IT loss of meaning and purpose subscale and PTGI appreciation of life subscale (p < 0.05) was found. This study shows, for the first time, a satisfactory level of reliability of the DS-IT and a high prevalence of severe demoralization in KTRs.


2004 ◽  
Vol 20 (4) ◽  
pp. 269-276 ◽  
Author(s):  
David W. Kissane ◽  
Simon Wein ◽  
Anthony Love ◽  
Xiu Qing Lee ◽  
Pei Lee Kee ◽  
...  

2017 ◽  
Vol 15 (5) ◽  
pp. 516-523 ◽  
Author(s):  
Laura Galiana ◽  
David Rudilla ◽  
Amparo Oliver ◽  
Pilar Barreto

ABSTRACTObjective:The Demoralization Scale (DS) is the most widely used measure for assessing demoralization. Following the recent clamor for brief assessment tools, and taking into account that demoralization has proved to be a symptom that needs to be controlled and treated in the palliative care setting, a shorter scale is needed. The aim of the present research is to introduce and evaluate the Short Demoralization Scale (SDS).Method:We employed a cross-sectional design that included a survey of 226 Spanish palliative care patients from the Hospital General Universitario de Valencia. We employed the SDS, the DS, and the Hospital Anxiety and Depression Scale (HADS).Results:The confirmatory factor analysis supported the one-factor structure of the SDS (χ2(5) = 12.915; p = 0.024; CFI = 0.999; RMSEA = 0.084; CI95% = [0.028, 0.141]). The reliability was found to be appropriate, with a value of Cronbach's alpha (α) equal to 0.920. A cutoff criterion of 10 was established, which favored the interpretability of the instrument.Significance of results:The SDS corrects previous limitations, has a simple scoring system, is cost-effective, and is widely and fully available. In addition, our findings demonstrate that the SDS can be employed effectively in the clinical context.


2009 ◽  
Vol 7 (3) ◽  
pp. 323-330 ◽  
Author(s):  
Mary Mullane ◽  
Barbara Dooley ◽  
Eoin Tiernan ◽  
Ursula Bates

AbstractObjective:This article presents a validation study of the Demoralization Scale, a 24-item, 5-point response questionnaire developed by Kissane et al. in 2004 to assess demoralization in advanced cancer patients.Method:One hundred Irish inpatients with advanced palliative cancer completed the Demoralization Scale and measures of depression, hopelessness, quality of life, and personal hopefulness.Results:Principal component analysis of the Demoralization Scale yielded four similar factors found by Kissane et al. (2004), namely, loss of meaning, dysphoria, disheartenment, and sense of failure. A new factor, the hopelessness factor, was also found in the current study. The reliability of the five factors was good, ranging from .72 to .93. Contrary to the findings of Kissane et al.'s (2004) study, divergent validity of the Demoralization Scale was not supported. Demoralized patients were significantly more likely to be depressed than those that did not score highly on the Demoralization Scale. In addition, this study found significantly lower levels of demoralization in general compared with Kissane et al.'s (2004) study.Significance of results:The results of the current study show that, in an Irish palliative care context, demoralization is not differentiated from depression. Additional factor analytic studies are needed to validate the Demoralization Scale.


Neurology ◽  
2018 ◽  
Vol 90 (18) ◽  
pp. e1613-e1617 ◽  
Author(s):  
Brian B. Koo ◽  
Christopher A. Chow ◽  
Divya R. Shah ◽  
Farhan H. Khan ◽  
Brittani Steinberg ◽  
...  

ObjectiveTo determine the prevalence and associated features of demoralization in Parkinson disease (PD).MethodsParticipants with PD and controls were prospectively recruited from outpatient movement disorder clinics and the community. Demoralization was defined as scoring positively on the Diagnostic Criteria for Psychosomatic Research, Demoralization questionnaire or Kissane Demoralization Scale score ≥24. Depression was defined as Patient Health Questionnaire-9 score ≥10. Forward stepwise logistic regression was used to determine the odds of having demoralization in the overall, control, and PD cohorts.ResultsDemoralization occurred in 18.1% of 94 participants with PD and 8.1% of 86 control participants (p = 0.05). These 2 groups were otherwise comparable in age, sex, education, economics, race, and marital status. Although demoralization was highly associated with depression, there were individuals with one and not the other. Among participants with PD, 7 of 19 (36.8%) depressed individuals were not demoralized, and 5 of 17 (29.4%) demoralized individuals were not depressed. In the overall cohort, having PD (odds ratio 2.60, 95% confidence interval 1.00–6.80, p = 0.051) was associated with demoralization, along with younger age and not currently being married. In the PD cohort, younger age and Unified Parkinson's Disease Rating Scale, part III score (per score 1) were associated with demoralization (odds ratio 1.06, 95% confidence interval 1.01–1.12, p = 0.02).ConclusionsDemoralization is common in PD and is associated with motor dysfunction. In demoralization, there is a prominent inability to cope, making it somewhat distinct from depression. Treatment approaches are also different, making it important to identify demoralization in patients with PD.


2010 ◽  
Vol 26 (4) ◽  
pp. 293-301 ◽  
Author(s):  
Wiede Vissers ◽  
Ger. P. J. Keijsers ◽  
William M. van der Veld ◽  
Cor A. J. de Jong ◽  
Giel J. M. Hutschemaekers

Remoralization is the process of restoration of morale. Remoralization constitutes an important step in the therapeutic change process. Because no appropriate self-report instrument was available to indicate the level of morale in mental health care, the Remoralization Scale (RS) was developed. In a first study (299 outpatients), a pool of 69 items was examined to produce an initial scale with 16 items with a unidimensional factor structure. In a second study (199 outpatients, 192 nonpatients), the unidimensionality and scalar invariance of the initial scale was tested. To make the RS as short and easy to complete as possible, four items with low factor loadings were removed. In a third study (124 students), the test-retest reliability (r = 0.89) and internal consistency (α = 0.91) of the RS were estimated. In a fourth study, the construct validity of the RS was investigated using a demoralization scale (r = –.72) and scales that measure anxiety (r = –.52), depression (r = –.50), somatic symptoms (r = –.36), and social dysfunction (r = –.37). In a fifth study (23 panic outpatients), the sensitivity of the RS to therapeutic change was examined and found to be good. In closing, limitations of the RS are discussed.


2008 ◽  
Author(s):  
Sonya E. Padilla ◽  
Darwin Dorr ◽  
C.D. Morgan

2016 ◽  
Author(s):  
David Rudilla ◽  
Laura Galiana ◽  
Amparo Oliver ◽  
Pilar Barreto

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