Skip to main content Accessibility help
×
Home

Validation of the Demoralization Scale in an Irish advanced cancer sample

  • Mary Mullane (a1), Barbara Dooley (a2), Eoin Tiernan (a3) and Ursula Bates (a3)

Abstract

Objective:

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.

Copyright

Corresponding author

Address correspondence and reprint requests to: Mary Mullane, Psychology Department, Child and Family Centre, County Clinic, Navan, Co. Meath, Ireland. E-mail: mullane.m@gmail.com

References

Hide All
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of the Mental Disorders (4th ed., text revision), Washington, DC: Author.
Beck, A.T. & Steer, R.A. (1988). Manual for the Beck Hopelessness Scale. San Antonio, TX: Psychological Corporation.
Beck, A.T., Steer, R.A. & Brown, G.K. (1996). Manual for the Beck Depression Inventory–II. San Antonio, TX: Psychological Corporation.
Cohen, S.R., Mount, B.M., Strobel, M.G., et al. (1995). The McGill Quality of Life Questionnaire: A measure of quality of life appropriate for people with advanced disease. A preliminary study of the validity and acceptability. Palliative Medicine, 9, 207219.
Kissane, D.W., Clarke, D.M. & Street, A. (2001). Demoralisation Syndrome: A relevant psychiatric diagnosis for palliative care. Journal of Palliative Care, 17, 1221.
Kissane, D.W., Wein, S., Love, A., et al. (2004). The Demoralization Scale: A report of its development and preliminary validation. Journal of Palliative Care, 20, 269276.
Kroenke, K., Spitzer, R.L. & Williams, J.B. (2001). The PHQ-9. Validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606613.
McClain, C.S., Rosenfeld, B. & Breitbart, W. (2003). Effect of spiritual well-being in end-of-life despair in terminally ill cancer patients. The Lancet, 361, 16031607.
Nelson, C.J., Rosenfeld, B., Breitbart, W., et al. (2002). Spirituality, religion and depression in the terminally ill. Psychosomatics, 43, 213220.
Nunn, K.P., Lewin, T.J. & Walton, J.M. (1996). The construction and characteristics of an instrument to measure hopefulness. Psychological Medicine, 26, 531545.
Parker, M. (2004). Medicalising meaning: Demoralisation syndrome and the desire to die. Australian and New Zealand Journal of Psychiatry, 38, 765773.
Rosenfeld, B., Breitbart, W., Galietta, M., et al. (2000). The Schedule of Attitudes toward Hastened Death. Measuring desire for death in terminally ill cancer patients. Cancer, 88, 28682875.
Slavney, P.R. (1999). Diagnosing demoralisation in consultation psychiatry. Psychosomatics, 40, 325329.

Keywords

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed