Refinement and revalidation of the demoralization scale: The DS-II-external validity

Sophie Robinson, David W. Kissane, Joanne Brooker, Courtney Hempton, Natasha Michael, Jane Fischer, Michael Franco, Merlina Sulistio, David M. Clarke, Mehmet Ozmen, Susan Burney

Research output: Contribution to journalArticleResearchpeer-review

Abstract

BACKGROUND
The recently refined Demoralization Scale-II (DS-II) is a 16-item, self-report measure of demoralization. Its 2 factors—Meaning and Purpose and Distress and Coping Ability—demonstrate sound internal validity, including item fit, unidimensionality, internal consistency, and test-retest reliability. The convergent and discriminant validity of the DS-II with various measures is reported here.
METHODS
Patients who had cancer or other progressive diseases and were receiving palliative care (n = 211) completed a battery of questionnaires, including the DS-II and measures of symptom burden, quality of life, depression, and attitudes toward the end of life. Spearman ρ correlations were determined to assess convergent validity. Mann-Whitney U tests with calculated effect sizes were used to examine discriminant validity and establish the minimal clinically important difference (MCID). Cross-tabulation frequencies with chi-square analyses were used to examine discriminant validity with major depression.
RESULTS
The DS-II demonstrated convergent validity with measures of psychological distress, quality of life, and attitudes toward the end of life. It also demonstrated discriminant validity, as the DS-II differentiated patients who had different functional performance levels and high/low symptoms, with a difference of 2 points between groups on the DS-II considered clinically meaningful. Furthermore, discriminant validity was demonstrated, as comorbidity with depression was not observed at moderate levels of demoralization.
CONCLUSIONS
The DS-II has sound psychometric properties and is an appropriate measure of demoralization. Given its structural simplicity and brevity, it is likely to be a useful tool in meaning-centered therapies. Cancer 2016;122:2260–7. © 2016 American Cancer Society.
Original languageEnglish
Pages (from-to)2260-2267
Number of pages8
JournalCancer
Volume122
Issue number14
DOIs
Publication statusPublished - 15 Jul 2016

Keywords

  • cancer
  • construct validity
  • convergent validity
  • demoralization
  • discriminant validity
  • external validity
  • revalidation

Cite this

Robinson, Sophie ; Kissane, David W. ; Brooker, Joanne ; Hempton, Courtney ; Michael, Natasha ; Fischer, Jane ; Franco, Michael ; Sulistio, Merlina ; Clarke, David M. ; Ozmen, Mehmet ; Burney, Susan. / Refinement and revalidation of the demoralization scale : The DS-II-external validity. In: Cancer. 2016 ; Vol. 122, No. 14. pp. 2260-2267.
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title = "Refinement and revalidation of the demoralization scale: The DS-II-external validity",
abstract = "BACKGROUNDThe recently refined Demoralization Scale-II (DS-II) is a 16-item, self-report measure of demoralization. Its 2 factors—Meaning and Purpose and Distress and Coping Ability—demonstrate sound internal validity, including item fit, unidimensionality, internal consistency, and test-retest reliability. The convergent and discriminant validity of the DS-II with various measures is reported here.METHODSPatients who had cancer or other progressive diseases and were receiving palliative care (n = 211) completed a battery of questionnaires, including the DS-II and measures of symptom burden, quality of life, depression, and attitudes toward the end of life. Spearman ρ correlations were determined to assess convergent validity. Mann-Whitney U tests with calculated effect sizes were used to examine discriminant validity and establish the minimal clinically important difference (MCID). Cross-tabulation frequencies with chi-square analyses were used to examine discriminant validity with major depression.RESULTSThe DS-II demonstrated convergent validity with measures of psychological distress, quality of life, and attitudes toward the end of life. It also demonstrated discriminant validity, as the DS-II differentiated patients who had different functional performance levels and high/low symptoms, with a difference of 2 points between groups on the DS-II considered clinically meaningful. Furthermore, discriminant validity was demonstrated, as comorbidity with depression was not observed at moderate levels of demoralization.CONCLUSIONSThe DS-II has sound psychometric properties and is an appropriate measure of demoralization. Given its structural simplicity and brevity, it is likely to be a useful tool in meaning-centered therapies. Cancer 2016;122:2260–7. {\circledC} 2016 American Cancer Society.",
keywords = "cancer, construct validity, convergent validity, demoralization, discriminant validity, external validity, revalidation",
author = "Sophie Robinson and Kissane, {David W.} and Joanne Brooker and Courtney Hempton and Natasha Michael and Jane Fischer and Michael Franco and Merlina Sulistio and Clarke, {David M.} and Mehmet Ozmen and Susan Burney",
year = "2016",
month = "7",
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doi = "10.1002/cncr.30012",
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Refinement and revalidation of the demoralization scale : The DS-II-external validity. / Robinson, Sophie; Kissane, David W.; Brooker, Joanne; Hempton, Courtney; Michael, Natasha; Fischer, Jane; Franco, Michael; Sulistio, Merlina; Clarke, David M.; Ozmen, Mehmet; Burney, Susan.

In: Cancer, Vol. 122, No. 14, 15.07.2016, p. 2260-2267.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Refinement and revalidation of the demoralization scale

T2 - The DS-II-external validity

AU - Robinson, Sophie

AU - Kissane, David W.

AU - Brooker, Joanne

AU - Hempton, Courtney

AU - Michael, Natasha

AU - Fischer, Jane

AU - Franco, Michael

AU - Sulistio, Merlina

AU - Clarke, David M.

AU - Ozmen, Mehmet

AU - Burney, Susan

PY - 2016/7/15

Y1 - 2016/7/15

N2 - BACKGROUNDThe recently refined Demoralization Scale-II (DS-II) is a 16-item, self-report measure of demoralization. Its 2 factors—Meaning and Purpose and Distress and Coping Ability—demonstrate sound internal validity, including item fit, unidimensionality, internal consistency, and test-retest reliability. The convergent and discriminant validity of the DS-II with various measures is reported here.METHODSPatients who had cancer or other progressive diseases and were receiving palliative care (n = 211) completed a battery of questionnaires, including the DS-II and measures of symptom burden, quality of life, depression, and attitudes toward the end of life. Spearman ρ correlations were determined to assess convergent validity. Mann-Whitney U tests with calculated effect sizes were used to examine discriminant validity and establish the minimal clinically important difference (MCID). Cross-tabulation frequencies with chi-square analyses were used to examine discriminant validity with major depression.RESULTSThe DS-II demonstrated convergent validity with measures of psychological distress, quality of life, and attitudes toward the end of life. It also demonstrated discriminant validity, as the DS-II differentiated patients who had different functional performance levels and high/low symptoms, with a difference of 2 points between groups on the DS-II considered clinically meaningful. Furthermore, discriminant validity was demonstrated, as comorbidity with depression was not observed at moderate levels of demoralization.CONCLUSIONSThe DS-II has sound psychometric properties and is an appropriate measure of demoralization. Given its structural simplicity and brevity, it is likely to be a useful tool in meaning-centered therapies. Cancer 2016;122:2260–7. © 2016 American Cancer Society.

AB - BACKGROUNDThe recently refined Demoralization Scale-II (DS-II) is a 16-item, self-report measure of demoralization. Its 2 factors—Meaning and Purpose and Distress and Coping Ability—demonstrate sound internal validity, including item fit, unidimensionality, internal consistency, and test-retest reliability. The convergent and discriminant validity of the DS-II with various measures is reported here.METHODSPatients who had cancer or other progressive diseases and were receiving palliative care (n = 211) completed a battery of questionnaires, including the DS-II and measures of symptom burden, quality of life, depression, and attitudes toward the end of life. Spearman ρ correlations were determined to assess convergent validity. Mann-Whitney U tests with calculated effect sizes were used to examine discriminant validity and establish the minimal clinically important difference (MCID). Cross-tabulation frequencies with chi-square analyses were used to examine discriminant validity with major depression.RESULTSThe DS-II demonstrated convergent validity with measures of psychological distress, quality of life, and attitudes toward the end of life. It also demonstrated discriminant validity, as the DS-II differentiated patients who had different functional performance levels and high/low symptoms, with a difference of 2 points between groups on the DS-II considered clinically meaningful. Furthermore, discriminant validity was demonstrated, as comorbidity with depression was not observed at moderate levels of demoralization.CONCLUSIONSThe DS-II has sound psychometric properties and is an appropriate measure of demoralization. Given its structural simplicity and brevity, it is likely to be a useful tool in meaning-centered therapies. Cancer 2016;122:2260–7. © 2016 American Cancer Society.

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KW - demoralization

KW - discriminant validity

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KW - revalidation

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