The factor structure and use of the Demoralization Scale (DS-IT) in Italian cancer patients

Luigi Grassi, Anna Costantini, David Kissane, Serena Brunetti, Rosangela Caruso, Giulia Piazza, Paolo Marchetti, Silvana Sabato, Maria Giulia Nanni

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objective: Demoralization is a commonly observed syndrome in cancer patients, deserving to be carefully assessed in cross-cultural contexts. Aims: To examine the factor structure and concurrent and divergent validity of the Italian version of the Demoralization Scale (DS-IT) in cancer patients. Methods: The sample included 194 Italian cancer outpatients who were assessed by using the DS-IT and the Diagnostic Criteria of Psychosomatic Research-Demoralization module to examine demoralization. The Patient Health Questionnaire-9 (PHQ-9) to explore depression and the Mini-Mental Adjustment-to-Cancer-Hopelessness/Helplessness scale (Mini-MAC-HH) to explore maladaptive coping were also administered. Results: Four factors were extracted by exploratory factor analysis on the DS-IT (disheartenment, α = .87; sense of failure, α = .77; dysphoria, α = .73; loss of meaning/purpose, α = .72; total = 0.91), accounting for 57.1% of the variance. The DS-IT factors shared between 17% and 36% of the variance. Patients reporting a diagnosis of demoralization on the Diagnostic Criteria of Psychosomatic Research-Demoralization module (23.7%) had higher scores on DS-IT loss of meaning/purpose, sense of failure, dysphoria, and DS-IT total. About half of those who were highly demoralized were not depressed and among those who had moderate or moderately severe demoralization, about 80% were not depressed on the PHQ-9. The DS-IT was significantly associated with PHQ-9 and Mini-MAC-HH. Conclusions: The study presents further evidence that demoralization is a significant clinical condition and that the DS-IT demonstrates satisfactory levels of validity and reliability to support its use in patients in the ambulatory cancer setting.

Original languageEnglish
Pages (from-to)1965-1971
Number of pages7
JournalPsycho-Oncology
Volume26
Issue number11
DOIs
Publication statusPublished - Nov 2017

Keywords

  • Cancer
  • Demoralization
  • Depression
  • Oncology
  • Psychiatry
  • Psycho-oncology

Cite this

Grassi, L., Costantini, A., Kissane, D., Brunetti, S., Caruso, R., Piazza, G., ... Nanni, M. G. (2017). The factor structure and use of the Demoralization Scale (DS-IT) in Italian cancer patients. Psycho-Oncology, 26(11), 1965-1971. https://doi.org/10.1002/pon.4413
Grassi, Luigi ; Costantini, Anna ; Kissane, David ; Brunetti, Serena ; Caruso, Rosangela ; Piazza, Giulia ; Marchetti, Paolo ; Sabato, Silvana ; Nanni, Maria Giulia. / The factor structure and use of the Demoralization Scale (DS-IT) in Italian cancer patients. In: Psycho-Oncology. 2017 ; Vol. 26, No. 11. pp. 1965-1971.
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abstract = "Objective: Demoralization is a commonly observed syndrome in cancer patients, deserving to be carefully assessed in cross-cultural contexts. Aims: To examine the factor structure and concurrent and divergent validity of the Italian version of the Demoralization Scale (DS-IT) in cancer patients. Methods: The sample included 194 Italian cancer outpatients who were assessed by using the DS-IT and the Diagnostic Criteria of Psychosomatic Research-Demoralization module to examine demoralization. The Patient Health Questionnaire-9 (PHQ-9) to explore depression and the Mini-Mental Adjustment-to-Cancer-Hopelessness/Helplessness scale (Mini-MAC-HH) to explore maladaptive coping were also administered. Results: Four factors were extracted by exploratory factor analysis on the DS-IT (disheartenment, α = .87; sense of failure, α = .77; dysphoria, α = .73; loss of meaning/purpose, α = .72; total = 0.91), accounting for 57.1{\%} of the variance. The DS-IT factors shared between 17{\%} and 36{\%} of the variance. Patients reporting a diagnosis of demoralization on the Diagnostic Criteria of Psychosomatic Research-Demoralization module (23.7{\%}) had higher scores on DS-IT loss of meaning/purpose, sense of failure, dysphoria, and DS-IT total. About half of those who were highly demoralized were not depressed and among those who had moderate or moderately severe demoralization, about 80{\%} were not depressed on the PHQ-9. The DS-IT was significantly associated with PHQ-9 and Mini-MAC-HH. Conclusions: The study presents further evidence that demoralization is a significant clinical condition and that the DS-IT demonstrates satisfactory levels of validity and reliability to support its use in patients in the ambulatory cancer setting.",
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Grassi, L, Costantini, A, Kissane, D, Brunetti, S, Caruso, R, Piazza, G, Marchetti, P, Sabato, S & Nanni, MG 2017, 'The factor structure and use of the Demoralization Scale (DS-IT) in Italian cancer patients' Psycho-Oncology, vol. 26, no. 11, pp. 1965-1971. https://doi.org/10.1002/pon.4413

The factor structure and use of the Demoralization Scale (DS-IT) in Italian cancer patients. / Grassi, Luigi; Costantini, Anna; Kissane, David; Brunetti, Serena; Caruso, Rosangela; Piazza, Giulia; Marchetti, Paolo; Sabato, Silvana; Nanni, Maria Giulia.

In: Psycho-Oncology, Vol. 26, No. 11, 11.2017, p. 1965-1971.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - The factor structure and use of the Demoralization Scale (DS-IT) in Italian cancer patients

AU - Grassi, Luigi

AU - Costantini, Anna

AU - Kissane, David

AU - Brunetti, Serena

AU - Caruso, Rosangela

AU - Piazza, Giulia

AU - Marchetti, Paolo

AU - Sabato, Silvana

AU - Nanni, Maria Giulia

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N2 - Objective: Demoralization is a commonly observed syndrome in cancer patients, deserving to be carefully assessed in cross-cultural contexts. Aims: To examine the factor structure and concurrent and divergent validity of the Italian version of the Demoralization Scale (DS-IT) in cancer patients. Methods: The sample included 194 Italian cancer outpatients who were assessed by using the DS-IT and the Diagnostic Criteria of Psychosomatic Research-Demoralization module to examine demoralization. The Patient Health Questionnaire-9 (PHQ-9) to explore depression and the Mini-Mental Adjustment-to-Cancer-Hopelessness/Helplessness scale (Mini-MAC-HH) to explore maladaptive coping were also administered. Results: Four factors were extracted by exploratory factor analysis on the DS-IT (disheartenment, α = .87; sense of failure, α = .77; dysphoria, α = .73; loss of meaning/purpose, α = .72; total = 0.91), accounting for 57.1% of the variance. The DS-IT factors shared between 17% and 36% of the variance. Patients reporting a diagnosis of demoralization on the Diagnostic Criteria of Psychosomatic Research-Demoralization module (23.7%) had higher scores on DS-IT loss of meaning/purpose, sense of failure, dysphoria, and DS-IT total. About half of those who were highly demoralized were not depressed and among those who had moderate or moderately severe demoralization, about 80% were not depressed on the PHQ-9. The DS-IT was significantly associated with PHQ-9 and Mini-MAC-HH. Conclusions: The study presents further evidence that demoralization is a significant clinical condition and that the DS-IT demonstrates satisfactory levels of validity and reliability to support its use in patients in the ambulatory cancer setting.

AB - Objective: Demoralization is a commonly observed syndrome in cancer patients, deserving to be carefully assessed in cross-cultural contexts. Aims: To examine the factor structure and concurrent and divergent validity of the Italian version of the Demoralization Scale (DS-IT) in cancer patients. Methods: The sample included 194 Italian cancer outpatients who were assessed by using the DS-IT and the Diagnostic Criteria of Psychosomatic Research-Demoralization module to examine demoralization. The Patient Health Questionnaire-9 (PHQ-9) to explore depression and the Mini-Mental Adjustment-to-Cancer-Hopelessness/Helplessness scale (Mini-MAC-HH) to explore maladaptive coping were also administered. Results: Four factors were extracted by exploratory factor analysis on the DS-IT (disheartenment, α = .87; sense of failure, α = .77; dysphoria, α = .73; loss of meaning/purpose, α = .72; total = 0.91), accounting for 57.1% of the variance. The DS-IT factors shared between 17% and 36% of the variance. Patients reporting a diagnosis of demoralization on the Diagnostic Criteria of Psychosomatic Research-Demoralization module (23.7%) had higher scores on DS-IT loss of meaning/purpose, sense of failure, dysphoria, and DS-IT total. About half of those who were highly demoralized were not depressed and among those who had moderate or moderately severe demoralization, about 80% were not depressed on the PHQ-9. The DS-IT was significantly associated with PHQ-9 and Mini-MAC-HH. Conclusions: The study presents further evidence that demoralization is a significant clinical condition and that the DS-IT demonstrates satisfactory levels of validity and reliability to support its use in patients in the ambulatory cancer setting.

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KW - Depression

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