암 환자에서 한국어판 사기 저하 척도(DS-II-Kr)의 표준화 및 타당도
Standardization and Validation of the Korean Version of Demoralization Scale-II (DS-II-Kr) in Cancer Patients
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objectives Demoralization, which results from the inability to cope, is characterized by hopelessness, helplessness, and loss of the meaning and purpose of life. Although demoralization is prevalent in patients with chronic illness, including cancer, a Korean version of the scale has not been developed and validated. Thus, we translated into Korean and validated a version of the Demoralization Scale-II (DS-II-Kr) for cancer patients. Methods This cross-sectional study recruited cancer patients and survivors who visited a mental health clinic in a cancer hospital. Internal consistency, test-retest reliability, and concurrent validity of DS-II-Kr were assessed. Additionally, the construct validity of two sub-factors was evaluated using confirmatory factor analysis. The optimal DS-II-Kr cut-off point was determined by logistic regression analysis based on the distress cut-off in the Hospital Anxiety-Depression Scale (HADS). Results This study included 105 participants. The mean and standard deviation for total DS-IIKr scores were 11.9 and 7.6, respectively. The scale demonstrated good internal consistency and test-retest reliability. Goodness-of-fit analysis was moderate for the Meaning and Purpose subscale, and a good fit was found for the Distress and Coping Ability subscale. The DS-II-Kr cut-off value based on HADS was 10 (≤10 vs. >10). Conclusion The DS-II-Kr is a useful tool for assessing demoralization in clinical and research settings. However, further studies are needed to confirm the optimal DS-II-Kr cut-off score. External validation in other populations is also needed.
Abstract
Objectives Demoralization, which results from the inability to cope, is characterized by hopelessness, helplessness, and loss of the meaning and purpose of life. Although demoralization is prevalent in patients with chronic illness, including cancer, a Korean version of the scale has not been developed and validated. Thus, we translated into Korean and validated a version of the Demoralization Scale-II (DS-II-Kr) for cancer patients. Methods This cross-sectional study recruited cancer patients and survivors who visited a mental health clinic in a cancer hospital. Internal consistency, test-retest reliability, and concurrent validity of DS-II-Kr were assessed. Additionally, the construct validity of two sub-factors was evaluated using confirmatory factor analysis. The optimal DS-II-Kr cut-off point was determined by logistic regression analysis based on the distress cut-off in the Hospital Anxiety-Depression Scale (HADS). Results This study included 105 participants. The mean and standard deviation for total DS-IIKr scores were 11.9 and 7.6, respectively. The scale demonstrated good internal consistency and test-retest reliability. Goodness-of-fit analysis was moderate for the Meaning and Purpose subscale, and a good fit was found for the Distress and Coping Ability subscale. The DS-II-Kr cut-off value based on HADS was 10 (≤10 vs. >10). Conclusion The DS-II-Kr is a useful tool for assessing demoralization in clinical and research settings. However, further studies are needed to confirm the optimal DS-II-Kr cut-off score. External validation in other populations is also needed.
참고문헌 (24)
- Kissane DW, "Demoralization syndrome--a relevant psychiatric diagnosis for palliative care", J Palliat Care, 17, pp.12~21 (2001)
- Kissane DW, "The contribution of demoralization to end of life decisionmaking", Hastings Cent Rep, 34, pp.21~31 (2004)
- Gan LL, "Mental state of demoralisation across diverse clinical settings: a systematic review, meta-analysis and proposal for its use as a ‘specifier’ in mental illness", Aust N Z J Psychiatry (2021)
- de Figueiredo JM, "Depression and demoralization : phenomenologic differences and research perspectives", Compr Psychiatry, 34, pp.308~311 (1993)
- Mullane M, "Validation of the demoralization scale in an Irish advanced cancer sample", Palliat Support Care, 7, pp.323~330 (2009)
- Tang PL, "A systematic review and meta-analysis of demoralization and depression in patients with cancer", Psychosomatics, 56, pp.634~643 (2015)
- de Weert-van Oene GH, "Demoralisation in alcohol-dependent patients with co-occurring psychiatric disorders", Tijdschr Psychiatr, 61, pp.84~91 (2019)
- Grassi L, "Psychosomatic characterization of adjustment disorders in the medical setting : some suggestions for DSM-V", J Affect Disord, 101, pp.251~254 (2007)
- Fang CK, "A correlational study of suicidal ideation with psychological distress, depression, and demoralization in patients with cancer", Support Care Cancer, 22, pp.3165~3174 (2014)
- de Figueiredo JM, "Distress, demoralization and psychopathology: diagnostic boundaries", Eur J Psychiatry, 27, pp.61~73 (2013)
- Galeazzi GM, "Interrater reliability, prevalence, and relation to ICD-10 diagnoses of the diagnostic criteria for psychosomatic research in consultation-liaison psychiatry patients", Psychosomatics, 45, pp.386~393 (2004)
- Fava GA, "Assessment of psychological distress in the setting of medical disease", Psychother Psychosom, 70, pp.171~175 (2001)
- Robinson S, "Refinement and revalidation of the demoralization scale : the DS-II-internal validity", Cancer, 122, pp.2251~2259 (2016)
- Zigmond AS, "The hospital anxiety and depression scale", Acta Psychiatr Scand, 67, pp.361~370 (1983)
- Oh SM, "A study on the standardization of the hospital anxiety and depression scale for Koreans: a comparison of normal, depressed and anxious groups", J Korean Neuropsychiatr Assoc, 38, pp.289~296 (1999)
- Wang GL, "The HADS and the DT for screening psychosocial distress of cancer patients in Taiwan", Psychooncology, 20, pp.639~646 (2011)
- Robinson S, "Refinement and revalidation of the demoralization scale : the DS-II-external validity", Cancer, 122, pp.2260~2267 (2016)
- Ignatius J, "Frequency of demoralization and depression in cancer patients", Gen Hosp Psychiatry, 60, pp.137~140 (2019)
- Bailey C, "Demoralization and chronic illness in rural Australia : a cross-sectional survey", Palliat Support Care, 18, pp.271~276 (2020)
- Cersonsky TEK, "Demoralization in essential tremor: prevalence, clinical correlates, and dissociation from tremor severity", CNS Spectr, 25, pp.16~23 (2020)
- Belar A, "Multicenter study of the psychometric properties of the new demoralization scale (DS-II) in Spanish-speaking advanced cancer patients", J Pain Symptom Manage, 57, pp.627~634 (2019)
- Fabrigar LR, "Evaluating the use of exploratory factor analysis in psychological research", Psychol Methods, 4, pp.272~299 (1999)
- Hu Lt, "Cutoffcriteria for fit indexes in covariance structure analysis : conventional criteria versus new alternatives", Struct Equ Model, 6, pp.1~55 (1999)
- Belvederi Murri M, "Assessing demoralization in medically ill patients: factor structure of the Italian version of the demoralization scale and development of short versions with the item response theory framework", J Psychosom Res, 128, pp.109889~ (2020)