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Anja Mehnert - One of the best experts on this subject based on the ideXlab platform.

  • latent class analysis differentiation of adjustment disorder and Demoralization more severe depressive and anxiety disorders and somatic symptoms in patients with cancer
    Psycho-oncology, 2018
    Co-Authors: Irene Bobevski, Sigrun Vehling, David W. Kissane, Dean Philip Mckenzie, H Glaesmer, Anja Mehnert
    Abstract:

    OBJECTIVES Demoralization as a form of existential distress involves poor coping, low morale, hopelessness, helplessness, and meaninglessness. In a secondary analysis of a cohort of German cancer patients, we aimed to explore latent class structure to assess the contribution that symptoms of Demoralization make to anhedonic depression, anxiety, adjustment, and somatic disorders. METHODS Measures of Demoralization, depression, anxiety, physical symptoms, and functional impairment had been completed cross-sectionally by 1527 patients with early or advanced cancer. Latent class analysis used maximum likelihood techniques to define the unobserved latent constructs that can be predicted as symptom clusters. Individual patients were assigned to the most probable class. Classes were compared on demographics, and logistic regression assessed the odds of individual items predicting each class. RESULTS A 4-class model provided the best fit. Class 1 (n = 829, 54.3%) was defined by the absence of distress; Classes 2 to 4 all carried functional impairment. Class 2 (n = 333, 21.8%) was differentiated by somatic symptoms (sleep, tiredness, and appetite); Class 3 (n = 163, 10.7%) by anhedonia, anxiety, and severe Demoralization; and Class 4 (n = 202, 13.2%) by adjustment and moderate Demoralization. Members of Class 3 were more likely to be younger, female, anhedonic, depressed, and anxious. In both Classes 3 and 4, functional impairment, physical symptom burden, and suicidal ideation were present. CONCLUSIONS In contrast with the severe symptom cluster carrying anhedonia, anxiety, and Demoralization, the moderate symptom cluster was formed by patients with Demoralization and impaired functioning, a clinical picture consistent with a unidimensional model of adjustment disorder.

  • perceived doctor patient relationship and its association with Demoralization in patients with advanced cancer
    Psycho-oncology, 2018
    Co-Authors: Leonhard Quintero Garzón, Susan Koranyi, Dorit Engelmann, Rebecca Philipp, Katharina Scheffold, Martin Härter, Frank Schulzkindermann, Anja Mehnert
    Abstract:

    BACKGROUND Advanced diseases pose a great burden on patients and go hand in hand with existential concerns. Demoralization is considered as a syndrome of existential distress with a perceived inability to cope with loss of meaning in life and feelings of helplessness and hopelessness. Professional health care providers play an important role in providing support for patients and unfavorable conversational styles in their relationship can increase patient's distress. In this study, we examine the association between the patient's perceived relationship to health care providers and Demoralization. METHODS We used baseline data of a randomized control trial intervention study for advanced cancer patients (UICC-Stage ≥ III; PHQ ≥ 9 and/or Distress-Thermometer ≥5). We used a subscale of the QUAL-EC-P for assessing doctor-patient relationship, Beck Depression Inventory-II for depressive symptoms, a modified version of the MSAS as physiological symptom checklist, and the Demoralization Scale to assess Demoralization. A hierarchical regression analysis was calculated. RESULTS In our sample of 187 patients with stage III or IV cancer (62% women), Demoralization was present in 53.4% (16% moderate Demoralization; 37.4% high Demoralization) of the patients. Relationship to health care provider was an independent predictor (β = -.33, t(186) = -6.70, P < .001) of Demoralization. CONCLUSIONS Our findings underline the importance of the physician-patient relationship in the context of coping with existential challenges in advanced cancer patients. Trainings on how to communicate and build a sustainable relationship with patients and their specific needs may increase the buffering effect of social support by the physicians on patient's existential distress.

  • Perceived doctor-patient relationship and its association with Demoralization in patients with advanced cancer.
    Psycho-Oncology, 2018
    Co-Authors: Leonhard Quintero Garzón, Susan Koranyi, Dorit Engelmann, Rebecca Philipp, Katharina Scheffold, Frank Schulz-kindermann, Martin Härter, Anja Mehnert
    Abstract:

    BACKGROUND Advanced diseases pose a great burden on patients and go hand in hand with existential concerns. Demoralization is considered as a syndrome of existential distress with a perceived inability to cope with loss of meaning in life and feelings of helplessness and hopelessness. Professional health care providers play an important role in providing support for patients and unfavorable conversational styles in their relationship can increase patient's distress. In this study, we examine the association between the patient's perceived relationship to health care providers and Demoralization. METHODS We used baseline data of a randomized control trial intervention study for advanced cancer patients (UICC-Stage ≥ III; PHQ ≥ 9 and/or Distress-Thermometer ≥5). We used a subscale of the QUAL-EC-P for assessing doctor-patient relationship, Beck Depression Inventory-II for depressive symptoms, a modified version of the MSAS as physiological symptom checklist, and the Demoralization Scale to assess Demoralization. A hierarchical regression analysis was calculated. RESULTS In our sample of 187 patients with stage III or IV cancer (62% women), Demoralization was present in 53.4% (16% moderate Demoralization; 37.4% high Demoralization) of the patients. Relationship to health care provider was an independent predictor (β = -.33, t(186) = -6.70, P 

  • The association of Demoralization with mental disorders and suicidal ideation in patients with cancer
    Cancer, 2017
    Co-Authors: Sigrun Vehling, David W. Kissane, Heide Glaesmer, Tim J. Hartung, Gary Rodin, Anja Mehnert
    Abstract:

    BACKGROUND Demoralization refers to a state in which there is a perceived inability to cope, that is associated with a sense of disheartenment and a loss of hope and meaning. This study investigated the co-occurrence versus independence of Demoralization with mental disorders and suicidal ideation to evaluate its features as a concept of distress in the context of severe illness. METHODS In a cross-sectional sample of 430 mixed cancer patients, we assessed Demoralization with the Demoralization Scale (DS); the 4-week prevalence of mood, anxiety, and adjustment disorders and suicidal ideation with the standardized Composite International Diagnostic Interview–Oncology (CIDI-O); and depressive symptoms with the Patient Health Questionnaire-9 (PHQ-9). We compared the relative risk (RR) for mental disorders associated with Demoralization to that associated with self-reported depression. RESULTS Clinically relevant levels of Demoralization were present in 21% of the patients. Demoralization co-occurred with a mood/anxiety disorder in 7%; 14% were demoralized in absence of any mood/anxiety disorder. Demoralization and adjustment disorders co-occurred in 2%. The RR for any mood/anxiety disorder was 4.0 in patients with Demoralization (95% confidence interval [CI], 2.5-6.2) and 3.0 in those with depression (95% CI, 1.9-4.6). Demoralization, but not depression, was associated with a significantly increased risk for suicidal ideation after controlling for mental disorders (RR, 2.0; 95% CI, 1.1-3.5). CONCLUSIONS Clinically relevant Demoralization frequently occurs independently of a mental disorder in patients with cancer and has a unique contribution to suicidal ideation. Demoralization is a useful concept to identify profiles of psychological distress symptoms amenable to interventions improving psychological well-being in this population. Cancer 2017. © 2017 American Cancer Society.

  • symptom burden loss of dignity and Demoralization in patients with cancer a mediation model
    Psycho-oncology, 2014
    Co-Authors: Sigrun Vehling, Anja Mehnert
    Abstract:

    Background Demoralization is a syndrome of existential distress that occurs in a substantial minority of cancer patients and is associated with a higher number of physical problems. Loss of dignity refers to a range of specific existential concerns. This study examines whether the association between number of physical problems and Demoralization is mediated by loss of dignity. Methods This cross-sectional study examined N = 112 inpatients with mixed tumor sites at early and advanced disease stages using the following standardized self-report questionnaires: Physical problems list of the National Comprehensive Cancer Network (NCCN) Distress Thermometer (DT), Patient Dignity Inventory (PDI), Demoralization Scale (DS), Patient Health Questionnaire-9 (PHQ-9) and Illness-Specific Social Support Scale Short Version-8 (ISSS-8). The mediation hypothesis was tested by multiple regression analyses controlling for age, gender, curative versus palliative treatment phase, and social support. Results Patients reported M = 4.7 (SD = 6.0) dignity-related problems; 20% showed moderate to severe Demoralization. Loss of dignity significantly mediated 81% of the effect of the number of physical problems on Demoralization (Sobel zs = 4.4, p < .001). Testing the reverse direction, we found that Demoralization mediated only 53% of the association between physical problems and loss of dignity (zs = 3.7, p < .001). Conclusions By supporting the mediation hypothesis, our results indicate that loss of dignity partially explains the association between physical problems and Demoralization. Early recognition of dignity-related existential concerns and interventions to enhance the sense of dignity may prevent Demoralization in patients with cancer. Results provide a conceptual link between existential concerns (loss of dignity) and existential distress (Demoralization) as two approaches to existential suffering in patients with cancer. Copyright © 2013 John Wiley & Sons, Ltd.

David W. Kissane - One of the best experts on this subject based on the ideXlab platform.

  • Demoralization and chronic illness in rural australia a cross sectional survey
    Palliative & Supportive Care, 2020
    Co-Authors: Claire Bailey, Zelda Doyle, John Walton Dearin, Natasha Michael, David W. Kissane
    Abstract:

    OBJECTIVE Demoralization is prevalent in patients with life-limiting chronic illnesses, many of whom reside in rural areas. These patients also have an increased risk of disease-related psychosocial burden due to the unique health barriers in this population. However, the factors affecting Demoralization in this cohort are currently unknown. This study aimed to examine Demoralization amongst the chronically ill in Lithgow, a town in rural New South Wales, Australia, and identify any correlated demographic, physical, and psychosocial factors in this population. METHOD A cross-sectional survey of 73 participants drawn from Lithgow Hospital, the adjoining retirement village and nursing home, assessing correlating demographic, physical, psychiatric, and psychosocial factors. RESULTS The total mean score of the DS-II was 7.8 (SD 26.4), and high Demoralization scores were associated with the level of education (p = 0.01), comorbid condition (p = 0.04), severity of symptom burden (p = <0.001), depression (p = <0.001), and psychological distress (p = <0.001). Prevalence of serious Demoralization in this population was 27.4% according to a cutoff of a DS-II score ≥11. Of those, 11 (15%) met the criteria for clinical depression, leaving 9 (12.3%) of the cohort demoralized but not depressed. SIGNIFICANCE OF RESULTS Prevalence of Demoralization was high in this population. In line with the existing literature, Demoralization was associated with the level of education, symptom burden, and psychological distress, demonstrating that Demoralization is a relevant psychometric factor in rural populations. Further stratification of the unique biopsychosocial factors at play in this population would contribute to better understanding the burdens experienced by people with chronic illness in this population and the nature of Demoralization.

  • Exploring and assessing Demoralization in patients with non-psychotic affective disorders.
    Journal of Affective Disorders, 2020
    Co-Authors: Luigi Grassi, David W. Kissane, Massimo Pasquini, Luigi Zerbinati, Rosangela Caruso, Silvana Sabato, Maria Giulia Nanni, Heifa Ounalli, Annalisa Maraone, Valentina Roselli
    Abstract:

    Abstract Background Demoralization, as assessed through the Diagnostic Criteria for Psychosomatic Research–Demoralization (DCPR/D) interview or the Demoralization Scale (DS), has been found to affect about 30% of patients with medical disorders, while few studies have been done in patients with psychiatric disorders. Methods A convenience sample of 377 patients with ICD-10 diagnoses of mood, anxiety, stress-related disorders or other non-psychotic disorders was recruited from two Italian university psychiatry centers. The DCPR/D interview and the Italian version of the DS (DS-IT) were used to assess Demoralization and the Patient Health Questionnaire-9 (PHQ-9) to assess depression. Results Demoralization was diagnosable in more than 50% of the patients. Factor analysis of the DS-IT indicated four main factors, Meaninglessness/Helplessness, Disheartenment, Dysphoria and Sense of Failure, explaining 62% of the variance of the scale. Patients with bipolar or unipolar major depression and personality disorders had the highest prevalence of Demoralization (DCPR/D) and the highest scores on all the DS-IT factors in comparison with patients with adjustment or anxiety disorders. About 50% of patients with moderate Demoralization (DS-IT) were not clinically depressed (PHQ-9 Limitations Prospective studies on larger samples with other psychiatric disorders, also taking into account subjective incompetence, are needed. Since the DCPR/D assesses Demoralization as a categorical construct, a dimensional framework should be necessary. Conclusions The findings enrich the research on Demoralization, showing for the first time the importance of this construct, as measured by the DCPR/D and the DS-IT, in patients with psychiatric disorders.

  • Demoralization and chronic illness in rural Australia: A cross-sectional survey
    Palliative and Supportive Care, 2019
    Co-Authors: Claire Bailey, Zelda Doyle, John Walton Dearin, Natasha Michael, David W. Kissane
    Abstract:

    OBJECTIVE Demoralization is prevalent in patients with life-limiting chronic illnesses, many of whom reside in rural areas. These patients also have an increased risk of disease-related psychosocial burden due to the unique health barriers in this population. However, the factors affecting Demoralization in this cohort are currently unknown. This study aimed to examine Demoralization amongst the chronically ill in Lithgow, a town in rural New South Wales, Australia, and identify any correlated demographic, physical, and psychosocial factors in this population. METHOD A cross-sectional survey of 73 participants drawn from Lithgow Hospital, the adjoining retirement village and nursing home, assessing correlating demographic, physical, psychiatric, and psychosocial factors. RESULTS The total mean score of the DS-II was 7.8 (SD 26.4), and high Demoralization scores were associated with the level of education (p = 0.01), comorbid condition (p = 0.04), severity of symptom burden (p =

  • Translation and psychometric properties for the Demoralization Scale in Chinese breast cancer patients.
    European Journal of Oncology Nursing, 2019
    Co-Authors: Jie Cheng, David W. Kissane, Jing Chen, Yuening Zhang, Jun Yan
    Abstract:

    Abstract Purpose To translate and validate the Chinese version of the Demoralization Scale among breast cancer patients. Method A cross-sectional, descriptive correlational design was employed. From September 2016 to May 2017, 203 breast cancer survivors completed the survey. Content, construct, concurrent and divergent validity and internal consistency of the Chinese version of the Demoralization Scale were evaluated. Results The proposed factor structures of the Demoralization Scale in previous studies cannot be confirmed using confirmatory factor analysis in the present study. Moreover, four factors were extracted by exploratory factor analysis, which accounted for 58.66% of the variance. Each subscale yielded satisfactory internal consistency with coefficient alphas ranging from 0.720 to 0.894. Relationships/differences between Demoralization, quality of life, despair and depression provide initial support for the concurrent/divergent validity. Given these results, the Chinese version of the Demoralization Scale appears to be both valid and reliable. Conclusions Our results preliminary supported that the Chinese version of the Demoralization Scale is a reliable and valid instrument for assessing Demoralization among mainland Chinese breast cancer patients, and the factor structure of this measurement needs to be further addressed in future studies.

  • latent class analysis differentiation of adjustment disorder and Demoralization more severe depressive and anxiety disorders and somatic symptoms in patients with cancer
    Psycho-oncology, 2018
    Co-Authors: Irene Bobevski, Sigrun Vehling, David W. Kissane, Dean Philip Mckenzie, H Glaesmer, Anja Mehnert
    Abstract:

    OBJECTIVES Demoralization as a form of existential distress involves poor coping, low morale, hopelessness, helplessness, and meaninglessness. In a secondary analysis of a cohort of German cancer patients, we aimed to explore latent class structure to assess the contribution that symptoms of Demoralization make to anhedonic depression, anxiety, adjustment, and somatic disorders. METHODS Measures of Demoralization, depression, anxiety, physical symptoms, and functional impairment had been completed cross-sectionally by 1527 patients with early or advanced cancer. Latent class analysis used maximum likelihood techniques to define the unobserved latent constructs that can be predicted as symptom clusters. Individual patients were assigned to the most probable class. Classes were compared on demographics, and logistic regression assessed the odds of individual items predicting each class. RESULTS A 4-class model provided the best fit. Class 1 (n = 829, 54.3%) was defined by the absence of distress; Classes 2 to 4 all carried functional impairment. Class 2 (n = 333, 21.8%) was differentiated by somatic symptoms (sleep, tiredness, and appetite); Class 3 (n = 163, 10.7%) by anhedonia, anxiety, and severe Demoralization; and Class 4 (n = 202, 13.2%) by adjustment and moderate Demoralization. Members of Class 3 were more likely to be younger, female, anhedonic, depressed, and anxious. In both Classes 3 and 4, functional impairment, physical symptom burden, and suicidal ideation were present. CONCLUSIONS In contrast with the severe symptom cluster carrying anhedonia, anxiety, and Demoralization, the moderate symptom cluster was formed by patients with Demoralization and impaired functioning, a clinical picture consistent with a unidimensional model of adjustment disorder.

Sigrun Vehling - One of the best experts on this subject based on the ideXlab platform.

  • Loss of resources and Demoralization in the chronically ill.
    General Hospital Psychiatry, 2019
    Co-Authors: M.i. Dischinger, L. Lange, Sigrun Vehling
    Abstract:

    Abstract Objective The study examined whether the association between the severity of physical symptoms and Demoralization is mediated by loss of resources in individuals with chronic conditions including conventional diagnoses, functional somatic syndromes, and medically unexplained symptoms. Method This cross-sectional study evaluated N = 194 patients (mean age = 46, 83.5% female) who reported at least 3 months of persistent physical symptoms using the following self-report instruments: PHQ-15 (modified), Loss of Resources Inventory, Psychosocial Questionnaire – Demoralization Subscale, and PHQ-8. The mediation hypothesis was tested by multiple regression analyses controlling for age, race, employment status, income, educational attainment, and depression. Results Participants experienced M = 9.3 out of 16 possible health-related losses (SD = 4.4). Average to severe Demoralization scores were indicated by 59.1% of individuals, of which only 17.1% experienced high Demoralization. Loss of resources fully mediated the effect of symptom severity on Demoralization, explaining 56% of the variance of Demoralization and inhibiting the initially significant effect of symptom severity on Demoralization to nonsignificant levels [from b = 0.67, 95% CI (0.26, 1.07) to b = 0.03, 95% CI (−0.27, 0.32)]. Conclusion Early recognition of the loss of resources phenomena and interventions to reduce its progression through the introduction of resource gains may diminish, or even prevent, the installation of Demoralization in individuals with chronic symptoms.

  • latent class analysis differentiation of adjustment disorder and Demoralization more severe depressive and anxiety disorders and somatic symptoms in patients with cancer
    Psycho-oncology, 2018
    Co-Authors: Irene Bobevski, Sigrun Vehling, David W. Kissane, Dean Philip Mckenzie, H Glaesmer, Anja Mehnert
    Abstract:

    OBJECTIVES Demoralization as a form of existential distress involves poor coping, low morale, hopelessness, helplessness, and meaninglessness. In a secondary analysis of a cohort of German cancer patients, we aimed to explore latent class structure to assess the contribution that symptoms of Demoralization make to anhedonic depression, anxiety, adjustment, and somatic disorders. METHODS Measures of Demoralization, depression, anxiety, physical symptoms, and functional impairment had been completed cross-sectionally by 1527 patients with early or advanced cancer. Latent class analysis used maximum likelihood techniques to define the unobserved latent constructs that can be predicted as symptom clusters. Individual patients were assigned to the most probable class. Classes were compared on demographics, and logistic regression assessed the odds of individual items predicting each class. RESULTS A 4-class model provided the best fit. Class 1 (n = 829, 54.3%) was defined by the absence of distress; Classes 2 to 4 all carried functional impairment. Class 2 (n = 333, 21.8%) was differentiated by somatic symptoms (sleep, tiredness, and appetite); Class 3 (n = 163, 10.7%) by anhedonia, anxiety, and severe Demoralization; and Class 4 (n = 202, 13.2%) by adjustment and moderate Demoralization. Members of Class 3 were more likely to be younger, female, anhedonic, depressed, and anxious. In both Classes 3 and 4, functional impairment, physical symptom burden, and suicidal ideation were present. CONCLUSIONS In contrast with the severe symptom cluster carrying anhedonia, anxiety, and Demoralization, the moderate symptom cluster was formed by patients with Demoralization and impaired functioning, a clinical picture consistent with a unidimensional model of adjustment disorder.

  • The association of Demoralization with mental disorders and suicidal ideation in patients with cancer
    Cancer, 2017
    Co-Authors: Sigrun Vehling, David W. Kissane, Heide Glaesmer, Tim J. Hartung, Gary Rodin, Anja Mehnert
    Abstract:

    BACKGROUND Demoralization refers to a state in which there is a perceived inability to cope, that is associated with a sense of disheartenment and a loss of hope and meaning. This study investigated the co-occurrence versus independence of Demoralization with mental disorders and suicidal ideation to evaluate its features as a concept of distress in the context of severe illness. METHODS In a cross-sectional sample of 430 mixed cancer patients, we assessed Demoralization with the Demoralization Scale (DS); the 4-week prevalence of mood, anxiety, and adjustment disorders and suicidal ideation with the standardized Composite International Diagnostic Interview–Oncology (CIDI-O); and depressive symptoms with the Patient Health Questionnaire-9 (PHQ-9). We compared the relative risk (RR) for mental disorders associated with Demoralization to that associated with self-reported depression. RESULTS Clinically relevant levels of Demoralization were present in 21% of the patients. Demoralization co-occurred with a mood/anxiety disorder in 7%; 14% were demoralized in absence of any mood/anxiety disorder. Demoralization and adjustment disorders co-occurred in 2%. The RR for any mood/anxiety disorder was 4.0 in patients with Demoralization (95% confidence interval [CI], 2.5-6.2) and 3.0 in those with depression (95% CI, 1.9-4.6). Demoralization, but not depression, was associated with a significantly increased risk for suicidal ideation after controlling for mental disorders (RR, 2.0; 95% CI, 1.1-3.5). CONCLUSIONS Clinically relevant Demoralization frequently occurs independently of a mental disorder in patients with cancer and has a unique contribution to suicidal ideation. Demoralization is a useful concept to identify profiles of psychological distress symptoms amenable to interventions improving psychological well-being in this population. Cancer 2017. © 2017 American Cancer Society.

  • symptom burden loss of dignity and Demoralization in patients with cancer a mediation model
    Psycho-oncology, 2014
    Co-Authors: Sigrun Vehling, Anja Mehnert
    Abstract:

    Background Demoralization is a syndrome of existential distress that occurs in a substantial minority of cancer patients and is associated with a higher number of physical problems. Loss of dignity refers to a range of specific existential concerns. This study examines whether the association between number of physical problems and Demoralization is mediated by loss of dignity. Methods This cross-sectional study examined N = 112 inpatients with mixed tumor sites at early and advanced disease stages using the following standardized self-report questionnaires: Physical problems list of the National Comprehensive Cancer Network (NCCN) Distress Thermometer (DT), Patient Dignity Inventory (PDI), Demoralization Scale (DS), Patient Health Questionnaire-9 (PHQ-9) and Illness-Specific Social Support Scale Short Version-8 (ISSS-8). The mediation hypothesis was tested by multiple regression analyses controlling for age, gender, curative versus palliative treatment phase, and social support. Results Patients reported M = 4.7 (SD = 6.0) dignity-related problems; 20% showed moderate to severe Demoralization. Loss of dignity significantly mediated 81% of the effect of the number of physical problems on Demoralization (Sobel zs = 4.4, p < .001). Testing the reverse direction, we found that Demoralization mediated only 53% of the association between physical problems and loss of dignity (zs = 3.7, p < .001). Conclusions By supporting the mediation hypothesis, our results indicate that loss of dignity partially explains the association between physical problems and Demoralization. Early recognition of dignity-related existential concerns and interventions to enhance the sense of dignity may prevent Demoralization in patients with cancer. Results provide a conceptual link between existential concerns (loss of dignity) and existential distress (Demoralization) as two approaches to existential suffering in patients with cancer. Copyright © 2013 John Wiley & Sons, Ltd.

  • Symptom burden, loss of dignity, and Demoralization in patients with cancer: a mediation model
    Psycho-Oncology, 2013
    Co-Authors: Sigrun Vehling, Anja Mehnert
    Abstract:

    Background Demoralization is a syndrome of existential distress that occurs in a substantial minority of cancer patients and is associated with a higher number of physical problems. Loss of dignity refers to a range of specific existential concerns. This study examines whether the association between number of physical problems and Demoralization is mediated by loss of dignity. Methods This cross-sectional study examined N = 112 inpatients with mixed tumor sites at early and advanced disease stages using the following standardized self-report questionnaires: Physical problems list of the National Comprehensive Cancer Network (NCCN) Distress Thermometer (DT), Patient Dignity Inventory (PDI), Demoralization Scale (DS), Patient Health Questionnaire-9 (PHQ-9) and Illness-Specific Social Support Scale Short Version-8 (ISSS-8). The mediation hypothesis was tested by multiple regression analyses controlling for age, gender, curative versus palliative treatment phase, and social support. Results Patients reported M = 4.7 (SD = 6.0) dignity-related problems; 20% showed moderate to severe Demoralization. Loss of dignity significantly mediated 81% of the effect of the number of physical problems on Demoralization (Sobel zs = 4.4, p 

Joanne A Dehullu - One of the best experts on this subject based on the ideXlab platform.

  • High Demoralization in a minority of oophorectomized BRCA1/2 mutation carriers influences quality of life.
    Journal of Psychosomatic Obstetrics & Gynecology, 2017
    Co-Authors: Marieke Arts-de Jong, David W. Kissane, Cor A.j. Dejong, Rosella P.m.g. Hermens, Leon M Massuger, Nicoline Hoogerbrugge, Judith B. Prins, Joanne A Dehullu
    Abstract:

    AbstractIntroduction: Demoralization is a relatively neglected issue in which low morale and poor coping result from a stressor such as familial cancer risk. Female BRCA1/2 mutation carriers are highly susceptible for developing breast and ovarian cancer. The aim of this study was to evaluate Demoralization in oophorectomized BRCA1/2 mutation carriers and its relation to quality of life.Methods: This cross-sectional study examined 288 oophorectomized BRCA1/2 mutation carriers using the following standardized self-report measures: Demoralization Scale, EORTC Quality of Life Questionnaire-C30, State-Trait Anxiety Inventory and the Cancer Worry Scale.Results: The mean score on the Demoralization Scale was 17.8 (SD 14.0). A clinically significant level of Demoralization, defined as a score ≥30, was found in 45 BRCA1/2 mutation carriers (16%). Being highly demoralized was associated with a significantly lower quality of life, and higher levels of physical problems, anxiety and cancer worries. No demographic or...

  • high Demoralization in a minority of oophorectomized brca1 2 mutation carriers influences quality of life
    Journal of Psychosomatic Obstetrics & Gynecology, 2017
    Co-Authors: Marieke Arts-de Jong, David W. Kissane, Cor A.j. Dejong, Rosella P.m.g. Hermens, Leon M Massuger, Nicoline Hoogerbrugge, Judith B. Prins, Joanne A Dehullu
    Abstract:

    AbstractIntroduction: Demoralization is a relatively neglected issue in which low morale and poor coping result from a stressor such as familial cancer risk. Female BRCA1/2 mutation carriers are highly susceptible for developing breast and ovarian cancer. The aim of this study was to evaluate Demoralization in oophorectomized BRCA1/2 mutation carriers and its relation to quality of life.Methods: This cross-sectional study examined 288 oophorectomized BRCA1/2 mutation carriers using the following standardized self-report measures: Demoralization Scale, EORTC Quality of Life Questionnaire-C30, State-Trait Anxiety Inventory and the Cancer Worry Scale.Results: The mean score on the Demoralization Scale was 17.8 (SD 14.0). A clinically significant level of Demoralization, defined as a score ≥30, was found in 45 BRCA1/2 mutation carriers (16%). Being highly demoralized was associated with a significantly lower quality of life, and higher levels of physical problems, anxiety and cancer worries. No demographic or...

Marieke Arts-de Jong - One of the best experts on this subject based on the ideXlab platform.

  • High Demoralization in a minority of oophorectomized BRCA1/2 mutation carriers influences quality of life.
    Journal of Psychosomatic Obstetrics & Gynecology, 2017
    Co-Authors: Marieke Arts-de Jong, David W. Kissane, Cor A.j. Dejong, Rosella P.m.g. Hermens, Leon M Massuger, Nicoline Hoogerbrugge, Judith B. Prins, Joanne A Dehullu
    Abstract:

    AbstractIntroduction: Demoralization is a relatively neglected issue in which low morale and poor coping result from a stressor such as familial cancer risk. Female BRCA1/2 mutation carriers are highly susceptible for developing breast and ovarian cancer. The aim of this study was to evaluate Demoralization in oophorectomized BRCA1/2 mutation carriers and its relation to quality of life.Methods: This cross-sectional study examined 288 oophorectomized BRCA1/2 mutation carriers using the following standardized self-report measures: Demoralization Scale, EORTC Quality of Life Questionnaire-C30, State-Trait Anxiety Inventory and the Cancer Worry Scale.Results: The mean score on the Demoralization Scale was 17.8 (SD 14.0). A clinically significant level of Demoralization, defined as a score ≥30, was found in 45 BRCA1/2 mutation carriers (16%). Being highly demoralized was associated with a significantly lower quality of life, and higher levels of physical problems, anxiety and cancer worries. No demographic or...

  • high Demoralization in a minority of oophorectomized brca1 2 mutation carriers influences quality of life
    Journal of Psychosomatic Obstetrics & Gynecology, 2017
    Co-Authors: Marieke Arts-de Jong, David W. Kissane, Cor A.j. Dejong, Rosella P.m.g. Hermens, Leon M Massuger, Nicoline Hoogerbrugge, Judith B. Prins, Joanne A Dehullu
    Abstract:

    AbstractIntroduction: Demoralization is a relatively neglected issue in which low morale and poor coping result from a stressor such as familial cancer risk. Female BRCA1/2 mutation carriers are highly susceptible for developing breast and ovarian cancer. The aim of this study was to evaluate Demoralization in oophorectomized BRCA1/2 mutation carriers and its relation to quality of life.Methods: This cross-sectional study examined 288 oophorectomized BRCA1/2 mutation carriers using the following standardized self-report measures: Demoralization Scale, EORTC Quality of Life Questionnaire-C30, State-Trait Anxiety Inventory and the Cancer Worry Scale.Results: The mean score on the Demoralization Scale was 17.8 (SD 14.0). A clinically significant level of Demoralization, defined as a score ≥30, was found in 45 BRCA1/2 mutation carriers (16%). Being highly demoralized was associated with a significantly lower quality of life, and higher levels of physical problems, anxiety and cancer worries. No demographic or...