Cancer patients frequently demoralized

Demoralization appears to be common among cancer patients, according to a new China study. Having a positive outlook helps avoid this type of psychological distress.

Researchers performed a cross-sectional analysis of 296 cancer patients (mean age, 50 years; 64.9 percent female) who were made to accomplish the Mandarin version of the Demoralization Scale (DS-MV), the Patient Health Questionnaire-9 (PHQ-9), the Revised Life Orientation Test (CLOT-R), the Beck Hopelessness Scale and the 12-item Short Form Health Survey version 2 (SF-12V2).

The mean DS-MV score was 30.4±13.0 while the mean PHQ-9 score was 6.5±5.3. A fifth (20 percent; n=60) of the participants had high depression levels, while almost half (47 percent; n=139) were highly demoralized. More than a quarter satisfied the criteria for demoralization but were not deemed to be depressed.

Demoralization was significantly and positively correlated with depression (r, 0.653; p<0.001) and hopelessness (r, 0.661; p<0.001). Having a positive life orientation, on the other hand, appeared to be significantly protective (r, –0.471; p<0.001), as were all aspects of quality of life (p<0.001 for all).

Regression analysis further confirmed these findings. More than half (53 percent) of the variance in DS-MV scores could be explained by hopelessness (b, 0.492; p<0.001), resignation (b, 0.279; p<0.001), the loss of positive life orientation (b, 0.170; p<0.001) and low education (b, 0.132; p<0.001).

In turn, demoralization worsened scores in the mental component summary of the SF-12V2 (p<0.001) but only had marginal effects on the physical component summary subdomain.