AI Insight
Researchers developed and validated a shortened 14-item Mandarin Chinese demoralization scale (s-DS-MV) for cancer patients, reducing it from the original 24-item version while maintaining strong psychometric properties. The study involved 971 Chinese cancer patients and used exploratory factor analysis and Rasch modeling to create a two-subscale instrument with a 3-point Likert format. The abbreviated scale demonstrated good internal consistency and test-retest reliability, making it suitable for efficient clinical screening of demoralization in oncology settings.
Why it matters
This shorter assessment tool enables busy oncology clinics to quickly and repeatedly screen cancer patients for demoralization, a psychological distress that affects treatment adherence and quality of life. The validated instrument addresses NCCN Guidelines recommendations for routine distress monitoring while being more practical for clinical implementation than longer assessment tools.
BackgroundDemoralization is a common psychological distress in Chinese cancer patients, affecting treatment adherence and quality of life. NCCN Guidelines recommend routine monitoring of distress. The original 24-item Mandarin Demoralization Scale (DS-MV) is comprehensive but less suited for rapid, repeated screening in busy oncology clinics. We therefore refined and validated a short-form Mandarin Demoralization Scale (s-DS-MV) for efficient demoralization assessment.MethodsThis psychometric validation study initially enrolled 1,050 Chinese cancer patients between June 14, 2022 and June 13, 2023. Of these participants, 971 completed the original 24-item DS-MV through face-to-face questionnaire administration. Exploratory factor analysis and Rasch modeling were used to evaluate, refine, and revalidate the scale, including examinations of dimensionality, response scale appropriateness, item fit, item bias, and item difficulty. Test–retest reliability was assessed in a subgroup of 50 patients with relatively stable clinical symptoms.ResultsThe revised 14-item s-DS-MV (3-point Likert format) showed a 2-subscale structure supported by exploratory factor analysis. Rasch modeling confirmed acceptable model fit, unidimensionality and compliance with core criteria for each subscale. The scale exhibited satisfactory internal consistency and test–retest reliability (Existential Emptiness and Affective Distress subscale: 9 items, α = 0.855, intraclass correlation coefficient (ICC) = 0.934; Self-Worth and Life Valuation subscale: 5 items, α = 0.708, ICC = 0.881; full scale: α = 0.864, ICC = 0.933).ConclusionThe s-DS-MV is a 3-point two-factor self-report scale with robust psychometric properties and favorable screening utility, making it well-suited for rapid clinical screening, dynamic monitoring, and related research on demoralization among cancer patients with similar demographic and clinical characteristics in Hunan and adjacent regions of China.