Using the demoralization scale for the early detection of demoralization in health professionals

Demoralization is a marker of existential distress and loss of meaning and purpose in patients suffering from advanced diseases. However, health professionals can also suffer from demoralization. There is little education for health professionals to prevent demoralization. The Demoralization Scale is a tool to test the severity of demoralization. The aim of this study was to evaluate the applicability of the demoralization scale to doctors and nurses. The participants were medical and nursing staff of the Mackay Memorial Hospital, a large hospital in Taiwan with a high proportion of cancer patients. All participants used the Mandarin version of the Demoralization Scale (DS-MV). For the reliability tests, we used factor analysis and internal consistency calculated by Cronbach’s alpha, using SPSS 18.0. Acceptable reliability of factor analysis in the DS-MV was found for both doctors and nurses. The Cronbach’s alpha value of the total score was 0.95 for doctors and 0.94 for nurses. This suggests that the Demoralization Scale is a suitable tool not only for evaluating the severity of demoralization amongst doctors and nurses, but also for examining the outcomes of continuing educations in health professionals.

[1]  David A. Nadler,et al.  Michigan Organizational Assessment Questionnaire , 2013 .

[2]  A. Mehnert,et al.  Demoralization and depression in patients with advanced cancer: validation of the German version of the demoralization scale. , 2011, Journal of pain and symptom management.

[3]  T. Shanafelt,et al.  Lack of association between resident doctors' well‐being and medical knowledge , 2010, Medical education.

[4]  M. Lai,et al.  Establishing a ‘physician's spiritual well-being scale’ and testing its reliability and validity , 2010, Journal of Medical Ethics.

[5]  Janet B. Craig,et al.  Compassion satisfaction, burnout, and compassion fatigue among emergency nurses compared with nurses in other selected inpatient specialties. , 2010, Journal of emergency nursing: JEN : official publication of the Emergency Department Nurses Association.

[6]  B. Garssen,et al.  Spirituality and well‐being in cancer patients: a review , 2010, Psycho-oncology.

[7]  Ke-Ping A. Yang,et al.  Spiritual Intelligence of Nurses in Two Chinese Social Systems: A Cross-Sectional Comparison Study , 2009, The journal of nursing research : JNR.

[8]  B. Dooley,et al.  Validation of the Demoralization Scale in an Irish advanced cancer sample , 2009, Palliative and Supportive Care.

[9]  J. de Figueiredo,et al.  Diagnosis and Measurement of Subjective Incompetence: The Clinical Hallmark of Demoralization , 2009, Psychotherapy and Psychosomatics.

[10]  H. Yasunaga The catastrophic collapse of morale among hospital physicians in Japan , 2008, Risk management and healthcare policy.

[11]  J. Middleton Today I’m Grieving a Physician Suicide , 2008, The Annals of Family Medicine.

[12]  M. Attree Nursing agency and governance: registered nurses' perceptions. , 2005, Journal of nursing management.

[13]  J. Sloan,et al.  The Well-Being and Personal Wellness Promotion Strategies of Medical Oncologists in the North Central Cancer Treatment Group , 2005, Oncology.

[14]  D. Kissane,et al.  The Demoralization Scale: A Report of its Development and Preliminary Validation , 2004, Journal of palliative care.

[15]  M. Halter Stigma and help seeking related to depression: a study of nursing students. , 2004, Journal of psychosocial nursing and mental health services.

[16]  A. Haas,et al.  A physician's suicide. , 2003, The American journal of psychiatry.

[17]  D. Kissane,et al.  Demoralization: Its Phenomenology and Importance , 2002, The Australian and New Zealand journal of psychiatry.

[18]  G. Raviola,et al.  HIV, Disease Plague, Demoralization and ``Burnout'': Resident Experience of the Medical Profession in Nairobi, Kenya , 2002, Culture, medicine and psychiatry.

[19]  A. Street,et al.  Demoralization Syndrome — a Relevant Psychiatric Diagnosis for Palliative Care , 2001, Journal of palliative care.

[20]  L. Peipins,et al.  Mortality patterns among female nurses: a 27-state study, 1984 through 1990. , 1997, American journal of public health.

[21]  C. North,et al.  Psychiatric illness in female physicians. Are high rates of depression an occupational hazard? , 1997, Postgraduate medicine.

[22]  Philip H. Mirvis,et al.  Assessing organizational change : a guide to methods, measures, and practices , 1984 .

[23]  A. Caplan Review essay / demoralizing professionals , 1983 .

[24]  S. Jackson,et al.  The Measurement of experienced burnout , 1981 .

[25]  G. Parrinello,et al.  An integrated model for the assessment of stress-related risk factors in health care professionals. , 2011, Industrial health.

[26]  J. Gustavsson,et al.  A psychometric evaluation of the Scale of Work Engagement and Burnout (SWEBO). , 2010, Work.

[27]  R. Wolman Thinking with Your Soul: Spiritual Intelligence and Why It Matters , 2001 .

[28]  W. Doherty,et al.  Systems analysis and guidelines for behavioral scientists in family medicine. , 1988, Family medicine.