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Demoralization profiles and their association with depression and quality of life in Chinese patients with cancer: a latent class analysis

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Abstract

Purpose

The study aimed to identify latent classes of demoralization and examine their associations with depression and quality of life (QOL) among patients with cancer.

Methods

Cross-sectional data from 874 patients with cancer from three tertiary hospitals in Fujian province were collected using a convenience sampling method. Demoralization, depression, and QOL were assessed using the Chinese version of the Demoralization Scale-II, Patient Health Questionnaire-9, and McGill Quality of Life Questionnaire. Latent class analysis was performed on demoralization profiles. Binary logistic regression and multiple stepwise linear regression were used to examine the identified classes’ associations with depression and QOL.

Results

Three latent classes of demoralization were identified: the “low demoralization and emotional disturbance” class (Class 1; 49.6%); “moderate demoralization and meaninglessness” class (Class 2; 29.1%); and “high demoralization and existential despair” class (Class 3; 21.3%). The severity of depression increased and the levels of QOL decreased with the three classes of demoralization. Patients with cancer being depressed in Classes 1 and 2 were 0.128 and 0.018 times that of Class 3, respectively, whereas the magnitudes of decrease in QOL scores for Classes 2 and 3 were 0.378 and 0.629, respectively.

Conclusion

This study revealed three heterogeneous classes of demoralization in Chinese patients with cancer and indicated that increased classes were associated with more severe depression and decreased QOL. Targeted, step-by-step psychological interventions should be developed and implemented according to the characteristics of each class of demoralization to effectively promote psychological well-being among patients with cancer.

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Acknowledgements

We are grateful to the patients who participated in the study.

Funding

This research was supported by the General Project of Fujian Provincial Nature Science Foundation, with grant number [2021J01133126].

Author information

Author notes

  1. Fumei Lin and Yuting Hong contributed equally to this work.

Authors and Affiliations

  1. Emergency Department, Fuqing City Hospital Affiliated to Fujian Medical University, Fuqing, China

    Fumei Lin

  2. School of Nursing, Fujian Medical University, No 1. Xuefu North Road, Minhou County, Fujian, 350108, Fuzhou, China

    Yuting Hong, Xiujing Lin, Yu-an Lin, Qiuhong Chen & Feifei Huang

  3. School of Nursing, Quanzhou Medical College, Quanzhou, China

    Qingqin Chen

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  1. Fumei Lin
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Contributions

Fefei Huang and Fumei Lin contributed to the study conception and design. Material preparation, data collection and analysis were performed by Fumei Lin, Xiujing Lin, Qingqin Chen, Yu-an Lin and Qiuhong Chen. The first draft of the manuscript was written by Yuting Hong and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Feifei Huang.

Ethics declarations

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Fujian Medical University (No: FMU2019012).

Consent to participate

Informed consent was obtained from all individual participants included in the study.

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Not applicable.

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The authors declare no competing interests.

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Appendix

Appendix

Fig. 4
figure 4

The cross-cultural translation of DS-II. DS-II, the Demoralization Scale-II; TVI, Translation validity index; CTT, Classical Test Theory

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Table 5 The 14-item of the Chinese version of the Demoralization Scale-II (DS-II-CV)
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Table 6 Value assignment for categorical independent variables in the multiple regression analysis of the quality of life
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Table 7 Depression and quality of life of three classes of demoralization
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Lin, F., Hong, Y., Lin, X. et al. Demoralization profiles and their association with depression and quality of life in Chinese patients with cancer: a latent class analysis. Support Care Cancer 30, 10019–10030 (2022). https://doi.org/10.1007/s00520-022-07412-9

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