ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Psychological Therapy and Psychosomatics
Heterogeneity of demoralization syndrome in Chinese cancer patients: An optimal cut-off threshold for the Demoralization Scale
Provisionally accepted
- 1Patient Service Center, The Second Xiangya Hospital, Central South University, Changsha, Anhui Province, China
- 2Clinical Nursing Teaching and Research Section, Second Xiangya Hospital, Central South University, Changsha, Anhui Province, China
- 3Department of Oncology, Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
- 4Intravenous Therapy Center of Hunan Province, Changsha, Hunan, China, 410011, Changsha, Anhui Province, China
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Background: The development of numerous demoralization assessment tools has significantly contributed to the field, with the Demoralization Scale being the most frequently utilized. Nevertheless, the inconsistency in cutoff values for these tools hinders accurate estimation of demoralization, underscoring the need for research to determine an optimal threshold. This study examined the heterogeneity of demoralization syndrome among cancer patients in China, aiming to establish an optimal cut-off value for the mandarin version demoralization scale. Method: A cross-sectional study recruited 971 cancer patients from Hunan Province between June 14, 2022 and June 13, 2023. Latent profile analysis was used to identify distinct profiles, and receiver operating characteristic curve analysis determined the optimal cut-off point. Result: Three distinct profiles were identified: "minimal demoralization - meaningful" (22.3%), "moderate demoralization" (59.9%), and "severe demoralization - hopelessness" (17.9%). The mandarin version demoralization scale showed high accuracy (AUC = 0.995) with an optimal cut-off point of 23.5 (sensitivity: 98.9%, specificity: 94.8%, and accuracy: 93.7%). Conclusion: The distinct profiles highlight varying demoralization syndrome in cancer patients. Notably, the Mandarin Version Demoralization Scale exhibits excellent properties, with a cutoff of 23.50 for Chinese cancer patients. Our study deepens understanding, offering insights for standardized clinical classifications, enabling cross-setting comparisons.
Keywords: Cancer, cut-off threshold, demoralization, demoralization scale, heterogeneity, Profile
Received: 14 Jan 2025; Accepted: 03 Dec 2025.
Copyright: © 2025 Yanhua, Liu and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiaoxin Liu
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