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. 2022 Oct 6;19(19):12815.
doi: 10.3390/ijerph191912815.

Demoralization and Its Association with Quality of Life, Sleep Quality, Spiritual Interests, and Suicide Risk in Breast Cancer Inpatients: A Cross-Sectional Study

Ting-Gang Chang  1   2   3   4 , Chih-Chiang Hung  5   6 , Pei-Ching Huang  7 , Chiann-Yi Hsu  8 , Ting-Ting Yen  3   9
Affiliations

Demoralization and Its Association with Quality of Life, Sleep Quality, Spiritual Interests, and Suicide Risk in Breast Cancer Inpatients: A Cross-Sectional Study

Ting-Gang Chang et al. Int J Environ Res Public Health. .

Abstract

With decreasing mortality, the quality of life, spiritual needs, and mental health of breast cancer patients have become increasingly important. Demoralization is a poor prognostic factor for cancer patients. The extent of demoralization in breast cancer patients and its association with these factors remains unclear. This cross-sectional study was conducted at a Taiwanese medical center. We enrolled 121 participants (34 with high demoralization and 87 with low demoralization, as per the Mandarin Version of Demoralization Scale). High demoralization was associated with reduced quality of life, sleep quality, and spiritual interests. Multivariate analyses revealed that the scores of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire ≥ 62.5 (OR = 0.21, p = 0.002) and Spiritual Interests Related to Illness Tool Chinese Version ≥ 3.66 (OR = 0.11, p < 0.001) were associated with low demoralization. Demoralized patients with depression had a poorer quality of life and sleep quality. Although not statistically significant, depressed and demoralized participants were at a higher risk of suicide. Cancer patients with both depression and demoralization had the worst prognosis. Breast cancer patients exhibited demoralization when they had unmet bio-psycho-social-spiritual needs. An early assessment of demoralization may improve holistic healthcare for breast cancer patients.

Keywords: breast cancer; demoralization; depression; quality of life; spiritual interests; suicide.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have influenced this study. The funders had no role in the study design; the collection, analyses, or interpretation of data; the writing of the manuscript; or the decision to publish the results.

Figures

Figure 1
Figure 1
Receiver operating characteristic curve analysis of the scores of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and spiritual interests (total scores of Spiritual Interests Related to Illness Tool Chinese Version) for demoralized patients. Global health status is the total scores of EORTC QLQ-C30.
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