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Clinical judgement versus self-rating of demoralization in outpatients with a substance-use disorder: A
Marjolein J van Tongeren1, Wiebren Markus2, Barbara Stringer3
1IrisZorg (center for addiction care and sheltered housing), Arnhem/Clinical Health Sciences, Faculty of Medicine, Utrecht University, Utrecht, The Netherlands.
Purpose:
To investigate the ability of case managers, working in ambulatory treatment settings specialized in addiction care, to clinically judge demoralization in substance-dependent patients.
Design And Methods:
In a cross-sectional study, clinical judgments of case managers were compared with the patients' scores on the Demoralization Scale, by calculating the sensitivity and specificity scores.
Findings:
Case managers identified demoralization in 85% of the cases (sensitivity), the specificity of 62% suggests that demoralization was overestimated by case managers.
Practice Implications:
Demoralization is a frequently occurring phenomenon in patients. Methods should be developed that allow professionals and patients to identify demoralization collaboratively, and to develop tailored interventions to prevent demoralization and its negative consequences.
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