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Vinokurtseva A, Quinn MP, Wai M, Leung V, Malvankar-Mehta M, Hutnik CML. Evaluating Measurement Properties of Patient-Reported Outcome Measures in Glaucoma: A Systematic Review. Ophthalmol Glaucoma 2023; 6:541-563. [PMID: 37142217 DOI: 10.1016/j.ogla.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 04/14/2023] [Accepted: 04/21/2023] [Indexed: 05/06/2023]
Abstract
TOPIC The purpose of the current study was to systematically identify and evaluate existing patient-reported outcome measures (PROMs) for clinical glaucoma practice. CLINICAL RELEVANCE Understanding and incorporating patient preferences into decision-making is now recognized as critical for optimal resource allocation, especially in technologically advancing areas, such as minimally invasive surgeries. Patient-reported outcome measures are instruments designed to evaluate the health outcomes that are most important to patients. Despite their recognized importance, especially in the era of patient-centered care, their routine use in clinical settings remains low. METHODS A systematic literature search was conducted in 6 databases (EMBASE, MEDLINE, PsycINFO, Scopus, BIOSIS, and Web of Science) from the date of inception. Studies were included in the qualitative review if they reported measurement properties of PROMs in adult patients with glaucoma. COnsensus-based Standards for the selection of health Measurement INstruments guidelines were used to assess the included PROMs. The study protocol is registered with PROSPERO (registration number: CRD42020176064). RESULTS The literature search yielded 2661 records. After deduplication, 1259 studies entered level 1 screening, and based on title and abstract review, 164 records proceeded to full-text screening. In 48 included studies, 70 instrument reports discuss 43 distinct instruments in 3 major categories: glaucoma-specific, vision-specific, and general health-related quality of life. Most used measures were glaucoma-specific (Glaucoma Quality of Life [GQL] and Glaucoma Symptom Scale [GSS]) and vision-specific (National Eye Institute Visual Function Questionnaire [NEI VFQ-25]). All 3 have sufficient validity (especially construct), with GQL and GSS having sufficient internal consistency, cross-cultural validity, and reliability, with reports suggesting high methodological quality. CONCLUSION The GQL, GSS, and NEI VFQ-25 are the 3 most used questionnaires in a research setting, having considerable validation in a patient population with glaucoma. Limited reports on interpretability, responsiveness, and feasibility in all 43 identified instruments make identifying a single optimal questionnaire for clinical use challenging and highlight the need for further studies. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Anastasiya Vinokurtseva
- Department of Ophthalmology, Schulich School of Medicine, Western University, London, Ontario.
| | - Matthew P Quinn
- Department of Ophthalmology, Queen's University, Kingston, Ontario; Department of Ophthalmology, University of Ottawa, Ottawa, Ontario
| | - Mandy Wai
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario
| | - Victoria Leung
- Department of Physiology and Pharmacology, Western University, London, Ontario
| | - Monali Malvankar-Mehta
- Department of Ophthalmology, Schulich School of Medicine, Western University, London, Ontario; Department of Epidemiology and Biostatistics, Schulich School of Medicine, University of Western Ontario, London, Ontario
| | - Cindy M L Hutnik
- Department of Ophthalmology, Schulich School of Medicine, Western University, London, Ontario; Ivey Eye Institute, St. Joseph's Health Care, London, Ontario
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Guo Y, Wu D, Jin Y, Tian Y, Li X. Prevalence and risk factors for depression and anxiety in patients with nasolacrimal duct obstruction. Front Psychiatry 2023; 14:1174404. [PMID: 37614647 PMCID: PMC10442548 DOI: 10.3389/fpsyt.2023.1174404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 07/25/2023] [Indexed: 08/25/2023] Open
Abstract
Objective To investigate the prevalence and risk factors for depression and anxiety in patients with nasolacrimal duct obstruction (NLDO). Methods We conducted a telephone-based survey of patients with NLDO who underwent dacryocystorhinostomy (DCR) at the Department of Ophthalmology of Peking University Third Hospital in China between January 2016 and January 2021. Depression and anxiety were assessed with the PHQ-9 (range 0-25) and STAI (range 20-80) scales. PHQ-9 ≥ 5 and STAI ≥ 55 were considered clinically significant. Logistic regression and linear regression were performed to determine the factors related to depression and anxiety. Results Of 565 patients approached, 344 (60.9%) completed the survey. A total of 13.1% of patients had mild-severe depression and 63.4% had severe anxiety. Univariate logistic regression revealed that hypertension, dry eye, and cataract were associated with mild to severe depression (P = 0.018, 0.045, 0.035, respectively). Dry eye was associated with severe anxiety (P = 0.007). Univariate linear regression revealed that male and income levels were significantly negatively correlated with PHQ-9 scores (P = 0.011, 0.010, respectively). Hypertension and dry eye were significantly positively correlated with PHQ-9 scores (P = 0.030, P < 0.001, respectively). Male, income levels, and educational levels were significantly negatively correlated with STAI scores (P = 0.022, P < 0.001, P = 0.005, respectively). Dry eye was significantly positively correlated with STAI scores (P < 0.001). Conclusion Prevalence of depression and anxiety disorders was relatively high among NLDO patients. Our results demonstrate the importance of depression and anxiety screening and psychosocial support for patients with NLDO, which can improve their quality of life and compliance with medical appointments.
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Affiliation(s)
- Yining Guo
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Defu Wu
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Yu Jin
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Yanjie Tian
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Xuemin Li
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
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Bhardwaj T, Arora N, Paul A, Chowdhary P. Cultural Adaptation of Patient Health Questionnaire-9 in Hindi for Use with Patients with Cancer in Community Palliative Care Settings. Indian J Palliat Care 2023; 29:292-311. [PMID: 37700900 PMCID: PMC10493686 DOI: 10.25259/ijpc_96_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 08/14/2023] [Indexed: 09/14/2023] Open
Abstract
Objectives Patient Health Questionnaire-9 (PHQ-9) in Indian settings is yet not very often used in palliative care with the Hindi-speaking population. The Hindi version of PHQ-9 is available but its cultural adaptation to the Hindi-speaking population in North India receiving palliative care services is required to be tested. PHQ-9 as a depression screening questionnaire may help to identify depression symptoms among patients with cancer. This study aimed to examine the cultural equivalence of PHQ-9 Hindi for use with patients with cancer receiving palliative care services in North India. Material and Methods Based on the standard methodology of translation and adaptation of the scale, the following process was used: (i) Two focused group discussions with 17 experts working in a cancer palliative care setting, (ii) qualitative interviewing with 11 patients, and (iii) research team review. All interviews were audio recorded, transcribed, and item-wise content analysis was conducted. Results A few difficult phrases in the original PHQ-9 were 'dilchaspi', 'avasadgrast', 'kam urja', 'nakaam', parivar ko neecha dhikhana and 'ashthir' which were changed to Kam Mann Lagna, Mann Dukhi hona, kamjori, saksham nahi hain' 'asafal', Parivar ko nirash karna' and 'bechain,' respectively. Two items, namely no. 6 and 8 were changed to shorten the length for appropriately conveying the meaning. Conclusion Hindi language involves various dialects which change from region to region bringing variations in understanding the meaning of the words. It is recommended that culturally equivalent scales are used in practice and research. PHQ-9 is now culturally adapted for the Hindi-speaking population in North India. PHQ-9 will help identidy depressive symptoms at an early stage. Psychometric testing of PHQ-9 is underway.
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Affiliation(s)
- Tushti Bhardwaj
- Department of Social Work, Dr. Bhim Rao Ambedkar College, University of Delhi, New Delhi, India
| | - Neha Arora
- Department of Psychology, Dr. Bhim Rao Ambedkar College, University of Delhi, New Delhi, India
| | - Anu Paul
- Home Care, CanSupport, New Delhi, India
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Lua I, Freitas KS, Teixeira JRB, Reichenheim ME, Almeida MMGD, Araújo TMD. Measurement of depression in the Brazilian population: validation of the Patient Health Questionnaire (PHQ-8). CAD SAUDE PUBLICA 2022; 38:e00176421. [PMID: 35766627 DOI: 10.1590/0102-311xen176421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 04/20/2022] [Indexed: 11/22/2022] Open
Abstract
We aimed to evaluate the psychometric properties of the Brazilian version of the Patient Health Questionnaire (PHQ-8). A study with a sample of 4,170 individuals (≥ 15 years old) from the urban area. Conglomerate sampling was adopted in two stages (census sectors and streets), with weighting of estimates by sample weights. A structured questionnaire with sociodemographic data, the PHQ - the modules for depression, generalized anxiety disorder and panic disorder - and the Self-Reporting Questionnaire (SRQ-20) were used. In the evaluation of the PHQ-8, we verified the construct validity by analyzing the dimensional structure, convergent validity and internal consistency. We found a linear disorder without losses to maintain the four response categories. The factor analysis found unidimensionality of the depression construct, with strong factor loads, low residual variances, low residual correlation between items, good fit of the model, internal consistency and satisfactory convergent factorial validity (high loads and correlations with other tests/scales of similar constructs). The PHQ-8 has a one-dimensional structure with evidence of good validity and reliability, being suitable for use in the Brazilian population.
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Affiliation(s)
- Iracema Lua
- Universidade Federal da Bahia, Salvador, Brasil
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Carroll HA, Hook K, Perez OFR, Denckla C, Vince CC, Ghebrehiwet S, Ando K, Touma M, Borba CPC, Fricchione GL, Henderson DC. Establishing reliability and validity for mental health screening instruments in resource-constrained settings: Systematic review of the PHQ-9 and key recommendations. Psychiatry Res 2020; 291:113236. [PMID: 32593853 PMCID: PMC7484202 DOI: 10.1016/j.psychres.2020.113236] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 06/08/2020] [Accepted: 06/13/2020] [Indexed: 01/28/2023]
Abstract
Mental illness is one of the largest contributors to the global disease burden. The importance of valid and reliable mental health measures is crucial in order to accurately measure said burden, to capture symptom improvement, and to ensure that symptoms are appropriately identified and quantified. This is of particular importance in low and middle-income countries (LMICs), where the burden of mental illness is relatively high, and there is heterogeneity in linguistic, racial, and ethnic groups. Using the PHQ-9 as an illustrative example, this systematic review aims to provide an overview of existing work and highlight common validation and reporting practices. A systematic review of published literature validating the use of the PHQ-9 in LMICs as indexed in the PubMed and PsychInfo databases was conducted. The review included n = 49 articles (reduced from n = 2,349). This manuscript summarizes these results in terms of the frequency of reporting on important procedures and in regards to the types of reliability and validity measured. Then, building off of the existing literature, we provide key recommendations for measure validation in LMICs, which can be generalized for any type of measure used in a setting in which it was not initially developed.
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Affiliation(s)
- Haley A Carroll
- Boston Medical Center, Department of Psychiatry, Boston, MA, United States; Boston University School of Medicine, Department of Psychiatry, Boston, MA, United States; Massachusetts General Hospital, Department of Psychiatry, Boston, MA, United States
| | - Kimberly Hook
- Boston Medical Center, Department of Psychiatry, Boston, MA, United States; Boston University School of Medicine, Department of Psychiatry, Boston, MA, United States; Massachusetts General Hospital, Department of Psychiatry, Boston, MA, United States.
| | - Oscar F Rojas Perez
- Boston Medical Center, Department of Psychiatry, Boston, MA, United States; Boston University School of Medicine, Department of Psychiatry, Boston, MA, United States; Massachusetts General Hospital, Department of Psychiatry, Boston, MA, United States
| | - Christy Denckla
- Boston University School of Medicine, Department of Psychiatry, Boston, MA, United States; Massachusetts General Hospital, Department of Psychiatry, Boston, MA, United States; Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | | | - Senait Ghebrehiwet
- Boston Medical Center, Department of Psychiatry, Boston, MA, United States
| | - Kanako Ando
- Northeastern University, Boston, MA, United States
| | - Mia Touma
- Boston University, Boston, MA, United States
| | - Christina P C Borba
- Boston Medical Center, Department of Psychiatry, Boston, MA, United States; Boston University School of Medicine, Department of Psychiatry, Boston, MA, United States
| | - Gregory L Fricchione
- Massachusetts General Hospital, Department of Psychiatry, Boston, MA, United States; Harvard Medical School, Boston, USA
| | - David C Henderson
- Boston Medical Center, Department of Psychiatry, Boston, MA, United States; Boston University School of Medicine, Department of Psychiatry, Boston, MA, United States; Massachusetts General Hospital, Department of Psychiatry, Boston, MA, United States; Harvard T.H. Chan School of Public Health, Boston, MA, United States
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Dadfar M, Kalibatseva Z, Lester D. Reliability and validity of the Farsi version of the Patient Health Questionnaire-9 (PHQ-9) with Iranian psychiatric outpatients. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2018; 40:144-151. [DOI: 10.1590/2237-6089-2017-0116] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 08/23/2017] [Indexed: 12/27/2022]
Abstract
Abstract Introduction: The Patient Health Questionnaire-9 (PHQ-9) is a brief screening and diagnostic tool for depression. It has been used in research and clinical practice in primary care and other clinical and non-clinical settings. The PHQ-9 has not had its validity examined in psychiatric and psychological settings in Iran. Methods: A cross-sectional study was conducted to investigate the validation of the Farsi version of the PHQ-9. A convenience sample of 130 Iranian volunteer psychiatric outpatients was selected from psychiatric and psychological clinics. They completed the PHQ-9, the Patient Health Questionnaire-15 (PHQ-15), the World Health Organization-five Well-Being Index (WHO-5), and the short form of the Beck Depression Inventory-13 (BDI-13). Data were analyzed by descriptive statistics, Cronbach's α, Pearson correlation coefficient, principal component analysis, exploratory factor analysis, and confirmatory factor analysis. Results: Mean score of the PHQ-9 was 12.83 (standard deviation = 6.25), indicating moderately severe depression in the sample. Cronbach's α coefficient for PHQ-9 was 0.88, and one-week test-retest reliability 0.79. The PHQ-9 correlated 0.64 with PHQ-15, −0.35 with WHO-5, and 0.70 with BDI-13, indicating good construct and criterion-related validity. The results of the factor analysis of PHQ-9 items identified and confirmatory factor analysis confirmed a single factor labeled general depression. Conclusions: The PHQ-9 appears to have a unidimensional structure, adequate validity and reliability, and can be useful in epidemiological/research settings. Based on previous literature and on the present findings, the PHQ-9 may have applicability to other contexts in the studied population, but this needs to be confirmed by other studies.
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Woldetensay YK, Belachew T, Tesfaye M, Spielman K, Biesalski HK, Kantelhardt EJ, Scherbaum V. Validation of the Patient Health Questionnaire (PHQ-9) as a screening tool for depression in pregnant women: Afaan Oromo version. PLoS One 2018; 13:e0191782. [PMID: 29408928 PMCID: PMC5800570 DOI: 10.1371/journal.pone.0191782] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Accepted: 01/04/2018] [Indexed: 12/03/2022] Open
Abstract
Background Semantic, technical, content, criterion and conceptual equivalence must be examined in order to validate a psychological rating scale in a new cultural setting. Few validation studies have been conducted in sub-Saharan Africa for scales seeking to detect depression in pregnant women. The aim of this study is to validate the 9-item Patient Health Questionnaire (PHQ-9) as a screening instrument for depression among Afaan Oromo speaking pregnant Ethiopian women. Methods A random sample of 246 pregnant women were recruited in Seka Chekorsa District, Ethiopia during their first, second or third trimester. One week later, 29 participants were selected to answer the questionnaire for a second time to evaluate test retest reliability. The Mini International Neuropsychiatric Interview (MINI-Plus) scale was used as a gold standard to evaluate validity. PHQ-9 was compared with MINI-Plus and sensitivity, specificity, accuracy, positive likelihood ratio, negative likelihood ratio and Receiver Operating Characteristic Curves (ROC) for PHQ-9 were calculated. Rasch analysis was also carried out using Winsteps version 3.81.0. Results The reliability coefficient, Cronbach's alpha, for the PHQ-9 total score was 0.84. Both the agreement and consistency Intra-class Correlation coefficients (ICC) for the one-week test-retest reliability were 0.98. The cut-off point of a summed score of eight resulted in a sensitivity of 80.8% and a specificity of 79.5%. The calculated area under the curve (AUC) for the PHQ-9 score versus the MINI-Plus was excellent, 0.88 (SE = 0.04; CI = 0.81–0.95). The PHQ-9 meets the criteria established by Linacre for rating scale effectiveness. Conclusions The PHQ-9 proved to be a reliable and valid instrument that may be used to screen major depressive disorders among Afaan Oromo speaking Ethiopian pregnant women.
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Affiliation(s)
- Yitbarek Kidane Woldetensay
- Institute of Biological Chemistry and Nutrition (140a), University of Hohenheim, Stuttgart, Germany
- Food Security Center, University of Hohenheim, Stuttgart, Germany
- Department of Population and Family Health, College of Health Sciences, Jimma University, Jimma, Ethiopia
- * E-mail:
| | - Tefera Belachew
- Department of Population and Family Health, College of Health Sciences, Jimma University, Jimma, Ethiopia
| | - Markos Tesfaye
- Department of Population and Family Health, College of Health Sciences, Jimma University, Jimma, Ethiopia
| | - Kathryn Spielman
- Tufts University, Freidman School of Nutrition Science and policy, Boston, United States of America
| | - Hans Konrad Biesalski
- Institute of Biological Chemistry and Nutrition (140a), University of Hohenheim, Stuttgart, Germany
- Food Security Center, University of Hohenheim, Stuttgart, Germany
| | - Eva Johanna Kantelhardt
- Department of Gynecology, Faculty of Medicine, Martin-Luther University, Halle, Germany
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Faculty of Medicine, Martin-Luther University, Halle, Germany
| | - Veronika Scherbaum
- Institute of Biological Chemistry and Nutrition (140a), University of Hohenheim, Stuttgart, Germany
- Food Security Center, University of Hohenheim, Stuttgart, Germany
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Kato T. Relationship between coping flexibility and the risk of depression in Indian adults. Asian J Psychiatr 2016; 24:130-134. [PMID: 27931896 DOI: 10.1016/j.ajp.2016.09.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 09/01/2016] [Accepted: 09/01/2016] [Indexed: 11/17/2022]
Abstract
According to the dual-process theory of coping flexibility, coping flexibility is the ability to discontinue an ineffective coping strategy and produce and implement an alternative coping strategy. In order to test the coping flexibility hypothesis, which posits that flexible coping produces adaptive outcomes, the relationship between coping flexibility and the risk of depression was examined in the context of Indian adults. Participants (150 men and 150 women) answered questionnaires measuring coping flexibility and depressive symptoms. The risk of depression was assessed using a Patient Health Questionnaire-9 score of 10 and a Center for Epidemiologic Studies' Depression Scale score of 16 as cut-off points. Logistic regression analyses of the score cut-off points revealed that higher levels of coping flexibility were associated with lower risks of depression, after controlling for the effects of gender, age, and marital status. Overall, the coping flexibility hypothesis was supported in this Indian adult sample. These findings might contribute to preventing recurrent depression and to attenuating depressive symptoms.
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Affiliation(s)
- Tsukasa Kato
- Department of Social Psychology, Toyo University, 5-28-20 Hakusan, Bunkyo-ku, Tokyo 112-8606, Japan.
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Pedersen SS, Mathiasen K, Christensen KB, Makransky G. Psychometric analysis of the Patient Health Questionnaire in Danish patients with an implantable cardioverter defibrillator (The DEFIB-WOMEN study). J Psychosom Res 2016; 90:105-112. [PMID: 27772556 DOI: 10.1016/j.jpsychores.2016.09.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 09/24/2016] [Accepted: 09/27/2016] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To assess the psychometric properties of the Patient Health Questionnaire (PHQ-9), a measure of depressive symptoms, in a large Danish national cohort of patients with heart disease, implanted with an implantable cardioverter defibrillator (ICD), using item response theory. METHODS A prospective cohort of patients implanted with an ICD (n=1531; 80.4% men) completed the PHQ-9 at the time of implant. Data were analyzed using two item response theory models, the partial credit model and the generalized partial credit model. RESULTS The analysis showed disordered response thresholds in eight of nine items for the partial credit model and five of nine items for the generalized partial credit model, indicating that respondents have difficulty discriminating between response options. When collapsing response options 2 and 3, the rescored PHQ-9 had a better fit to both models. The unidimensionality and the precision of the rescored PHQ-9 were confirmed. Items did not have any differential functioning (DIF) across educational level, age, indication for ICD implantation, and severity of heart failure that influence depression outcomes in patients with an ICD. One item exhibited DIF by gender. Three items did not fit the partial credit model, but the generalized partial credit model could be fitted to the full item set. CONCLUSION The unidimensionality and reliability of the Danish version of the PHQ-9 were confirmed. However, the associated consequences of the number of response options (3-point versus 4-point Likert scale) need to be further examined for the PHQ-9 both as a screening tool and outcome measure.
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Affiliation(s)
- Susanne S Pedersen
- Department of Psychology, University of Southern Denmark, Odense, Denmark; Department of Cardiology, Odense University Hospital, Odense, Denmark; Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands.
| | - Kim Mathiasen
- Department of Psychology, University of Southern Denmark, Odense, Denmark; Mental Health Services, Centre for Telepsychiatry, Odense, Denmark
| | | | - Guido Makransky
- Department of Psychology, University of Southern Denmark, Odense, Denmark
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Kato T. Psychological inflexibility and depressive symptoms among Asian English speakers: A study on Indian, Philippine, and Singaporean samples. Psychiatry Res 2016; 238:1-7. [PMID: 27086203 DOI: 10.1016/j.psychres.2016.02.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Revised: 12/29/2015] [Accepted: 02/08/2016] [Indexed: 10/22/2022]
Abstract
Psychological inflexibility is a core concept in Acceptance and Commitment Therapy. The primary aim of this study was to examine psychological inflexibility and depressive symptoms among Asian English speakers. A total of 900 adults in India, the Philippines, and Singapore completed some measures related to psychological inflexibility and depressive symptoms through a Web-based survey. Multiple regression analyses revealed that higher psychological inflexibility was significantly associated with higher levels of depressive symptoms in all the samples, after controlling for the effects of gender, marital status, and interpersonal stress. In addition, the effect sizes of the changes in the R(2) values when only psychological flexibility scores were entered in the regression model were large for all the samples. Moreover, overall, the beta-weight of the psychological flexibility scores obtained by the Philippine sample was the lowest of all three samples.
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Affiliation(s)
- Tsukasa Kato
- Toyo University, Department of Social Psychology, 5-28-20 Hakusan, Bunkyo-ku, Tokyo 112-8606, Japan.
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Gothwal VK, Bharani S, Kekunnaya R, Chhablani P, Sachdeva V, Pehere NK, Narasaiah A, Gunturu R. Measuring Health-Related Quality of Life in Strabismus: A Modification of the Adult Strabismus-20 (AS-20) Questionnaire Using Rasch Analysis. PLoS One 2015; 10:e0127064. [PMID: 26011430 PMCID: PMC4444101 DOI: 10.1371/journal.pone.0127064] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 04/10/2015] [Indexed: 11/18/2022] Open
Abstract
Purpose To evaluate the psychometric properties of the Adult Strabismus-20 (AS-20)- a health-related quality of life (HRQoL) questionnaire in adults with strabismus, and if flawed, to revise the AS-20 and its subscales creating valid measurement scales. Methods 584 adults (meanage, 27.5 years) with strabismus were recruited from an outpatient clinic at a South Indian tertiary eye care centre and were administered the AS-20 questionnaire.The AS-20 was translated and back translated into two Indian languages. The AS-20 and its two 10-item subscales – ‘psychosocial’ and ‘function’were assessed separately for fit to the Rasch model, including an assessment of the rating scale, unidimensionality (by principal components analysis), measurement precision by person separation reliability, PSR, targeting, and differential item functioning (DIF; notable > 1.0 logits). Results Response categories were not used as intended, thereby, required re-organization and reducing their number from 5 to 3. The AS-20 had adequate measurement precision (PSR = 0.87) but lacked unidimensionality; however, deletion of the six multi-dimensionality causing items and an additional three misfitting items resulted in 11-item unidimensional questionnaire (AS-11). Two items failed to satisfy the model expectations in the ‘psychosocial’ subscale and were deleted – resulting in an 8-item unidimensional scale with adequate PSR (0.81) and targeting (0.23 logits). One item misfit in the ‘function’ subscale and was deleted—resulting in a 9 item Rasch-revised unidimensional subscale with acceptable PSR (0.80) and targeting (0.97 logits).None of the items displayed notable DIF by age, gender and level of education. Conclusions The AS-11 and its two Rasch-revised subscales – 8-item psychosocial and 9-item function subscale may be more appropriate than the original AS-20 and its two 10-item subscales for use as unidimensional measures of HRQoL in adults with strabismus in India. Further work is required to establish the validity of the revised rating scale.
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Affiliation(s)
- Vijaya K. Gothwal
- Meera and L B Deshpande Centre for Sight Enhancement, L V Prasad Eye Institute, KallamAnji Reddy campus, Hyderabad, India
- * E-mail:
| | - Seelam Bharani
- Meera and L B Deshpande Centre for Sight Enhancement, L V Prasad Eye Institute, KallamAnji Reddy campus, Hyderabad, India
| | - Ramesh Kekunnaya
- Jasti V Ramanamma Children’s Eye Care Centre, L V Prasad Eye Institute, Hyderabad, India
| | - PreetiPatil Chhablani
- Jasti V Ramanamma Children’s Eye Care Centre, L V Prasad Eye Institute, Hyderabad, India
| | - Virender Sachdeva
- Nimmagadda Prasad Children’s Eye Care Centre, L V Prasad Eye Institute, GMR Varalakshmi Campus, Vishakapatnam, India
| | - Niranjan K. Pehere
- The David Brown Children’s Eye Care Centre, KodeVenkatadriChowdary Campus, Vijayawada, India
| | - Asa Narasaiah
- The David Brown Children’s Eye Care Centre, KodeVenkatadriChowdary Campus, Vijayawada, India
| | - Rekha Gunturu
- Nimmagadda Prasad Children’s Eye Care Centre, L V Prasad Eye Institute, GMR Varalakshmi Campus, Vishakapatnam, India
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