Ataque de nervios: The impact of sociodemographic, health history, and psychological dimensions on Puerto Rican adults

How Culture Impacts Health: The Hispanic Narrative

The Hispanic population is the largest and fastest-growing minority group in the United States, and is disproportionately impacted by health problems, including heart disease, stroke, diabetes, obesity, cancer, and unintentional injuries. Factors contributing to these disparities include cultural practices, lack of access to health care, language barriers, and a lack of cultural competence by health-care providers. Family, religion, and gender roles play an essential part in the cultural heritage of Hispanic people, which heavily impacts health outcomes in this population. Nurses must be knowledgeable about the impact of culture on health to dismantle racial/ethnic health disparities and deliver equitable and high-quality care to individuals, families, and communities. This narrative aims to introduce some fundamental cultural factors and beliefs in the Hispanic culture that impact health. It also seeks to provide insights into culturally sensitive practices, to promote quality nursing care and address health disparities within this population.

Review of the psychometric properties of the Patient Health Questionnaire-9 (PHQ-9) Spanish version in a sample of Puerto Rican workers

Background

This study aimed to examine the internal structure and assess the psychometric properties of the Patient Health Questionnaire (PHQ-9) in a Puerto Rican sample of workers. This instrument is a nine-item questionnaire, which was conceptualized as a unidimensional structure; however, there are mixed results regarding this internal structure. This measure is used in the occupational health psychology context in organizations in Puerto Rico; nevertheless, there is little evidence of its psychometric properties with samples of workers.

Materials and methods

A total of 955 samples from two different study samples were used in this cross-sectional study design in which the PHQ-9 was used. We conducted confirmatory factor analysis, bifactor analysis, and random intercept item factor analysis to examine the internal structure of the PHQ-9. Moreover, a two-factor model was examined by randomly assigning items to the two factors. Measurement invariance across sex and the relationship with other constructs were examined.

Results

The best-fitted model was the bifactor model followed by the random intercept item factor. The five sets of two-factor models with items randomly assigned obtained acceptable and similar fit indices regardless of the items.

Conclusion

The results suggest that the PHQ-9 appears to be a reliable and valid instrument to measure depression. The more parsimonious interpretation of its scores, for now, is a unidimensional structure. Comparison across sex appears to be useful in occupational health psychology research settings since the results suggest that the PHQ-9 is invariant regarding this variable.