Jennifer E Jutte1, Dale M Needham2, Elizabeth R Pfoh3, O Joseph Bienvenu4. 1. Department of Rehabilitation Medicine, University of Washington School of Medicine, Harborview Medical Center, Seattle, WA. 2. Department of Physical Medicine and Rehabilitation, the Johns Hopkins University School of Medicine, Baltimore, MD; Outcomes After Critical Illness and Surgery (OACIS) Group, the Johns Hopkins University, Baltimore, MD; Division of Pulmonary and Critical Care Medicine, the Johns Hopkins University School of Medicine, Baltimore, MD. 3. Division of General Internal Medicine, the Johns Hopkins University School of Medicine, Baltimore, MD. 4. Outcomes After Critical Illness and Surgery (OACIS) Group, the Johns Hopkins University, Baltimore, MD; Department of Psychiatry and Behavioral Sciences, the Johns Hopkins University School of Medicine, Baltimore, MD; Department of Mental Health, the Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD. Electronic address: obienve1@jhmi.edu.
Abstract
PURPOSE: To conduct a psychometric evaluation of the Hospital Anxiety and Depression Scale (HADS) and to evaluate associations of 2 measures of psychological distress with the HADS Anxiety (HADS-A) and HADS Depression (HADS-D) subscales in acute lung injury (ALI) survivors. MATERIALS AND METHODS: We used 3-month post-ALI follow-up data from 151 participants in a multisite prospective cohort study to evaluate the internal consistency and structure of the HADS subscales and items, respectively. We used Spearman ρ correlations and other statistics to relate the 3-level version of the EuroQol-5D (EQ-5D-3L) anxiety/depression item and Medical Outcomes Study Short Form-36 (SF-36) "mental health"-related domains to the HADS subscales. RESULTS: Internal consistency was good for each of the HADS subscales (α ≥ .70). Exploratory factor analysis revealed a 2-factor structure (anxiety and depression). The EQ-5D-3L item and the SF-36 mental health-related domain scores were associated with HADS-A (ρ = 0.54 and -0.48 to -0.70, respectively) and HADS-D (ρ = 0.41 and -0.48 to -0.52, respectively) scores (all P < .01). The relationship between the SF-36 mental health domain score and the HADS-A subscale score was particularly strong (ρ = -0.70, P < .01). CONCLUSIONS: When evaluated in ALI survivors, the HADS has good internal consistency and a 2-factor structure. The HADS subscales were substantially correlated with the EQ-5D-3L anxiety/depression item and SF-36 mental health-related domain scores, suggesting convergent validity for these measures of psychological distress in ALI survivors.
PURPOSE: To conduct a psychometric evaluation of the Hospital Anxiety and Depression Scale (HADS) and to evaluate associations of 2 measures of psychological distress with the HADS Anxiety (HADS-A) and HADS Depression (HADS-D) subscales in acute lung injury (ALI) survivors. MATERIALS AND METHODS: We used 3-month post-ALI follow-up data from 151 participants in a multisite prospective cohort study to evaluate the internal consistency and structure of the HADS subscales and items, respectively. We used Spearman ρ correlations and other statistics to relate the 3-level version of the EuroQol-5D (EQ-5D-3L) anxiety/depression item and Medical Outcomes Study Short Form-36 (SF-36) "mental health"-related domains to the HADS subscales. RESULTS: Internal consistency was good for each of the HADS subscales (α ≥ .70). Exploratory factor analysis revealed a 2-factor structure (anxiety and depression). The EQ-5D-3L item and the SF-36 mental health-related domain scores were associated with HADS-A (ρ = 0.54 and -0.48 to -0.70, respectively) and HADS-D (ρ = 0.41 and -0.48 to -0.52, respectively) scores (all P < .01). The relationship between the SF-36 mental health domain score and the HADS-A subscale score was particularly strong (ρ = -0.70, P < .01). CONCLUSIONS: When evaluated in ALI survivors, the HADS has good internal consistency and a 2-factor structure. The HADS subscales were substantially correlated with the EQ-5D-3L anxiety/depression item and SF-36 mental health-related domain scores, suggesting convergent validity for these measures of psychological distress in ALI survivors.
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