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J Crit Care. 2015 Aug;30(4):793-8. doi: 10.1016/j.jcrc.2015.04.006. Epub 2015 Apr 17.

Psychometric evaluation of the Hospital Anxiety and Depression Scale 3 months after acute lung injury.

Author information

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.

KEYWORDS:

Acute lung injury; Anxiety; Critical care; Depression; Intensive care unit; Psychometrics

PMID:
25981443
PMCID:
PMC4466136
DOI:
10.1016/j.jcrc.2015.04.006
[Indexed for MEDLINE]
Free PMC Article

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