Periyakoil Vyjeyanthi S, Kraemer Helena C, Noda Art, Moos Rudolf, Hallenbeck James, Webster Maria, Yesavage Jerome A
Palo Alto Veterans Affairs Health Care System, Palo Alto 94304, USA.
Int J Methods Psychiatr Res. 2005;14(4):202-12. doi: 10.1002/mpr.8.
Patients often experience 'preparatory-grief' as they cope with the dying process. Some may be depressed. The Terminally Ill Grief or Depression Scale (TIGDS), comprising grief and depression sub-scales, is a new self-report measure designed to differentiate between preparatory-grief and depression in adult inpatients. The initial 100-item inventory was assembled based on literature review, interviews with clinicians and dying patients and then shortened to 42 items based on consensus expert opinion. Validity and reliability were tested in a sample of 55 terminally ill adults. The consensus clinical opinion was used as the gold standard to differentiate between preparatory grief and depression. The intra-class correlation coefficient was high (it was calculated to estimate the test-retest reliability for the 47 patients who had completed the TIGDS twice--retest was administered 2 to 7 days after the initial test), ranging from 0.86 (grief) to 0.97 (depression). The validity of TIGDS was assessed using a receiver operating characteristic curve analysis, comparing the first test with the clinical criterion. The first and only variable and cut-point was the depression score (chi-square = 18.4, p < 0.001, cut point = 3). The sensitivity of the TIGDS was 0.727 and specificity was 0.886 for the depression = 3 cutoff score. The construct validity of the TIGDS was tested by comparing with the Hospital Anxiety and Depression Scale (HADS). The TIGDS depression subscale showed strong convergent validity and the TIGDS grief subscale showed strong discriminant validity with the HADS total score.
患者在应对死亡过程时常常经历“临终前悲伤”。有些人可能会抑郁。晚期疾病悲伤或抑郁量表（TIGDS）由悲伤和抑郁分量表组成，是一种新的自我报告测量工具，旨在区分成年住院患者的临终前悲伤和抑郁。最初的100项问卷是基于文献综述、对临床医生和临终患者的访谈编制而成，然后根据专家共识意见缩短至42项。在55名晚期成年患者样本中测试了其有效性和可靠性。以临床专家共识意见作为区分临终前悲伤和抑郁的金标准。组内相关系数较高（计算该系数是为了估计47名完成两次TIGDS测试的患者的重测信度——在初次测试后2至7天进行重测），范围从0.86（悲伤）到0.97（抑郁）。使用受试者工作特征曲线分析评估TIGDS的有效性，将初次测试结果与临床标准进行比较。第一个也是唯一的变量和切点是抑郁得分（卡方 = 18.4，p < 0.001，切点 = 3）。对于抑郁得分 = 3的临界值，TIGDS的敏感性为0.727，特异性为0.886。通过与医院焦虑抑郁量表（HADS）比较来测试TIGDS的结构效度。TIGDS抑郁分量表显示出很强的收敛效度，TIGDS悲伤分量表与HADS总分显示出很强的区分效度。
