Vidotto Giulio, Moroni Loretta, Burro Roberto, Filipponi Luca, Balestroni Gianluigi, Bettinardi Ornella, Bruletti Gisella, Giorgi Ines, Naimo Marianna, Bertolotti Giorgio
Department of General Psychology, University of Padua, Italy.
Eur J Cardiovasc Prev Rehabil. 2010 Apr;17(2):187-97. doi: 10.1097/HJR.0b013e328333edc8.
The Depression Questionnaire (QD) is an instrument designed to measure depression in an inpatient-rehabilitation setting. This study proposes a reduced version of the original 24-item QD, to make it better suited to the characteristics of patients in this setting.
The study population consisted of 801 individuals admitted to cardiac rehabilitation (564 males and 237 females) who had validly completed the original version of the QD. Data were analyzed first through confirmatory factor analysis and then using logistic models.
Factor analysis of QD-24 items form, confirmed the plausibility of the monofactorial solution, both for males and females. Factor analysis combined with clinical observation suggested the possibility of reducing the QD to 17 items. Two further items were eliminated through use of simple logistic models. We thus obtained a shortened 15-item version of the QD (QD-R) that maintains a good index of separation (0.80), that is, good capacity to discriminate between individuals with different levels of depression, and a good item-trait interaction (chi(2)153=165.37, P>0.05). A second confirmatory factor analysis applied to the 15-item monofactorial model confirmed the validity of this shortened version of the instrument. The QD-R scores significantly correlated with metres walked during the 6 minute walking test (r=-0.316; P<0.01).
Combined use of confirmatory factor analysis and simple logistic models together with observations drawn from clinical experience constitutes a valid method for shortening a questionnaire while at the same time maintaining, if not improving, its psychometric properties. The QD-R, seems adequate to how much is required in rehabilitation to point out the outcome, in case of variation of depression, easily to fill in by the debilitated individual or elderly, mainly because some item excessively influenced by the pathology or the hospital context were removed.
抑郁问卷（QD）是一种用于测量住院康复患者抑郁程度的工具。本研究提出了原始24项QD的简化版本，使其更适合该环境下患者的特点。
研究人群包括801名接受心脏康复治疗的患者（564名男性和237名女性），他们有效完成了原始版本的QD。数据首先通过验证性因素分析进行分析，然后使用逻辑模型。
对QD的24项形式进行因素分析，证实了单因素解决方案对男性和女性的合理性。因素分析结合临床观察表明，有可能将QD简化为17项。通过使用简单逻辑模型又消除了另外两项。因此，我们获得了一个缩短为15项的QD版本（QD-R），其保持了良好的区分指数（0.80），即能够很好地区分不同抑郁水平个体的能力，以及良好的项目-特质交互作用（卡方153=165.37，P>0.05）。对15项单因素模型进行的第二次验证性因素分析证实了该简化版本工具的有效性。QD-R得分与6分钟步行试验中的步行距离显著相关（r=-0.316；P<0.01）。
将验证性因素分析和简单逻辑模型与临床经验相结合，构成了一种有效的问卷缩短方法，同时保持（如果不是提高）其心理测量特性。QD-R似乎足以满足康复中指出结果的要求，在抑郁发生变化时，虚弱个体或老年人易于填写，主要是因为去除了一些受病理或医院环境过度影响的项目。
