Centre for Health Research and Psycho-oncology (CHeRP), Cancer Council NSW, University of Newcastle and Hunter Medical Research Institute, Callaghan, New South Wales, Australia.
Psychooncology. 2011 Sep;20(9):919-25. doi: 10.1002/pon.1803. Epub 2010 Jul 28.
The Hospital Anxiety and Depression Scale (HADS) is often used to screen for cancer caregivers' anxiety and depression, despite few studies examining the tool's psychometric performance within this population. The purpose of this article is to use Rasch analysis to assess the psychometric properties of the HADS in a sample of cancer caregivers.
HADS was administered to 541 caregivers of a population-based sample of patients diagnosed with one of the eight most incident cancers in Australia. Rasch analysis was conducted using RUMM2020.
More than two-thirds of caregivers were women and most participants were married (95.9%) and caring for their spouse/partner with cancer (89.8%). The HADS-Anxiety (HADS-A) subscale showed good fit to the model, with appropriate internal consistency after removal of item 11. There were no disordered thresholds and no differential item functioning (DIF) for sex or age. To achieve satisfactory model fit for the HADS-Depression (HADS-D) subscale item 8 was removed due to DIF for sex and item 14 was rescored to resolve disordered thresholds. Analyses supported the unidimensionality of the individual subscales; however, there was no support for the combination of subscales to form a HADS-Total.
The results of Rasch analysis support the use of a modified version of the HADS-A and HADS-D among cancer caregivers. Further research is needed to confirm these findings and identify revised clinical cut-points. Findings reinforce the need for clinicians and researchers to formally test the psychometric properties of the instruments that they intend to use with different samples. Copyright © 2010 John Wiley & Sons, Ltd.
医院焦虑和抑郁量表（HADS）常用于筛查癌症照顾者的焦虑和抑郁，尽管很少有研究在该人群中检验该工具的心理计量学性能。本文的目的是使用 Rasch 分析评估 HADS 在癌症照顾者样本中的心理计量学特性。
对基于人群的 541 名被诊断患有澳大利亚最常见的八种癌症之一的患者的照顾者进行 HADS 评估。使用 RUMM2020 进行 Rasch 分析。
超过三分之二的照顾者为女性，大多数参与者已婚（95.9%），照顾癌症配偶/伴侣（89.8%）。HADS 焦虑（HADS-A）分量表与模型拟合良好，在删除第 11 项后内部一致性良好。没有无序阈值，也没有性别或年龄的差异项目功能（DIF）。为了使 HADS 抑郁（HADS-D）分量表的模型拟合达到满意的程度，由于性别上的 DIF，删除了第 8 项，对第 14 项进行重新评分以解决无序阈值的问题。分析支持了个体分量表的单维性；然而，不支持子量表的组合来形成 HADS 总分。
Rasch 分析的结果支持在癌症照顾者中使用 HADS-A 和 HADS-D 的修改版本。需要进一步的研究来证实这些发现并确定修订后的临床临界点。这些发现强化了临床医生和研究人员在使用不同样本时正式检验他们打算使用的工具的心理计量学特性的必要性。版权所有©2010 年 John Wiley & Sons, Ltd.
