Massachusetts General Hospital & Harvard Medical School, Boston, MA 02114, USA.
Eval Health Prof. 2012 Sep;35(3):259-79. doi: 10.1177/0163278711424282. Epub 2011 Oct 18.
Health care professionals are coming under increased pressure to empirically monitor patient outcomes across settings as a means of improving clinical practice. Within the psychiatric and primary care communities, many have begun utilizing brief psychometric measures of psychological functioning to accomplish these goals. The purpose of this study was to evaluate the psychometric properties and clinical utility of the Depression, Anxiety, and Stress Scales-21-item version (DASS-21), and contribute normative data to facilitate interpretation using a sample of U.S. adults (N = 503). Item-scale convergence was generally supported, although assumptions of item-scale divergence were not met. Only 86%, 50%, and 43% of Depression, Anxiety, and Stress items, respectively, correlated significantly greater with their hypothesized scales than other scales. Internal consistency reliability was acceptable for all scales and comparable to existing research (αs = .91, .80, and .84 for Depression, Anxiety, and Stress, respectively). Scale-level correlations were greater than what has been reported elsewhere (range of rs = .68 to .73), and principal components analysis supported the extraction of only one component accounting for 47% of the item-level variance. However, confirmatory factor analysis (CFA) favored a three-factor structure when compared to a one-factor model. The implications for the health care professions are discussed.
医疗保健专业人员面临越来越大的压力，需要在各种环境中对患者的结果进行实证监测，以改善临床实践。在精神科和初级保健领域，许多人已经开始利用简短的心理功能心理测量措施来实现这些目标。本研究旨在评估抑郁、焦虑和压力量表 21 项版本（DASS-21）的心理测量特性和临床实用性，并提供有助于解释的常模数据，研究对象为美国成年人（N=503）。项目-量表的收敛性通常得到支持，尽管项目-量表发散的假设没有得到满足。只有 86%、50%和 43%的抑郁、焦虑和压力项目分别与假设量表的相关性显著大于与其他量表的相关性。所有量表的内部一致性信度均可接受，与现有研究相当（抑郁、焦虑和压力的αs分别为.91、.80 和.84）。量表水平的相关性大于其他地方报告的（rs 范围为.68 至.73），主成分分析支持仅提取一个占项目水平变异 47%的成分。然而，与单因素模型相比，验证性因子分析（CFA）更倾向于三因素结构。讨论了对医疗保健专业的影响。
