1 型或 2 型糖尿病成年门诊患者 WHO-5 幸福指数的心理计量学和筛查特性。

Psychometric and screening properties of the WHO-5 well-being index in adult outpatients with Type 1 or Type 2 diabetes mellitus.

机构信息

Diabetes Psychology Research Group, Department of Medical Psychology, EMGO-Institute, VU University Medical Centre, Amsterdam.

出版信息

Diabet Med. 2013 Feb;30(2):e63-9. doi: 10.1111/dme.12040.

DOI:10.1111/dme.12040

PMID:23072401

Abstract

OBJECTIVE

The 5-item World Health Organization well-being index is a commonly used measure of emotional well-being, but research on psychometric properties in outpatients with diabetes is scarce. We examined psychometric and screening properties for depression of this index in a large sample of Dutch outpatients with diabetes.

METHODS

Patients with Type 1 (n = 384) and Type 2 (n = 549) diabetes from three outpatient clinics completed the WHO-5 index, the nine-item Patient Health Questionnaire, the Problem Areas in Diabetes survey and the Short Form-12 health survey. Internal consistency of the WHO-5 index was determined by Cronbach's alpha. The factor structure was tested by confirmatory factor analysis. Concurrent validity was assessed by correlations with the Patient Health Questionnaire, Problem Areas in Diabetes and the Short Form-12 mental component scores. Sensitivity and specificity of the WHO-5 index as depression screener were tested against two existing Patient Health Questionnaire cut-off scores for depression using receiver operating characteristic curves.

RESULTS

A one-factor structure of the WHO-5 index was verified by confirmatory factor analysis for patients with Type 1 and Type 2 diabetes. Moderate to strong correlations were observed between the WHO-5 index and the Patient Health Questionnaire scores, the Problem Areas in Diabetes scores and the Short Form-12 mental component scores (r = 0.55-0.69, P < 0.001). Receiver operating characteristic curves showed that a WHO-5 index cut-off of < 50 performed best as an indication for likely depression, with sensitivity compared with a Patient Health Questionnaire score ≥ 10 and ≥ 12 of 79% and 88%, respectively, and specificity of 88% and 76%, respectively.

CONCLUSIONS

The WHO-5 index is a short, psychometrically sound measure of emotional well-being that appears suitable for use as screening test for likely depression in outpatients with Type 1 and Type 2 diabetes.

摘要

目的

五分量表世界卫生组织幸福指数是一种常用的情绪幸福感衡量标准，但针对糖尿病门诊患者的心理测量学特性研究却很少。我们在一个大型荷兰糖尿病门诊患者样本中检验了该指数用于评估抑郁的心理测量学和筛查特性。

方法

来自三个门诊诊所的 1 型（n=384）和 2 型（n=549）糖尿病患者完成了五分量表世界卫生组织幸福指数、九分量表患者健康问卷、糖尿病问题区域量表和简短形式 12 项健康调查。五分量表世界卫生组织幸福指数的内部一致性通过 Cronbach's alpha 确定。通过验证性因子分析检验其因子结构。通过与患者健康问卷、糖尿病问题区域量表和简短形式 12 项心理成分评分的相关性评估其同时效度。使用受试者工作特征曲线，根据两个现有的患者健康问卷抑郁切点值，测试五分量表世界卫生组织幸福指数作为抑郁筛查工具的敏感性和特异性。

结果

对于 1 型和 2 型糖尿病患者，五分量表世界卫生组织幸福指数的单因素结构通过验证性因子分析得到验证。五分量表世界卫生组织幸福指数与患者健康问卷评分、糖尿病问题区域量表评分和简短形式 12 项心理成分评分之间存在中度到高度相关（r=0.55-0.69，P<0.001）。受试者工作特征曲线表明，五分量表世界卫生组织幸福指数<50 作为可能抑郁的指标表现最佳，与患者健康问卷评分≥10 和≥12 的敏感性分别为 79%和 88%，特异性分别为 88%和 76%。