Miljanović Maja, Sindik Joško, Milunović Vibor, Škoc Vesna Kralj, Braš Marijana, Đorđević Veljko
Department for Quality and Education in Health Care and Social Welfare, Planinska 13, 10 000 Zagreb, Croatia,
Psychiatr Danub. 2017 Dec;29(4):451-458. doi: 10.24869/psyd.2017.451.
Patients with cancer should be systematically screened for psychological problems at key points in their pathway. Usage of self-report scales for measuring anxiety and depression (such as Hospital Anxiety and Depression scale (HADS)) is a very practical methodfor detecting anxiety and depression. The aim of this research was to determine latent structure, reliability and cut-off scores of HADSin a Croatian sample of adult patients suffering from advanced metastatic cancer.
According to inclusion and exclusion criteria, participant were recruited at University Hospital Centre Zagreb (N=46; January 2015) and Clinical Hospital Centre 'Sisters of Mercy' (N=29; April 2015). All participants underwent short structured psychodiagnostic interview, cognitive evaluation (usingMontreal Cognitive Assessment (MoCA) test) and were given HADS.
When using PCA separately for the items of each original scale of HADS, only four items for the component Depression satisfactorily saturate principal component and when using PCA for all the items, only seven items from the original scale satisfactorily saturate unique principal component. Maximum Likelihood extraction method showed that only four items from the original scale satisfactorily saturated the theoretical scales.
The results show that the best solution to use HADS, in defined Croatian population, is as one-dimensional screening instrument (Cronbach's alpha coefficient of internal consistency=0.774) with cut-off score 11/12.
癌症患者应在其病程的关键节点接受心理问题的系统筛查。使用自我报告量表来测量焦虑和抑郁（如医院焦虑抑郁量表（HADS））是检测焦虑和抑郁的一种非常实用的方法。本研究的目的是确定HADS在克罗地亚成年晚期转移性癌症患者样本中的潜在结构、信度和临界值。
根据纳入和排除标准，在萨格勒布大学医院中心（N = 46；2015年1月）和“仁慈姐妹”临床医院中心（N = 29；2015年4月）招募参与者。所有参与者均接受简短的结构化心理诊断访谈、认知评估（使用蒙特利尔认知评估（MoCA）测试）并接受HADS测试。
当分别对HADS每个原始量表的项目使用主成分分析（PCA）时，只有抑郁分量表的4个项目能令人满意地饱和主成分，而对所有项目使用PCA时，原始量表中只有7个项目能令人满意地饱和唯一主成分。最大似然提取法表明，原始量表中只有4个项目能令人满意地饱和理论量表。
结果表明，在特定的克罗地亚人群中，使用HADS的最佳方案是作为一维筛查工具（内部一致性的克朗巴赫α系数 = 0.774），临界值为11/12。
