Department of Statistics, Data Science and Epidemiology, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, Victoria, Australia.
Organisation for Rural Community Development, Dariapur, Bangladesh.
BMJ Open. 2018 Jun 30;8(6):e022967. doi: 10.1136/bmjopen-2018-022967.
The aim of this study was to translate, adapt and validate the Kessler 10-item questionnaire (K10) for measuring psychological distress in rural Bangladesh.
Cohort study.
Narail district, Bangladesh.
A random sample of 2425 adults of age 18-90 years was recruited.
Validation of the K10 was the major outcome. Sociodemographic factors were measured to assess if the K10 needed adjustment for factors such as age or gender. The Rasch measurement model was used for the validation, and RUMM 2030 and SPSS V.24 software were used for analyses.
Initial inspection of the total sample showed poor overall fit. A sample size of 300, which is more satiated for Rasch analysis, also showed poor overall fit, as indicated by a significant item-trait interaction (χ= 262.27, df=40, p<0.001) and item fit residual values (mean=-0.25, SD=2.49). Of 10 items, five items were disordered thresholds, and seven items showed misfit, suggesting problems with the response format and items. After removing three items ('feel tired', 'depressed' and 'worthless') and changing the Likert scale categories from five to four categories, the remaining seven items showed ordered threshold. A revised seven-item scale has shown adequate internal consistency, with no evidence of multidimensionality, no differential item functioning on age and gender, and no signs of local dependency.
Analysis of the psychometric validity of K10 using the Rasch model showed that 10 items are not appropriate for measuring psychological distress in rural Bangladesh. A modified version of seven items (K7) with four response categories would provide a psychometrically more robust scale than the original K10. The study findings suggest repeating the K7 version in other remote areas for further validation can substantiate an efficient screening tool for measuring psychological distress among the general Bangladeshi population.
本研究旨在翻译、改编和验证 Kessler 10 项问卷（K10），以测量孟加拉国农村地区的心理困扰。
队列研究。
孟加拉国纳拉伊区。
招募了年龄在 18-90 岁之间的 2425 名成年人进行随机抽样。
K10 的验证是主要结局。测量了社会人口统计学因素，以评估 K10 是否需要根据年龄或性别等因素进行调整。使用 Rasch 测量模型进行验证，并使用 RUMM 2030 和 SPSS V.24 软件进行分析。
对总样本的初步检查显示整体拟合度较差。样本量为 300，更适合 Rasch 分析，但也显示出整体拟合度较差，表明项目特征交互作用显著（χ=262.27，df=40，p<0.001）和项目拟合残差值（均值=-0.25，SD=2.49）。在 10 个项目中，有 5 个项目的阈值顺序紊乱，有 7 个项目不拟合，这表明反应格式和项目存在问题。删除 3 个项目（“感到疲倦”、“沮丧”和“无价值”）并将李克特量表类别从 5 个改为 4 个类别后，其余 7 个项目显示出有序的阈值。修订后的七项量表显示出足够的内部一致性，没有多维性的证据，年龄和性别上没有差异项目功能，也没有局部依赖的迹象。
使用 Rasch 模型对 K10 的心理测量有效性进行分析表明，10 个项目不适合测量孟加拉国农村地区的心理困扰。具有四个反应类别和七个项目的修改版本将提供比原始 K10 更可靠的心理测量量表。研究结果表明，在其他偏远地区重复使用 K7 版本进行进一步验证，可以为衡量孟加拉国普通人群的心理困扰提供一种有效的筛选工具。
