Jiraniramai Surin, Wongpakaran Tinakon, Angkurawaranon Chaisiri, Jiraporncharoen Wichuda, Wongpakaran Nahathai
Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Kingdom of Thailand.
Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Kingdom of Thailand.
Neuropsychiatr Dis Treat. 2021 Apr 8;17:1035-1045. doi: 10.2147/NDT.S271987. eCollection 2021.
The Patient Health Questionnaire (PHQ-9) is a widely used self-report questionnaire to screen depression. Its psychometric property has been tested in many populations including health care workers. We used Rasch measurement theory to examine the psychometric properties of PHQ-9 regarding item difficulty, item fit and the differences between subgroups of respondents classified by sex, age, education and alcohol user status, based on the same overall location of participants.
In total, 3204 health care workers of Maharaj Nakorn Chiang Mai Hospital participated and were administered the PHQ-9. Rating scale Rasch measurement modeling was used to examine the psychometric properties of the PHQ-9.
The data fitted well to the Rasch model and no violations of the assumption of unidimensionality were observed. All 9 items could form a unidimensional construct of overall depressive severity. Suicidal ideation was the least endorsed while sleep problem was the most. No disordered category and threshold of the rating response were observed. No locally dependent items were observed. No items were found to show differential item functioning across age, sex, education and alcohol consumption. The item-person Wright map showed that the PHQ-9 did not target well with the sample, and a wide gap suggesting few or no items exist to differentiate participants at a certain ability level among the PHQ-9 items.
The PHQ-9 can be used as a screening questionnaire for major depressive disorder as its psychometric property was verified based on Rasch measurement model. The findings are generally consistent with related studies in other populations. However, the PHQ-9 may be unsuitable for assessing depressive symptoms among health care workers who have low levels of depression.
患者健康问卷（PHQ - 9）是一种广泛使用的用于筛查抑郁症的自评问卷。其心理测量特性已在包括医护人员在内的许多人群中进行了测试。我们基于参与者相同的总体位置，运用拉施测量理论来检验PHQ - 9在项目难度、项目拟合以及按性别、年龄、教育程度和饮酒状况分类的受访者亚组之间差异方面的心理测量特性。
共有3204名清迈玛哈拉吉医院的医护人员参与并接受了PHQ - 9测试。使用评分量表拉施测量模型来检验PHQ - 9的心理测量特性。
数据与拉施模型拟合良好，未观察到违反单维性假设的情况。所有9个项目可形成一个总体抑郁严重程度的单维结构。自杀观念的认可度最低，而睡眠问题的认可度最高。未观察到无序类别和评分反应阈值。未观察到局部依赖项目。未发现项目在年龄、性别、教育程度和饮酒量方面存在差异项目功能。项目 - 人赖特图显示PHQ - 9与样本的适配性不佳，存在较大差距，表明在PHQ - 9项目中，几乎没有或不存在能够区分特定能力水平参与者的项目。
PHQ - 9可作为重度抑郁症的筛查问卷，因为其心理测量特性基于拉施测量模型得到了验证。这些发现总体上与其他人群的相关研究一致。然而，PHQ - 9可能不适用于评估抑郁症水平较低的医护人员的抑郁症状。
