Department of Community Medicine and Behavioral Sciences, Faculty of Medicine, Kuwait University, Kuwait.
School of Community & Environmental Health, College of Health Sciences, Old Dominion University, Norfolk, VA, USA.
Psychol Health Med. 2024 Oct;29(9):1664-1679. doi: 10.1080/13548506.2021.2002922. Epub 2021 Nov 10.
The literature lacks a rigorous psychometric evaluation of the Arabic version of Hospital Anxiety and Depression Scale (HADS) in hemodialysis (HD) patients. This study aims to evaluate reliability, determine the underlying factor structure of the Arabic version of HADS and assess its suitability as screening tool for depression and anxiety among Arabic HD patients.A sample of 370 HD patients were recruited from all health districts in Kuwait. Reliability for HADS (all items) and its subscales HADS-A (anxiety) and HADS-D (depression) were estimated using Cronbach's alpha and item analysis was conducted. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to extract and test the factor structure for the Arabic version of HADS. Eight models were tested using CFA to determine goodness-of-fit.The Cronbach α for the Arabic HADS (all items), HADS-A and HADS-D were 0.884, 0.852 and 0.764, respectively. Pearson correlation coefficient between HADS-A and HADS-D subscales indicated significant correlation (r = +0.69, PV < 0.001). EFA indicated two factors with eigenvalues >1, which accounted for 48.5% of the total variance. CFA revealed the one-factor model had the poorest fit, the two-factor models with acceptable fit, and three-factor models showed good fit.The Arabic HADS has good reliability and internal consistency, which warrants its use in screening for anxiety and depression among Arabic HD patients. Furthermore, the three-factor structure has shown a better fit which warrants further exploration in HD patients with the advancement in theory of psychological models for anxiety and depression.
文献缺乏对血液透析（HD）患者的阿拉伯文版医院焦虑和抑郁量表（HADS）进行严格心理测量评估。本研究旨在评估其信度，确定阿拉伯文版 HADS 的潜在因子结构，并评估其作为阿拉伯文版 HD 患者抑郁和焦虑筛查工具的适用性。
从科威特所有卫生区招募了 370 名 HD 患者作为样本。使用 Cronbach's alpha 评估 HADS（所有项目）及其亚量表 HADS-A（焦虑）和 HADS-D（抑郁）的可靠性，并进行项目分析。进行探索性因素分析（EFA）和验证性因素分析（CFA）以提取和测试阿拉伯文版 HADS 的因子结构。使用 CFA 测试了 8 种模型以确定拟合优度。
阿拉伯文版 HADS（所有项目）、HADS-A 和 HADS-D 的 Cronbach α 分别为 0.884、0.852 和 0.764。HADS-A 和 HADS-D 亚量表之间的 Pearson 相关系数表明存在显著相关性（r=+0.69，PV <0.001）。EFA 表明有两个特征值>1 的因子，占总方差的 48.5%。CFA 显示单因素模型拟合最差，双因素模型拟合尚可，三因素模型拟合良好。
阿拉伯文版 HADS 具有良好的信度和内部一致性，可用于筛查阿拉伯文版 HD 患者的焦虑和抑郁。此外，三因素结构表现出更好的拟合度，这为在焦虑和抑郁的心理模型理论发展的基础上，进一步探索 HD 患者提供了依据。
