Meidl Verena, Dallmann Petra, Leonhart Rainer, Bretthauer Berit, Busch Aglaja, Kubosch Eva Johanna, Wrobel Nina, Hirschmüller Anja
Department of Orthopedics and Trauma Surgery, Center of Surgery, Medical Center-Albert-Ludwigs-University of Freiburg, Freiburg, Germany.
Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.
PM R. 2024 Feb;16(2):141-149. doi: 10.1002/pmrj.13011. Epub 2023 Aug 25.
Despite the increasing amount of research regarding mental health in elite athletes in recent years, athletes with impairments are hardly represented. Due to this lack of data and the significant need of athlete-specific mental health screening tools, a continuous mental health monitoring program for elite Para athletes was implemented.
Validation of the Patient Health Questionnaire-4 (PHQ-4) as a suitable tool for continuous mental health evaluation in elite Para athletes.
A 43-week prospective observational cohort study.
Online questionnaire, provided weekly via web browser and mobile app.
Seventy-eight Para athletes preparing for Paralympic Summer and Winter Games.
Not applicable.
Weekly PHQ-4 scores, stress level, and mood.
With a mean weekly response rate of 82.7% (SD = 8.0), 2149 PHQ-4, 2159 stress level and 2153 mood assessments were completed. Mean PHQ-4 score among all participating athletes was 1.2 (SD = 1.8; 95% confidence interval [CI], [1.1-1.3]). Individual weekly scores ranged from 0 to 12 and showed significant floor effects, with 54% of the scores being zero. PHQ-4 scores were significantly higher among female athletes and team sport members (p < .001). Internal consistency of the PHQ-4 was satisfying, Cronbach's α being 0.839. There were significant cross-sectional as well as longitudinal correlations of PHQ-4 and stress level as well as mood values (p < .001). 39.7% of all athletes (n = 31) had at least one positive screen for mental health symptoms.
The PHQ-4 was shown to be a valid tool for mental health surveillance in elite Para athletes. Significant correlations of the PHQ-4 and stress level as well as mood were shown. High weekly response rates among participating athletes indicated good acceptance of the program. The weekly monitoring allowed for the identification of individual fluctuations and could identify potential athletes at risk for mental health problems when combined with clinical follow-up.
尽管近年来关于精英运动员心理健康的研究数量不断增加，但残疾运动员在研究中却很少被纳入。由于缺乏相关数据以及对针对运动员的心理健康筛查工具的迫切需求，因此实施了一项针对精英残奥运动员的持续心理健康监测计划。
验证患者健康问卷 - 4（PHQ - 4）作为精英残奥运动员持续心理健康评估的合适工具。
一项为期43周的前瞻性观察队列研究。
通过网络浏览器和移动应用程序每周提供在线问卷。
78名备战夏季和冬季残奥会的残奥运动员。
不适用。
每周的PHQ - 4评分、压力水平和情绪。
平均每周回复率为82.7%（标准差 = 8.0），共完成了2149份PHQ - 4评估、2159份压力水平评估和2153份情绪评估。所有参与运动员的平均PHQ - 4评分为1.2（标准差 = 1.8；95%置信区间[CI]，[1.1 - 1.3]）。个体每周评分范围为0至12，且显示出显著的地板效应，54%的评分是零。女性运动员和团队运动成员的PHQ - 4评分显著更高（p < 0.001）。PHQ - 4的内部一致性令人满意，Cronbach's α为0.839。PHQ - 4与压力水平以及情绪值之间存在显著的横断面和纵向相关性（p < 0.001）。所有运动员中有39.7%（n = 31）至少有一次心理健康症状的阳性筛查结果。
PHQ - 4被证明是精英残奥运动员心理健康监测的有效工具。PHQ - 4与压力水平以及情绪之间存在显著相关性。参与运动员的高每周回复率表明该计划得到了良好的接受。每周监测能够识别个体波动情况，并且在结合临床随访时能够识别出有心理健康问题风险的潜在运动员。
