Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; National Institute for Health and Care Research Maudsley Biomedical Research Centre, South London and Maudsley NHS foundation trust, London, UK.
Gen Hosp Psychiatry. 2024 May-Jun;88:68-74. doi: 10.1016/j.genhosppsych.2024.03.004. Epub 2024 Mar 27.
Psychological distress persists amongst breast cancer survivors, so reliable assessment of symptoms is essential. The Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS) is a composite measure of depression and anxiety and has been used to measure distress. This study aimed to evaluate the psychometric properties of the PHQ-ADS within breast cancer survivors.
Breast cancer survivors (N = 280) were recruited online and followed up at 12-months. Depression (PHQ-8) and anxiety (GAD-7) items formed the composite PHQ-ADS score. Additional measures included: distress thermometer (convergent validity), fear of cancer recurrence and COVID distress (discriminant validity), and self-compassion (predictive validity). Confirmatory factor analysis (CFA) using weighted least squares mean and variance adjusted estimation was undertaken.
One, two, and bifactor models underlying the PHQ-ADS were evaluated. The bifactor model had the most appropriate model fit overall. Omega hierarchical for the general distress factor was 0.914, accounting for 82% of explained variance. This suggests the PHQ-ADS is sufficiently unidimensional to warrant use of a total composite score. The PHQ-ADS demonstrated strong convergent and moderate discriminant validity. Self-compassion was an independent predictor of distress at 12-months.
The PHQ-ADS is a valid measure for psychological distress in breast cancer survivors prescribed hormone therapy.
乳腺癌幸存者仍存在心理困扰，因此对症状进行可靠评估至关重要。患者健康问卷焦虑和抑郁量表（PHQ-ADS）是抑郁和焦虑的综合测量工具，已用于测量困扰。本研究旨在评估 PHQ-ADS 在乳腺癌幸存者中的心理测量特性。
通过网络招募乳腺癌幸存者（N=280），并在 12 个月时进行随访。抑郁（PHQ-8）和焦虑（GAD-7）项目构成了复合 PHQ-ADS 评分。其他措施包括：痛苦温度计（收敛效度）、对癌症复发和 COVID 担忧的恐惧（区分效度）以及自我同情（预测效度）。使用加权最小二乘法均值和方差调整估计进行验证性因子分析（CFA）。
评估了 PHQ-ADS 的单因素、双因素和双因素模型。双因素模型总体上具有最合适的模型拟合度。一般困扰因素的 omega 层次为 0.914，占解释方差的 82%。这表明 PHQ-ADS 具有足够的单维性，可以使用总综合评分。PHQ-ADS 具有较强的收敛效度和适度的区分效度。自我同情是 12 个月时痛苦的独立预测因素。
PHQ-ADS 是激素治疗乳腺癌幸存者心理困扰的有效测量工具。
