Evaluation of the Psychometric and Structural Properties of the Spanish Version of the Hospital Anxiety and Depression Scale in Latina Cancer Patients

Abstract

Context. The Hospital Anxiety and Depression Scale (HADS) is a brief self-report measure commonly used to screen for symptoms of anxiety and depression in cancer patients. The HADS has demonstrated validity in over 100 languages, including Spanish. However, validation studies have largely used European Spanish-speaking samples with a variety of medical diagnoses. Objectives. The aim of this study was to examine the psychometric properties of the Spanish version of the HADS in a sample of Spanish-speaking Latina women with cancer in the U.S. Methods. Participants (N ¼ 242) completed self-report measures of anxiety and depression (HADS), quality of life (Functional Assessment of Cancer TherapyeGeneral Version), cancer-related distress (Impact of Events ScaleeRevised Version Intrusion Subscale), and cancer symptomatology (Memorial Symptom Assessment ScaleeShort Form) before initiating chemotherapy and five to seven weeks later. Analyses evaluated internal consistency and test-retest reliability, construct validity, and convergent validity. Results. Factor analysis supported a two-factor structure as proposed by the original HADS developers (X 2 [76, N ¼ 242] ¼ 143.3, P < 0.001, comparative fit index ¼ 0.94, root-mean-square error of approximation ¼ 0.06, and standardized root-mean-square residual ¼ 0.06). The HADS and its subscales demonstrated good internal consistency (a ¼ 0.83e0.88) and test-retest reliability (intraclass correlation coefficient ¼ 0.76e0.82). Construct validity was evidenced by factor analysis and item-subscale, item-total, and subscale-total correlations. Convergent validity was demonstrated by strong positive correlations with cancer-related distress (r ¼ 0.51e0.71) and symptom severity (r ¼ 0.54e0.62) and strong negative correlations with quality of life (r ¼ À0.63 to À0.76) (all P's < 0.001). Conclusion. The Spanish version of the HADS evidenced sound psychometric properties in Latinas with cancer in the U.S., supporting its use in clinical oncology research and practice.

COPD at the end of life: Predictors of the emotional distress of patients and their family caregivers

“…The emotional state of the patient and his or her family caregiver was assessed using the Hospital Anxiety and Depression Scale (HADS) [ 36 ] as adapted for the Spanish population [ 37 ]. This instrument is widely used in the adult clinical field to assess anxiety and depression symptomatology in people with physical diseases [ 38 ].…”

Psychometric properties of the Urdu version of the Hospital Anxiety and Depression Scale (HADS) among pregnant women in Abbottabad, Pakistan

“…Test-retest reliability was also excellent and intraclass correlation was 0.93, which was similar to that of previous studies 32 and better than that of the Hyland et al study. 21 The stability of the test-retest score over 2 weeks and high alpha coefficient support the strength of the HADS for use among pregnant women. Correlation between two factors, HADS-A and HADS-D, was excellent (0.667), similar to the Greek, 33 Iranian, 22 Arabic 26 and Pashto versions.…”

“…The original research of HADS tested its psychometric soundness on a group of hospitalised patients who suffered from different diseases. The scale is proven to be valid and reliable for other groups of patients as well: for oncology, 21 22 HIV-infected patients, 23 hospitalised elderly, 24 gynaecology patients, 12 14 patients with coronary artery diseases, 25 patients in the emergency department 26 and among patients in primary healthcare. 27 In turn, our study contributes to the body of knowledge about irregularities of psychometric findings of HADS noticed in the literature 28 when it is applied on patients with chronic diseases to others who suffer from physiological changes during pregnancy.…”

Preoperative psychological distress no reason to delay total knee arthroplasty: a register-based prospective cohort study of 458 patients

“…It has good validity in defining anxiety and depression and in assessing their severity. It has been shown to be sensitive to change both during the disease course and in response to interventions [ 38 – 40 ].…”

“…HADS is a screening instrument designed mainly to explore anxiety and depression in patients with somatic and psychotic disorders [39]. It takes 2-5 min to complete and has been translated into many languages [32,40]. It has good validity in defining anxiety and depression and in assessing their severity.…”