The Reliability and Validity of the Korean Version of Hospital Anxiety and Depression Scale Using Rasch Measurement Theory in Patients with Parkinson’s Disease

Abstract

Background: Depression and anxiety are prevalent and can cause suffering in patients with Parkinson’s disease (PD). The Korean version of the Hospital Anxiety and Depression Scale (K-HADS) has been widely used to assess depression and anxiety symptoms in Korean patient with PD. The present study aimed to assess the reliability and validity of the K-HADS using Rasch measurement analysis.Methods: A total of 106 PD patients (54 males, 52 females) who met the diagnostic criteria of the United Kingdom Brain Bank were recruited. Unidimensionality, the Rasch model fit, response category functioning, patient-item distribution, and the separation reliability of the K-HADS depression (K-HADS-D) and anxiety (K-HADS-A) subscales were statistically evaluated.Results: The mean K-HADS-D and K-HADS-A scores were 8.08±4.69 (mean±standard deviation) and 5.44±4.18, respectively. Cronbach’s α coefficients of the K-HADS-D and K-HADS-A were 0.82 and 0.83. The Rasch analysis revealed that the K-HADS-D and K-HADS-A showed unidimensionality and no disordered functioning was observed in the 4-point polytomous scale. However, both K-HADS-D and K-HADS-A exhibited suboptimal separation reliability, while the K-HADS-A showed inadequate scale targeting with floor effect.Conclusions: The present study comprises the first validation of the K-HADS using the Rasch measurement model, suggesting that the K-HADS-D and K-HADS-A are clinimetrically acceptable and reliable scales for use in Korean patients with PD. However, the moderate person separation indices implicate the relatively low discriminatory ability of the K-HADS in our study patients.

A case study on the application evaluation of integrative medical service model for the improvement of quality of life for dementia patients and caregivers

“…A standardized study was conducted using the Korean version of GDS. [15] GDS 1 indicates clinically normal condition with no cognitive decline, GDS indicates subjective memory deficits, and GDS 3 indicates mild cognitive decline. Some patients with mild dementia are included in GDS 3.…”

“…GDS 4 indicates mild dementia, GDS 5 indicates moderate dementia, while GDS 6 and 7 indicate severe dementia. [15][16][17] ④MoCA-K…”

“…To adapt the Caregiver Burden Inventory developed by Novak and Guest (1989), [27] Jang [28] translated and modified this tool. This tool comprises 29 questions divided into 6 dimensions: time-dependence (1-5), developmental and achievement (6-10), physical (11)(12)(13)(14), social (15)(16)(17)(18)(19), emotional (20)(21)(22)(23)(24), and financial (25-29) dimensions. Each item is rated on a scale from 1 (not at all descriptive) to 5 (very descriptive).…”

Honorific Speech Impairment: A Characteristic Sign of Frontotemporal Dementia

“…Among the individuals with bvFTD and AD, we included only those whose dementia severity was mild to moderate as assessed by a Clinical Dementia Rating (Morris, 1993) score from 0.5 to 2 and a Korean version of the Global Deterioration Scale (Choi et al, 2002) score of 3 to 5 because individuals with severe dementia would be unable to perform our experimental tasks. We excluded individuals with the following conditions: non-native Korean speaker, history of brain damage or neurologic illness, hearing and/or sight difficulties that would make it impossible to perform the language test, and inability to make any utterances.…”

Cognitive decline according to amyloid uptake in patients with poststroke cognitive impairment

“…We will use the informant questionnaire on the cognitive decline in the elderly (IQCODE) [19] to compare a patient's performance after acute infarction with that before the infarction using the information provided by a patient's caregiver. To evaluate participant cognition, we will perform baseline assessments using the Korean Mini-Mental State Examination (K-MMSE), [20] the Korean version of the Montreal Cognitive Assessment (MoCA-K), [21] the CDR, the Global Deterioration Scale, [22] the Korean Instrumental Activities of Daily Living, [23] the Geriatric Depression Scale-short form, [24] and the Literacy Independent Cognitive Assessments or the Seoul Neuropsychological Screening Battery assessments.…”