Rasch analysis of the Hospital Anxiety and Depression Scale (HADS) for use in motor neurone disease

Health and Quality of Life Outcomes

Research

Alan Tennant¹  Kevin Talbot²  John Ealing³  Everard W Thornton⁴  John D Mitchell⁵  Pamela J Shaw⁶  Roger J Mills⁷  Carolyn A Young⁷  Chris J Gibbons⁸ 

[1] Academic Department of Rehabilitation Medicine, University of Leeds, Leeds General Infirmary, Leeds, UK;Department of Clinical Neurology, John Radcliffe Hospital, Oxford, UK;Department of Neurology, Hope Hospital, Stott Lane, Greater Manchester, UK;Department of Psychology, The University of Liverpool, Bedford Street South, Liverpool, UK;Royal Preston Hospital, Sharoe Green Lane, Preston, UK;Sheffield Institute of Translational Neuroscience (SITraN), University of Sheffield, 385A Glossop Road Sheffield, UK;Walton Centre for Neurology and Neurosurgery, Lower Lane, Liverpool, UK;Walton Centre for Neurology and Neurosurgery, Lower Lane, Liverpool, UK;Department of Psychology, The University of Liverpool, Bedford Street South, Liverpool, UK;

关键词: Differential Item Functioning;    Motor Neurone Disease;    Local Dependency;    Depression Subscale;    Person Separation Index;   

DOI  :  10.1186/1477-7525-9-82

 received in 2011-03-09, accepted in 2011-09-29,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundThe Hospital Anxiety and Depression Scale (HADS) is commonly used to assess symptoms of anxiety and depression in motor neurone disease (MND). The measure has never been specifically validated for use within this population, despite questions raised about the scale's validity. This study seeks to analyse the construct validity of the HADS in MND by fitting its data to the Rasch model.MethodsThe scale was administered to 298 patients with MND. Scale assessment included model fit, differential item functioning (DIF), unidimensionality, local dependency and category threshold analysis.ResultsRasch analyses were carried out on the HADS total score as well as depression and anxiety subscales (HADS-T, D and A respectively). After removing one item from both of the seven item scales, it was possible to produce modified HADS-A and HADS-D scales which fit the Rasch model. An 11-item higher-order HADS-T total scale was found to fit the Rasch model following the removal of one further item.ConclusionOur results suggest that a modified HADS-A and HADS-D are unidimensional, free of DIF and have good fit to the Rasch model in this population. As such they are suitable for use in MND clinics or research. The use of the modified HADS-T as a higher-order measure of psychological distress was supported by our data. Revised cut-off points are given for the modified HADS-A and HADS-D subscales.

【 授权许可】

CC BY   
© Gibbons et al; licensee BioMed Central Ltd. 2011