Psychometric evaluation of the Mainland Chinese version of the Edinburgh Postnatal Depression Scale

Background

The Edinburgh Postnatal Depression Scale (EPDS) has been validated in many countries, but not in Mainland China.

Objectives

This study investigated the reliability and validity of the Mainland Chinese version of the EPDS.

Design

A three-stage design was used for this study. Stage I consisted of a multi-stepped process of forward and backward translation, using a panel of six experts to test content validity. Stage II established the psychometric properties of the EPDS by examining the convergent, discriminant and construct validity, internal consistency and stability of the scale. Stage III established its sensitivity, specificity and the optimal cutoff score of the EPDS according the DSM-IV-TR criteria using the Structured Clinical Interview.

Setting

Three regional public hospitals in Chengdu.

Participants

A convenience sample was composed of 312 and 451 pregnant women at 28-36 weeks’ gestation.

Method

Translation and back-translation of the original English instrument and content validation by an expert panel. Receiver operating characteristic (ROC) analysis was carried out to evaluate the global functioning of the scale. The Beck Depression Inventory (BDI), Dyadic Adjustment Scale (DAS) and standard SF-12 Health Survey (SF-12) were used to investigate the convergent, discriminant and construct validity. The Cronbach's alpha reliability coefficient, split-half reliability and test-retest reliability were used to examine the internal consistency and stability of the scale.

Results

The translation process was rigorously conducted to ensure that equivalence was established. Content validity was confirmed by a satisfactory level of agreement with a content validity index (CVI) of 0.93. The area under curve (AUC) was 85.6% and the logistic estimate for the threshold score was 9.5 (sensitivity, 80.0%; specificity, 83.03%) for clinical depression. Convergent and construct validity was supported and discriminant validity suggested that the EPDS successfully discriminated among the non-depressed, mildly and clinically depressed groups. The split-half reliability of the EPDS was 0.76, Cronbach's alpha was 0.79 and test-retest reliability was 0.85.

Conclusions

Based on the results of this psychometric testing, the Mainland Chinese version of the EPDS is considered ready for use in the routine screening of pregnant women. It is hoped that with this type of cross-cultural information, the universality of the constructs of the instrument can be reliably demonstrated.     

The Incontinence Outcome Questionnaire: an instrument for assessing patient-reported outcomes after surgery for stress urinary incontinence

The aim of this study is to develop and psychometrically test a questionnaire (Incontinence Outcome Questionnaire, IOQ) for assessing quality of life (QOL) after surgery for stress urinary incontinence that can be used as a single measurement after the intervention. A total of 171 patients who underwent the tension-free vaginal tape (TVT/TVT-O) operation for stress urinary incontinence completed the King′s Health Questionnaire (KHQ), the Short Form-12 (SF-12) and the IOQ. The internal consistency, internal and external validity and responsiveness of the IOQ were tested. The IOQ–QOL subscale showed good internal consistency (Cronbach’s alpha = 0.83) and significant correlations with the KHQ and the SF-12 scales (r = 0.30–0.56). Partial correlations with objective parameters showed a significant relation for the IOQ–QOL subscale with objective continence/incontinence. The results of our study suggest that the IOQ is a valid and reliable instrument for assessing QOL after incontinence surgery and can be used if baseline or pre-operative data are unavailable.     

The Construction and Preliminary Validation of the Internet Behaviours and Attitudes Questionnaire (IBAQ)

This study describes the construction and preliminary validation of a measure of the attitudes and behaviours of convicted men whose offences are related to Internet child ‘pornography’ (abusive images). An initial measure was constructed through the generation of items with reference to the emerging literature on these offenders. Phase 1 involved piloting this first version of the measure with 40 Internet sexual offenders incarcerated in Her Majesty’s Prison Service. Phase 2 involved the validation of an improved version of the IBAQ with 123 Internet sexual offenders both incarcerated in Her Majesty’s Prison Service and subject to community dispositions. The measure had excellent internal consistency. Following factor analysis a two factor solution, ‘distorted thinking’, and ‘self-management’ emerged from the attitudinal items. The attitude measure was not influenced by social desirability, and was able to discriminate participants who disclosed the greater number of ‘offending behaviours’. These results are discussed in terms of their clinical implications.     

Psychometric properties of the 16-item Quick Inventory of Depressive Symptomatology: A systematic review and meta-analysis

Effective management of depression is predicated upon reliable assessment. The Quick Inventory of Depressive Symptomatology (QIDS) is a depression severity scale with both self-rated (QIDS-SR₁₆) and clinician-rated (QIDS-C₁₆) versions. Although widely used in research, the psychometric properties of the QIDS₁₆ have not been systematically reviewed. We performed a systematic review of studies of the psychometric properties (factor structure, internal consistency, convergent validity, discriminant validity, test-retest reliability and responsiveness to change) of the QIDS-SR₁₆ or QIDS-C₁₆. Six databases were searched: MEDLINE, EMBASE, PsycINFO, CinAHL, Web of Science and the Cochrane Central Register of Controlled Trials. Findings were summarised, bias assessed and correlations with reference standards were pooled. 37 studies (17,118 participants) were included in the review. Both versions of the QIDS₁₆ were unidimensional. Cronbach's alpha ranged from 0.69 to 0.89 for the QIDS-SR₁₆ and 0.65 to 0.87 for the QIDS-C₁₆. The QIDS-SR₁₆ correlated moderately to highly with several depression severity scales. Seven studies were pooled where QIDS-SR₁₆ was correlated with the HRSD-17 (r = 0.76, CI 0.69, 0.81) in patients diagnosed with depression. Four studies examined convergent validity with the QIDS-C₁₆. Four studies examined discriminant validity, for the QIDS-SR₁₆ alone. Eighteen studies had at least one author who was a co-author of the original QIDS₁₆ study. Most studies were conducted in the USA (n = 26). The QIDS-SR₁₆ and the QIDS-C₁₆ are unidimensional rating scales with acceptable internal consistency. To justify the use of the QIDS₁₆ scale in clinical practice, more research is needed on convergent and discriminant validity, and in populations outside the USA.     

Assessing disability in patients with rheumatic diseases: translation,reliability and validity testing of a Greek version of the Stanford Health Assessment Questionnaire (HAQ)

The purpose of this study was to translate into the Greek language the HAQ, validate its psychometric, and also, to assess the degree to which questions in the scale did address common themes, using exploratory factor analysis. HAQ has been translated into Greek (HAQ-GrV), applied to 53 patients with rheumatic pathology and validated as follows: Cronbach's alpha for the estimation of the internal consistency, and the assessment of test-retest reliability, Spearman's rho for the assessment of concurrent validity, and confirmatory factor analysis. The results showed the following: (a) The HAQ-GrV demonstrated very good internal consistency (alpha: 0.90), (b) test-retest scores produced no significant difference (P = 0.07). Spearman's rho ranged from 0.64 to 0.90 for each item. (c) Spearman's rho between HAQ-GrV and HADS was 0.31 (P < 0.05). (d) Factor analysis identified five factors with Eigen values ranging from 1.26 to 6.98, explaining totally 69.4% of the variance.     

Psychometric evaluation of the Persian version of the Heart Disease Fact Questionnaire (HDFQ) in people with diabetes in Iran

Background and aimsPublic health and clinic-based educational strategies are desperately needed to stem the tide of death from heart disease among people with diabetes in low and middle-income countries. This study translated the Heart Disease Fact Questionnaire into Persian and evaluated its reliability and validity for use in Iran.MethodsUsing rigorous translation methods, the 25-item scale was administered to Persian speakers with diabetes. The scale was evaluated for content validity, construct validity and reliability.ResultsParticipants were 268 patients with diabetes with mean age of 63.19 ± 16.61 years. The mean HDFQ score was 17.31 ± 5.11 (in the low range). Higher scores were associated with younger age, younger age of diabetes onset, higher education, higher employment position, family history of diabetes and hypertension, shorter diabetes duration, and adherence to home exercise regimens. Kuder–Richardson's reliability coefficient was good, i.e., 0.82. Confirmatory factor analysis showed that the factor loadings of all questions, except question number 25, were favorable, i.e., >0.3. Model fit indices were favorable: Chi-square statistic to degree of freedom ratio (χ²?df) = 1.82, Comparative fit index = 0.96, Tucker-Lewis Index = 0.96 and root mean square error = 0.06.ConclusionAfter removing item #25, the Persian heart disease fact questionnaire has good validity and reliability and can be used to inform and evaluate clinical and public health educational programs aimed at decreasing risk for heart disease among Persian speakers with diabetes.