Structural ambiguity of the Chinese version of the hospital anxiety and depression scale in patients with coronary heart
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Structural ambiguity of the Chinese version of the hospital anxiety and depression scale in patients with coronary heart disease Wenru Wang1, Violeta Lopez2, David Thompson3 and Colin R Martin*4 Address: 1School of Medicine, Xi'an Jiaotong University, Xi'an, Shannxi, China, 2Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, China, 3Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China and 4Department of Mental Health and Learning Disability, University of Sheffield, S63 7ER, UK Email: Wenru Wang - [email protected]; Violeta Lopez - [email protected]; David Thompson - [email protected]; Colin R Martin* - [email protected] * Corresponding author
Published: 26 January 2006 Health and Quality of Life Outcomes 2006, 4:6
doi:10.1186/1477-7525-4-6
Received: 25 November 2005 Accepted: 26 January 2006
This article is available from: http://www.hqlo.com/content/4/1/6 © 2006 Wang et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: The Hospital Anxiety and Depression Scale (HADS) is a widely used screening tool designed as a case detector for clinically relevant anxiety and depression. Recent studies of the HADS in coronary heart disease (CHD) patients in European countries suggest it comprises three, rather than two, underlying sub-scale dimensions. The factor structure of the Chinese version of the HADS was evaluated in patients with CHD in mainland China. Methods: Confirmatory factor analysis (CFA) was conducted on self-report HADS forms from 154 Chinese CHD patients. Results: Little difference was observed in model fit between best performing three-factor and two-factor models. Conclusion: The current observations are inconsistent with recent studies highlighting a dominant underlying tri-dimensional structure to the HADS in CHD patients. The Chinese version of the HADS may perform differently to European language versions of the instrument in patients with CHD.
Background In China, economic transition, urbanization, industrialization and an aging population have quickly increased the incidence and prevalence of coronary heart disease (CHD) in the past decades [1]. CHD has been ranked among the top three causes of death in China [2]. Anxiety and depression are common psychological problems associated with a diagnosis of CHD [3-5]. Importantly, depression and anxiety have been linked with the morbidity and mortality of CHD [6]. Therefore, valid and reliable screening for clinically significant anxiety and/or depression is paramount in this clinical group.
The Hospital Anxiety and Depression Scale (HADS) [7] is a widely used, self-administered questionnaire specifically developed to detect anxiety and depression states in hospital and medical out
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