Validity and reliability of the Patient Health Questionnaire-8 in Swedish for individuals with systemic sclerosis
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Rheumatology INTERNATIONAL
VALIDATION STUDIES
Validity and reliability of the Patient Health Questionnaire‑8 in Swedish for individuals with systemic sclerosis Malin Mattsson1,2 · Gunnel Sandqvist3,4 · Roger Hesselstrand3,4 · Annica Nordin5,6 · Carina Boström1,7 Received: 30 March 2020 / Accepted: 29 June 2020 © The Author(s) 2020
Abstract Background Depressive symptoms are common in rheumatic diseases and influence patients’ quality of life. The Patient Health Questionnaire-9 (PHQ-9), which assesses symptoms of depression, is valid in English in patients with systemic sclerosis (SSc). However, the measurement properties of the PHQ-8 (short version of the PHQ-9) have not been evaluated in Swedish patients with SSc. Objective To investigate different aspects of validity and reliability of the PHQ-8 in Swedish (PHQ-8 Swe) for individuals with SSc. Methods A total of 101 patients with SSc participated. Content validity was evaluated via interviews of 11 patients and 10 health professionals. Construct validity, internal consistency test–retest reliability, and floor/ceiling effects were evaluated in 90 patients. Results Content validity was satisfactory, but some linguistic adjustments were made. Confirmatory factor analysis supported a better fit for a two-factor structure. Moderate-to-strong correlations were found between the PHQ-8 Swe and scleroderma HAQ including VAS (rs = 0.4–0.7); Multidimensional Assessment of Fatigue (rs = 0.7); RAND-36 subscales (rs = − 0.5 to − 0.8); and lung disease severity (Medsger scores) (rs = 0.4). There were weak correlations (rs = 0.40, and the ICC for the total score was 0.83. No floor/ceiling effects were found. Conclusion The PHQ-8 Swe has satisfactory content validity and sufficient reliability in patients with in majority limited SSc. It is more strongly associated with self-reported disability, pain, disease interferences with daily activities, fatigue, and quality of life than with disease severity, except for a moderate association with lung severity. Keywords Depression · Scleroderma systemic · Patient-reported outcome measures · Psychometrics · Quality of life
Introduction Systemic sclerosis (SSc), or scleroderma, is a multisystem autoimmune inflammatory disorder. The disease is characterized by microvascular damage and increased deposition of collagen and other matrix molecules in skin and organ Related congress abstract publication. The preliminary results of this study have been presented as an abstract at the European Congress of Rheumatology (EULAR) 2019. Mattsson M, Sandqvist G, Hesselstrand R, Dyrsmeds E, Nordin A, Boström C (2019) AB1387-HPR Aspects of validity and reliability of the Swedish version of Patient Health Questionnaire-8 in individuals with systemic sclerosis. Ann Rheum Dis 78:2157. http://dx.doi. org/10.1136/annrheumdis-2019-eular.4076. * Malin Mattsson [email protected]; [email protected] Extended author information available on the last page of the article
systems [1]. SSc is more prevalent among women, with a fema
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