Articlediamond2017

Reliability and Validity of a Nepali-language Version of the Hospital Anxiety and Depression Scale (HADS)

Ajay Risal · Kedar Manandhar · Mattias Linde · Rajendra Koju · Timothy J. Steiner · Are Holen

55 citations0/0 files storedKathmandu University Medical Journal

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Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes Psychometric Methodologies and Testing Health Education and Validation

Abstract

BACKGROUND: In several languages and settings, the Hospital Anxiety and Depression Scale (HADS) has demonstrated reliable and valid screening properties in psychiatry. OBJECTIVE: To develop a Nepali version of HADS with acceptable reliability and construct validity for use among hospital patients and in the general population. METHOD: The original English version was translated into Nepali using a forward-backward translation protocol. Psychometric properties were tested by factor analysis and Cronbach's alpha. The translated scale was administered to three groups of adult in-patients in a university hospital in three trials, and to a sample of adults from the community in a fourth trial. Some of the 14 items were reworded reiteratively to achieve viable semantic and statistical solutions. RESULTS: The two-factor solution with anxiety and depression subscales eventually explained 40.3% of the total variance. Cronbach's alpha was 0.76 for anxiety (HADS-A) and 0.68 for depression (HADS-D). All seven HADS-A items showed at least acceptable item-to-factor correlations (range 0.44-0.74), and full construct validity was achieved for this subscale. Item-to-factor correlations for six HADS-D items were also at least acceptable (range 0.42-0.70); one item (D4) had persistently low correlations throughout all trials, although construct validity was still satisfactory. CONCLUSION: Reiterated rewording of items guided by statistical testing resulted in a Nepali version of HADS with satisfactory psychometric properties.

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References

1983The Hospital Anxiety and Depression Scale 2002The validity of the Hospital Anxiety and Depression Scale 1991Tripartite model of anxiety and depression: Psychometric evidence and taxonomic implications.1997International experiences with the Hospital Anxiety and Depression Scale-A review of validation data and clinical results 1983Hospital Anxiety and Depression Scale 2001Hospital Anxiety and Depression (HAD) scale: Factor structure, item analyses and internal consistency in a large population 2003A validation study of the hospital anxiety and depression scale (HADS) in a Spanish population 1999Validation of the Chinese‐Cantonese version of the Hospital Anxiety and Depression Scale and comparison with the Hamilton Rating Scale of Depression

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