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Hospital And Anxiety Depression Scale Pdf

hospital and anxiety depression scale pdf

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Box , Hawthorn, Victoria , Melbourne, Australia. Research suggests there is a high prevalence of anxiety and depression amongst patients with chronic musculoskeletal pain, which can influence the effectiveness of rehabilitation programs. It is therefore important for clinicians involved in musculoskeletal rehabilitation programs to consider screening patients for elevated levels of anxiety and depression and to provide appropriate counselling or treatment where necessary.

The hospital anxiety and depression scale, in patients with multiple sclerosis

Psychological distress is a common problem associated with cancer. The main objective of the present study was to test the Hospital Anxiety and Depression Scale HADS in a sample of Ethiopian cancer patients and to compare the results with those obtained from a sample in Germany.

Only a weak level of measurement invariance was detected between the Ethiopian and the German sample. In the Ethiopian sample, anxiety and depression were associated with tumor stage high levels in stage 4 and treatment high levels for patients not receiving surgery and chemotherapy. The high level of anxiety and depression present in that group indicates a need for psychosocial care.

This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the manuscript and its Supporting Information files. Competing interests: The authors have declared that no competing interests exist. Of the 7. As far as cancer incidence rates are concerned, Africa accounts for only 4.

Nevertheless, cancer incidence and mortality rates are increasing in LICs such as Ethiopia, mainly due to increases in life expectancy [ 2 — 7 ]. Nonetheless, some studies have been performed to investigate mental health and quality of life QoL in specific samples of Ethiopian cancer patients.

Most of these were conducted in the capital, Addis Ababa, among patients suffering from breast or gynecologic cancer [ 8 — 11 ]. Anxiety and depression are common psychological symptoms in cancer patients [ 12 — 15 ]. These symptoms can affect QoL, adherence to treatment, cancer survival, and treatment costs [ 16 — 18 ].

The Hospital Anxiety and Depression Scale HADS , developed by Zigmond and Snaith [ 19 ], is one of the most frequently used instruments for measuring anxiety and depression in patients suffering from physical illness, including cancer. It has been applied to a wide range of diseases [ 20 ], and multiple studies have been performed to test psychometric properties of the scale [ 21 — 24 ].

A particular problem in LICs is illiteracy. In Ethiopia, where the literacy rate is low, many patients cannot fill in questionnaires without help. In such cases, research assistants must read the questions aloud, ask the patients to respond verbally, and mark the response in the questionnaire. It has not yet been systematically studied whether this method of data collection has a substantial impact on the outcome.

Measurement invariance of the instrument used is an important issue to consider when comparing the mean scores of different samples. We therefore also tested the measurement invariance of the HADS by comparing an Ethiopian and a German sample of cancer patients.

Multiple examinations have been performed to study the impact of sociodemographic and clinical variables on anxiety and depression [ 15 , 26 — 28 ].

One typical result was that female cancer patients were generally more anxious than male patients [ 15 , 27 , 29 ]. Most of these studies have also been performed in HICs, and it is unclear to what degree the results are also applicable to LICs.

The general objective of this study was to test psychometric properties of the HADS in a sample of Ethiopian cancer patients and to compare the results with those obtained in Germany, a country with a longer tradition of applying this questionnaire.

In particular, the aims were a to explore the degree of anxiety and depression in Ethiopian cancer patients in comparison with German cancer patients, b to analyze the impact of sociodemographic and clinical variables on anxiety and depression, c to test psychometric properties of the HADS, d to compare the applicability of the scale in the Ethiopian context with the German context via measurement invariance analysis, and e to analyze the relationship between the HADS scales and several facets of QoL.

Gondar is the second largest city in Ethiopia, with a population of about , inhabitants. Between January and June , cancer patients treated at this hospital were eligible for this study. Participants were invited to take part in the study if they had a malignant tumor of any cancer site and disease stage, were at least 18 years old, and understood Amharic, the national language of Ethiopia and that predominantly spoken in Gondar and its surroundings.

Tumor entities, disease stage, and illiteracy did not serve as exclusion criteria. Trained nurse research assistants contacted the patients, explained the aims of the study, and asked them to participate and give informed consent.

If the patients were illiterate, the research assistants read the questions aloud, asked the patients to respond verbally, and marked the response in the questionnaire. Medical data was taken from the medical records kept by the hospital. The study was conducted in accordance with the Declaration of Helsinki and was approved by the Institutional Review Board of the University of Gondar Ref.

A group of German cancer patients served as controls. The patients were recruited in five study centers in Germany. Further details of the sample are published elsewhere [ 30 ]. Data on anxiety and depression in this sample have already been published [ 28 ]. The sample consisted of 1, males and 1, females with a mean age of Because of the differences in the age and gender distribution between the Ethiopian and the German samples, we selected a subsample of the German cancer patients matched to the Ethiopian one in those aspects.

The resulting German subsample consisted of 1, cancer patients, of which The mean age of this group was All participants gave informed consent. The HADS consists of 14 items. Seven of the items indicate anxiety and the remaining seven items indicate depression. The answer format offers four response options, which are scored with values ranging from 0 to 3. This results in scale values between 0 and 21 for each scale.

The original test authors defined three ranges for both of the scales: 0—7 non-cases , 8—10 doubtful cases , and 11—21 cases. It is possible to calculate a HADS total score by simply summing up the anxiety and depression items [ 31 ].

Normative values are available for several countries [ 32 — 35 ]. Two other questionnaires were used in addition to the HADS. It assesses five dimensions of fatigue: general fatigue, physical fatigue, reduced activity, reduced motivation, and mental fatigue. Each subscale consists of four items, scored with values from 1 to 5. Higher scores reflect a higher level of fatigue. We also calculated a sum score for all 20 items. To test the impact of sociodemographic and clinical variables on anxiety and depression, we used three-factor ANOVAs with gender and age group as cofactors.

The associations between the HADS scales and scales of other questionnaires were expressed with Pearson correlations. Of the patients eligible for participation in the study, The research assistants proofed the questionnaires so that there remained no missing items in the questionnaires.

Of the participants, Further sociodemographic and clinical variables are given in Table 1. The most frequent cancer types were breast cancer In the German sample, the most frequent cancer localizations were: breast The distribution of the tumor stage in the German sample was: stage 1 All items contributed positively to the scale scores with coefficients between 0.

The comparison between the Ethiopian and the German mean scores indicates that the Ethiopian patients had higher levels of psychological burden than the German patients.

This difference was especially high in the depression scale. All but one of the 14 items showed higher means in the Ethiopian sample. One item A3: frightened feeling showed an opposite trend. The greatest difference between the Ethiopian and the German cancer patients was found for the depression item D14, whereby an effect size of greater than 1 was observed.

The distributions of the three categories no, doubtful, severe cases of anxiety and depression in the two samples are presented in Table 3. All item loadings were between 0. The fit indices are given in the upper part of Table 4. While the criteria for metric weak invariance were fulfilled, scalar strong invariance was not supported since the CFI and TLI coefficients were lower than 0.

The model fit for strict invariance was even less satisfying than that for the strong invariance. The lower part of Table 4 documents the differences in the fit indices between subsequent models.

Table 5 shows the impact of sociodemographic and clinical variables on anxiety and depression in the Ethiopian sample. Neither age nor gender was significantly associated with anxiety and depression. Patients with low levels of education were more depressed than their better-educated counterparts. There was a nearly linear increase of anxiety and depression with tumor stage. Patients who received surgery or chemotherapy were less anxious and less depressed than patients who were not receiving cancer treatment Table 5.

Since education had a significant impact on depression, we looked for the items that contributed most significantly to this difference. To do so, we calculated the 14 item mean scores for the illiterate patients and those patients with school education separately, and we expressed the group differences in terms of effect sizes Table 6. The effect sizes of the seven anxiety items ranged from 0. Item D14 was also the item with the lowest loadings in Fig 1 and the largest group differences between the Ethiopian and the German cancer patients Table 2.

Therefore, we also calculated several analyses excluding this item. When we allowed the intercept of item D14 to be different in the measurement invariance analysis Table 4 , scalar strong invariance was approached. Illiteracy was confounded with several variables. There were no statistically significant associations between illiteracy and gender, marital status, tumor type, and tumor stage.

Despite the peculiarity of item D14, we used the original scales with seven items each. The correlations were very similar for the anxiety and depression subscale of the HADS. The first research question was whether the Amharic version of the HADS showed acceptable psychometric properties. These coefficients were even slightly higher than those of our German comparison sample 0.

All corrected item-test correlations were above 0. Taken together, these reliability coefficients suggest the applicability of the Amharic version of the HADS for use in groups of cancer patients.

However, the CFA coefficients of the Ethiopian sample were somewhat weaker than those of the German sample. The loading of this item was sufficiently high 0.

The Hospital Anxiety And Depression Scale

Javascript is currently disabled in your browser. Several features of this site will not function whilst javascript is disabled. Received 16 August Published 22 November Volume Pages — Review by Single anonymous peer review. Editor who approved publication: Dr Roger Pinder. Hospital Anxiety and Depression Scale HADS is a questionnaire developed to screen anxiety and depression among patients in hospital settings.

The journal is oriented to the study of mental illnesses, their pathological processes, and their psychosocial consequences, and has as its aim to disseminate the scientific advances in all fields related to the illness and mental health. It accepts unpublished works on psychiatry and mental health, and its medical and social repercussions. For this reason, space is provided in the Journal for works in the biological, clinical and psychosocial field. Manuscripts are evaluated, before being accepted, by external reviewers peer-review. The Impact Factor measures the average number of citations received in a particular year by papers published in the journal during the two receding years. CiteScore measures average citations received per document published.

Toll-Free U. From high-quality clinical care and groundbreaking research to community programs that improve quality of life, philanthropic support drives our mission and vision. Do you see an error or have a suggestion for this instrument summary? Meta-analysis: Brennan et al. Aben, I.

Hospital Anxiety and Depression Scale

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HADS is a item scale with seven items each for anxiety and depression subscales. Scoring for each item ranges from zero to three. Mean age at presentation was Mean duration of symptoms was 9. Mean presenting BCVA in the better eye was 0. Low vision correction can significantly improve anxiety and depression indicators in visually impaired patients. According to the World Health Organization, million people are visually impaired worldwide, of which 62 million reside in India.

The Hospital Anxiety and Depression Scale HADS is a self-report questionnaire designed to screen anxious and depressive states in patients in non-psychiatric settings. In spite of its large use, no agreement exists in literature on HADS accuracy in case finding. Receiver operating characteristic ROC curves were computed to identify a cut-off for anxious and depressive states in cancer patients. The area under the ROC curve was 0.

Metrics details. There is a need to assess the contribution of mood disorder, especially anxiety and depression, in order to understand the experience of suffering in the setting of medical practice. Most physicians are aware of this aspect of the illness of their patients but many feel incompetent to provide the patient with reliable information. The term 'hospital' in its title suggests that it is only valid in such a setting but many studies conducted throughout the world have confirmed that it is valid when used in community settings and primary care medical practice.

 Есть, но отец ее заблокировал. Он думает, что я балуюсь наркотиками. - А это не так? - спросил Беккер холодно, глядя на ее припухший локоть.

Hospital Anxiety and Depression Scale (HADS) accuracy in cancer patients

 - Ты только подумай: ТРАНСТЕКСТ бьется над одним-единственным файлом целых восемнадцать часов. Слыханное ли это. Отправляйся домой, уже поздно. Она окинула его высокомерным взглядом и швырнула отчет на стол.

 Неужели это так заметно. - Как ее зовут? - Женщина лукаво подмигнула. - Меган, - сказал он печально. - Я полагаю, что у вашей подруги есть и фамилия. Беккер шумно вздохнул.

 Лейтенант рассказал вам про кольцо? - удивился Клушар, - Рассказал. - Что вы говорите! - Старик был искренне изумлен.  - Я не думал, что он мне поверил. Он был так груб - словно заранее решил, что я лгу.

Солнечный удар и инфаркт. Бедолага. Беккер ничего не сказал и продолжал разглядывать пальцы умершего. - Вы уверены, что на руке у него не было перстня. Офицер удивленно на него посмотрел.

Он побледнел и вытер рукавом пот со лба. - Директор, у нас нет выбора. Мы должны вырубить питание главного банка данных.

 Вы уверены, что на руке у него не было перстня. Офицер удивленно на него посмотрел. - Перстня. - Да.

3 Comments

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    17.04.2021 at 14:23
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  3. Love R.

    22.04.2021 at 20:39
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    Hospital Anxiety and Depression Scale (HADS). Instructions: Doctors are aware that emotions play an important part in most illnesses. If your doctor knows.

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