2022, Number 3
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Rev Cuba Enf 2022; 38 (3)
Psychometric Properties and Factorial Structure of the Patient Health Questionnaire (PHQ-4) in Ecuadorian University Students
López GV, Aguirre MÁJ, Guerrero AJM
Language: Spanish
References: 31
Page: 1-15
PDF size: 694.34 Kb.
ABSTRACT
Introduction:
The Patient Health Questionnaire is a brief instrument for assessing anxiety and depression, whose factorial structure is not clear.
Objective:
To analyze the reliability, convergent, divergent and construct validity, as well as the factorial structure, of the Patient Health Questionnaire in Ecuadorian university students.
Methods:
The sample consisted of 1732 students, with an average age of twenty years. 55 % were women from three universities in Loja. The instruments applied were the Acceptance and Action Questionnaire, the Psychological Capital Questionnaire, the Depression and Anxiety Scale, and the Perceived Stress Scale.
Results:
The factorial structure was better adjusted to the bifactorial model (CMIN/DF=14.247; CFI = 0.996; GFI = 0.996; NFI = 0.996, RMSEA = 0.087). This model is invariant between men and women. Reliability was optimal for the total scale (α=0.879; ω=0.880) and its two factors: anxiety (α=0.838; ω=0.838) and depression (α=0.779; ω=0.780). Scores were correlated with mental health indicators.
Conclusions:
The Patient Health Questionnaire is a scale with optimal psychometric properties for Ecuadorian university students, presenting a bifactorial structure.
REFERENCES
Organización Panamericana de la Salud. Depresión y otros trastornos mentales comunes. Estimaciones sanitarias mundiales. Washington: OPS; 2017 [acceso: 15/08/2019]. Disponible en: Disponible en: https://iris.paho.org/bitstream/handle/10665.2/34006/PAHONMH17005-spa.pdf 1.
Organización Mundial de la Salud/Organización Panamericana de la Salud. Ginebra/, La carga de los trastornos mentales en la Región de las Américas, Washington: OPS ; 2018 [acceso: 15/08/2019]. Disponible en: Disponible en: https://iris.paho.org/bitstream/handle/10665.2/49578/9789275320280_spa.pdf?sequence = 9&isAllowed = y. 2.
Lazarus RS, Folkman S. Estrés y procesos cognitivos. Barcelona: Ediciones Martínez Roca; 1986.
Organización Mundial de la Salud. La Depresión. Ginebra: OMS; 2020 [acceso: 15/08/2019]. Disponible en: Disponible en: https://www.who.int/es/news-room/fact-sheets/detail/depression 4.
Eisenberg D, Gollust SE, Golberstein E, Hefner JL. Prevalence and correlates of depression, anxiety, and suicidality among university students. Am. J. Orthopsychiatry. 2007;77(4):534-42. DOI: https://doi.apa.org/doi/10.1037/00029432.77.4.5345.
Vanstone DM, Hicks RE. Transitioning to university: Coping styles as mediators between adaptive-maladaptive perfectionism and test anxiety. Pers. Individ. Differ. 2019;141:68.75. DOI: https://doi.org/10.1016/j.paid.2018.12.0266.
Caro Y, Trujillo S, Trujillo N. Prevalencia y factores asociados a sintomatología depresiva y ansiedad rasgo en estudiantes universitarios del área de la salud. Psychologia. 2019;13(1):41-50. DOI: http://dx.doi.org/10.21500/19002386.3726.7.
Wörfel F, Gusy B, Lohmann K, Töpritz K, Kleiber D. Mental health problems among university students and the impact of structural conditions. J Public Health. 2016;24:125-33. DOI: https://doi.org/10.1007/s10389-015-0703-68.
Blanco J, Ornelas M, Barrón J, Rodríguez J. Estructura factorial del inventario de trastornos de ansiedad generalizada en universitarios Mexicanos. Form. Univ. 2017;10(5):69-76. DOI: http://dx.doi.org/10.4067/S0718-500620170005000089.
Castro J, Olariu E, Garnier C, Martín L, Pérez V, Alonso J, et al. Diagnostic accuracy and adequacy of treatment of depressive and anxiety disorders: A comparison of primary care and specialized care patients. J. Affect. Disord. 2015;172:462-71. DOI: https://doi.org/10.1016/j.jad.2014.10.02010.
Cabrera J, Touriño R, Nuñez E. Los trastornos mentales y su infradiagnóstico en atención primaria. Semergen. 2018;44(4):234-42. DOI: https://doi.org/10.1016/j.semerg.2016.11.00711.
Kroenke K, Spitzer R, Williams J, Löwe B. An ultra-brief screening scale for anxiety and depression: The PHQ-4. Psychosomatics. 2009;50(6):613-21. DOI: https://doi.org/10.1176/appi.psy.50.6.61312.
Löwe B, Wahl I, Rose M, Spitzer C, Glaesmer H, Wingenfeld K, et al. A 4-item measure of depression and anxiety: validation and standardization of the Patient Health Questionnaire-4 (PHQ-4) in the general population. J. Affect. Disord. 2010; 122(1-2):86-95. DOI: https://doi.org/10.1016/j.jad.2009.06.019.13.
Materu J, Kuringe E, Nyato D, Galishi A, Mwanamsangu A, Katebalila M, et al. The psychometric properties of PHQ-4 anxiety and depression screening scale among out of school adolescent girls and young women in Tanzania: a cross-sectional study. BMC Psychiatry. 2020;20(321):2-8. DOI: http://dx.doi.org/10.1186/s12888-020-02735-514.
Kocalevent R, Finck C, Jimenez W, Sautier L, Hinz A. Standardization of the Colombian version of the PHQ-4 in the general population. BMC Psychiatry. 2014;14(205):429-37. DOI: https://doi.org/10.9758/cpn.2021.19.1.10415.
Ghaheri A, Omani-Samani R, Sepidarkish M, Hosseini M, Maroufizadeh S. The Four-Item Patient Health Questionnaire for Anxiety and Depression: A Validation Study in Infertile Patients. Rev. iberoam. fertil. reprod. hum. 2020 [acceso: 15/08/2019]:14(3):234-9. DOI: https://doi.org/10.22074/ijfs.2020.4441216.
Rodríguez M, Ruiz N, Soto C, Le H, Olivares M, Izquierdo N. The Psychometric Properties of the Patient Health Questionnaire-4 for Pregnant Women. Int. J. Environ. Res. Public Health. 2020;17(20):75-83. DOI: https://doi.org/10.3390/ijerph1720758317.
Kim H, Shin C, Lee S, Han C. Standardization of the Korean Version of the Patient Health Questionnaire-4 (PHQ-4). Clin. Psychopharmacol. Neurosci. 2021;19(1):104-11. DOI: https://doi.org/10.9758/cpn.2021.19.1.10418.
Khubchandani J, Brey R, Kotecki J, Kleinfelder J, Anderson J. The Psychometric Properties of PHQ-4 Depression and Anxiety Screening Scale Among College Students. Arch. Psychiatr. Nurs. 2016;30(4):457-62. DOI: http://dx.doi.org/10.1016/j.apnu.2016.01.01419.
Mills S, Fox R, Pan T, Malcarne V, Roesch S, Sadler G. Psychometric Evaluation of the Patient Health Questionnaire-4 in Hispanic. Hisp. J. Behav. Sci. 2017;37(4):560-71. DOI: https://doi.org/10.1177/073998631560812620.
Stephen L, Chi L. Evidence for measurement invariance and psychometric reliability for scores on the PHQ-4 from a rural and predominately hispanic community. Meas. Eval. Couns. Dev. 2021;54(1):1-13. DOI: https://doi.org/10.1080/07481756.2021.190615721.
Aragón L. Evaluación psicológica: historia fundamentos teórico-conceptuales y psicometría. En: Aragón L, editor. Fundamentos psicométricos en la evaluación psicológica. México: Manual Moderno; 2015. p. 44-45.
Hernández-Sampieri R, Mendoza C. Metodología de la Investigación. En: Hernández-Sampieri R, editor. Concepción o elección del diseño de investigación en la ruta cuantitativa: el mapa. México: McGraw-Hill Interamericana; 2018. p. 214-15.
Bond FW, Hayes SC, Baer RA, Carpenter KM, Guenole N, Orcutt HK, et al. Preliminary psychometric properties of the Acceptance and Action Questionnaire-II: A revised measure of psychological inflexibility and experiential avoidance. Behav Ther. 2011;42(4):676-88. DOI: https://doi.10.1016/j.beth.2011.03.00724.
Paladines B, López V, Ruisoto P, Vaca S, Cacho R. Psychometric Properties and Factor Structure of the Spanish Version of the Acceptance and Action Questionnaire-II (AAQ-II) in Ecuador. Int. J. Environ. Res. Public Health, 2021;18(6):2944. DOI: https://doi.org/10.3390/ijerph1806294425.
Ruisoto P, López V, Paladines M, Vaca S, Cacho R. Psychometric properties of the three versions of the Perceived Stress Scale in Ecuador. Physiol. Behav. 2020;224:113045. DOI: https://doi.org/10.1016/j.physbeh.2020.11304526.
Martínez I, Meneghel I, Carmona M, Youssef C. Adaptation and validation to Spanish of the Psychological Capital Questionnaire-12 (PCQ-12) in academic contexts. Curr Psychol. 2019;60(3):541-72. DOI: https://doi.org/10.1007/s12144-019-00276-z27.
Cheung G, Rensvold R. Evaluating Goodness-of-Fit Indexes for Testing Measurement Invariance. Struct. Equ. Model. 2002;9(2):233-55. DOI: https://doi.org/10.1207/S15328007SEM0902_528.
Asociación Médica Mundial. Declaración de Helsinki de la AMM - Principios éticos para las investigaciones médicas en seres humanos [Internet]. 2017 [acceso: 01/07/2022]. Disponible en: https://www.wma.net/es/policies-post/declaracion-de-helsinki-de-la-amm-principios-eticos-para-las-investigaciones-medicas-en-seres-humanos/29.
Liu L, Pang R, Sun W, Wu M, Qu P, Lu C, et al. Functional social support, psychological capital, and depressive and anxiety symptoms among people living with HIV/AIDS employed full-time. BMC psychiatry. 2013;13:324. DOI: https://doi.org/10.1186/1471-244X-13-32430.
Kamei H, Ferreira MC, Valentini F, Peres MF, Kamei PT, Damásio BF. Psychological Capital Questionnaire - Short Version (PCQ-12): evidence of Validity of the Brazilian Version. Psico-USF. 2018;23(2):203-214. DOI: https://doi.org/10.1590/1413-827120182302031.