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Validity and reliability of the Patient Health Questionnaire-8 in Swedish for individuals with systemic sclerosis

Mattsson, Malin ; Sandqvist, Gunnel LU orcid ; Hesselstrand, Roger LU ; Nordin, Annica and Boström, Carina (2020) In Rheumatology International 40(10). p.1675-1687
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... (More)

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 = <0.4) between the PHQ-8 Swe and modified Rodnan skin score; and vascular, heart, and kidney disease severity. Cronbach’s alpha was 0.85, corrected item-to-total correlations were >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.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Depression, Patient-reported outcome measures, Psychometrics, Quality of life, Scleroderma systemic
in
Rheumatology International
volume
40
issue
10
pages
13 pages
publisher
Springer
external identifiers
  • pmid:32661929
  • scopus:85087748331
ISSN
0172-8172
DOI
10.1007/s00296-020-04641-1
language
English
LU publication?
yes
id
6945900e-a5c6-468f-8189-c9d5f18bebb2
date added to LUP
2020-07-23 12:21:33
date last changed
2024-03-20 13:43:53
@article{6945900e-a5c6-468f-8189-c9d5f18bebb2,
  abstract     = {{<p>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 (r<sub>s</sub> = 0.4–0.7); Multidimensional Assessment of Fatigue (r<sub>s</sub> = 0.7); RAND-36 subscales (r<sub>s</sub> = − 0.5 to − 0.8); and lung disease severity (Medsger scores) (r<sub>s</sub> = 0.4). There were weak correlations (r<sub>s</sub> = &lt;0.4) between the PHQ-8 Swe and modified Rodnan skin score; and vascular, heart, and kidney disease severity. Cronbach’s alpha was 0.85, corrected item-to-total correlations were &gt;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.</p>}},
  author       = {{Mattsson, Malin and Sandqvist, Gunnel and Hesselstrand, Roger and Nordin, Annica and Boström, Carina}},
  issn         = {{0172-8172}},
  keywords     = {{Depression; Patient-reported outcome measures; Psychometrics; Quality of life; Scleroderma systemic}},
  language     = {{eng}},
  number       = {{10}},
  pages        = {{1675--1687}},
  publisher    = {{Springer}},
  series       = {{Rheumatology International}},
  title        = {{Validity and reliability of the Patient Health Questionnaire-8 in Swedish for individuals with systemic sclerosis}},
  url          = {{http://dx.doi.org/10.1007/s00296-020-04641-1}},
  doi          = {{10.1007/s00296-020-04641-1}},
  volume       = {{40}},
  year         = {{2020}},
}