医院焦虑抑郁量表对慢性阻塞性肺疾病患者焦虑抑郁情绪筛查价值的研究
|
摘要
目的:探讨医院焦虑抑郁量表在慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者焦虑、抑郁情绪筛查中的应用价值,并评估其信度和效度。方法:应用横断面研究方法,选择COPD住院患者200例,对其进行问卷调查。结果:获得有效问卷189份。医院焦虑抑郁量表(HADS)中焦虑、抑郁亚量表得分分别与焦虑自评量表、抑郁自评量表得分呈正相关(P<0.01);以焦虑自评量表和抑郁自评量表作为诊断"金标准"分别绘制焦虑亚量表和抑郁亚量表的ROC曲线,其曲线下面积分别为0.823(95%CI:0.752～0.881)和0.906 (95%CI:0.847～0.948);医院焦虑抑郁量表总表、焦虑亚量表及抑郁亚量表的内部一致性系数的Cronbach'sα分别为0.89, 0.76, 0.83;HADS得分水平与生活质量指数量表呈负相关,证明了其构念效度(P<0.05)。结论 :医院焦虑抑郁量表可以可靠、有效地筛查COPD患者的焦虑、抑郁情绪,可以提高临床医务人员对患者不良情绪的筛查效能。
Objective: To identify the clinical value of hospital anxiety and depression scale(HAD) in screening anxiety and depression of patients with chronic obstructive pulmonary disease(COPD) and test its reliability and validity. Methods:200 cases of patients with COPD hospitalized were enrolled by cross-sectional study. Then questionnaires were performed and analyzed. Results: The study of 189 valid questionnaires showed that the two subscales of HADS had significantly correlations with the self-rating anxiety scale(SAS) and the self-rating depression scale(SDS)(P<0.01). Taking SAS and SDS as the gold standard, the area under of the receiver operating characteristic curve(ROC) of both subscale were 0.823(95%CI:0.752～0.881)and 0.906(95%CI:0.847～0.948), respectively. The Cronbach's alpha coefcients of HADS and two subscales had been found to be 0.89, 0.76, 0.83 respectively. Conclusion: The HADS could help clinical medical staffs improve the screening efficiency of bad mood as a reliable and valid instrument for the assessment of anxiety and depression in patients with COPD.
Objective: To identify the clinical value of hospital anxiety and depression scale(HAD) in screening anxiety and depression of patients with chronic obstructive pulmonary disease(COPD) and test its reliability and validity. Methods:200 cases of patients with COPD hospitalized were enrolled by cross-sectional study. Then questionnaires were performed and analyzed. Results: The study of 189 valid questionnaires showed that the two subscales of HADS had significantly correlations with the self-rating anxiety scale(SAS) and the self-rating depression scale(SDS)(P<0.01). Taking SAS and SDS as the gold standard, the area under of the receiver operating characteristic curve(ROC) of both subscale were 0.823(95%CI:0.752～0.881)and 0.906(95%CI:0.847～0.948), respectively. The Cronbach's alpha coefcients of HADS and two subscales had been found to be 0.89, 0.76, 0.83 respectively. Conclusion: The HADS could help clinical medical staffs improve the screening efficiency of bad mood as a reliable and valid instrument for the assessment of anxiety and depression in patients with COPD.
引文
[1]Lozano R,Naghavi M,Foreman K,et al.Global and regional mortality from 235 causes of death for 20 age groups in 1990 and2010:a systematic analysis for the Global Burden of Disease Study 2010[J].Lancet,2012,80(9859):2095-2128.
[2]Miravitlles M,Price D,Rabe KF,et al.Comorbidities of patients in tiotropium clinical trials:comparison with observational studies of patients with chronic obstructive pulmonary disease[J].Int JChron Obstruct Pulmon Dis,2015,16(10):549-564.
[3]Negewo NA,Gibson PG,McDonald VM,et al.COPD and its comorbidities:Impact,measurement and mechanisms[J].Respirology,2015,20(8):1160-1171.
[4]郑丽梅,李海林.抗抑郁治疗对慢性阻塞性肺疾病患者负性情绪和生活质量的影响[J].2016,36(5):623-625.
[5]North M.Improving outcomes with online COPD self-care[J].Nurs Times,2015,111(30-31):22-23.
[6]Schüz N,Walters JA,Cameron-Tucker H,et al.Patient Anxiety and Depression Moderate the Effects of Increased Self~management Knowledge on Physical Activity:A Secondary Analysis of a Randomised Controlled Trial on Health-Mentoring in COPD[J].COPD,2015,12(5):502-509.
[7]Huber MB,Wacker ME,Vogelmeier CF,et al.Comorbid Influences on Generic Health-Related Quality of Life in COPD:ASystematic Review[J].PLoS One,2015,10(7):e0132670.
[8]Ekici A,Bulcun E,Karakoc T,et al.Factors Associated With Quality of Life in Subjects With Stable COPD[J].Respir Care,2015,60(11):1585-1591.
[9]Wu M1,Zhao Q2,Chen Y,et al.Quality of life and its association with direct medical costs for COPD in urban China[J].Health Qual Life Outcomes,2015,14(13):57-62.
[10]Borges-Santos E,Wada JT,da Silva CM,et al.Anxiety and depression are related to dyspnea and clinical control but not with thoracoabdominal mechanics in patients with COPD[J].Respir Physiol Neurobiol,2015,210:1-6.
[11]Brat覿s O,Gr?nning K,Forbord T.Psychometric properties of the Hospital Anxiety and Depression Scale and The General Health Questionnaire~20 in COPD inpatients[J].Scand J Caring Sci,2014,28(2):413-420.
[12]Al-Gamal E.Quality of life,anxiety and depression among patients with chronic obstructive pulmonary disease and their spouses[J].Issues Ment Health Nurs,2014,35(10):761-767.
[2]Miravitlles M,Price D,Rabe KF,et al.Comorbidities of patients in tiotropium clinical trials:comparison with observational studies of patients with chronic obstructive pulmonary disease[J].Int JChron Obstruct Pulmon Dis,2015,16(10):549-564.
[3]Negewo NA,Gibson PG,McDonald VM,et al.COPD and its comorbidities:Impact,measurement and mechanisms[J].Respirology,2015,20(8):1160-1171.
[4]郑丽梅,李海林.抗抑郁治疗对慢性阻塞性肺疾病患者负性情绪和生活质量的影响[J].2016,36(5):623-625.
[5]North M.Improving outcomes with online COPD self-care[J].Nurs Times,2015,111(30-31):22-23.
[6]Schüz N,Walters JA,Cameron-Tucker H,et al.Patient Anxiety and Depression Moderate the Effects of Increased Self~management Knowledge on Physical Activity:A Secondary Analysis of a Randomised Controlled Trial on Health-Mentoring in COPD[J].COPD,2015,12(5):502-509.
[7]Huber MB,Wacker ME,Vogelmeier CF,et al.Comorbid Influences on Generic Health-Related Quality of Life in COPD:ASystematic Review[J].PLoS One,2015,10(7):e0132670.
[8]Ekici A,Bulcun E,Karakoc T,et al.Factors Associated With Quality of Life in Subjects With Stable COPD[J].Respir Care,2015,60(11):1585-1591.
[9]Wu M1,Zhao Q2,Chen Y,et al.Quality of life and its association with direct medical costs for COPD in urban China[J].Health Qual Life Outcomes,2015,14(13):57-62.
[10]Borges-Santos E,Wada JT,da Silva CM,et al.Anxiety and depression are related to dyspnea and clinical control but not with thoracoabdominal mechanics in patients with COPD[J].Respir Physiol Neurobiol,2015,210:1-6.
[11]Brat覿s O,Gr?nning K,Forbord T.Psychometric properties of the Hospital Anxiety and Depression Scale and The General Health Questionnaire~20 in COPD inpatients[J].Scand J Caring Sci,2014,28(2):413-420.
[12]Al-Gamal E.Quality of life,anxiety and depression among patients with chronic obstructive pulmonary disease and their spouses[J].Issues Ment Health Nurs,2014,35(10):761-767.