A psychometric evaluation of the Hospital Anxiety and Depression Scale in patients diagnosed with end-stage renal disease.
OBJECTIVE
To determine the psychometric properties of the Hospital Anxiety and Depression Scale (HADS) in patients with end-stage renal disease (ESRD) and determine the suitability of the instrument for use with this clinical group.


METHODS
Between-subjects and cross-sectional design. The independent variable was type of treatment for ESRD. The dependent variables were HADS total (all items) and HADS anxiety and depression subscale scores.


METHODS
Group differences in HADS scores were determined using between-subjects one-way analysis of variance (ANOVA). Exploratory and confirmatory factor analyses were conducted on the HADS to determine its psychometric properties in 160 patients with ESRD. Seven models were tested to determine model fit to the data.


RESULTS
None of the seven models tested proved to be an adequate fit to the data. Treatment modality was found to have a significant impact on HADS-assessed levels of anxiety and depression. CONCLSIONS: The clinical utility of the HADS in the assessment of anxiety and depression in ESRD patients may be enhanced by using the HADS total (all items) score as an index of psychological distress. Further research is required to establish the appropriateness of using the HADS to screen ESRD patients.
Department of Health Sciences, University of York, UK. cm29@york.ac.uk
Colin R
CR
Martin
Alison E
AE
Tweed
Matthew S
MS
Metcalfe
D001007:Anxiety / Q000175:diagnosis* / Q000209:etiology; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis* / Q000209:etiology; D005163:Factor Analysis, Statistical; D005260:Female; D006760:Hospitalization; D006801:Humans; D007676:Kidney Failure, Chronic / Q000523:psychology* / Q000534:rehabilitation* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D006435:Renal Dialysis; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires