title: Clinical utility of the Hospital Anxiety and Depression Scale (HADS) for an outpatient fibromyalgia education program.
abstract: This paper examines the clinical utility of the Hospital Anxiety and Depression Scale (HADS) in the context of evaluating the Fibromyalgia Outpatient Education Program at Southlake Regional Health Centre (Newmarket, Canada). A pre-test/post-test design was implemented for data analysis. A total of 232 patients' data were obtained through retrospective patient chart review. Complete pre-post data were available for 70 patients and qualitative analysis was done for 12 patients. Main outcome measures included HADS and Arthritis Self-Efficacy (ASE) scores. At the end of the education program, subgroups of patients (high attendance, high exercise habit, low medication) experienced significant improvement on HADS-depression and ASE scores. Linear regression analysis found that HADS pre-program scores explain far more variance in HADS post-test scores than ASE pre-program scores explain in ASE post-program scores; more variance in ASE post-program scores was explained by other variables. In contrast to the quantitative analysis of the Anxiety subscale of HADS, patients in the focus group indicated that their anxiety level decreased through attending the education program. These findings suggest that HADS is an appropriate tool for evaluating fibromyalgia and related patient education programs. Moreover, patient education programs have positive effects on enhancing patients' psychological well-being and self-confidence in controlling fibromyalgia-related symptoms.
authors.affiliation: School of Health Policy and Management, York University, HNES Bldg., 413, Toronto, Ontario, M3J 1P3, Canada.
authors.forename: Seungree
authors.initials: S
authors.lastname: Nam
authors.forename: Diane
authors.initials: D
authors.lastname: Tin
authors.forename: Lorna
authors.initials: L
authors.lastname: Bain
authors.forename: J Carter
authors.initials: JC
authors.lastname: Thorne
authors.forename: Liane
authors.initials: L
authors.lastname: Ginsburg
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000150:complications* / Q000175:diagnosis; D001168:Arthritis / Q000150:complications / Q000175:diagnosis; D003863:Depression / Q000150:complications* / Q000175:diagnosis; D005260:Female; D005356:Fibromyalgia / Q000523:psychology* / Q000628:therapy; D017144:Focus Groups; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D010146:Pain / Q000523:psychology; D010353:Patient Education as Topic; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult