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Health and Quality of Life Outcomes
Published in: Health and Quality of Life Outcomes 1/2005

Open Access 01-12-2005 | Research

An investigation into the psychometric properties of the Hospital Anxiety and Depression Scale in patients with breast cancer

Authors: Jacqui Rodgers, Colin R Martin, Rachel C Morse, Kate Kendell, Mark Verrill

Published in: Health and Quality of Life Outcomes | Issue 1/2005

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Abstract

Background

To determine the psychometric properties of the Hospital Anxiety and Depression Scale (HADS) in patients with breast cancer and determine the suitability of the instrument for use with this clinical group.

Methods

A cross-sectional design was used. The study used a pooled data set from three breast cancer clinical groups. The dependent variables were HADS anxiety and depression sub-scale scores. Exploratory and confirmatory factor analyses were conducted on the HADS to determine its psychometric properties in 110 patients with breast cancer. Seven models were tested to determine model fit to the data.

Results

Both factor analysis methods indicated that three-factor models provided a better fit to the data compared to two-factor (anxiety and depression) models for breast cancer patients. Clark and Watson's three factor tripartite and three factor hierarchical models provided the best fit.

Conclusion

The underlying factor structure of the HADS in breast cancer patients comprises three distinct, but correlated factors, negative affectivity, autonomic anxiety and anhedonic depression. The clinical utility of the HADS in screening for anxiety and depression in breast cancer patients may be enhanced by using a modified scoring procedure based on a three-factor model of psychological distress. This proposed alternate scoring method involving regressing autonomic anxiety and anhedonic depression factors onto the third factor (negative affectivity) requires further investigation in order to establish its efficacy.
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Metadata
Title
An investigation into the psychometric properties of the Hospital Anxiety and Depression Scale in patients with breast cancer
Authors
Jacqui Rodgers
Colin R Martin
Rachel C Morse
Kate Kendell
Mark Verrill
Publication date
01-12-2005
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2005
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/1477-7525-3-41

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