This study examines the Thai version of the Multidimensional Scale of Perceived Social Support (MSPSS) for its psychometric properties.
In total 462 participants were recruited - 310 medical students from Chiang Mai University and 152 psychiatric patients, and they completed the Thai version of the MSPSS, the State Trait Anxiety Inventory (STAI), the Rosenberg Self-Esteem Scale (RSES) and the Thai Depression Inventory (TDI). Test-retest reliability was conducted over a four week period.
Factor analysis produced three-factor solutions for both patient (PG) and student groups (SG), and overall the model demonstrated adequate fit indices. The mean total score and the sub-scale score for the SG were statistically higher than those in the PG, except for ‘Significant Others’. The internal consistency of the scale was good, with a Cronbach’s alpha of 0.91 for the SG and 0.87 for the PG. After a four week retest for reliability exercise, the intra-class correlation coefficient (ICC) was found to be 0.84. The Thai-MSPSS was found to have a negative correlation with the STAI and the TDI, but was positively correlated with the RSES.
The Thai MSPSS is a reliable and valid instrument to use.
Social support; MSPSS; Reliability; Validity; Factor analysis; Confirmatory Factor analysis; Thai.
The 10-item Perceived Stress Scale (PSS-10) is one of most widely used instruments to measure a global level of perceived stress in a range of clinical and research settings. This study was conducted to examine the psychometric properties of the Simplified Chinese version of the PSS-10 in policewomen.
A total of 240 policewomen were recruited in this study. The Simplified Chinese versions of the PSS-10, the Beck Depression Inventory Revised (BDI-II), and the Beck Anxiety Inventory (BAI) were administered to all participants, and 36 of the participants were re-tested two weeks after the initial testing.
The overall Cronbach's alpha was 0.86, and the test–retest reliability coefficient was 0.68. Exploratory Factor Analysis (EFA) yielded 2 factors with eigenvalues of 4.76 and 1.48, accounting for 62.41% of variance. Factor 1 consisted of 6 items representing “negative feelings”; whereas Factor 2 consisted of 4 items representing “positive feelings”. The item loadings ranged from 0.72 to 0.83. The Confirmatory factor analysis (CFA) indicated a very good fit of this two-factor model to this sample. The PSS-10 significantly correlated with both BDI-II and BAI, indicating an acceptable concurrent validity.
The Simplified Chinese version of the PSS-10 demonstrated adequate psychometric properties for evaluating stress levels. The results support its use among the Chinese population.
This study seeks to investigate the psychometric properties of the short version of the revised ‘Experience of Close Relationships’ questionnaire, comparing non-clinical and clinical samples.
In total 702 subjects participated in this study, of whom 531 were non-clinical participants and 171 were psychiatric patients. They completed the short version of the revised ‘Experience of Close Relationships’ questionnaire (ECR-R-18), the Perceived Stress Scale-10(PSS-10), the Rosenberg Self-Esteem Scale (RSES) and the UCLA Loneliness scale. A retest of the ECR-R-18 was then performed at four-week intervals. Then, confirmatory factor analyses were performed to test the validity of the new scale.
The ECR-R-18 showed a fair to good internal consistency (α 0.77 to 0.87) for both samples, and the test-retest reliability was found to be satisfactory (ICC = 0.75). The anxiety sub-scale demonstrated concurrent validity with PSS-10 and RSES, while the avoidance sub-scale showed concurrent validity with the UCLA Loneliness Scale. Confirmatory factor analysis using method factors yielded two factors with an acceptable model fit for both groups. An invariance test revealed that the ECR-R-18 when used on the clinical group differed from when used with the non-clinical group.
The ECR-R-18 questionnaire revealed an overall better level of fit than the original 36 item questionnaire, indicating its suitability for use with a broader group of samples, including clinical samples. The reliability of the ECR-R- 18 might be increased if a modified scoring system is used and if our suggestions with regard to future studies are followed up.
ECR-R-18; short; the Experiences of Close Relationships; Confirmatory factor analysis.
To translate the Perceived Stress Scale (versions PSS-4, −10 and −14) and to assess its psychometric properties in a sample of general Greek population.
941 individuals completed anonymously questionnaires comprising of PSS, the Depression Anxiety and Stress scale (DASS-21 version), and a list of stress-related symptoms. Psychometric properties of PSS were investigated by confirmatory factor analysis (construct validity), Cronbach’s alpha (reliability), and by investigating relations with the DASS-21 scores and the number of symptoms, across individuals’ characteristics. The two-factor structure of PSS-10 and PSS-14 was confirmed in our analysis. We found satisfactory Cronbach’s alpha values (0.82 for the full scale) for PSS-14 and PSS-10 and marginal satisfactory values for PSS-4 (0.69). PSS score exhibited high correlation coefficients with DASS-21 subscales scores, meaning stress (r = 0.64), depression (r = 0.61), and anxiety (r = 0.54). Women reported significantly more stress compared to men and divorced or widows compared to married or singled only. A strong significant (p < 0.001) positive correlation between the stress score and the number of self-reported symptoms was also noted.
The Greek versions of the PSS-14 and PSS-10 exhibited satisfactory psychometric properties and their use for research and health care practice is warranted.
Perceived Stress Scale; translation; psychometric properties; validation; Greece
The clinical relevance of resilience has received considerable attention in recent years. The aim of this study is to demonstrate the reliability and validity of the Japanese version of the Resilience Scale (RS) and short version of the RS (RS-14).
The original English version of RS was translated to Japanese and the Japanese version was confirmed by back-translation. Participants were 430 nursing and university psychology students. The RS, Center for Epidemiologic Studies Depression Scale (CES-D), Rosenberg Self-Esteem Scale (RSES), Social Support Questionnaire (SSQ), Perceived Stress Scale (PSS), and Sheehan Disability Scale (SDS) were administered. Internal consistency, convergent validity and factor loadings were assessed at initial assessment. Test-retest reliability was assessed using data collected from 107 students at 3 months after baseline. Mean score on the RS was 111.19. Cronbach's alpha coefficients for the RS and RS-14 were 0.90 and 0.88, respectively. The test-retest correlation coefficients for the RS and RS-14 were 0.83 and 0.84, respectively. Both the RS and RS-14 were negatively correlated with the CES-D and SDS, and positively correlated with the RSES, SSQ and PSS (all p < 0.05), although the correlation between the RS and CES-D was somewhat lower than that in previous studies. Factor analyses indicated a one-factor solution for RS-14, but as for RS, the result was not consistent with previous studies.
This study demonstrates that the Japanese version of RS has psychometric properties with high degrees of internal consistency, high test-retest reliability, and relatively low concurrent validity. RS-14 was equivalent to the RS in internal consistency, test-retest reliability, and concurrent validity. Low scores on the RS, a positive correlation between the RS and perceived stress, and a relatively low correlation between the RS and depressive symptoms in this study suggest that validity of the Japanese version of the RS might be relatively low compared with the original English version.
The Connor-Davidson Resilience Scale (CD-RISC) measures various aspects of psychological resilience in patients with posttraumatic stress disorder (PTSD) and other psychiatric ailments. This study sought to assess the reliability and validity of the Korean version of the Connor-Davidson Resilience Scale (K-CD-RISC).
In total, 576 participants were enrolled (497 females and 79 males), including hospital nurses, university students, and firefighters. Subjects were evaluated using the K-CD-RISC, the Beck Depression Inventory (BDI), the Impact of Event Scale-Revised (IES-R), the Rosenberg Self-Esteem Scale (RSES), and the Perceived Stress Scale (PSS). Test-retest reliability and internal consistency were examined as a measure of reliability, and convergent validity and factor analysis were also performed to evaluate validity.
Cronbach's α coefficient and test-retest reliability were 0.93 and 0.93, respectively. The total score on the K-CD-RISC was positively correlated with the RSES (r=0.56, p<0.01). Conversely, BDI (r=-0.46, p<0.01), PSS (r=-0.32, p<0.01), and IES-R scores (r=-0.26, p<0.01) were negatively correlated with the K-CD-RISC. The K-CD-RISC showed a five-factor structure that explained 57.2% of the variance.
The K-CD-RISC showed good reliability and validity for measurement of resilience among Korean subjects.
Connor-Davidson Resilience Scale; Posttraumatic stress disorder; Resilience; Reliability; Validity; Trauma
The occurrence of stress and stress related anxiety and depression in medical personnel are being increasingly reported in literature. The perceived stress scale (PSS) is the most widely used psychological instrument for measuring the perception of stress. It is needed to assess perceived stress in our population using appropriately translated version of PSS. The objectives of study were to prepare a Bengali version of PSS-10 and to establish its psychometric properties in the study population.
Materials and Methods:
The study was conducted in a teaching hospital among medical students and interns (N=37). The translated Bengali version and the original English version of PSS-10 were separately handed over to the individual subjects. The scores were compared across different subgroups and psychometric properties of the translated version were assessed using SPSS 16.
Internal consistency of PSS English (α=0.79) and Bengali (α=0.80) was satisfactory. Intra-rater reliability was adequate (κ>0.5) for most of the items, but showed an inadequate value (κ<0.5) for four items on the scale. After deleting these four items from the Bengali version, a new six-item PSS in Bengali was derived that showed good internal consistency (α=0.699).
This new version needs to be validated in a larger study population. Perceived stress score using PSS-10 was considerably high in our study population, although there was no significant difference between the subgroups (male/female, intern/student).
Perceived stress scale; psychometric property; translation
Smoking causes heart disease, the major cause of death in China and Hong Kong. Stress is one major trigger of smoking and relapse, and understanding stress among smoking cardiac patients can therefore help in designing effective interventions to motivate them to quit. The objective of this study was to examine the psychometric properties of the Perceived Stress Scale (PSS), and to compare the appropriateness of the three versions of the scale (PSS-14, PSS-10, and PSS-4) among Chinese cardiac patients who were also smokers.
From March 2002 to December 2004, 1860 cardiac patients who smoked were recruited at the cardiac outpatient clinics of ten acute hospitals in Hong Kong, and 1800 questionnaires were analysed. Participants completed a questionnaire including the PSS, nicotine dependence and certain demographic variables. The psychometric properties of the PSS were investigated: construct validity using confirmatory factor analysis, reliability using Cronbach's alpha and concurrent validity by examining the relationship with smoking- and health-related variables.
For all the three versions of the PSS, confirmatory factor analyses corroborated the 2-factor structure of the scale, with the positive and negative factors correlating significantly and negatively to a moderate extent (r < -0.5), and high Cronbach's alpha values for the two subscales (alpha > 0.5). All the correlations of the two subscales and the smoking- and health-related variables were statistically significant and in the expected directions although of small magnitudes, except daily cigarette consumption.
The findings confirmed the satisfactory psychometric properties of all three Chinese versions of PSS. We recommend the use of PSS-10 for research which focuses on the two components of perceived stress, as it shows a higher reliability; and the use of PSS-4 if such partition is not essential and space for multiple measures is limited.
The Health Assessment Questionnaire Disability Index (HAQ-DI) is a commonly used instrument to assess functional status of patients with rheumatoid arthritis (RA). Translations and adaptations of the HAQ-DI have been carried out for use with RA patients in several countries. The objective of this study was to evaluate the psychometric properties of the Thai version of the HAQ-DI (Thai HAQ) in Thai patients with RA.
Comprehensibility of the Thai HAQ was assessed by 126 patients with RA from 6 medical centers in Thailand. Another group of 115 patients with active RA was enrolled to test the reliability (internal reliability and 1-week test-retest reliability), construct validity (correlations with other measures of RA disease activity), floor and ceiling effects, and sensitivity to change of the Thai HAQ at 3 months of treatment with disease-modifying antirheumatic drugs.
More than 98% of the patients regarded the Thai HAQ as comprehensible. The internal consistency of the Thai HAQ was satisfactory with the overall Cronbach alpha of 0.91. The test-retest reliability of the Thai HAQ was acceptable with the intraclass correlation coefficient of 0.89. Moderate correlations between the Thai HAQ and other outcomes of RA disease activity were observed, except erythrocyte sedimentation rate, with the Spearman correlation coefficients ranging from 0.42 to 0.57. The responsiveness of the Thai HAQ was moderate, with a standardized response mean of 0.75 (95% confidence interval 0.56 to 0.94).
The Thai HAQ is comprehensible, reliable, valid and sensitive to change in the evaluation of functional status of Thai patients with RA. The Thai HAQ is an essential tool to measure treatment effects and progression of disability in RA patients and should be applied in both clinical trials and routine clinical care settings.
The Perceived Stress Scale 10 (PSS-10) is a validated and reliable instrument to measure global levels of perceived stress. This study aims to assess the internal consistency, reliability, and factor structure of the Malay version of the PSS-10 for use among medical students.
The original English version of the PSS-10 was translated and back-translated into Malay language. The Malay version was distributed to 242 Bachelor of Medical Science students in a private university in Malaysia. Test–retest reliability was assessed in 70 students. An exploratory principal component factor analysis with varimax rotation was performed. Reliability was tested using the intraclass correlation coefficient (ICC).
All 242 students participated in the initial questionnaire study (validity and factor structure), and 70 students participated in the test–retest reliability of the study. Exploratory factor analysis yielded 2 factors that accounted for 57.8% of the variance. Cronbach’s alpha coefficients for the 2 factors were 0.85 and 0.70, respectively. The reliability test showed an ICC of 0.82 (95% CI: 0.70, 0.89).
The Malay version of the PSS-10 showed adequate psychometric properties. It is a useful instrument for measuring stress among medical students in Malaysia.
Malaysia; medical; psychological; reliability and validity; stress; students
Since its translation to Thai in 2000, the SF-36 Health Survey has been used extensively in many different clinical settings in Thailand. Its popularity has increased despite the absence of published evidence that the translated instrument satisfies scoring assumptions, the psychometric properties required for valid interpretation of the SF-36 summated ratings scales. The purpose of this paper was to examine these properties and to report on the reliability and validity of the Thai SF-36 in a non-clinical general population.
1345 distance-education university students who live in all areas of Thailand completed a questionnaire comprising the Thai SF-36 (Version 1). Median age was 31 years. Psychometric tests recommended by the International Quality of Life Assessment Project were used.
Data quality was satisfactory: questionnaire completion rate was high (97.5%) and missing data rates were low (< 1.5% for all items). The ordering of item means within scales generally were clustered as hypothesized and scaling assumptions were satisfied. Known groups analysis showed good discriminant validity between subgroups of healthy persons with differing health states. However, some areas of concern were revealed. Possible translation problems of the Physical Functioning (PF) items were indicated by the comparatively low ceiling effects. High ceiling and floor effects were seen in both role functioning scales, possibly due to the dichotomous format of their response choices. The Social Functioning scale had a low reliability of 0.55, which may be due to cultural differences in the concept of social functioning. The Vitality scale correlated better with the Mental Health scale than with itself, possibly because a healthy mental state is central to the concept of vitality in Thailand.
The summated ratings method can be used for scoring the Thai SF-36. The instrument was found to be reliable and valid for use in a general non-clinical population. Version 2 of the SF-36 could improve ceiling and floor effects in the role functioning scales. Further work is warranted to refine items that measure the concepts of social functioning, vitality and mental health to improve the reliability and discriminant validity of these scales.
To provide a measure of perceived stress that is psychometrically superior to existing instruments and novel in dimensionality.
At 4-week intervals over 48 weeks, patients with multiple sclerosis (N = 138) completed 26 items from the Perceived Stress Scale (PSS) and the Perceived Stress Questionnaire (PSQ).
Extant factor analytic models of the PSS fit poorly. A new measure using nine PSS and PSQ items, the Brief Inventory of Perceived Stress (BIPS), demonstrated good fit, construct validity, and stability with 3 factors: Lack of Control, Pushed, and Conflict and Imposition.
Items commonly used to measure perceived stress may have a more sophisticated underlying structure than previously thought. The BIPS's multidimensionality and longitudinal stability offer potential benefits in conceptualization and outcome prediction.
perceived stress; factor analysis; psychometric properties; stress appraisal; factorial invariance; measurement
This paper describes the development of a Japanese version of the Perceived Stress Scale (PSS), and examines the equivalence between the original and translated version. The PSS is one of the few instruments to measure a global level of perceived stress, and has been widely used in a range of clinical and research settings. The PSS has already been translated into several languages, but there is no validated Japanese version.
A forward-backward procedure was implemented. Multiple forward and backward translations were produced, and a panel of reviewers verified conceptual and semantic equivalence between the source and final versions. Non-professional translators who were not brought up in bilingual families were used in order to enhance representativeness of language in the target populations. The PSS was administered to 222 native English speakers and the Japanese version (PSS-J) to 1320 native Japanese speakers.
Factor analysis showed similar factor loadings of the items and satisfactory factorial agreement between the PSS and PSS-J. Cronbach's alpha coefficient was high for both versions and for each factor.
It is concluded that the PSS and PSS-J are substantially equivalent and suited for use in comparative cross-cultural studies.
This study was conducted to evaluate the validity of the Arabic translation of the Cohen Perceived Stress Scale (PSS-10) in pregnant and postpartum women.
A sample of 268 women participated. These included 113 women in their third trimester of pregnancy, 97 in the postpartum period and 58 healthy female university students. GHQ-12 and EPDS were also administered to the participants. Internal consistency reliability, assessed using Cronbach's α, was 0.74.
PSS-10 significantly correlated with both EPDS and GHQ12 (ρ = 0.58 and ρ = 0.48 respectively), and significantly increased with higher scores on stressful life events. PSS-10 scores were higher among university students who also recorded higher stressful life events scores.
The Arabic translated version of the PSS-10 showed reasonably adequate psychometric properties.
Using the Perceived Stress Scale (PSS), perceptions of global stress were assessed in 111 women following breast cancer surgery and at 12 and 24 months later. This is the first study to factor analyze the PSS. The PSS data were factor analyzed each time using exploratory factor analysis with oblique direct quartimin rotation. Goodness-of-fit indices (root mean square error of approximation [RMSEA]), magnitude and pattern of factor loadings, and confidence interval data revealed a two-factor solution of positive versus negative stress items. The findings, replicated across time, also indicate factor stability. Hierarchical factor analyses supported a second-order factor of “perceived stress.” This alternative factor model of the PSS is presented along with observations regarding the measure's use in cancer research.
perceived stress; factor analysis; breast cancer
The Rosenberg Self-Esteem Scale (RSES) is a widely used instrument that has been tested for reliability and validity in many settings; however, some negative-worded items appear to have caused it to reveal low reliability in a number of studies. In this study, we revised one negative item that had previously (from the previous studies) produced the worst outcome in terms of the structure of the scale, then re-analyzed the new version for its reliability and construct validity, comparing it to the original version with respect to fit indices.
In total, 851 students from Chiang Mai University (mean age: 19.51±1.7, 57% of whom were female), participated in this study. Of these, 664 students completed the Thai version of the original RSES - containing five positively worded and five negatively worded items, while 187 students used the revised version containing six positively worded and four negatively worded items. Confirmatory factor analysis was applied, using a uni-dimensional model with method effects and a correlated uniqueness approach.
The revised version showed the same level of reliability (good) as the original, but yielded a better model fit. The revised RSES demonstrated excellent fit statistics, with χ2=29.19 (df=19, n=187, p=0.063), GFI=0.970, TFI=0.969, NFI=0.964, CFI=0.987, SRMR=0.040 and RMSEA=0.054.
The revised version of the Thai RSES demonstrated an equivalent level of reliability but a better construct validity when compared to the original.
Rosenberg Self Esteem Scale; Revised; Reliability; Validity
Most depression screening tools in Thailand are lengthy. The long process makes them impractical for routine use in primary care. This study aims to examine the reliability and validity of a Thai version Patient Health Questionnaire (PHQ-9) as a screening tool for major depression in primary care patients.
The English language PHQ-9 was translated into Thai. The process involved back-translation, cross-cultural adaptation, field testing of the pre-final version, as well as final adjustments. The PHQ-9 was then administered among 1,000 patients in family practice clinic. Of these 1,000 patients, 300 were further assessed by the Thai version of the Mini International Neuropsychiatric Interview (MINI) and the Thai version of the Hamilton Rating Scale for Depression (HAM-D). These tools served as gold-standards for diagnosing depression and for assessing symptom severity, respectively. In the assessment, reliability and validity analyses, and receiver operating characteristic curve analysis were performed.
Complete data were obtained from 924 participants and 279 interviewed respondents. The mean age of the participants was 45.0 years (SD = 14.3) and 73.7% of them were females. The mean PHQ-9 score was 4.93 (SD = 3.75). The Thai version of the PHQ-9 had satisfactory internal consistency (Cronbach's alpha = 0.79) and showed moderate convergent validity with the HAM-D (r = 0.56; P < 0.001). The categorical algorithm of the PHQ-9 had low sensitivity (0.53) but very high specificity (0.98) and positive likelihood ratio (27.37). Used as a continuous measure, the optimal cut-off score of PHQ-9 ≥ 9 revealed a sensitivity of 0.84, specificity of 0.77, positive predictive value (PPV) of 0.21, negative predictive value (NPV) of 0.99, and positive likelihood ratio of 3.71. The area under the curve (AUC) in this study was 0.89 (SD = 0.05, 95% CI 0.85 to 0.92).
The Thai version of the PHQ-9 has acceptable psychometric properties for screening for major depression in general practice with a recommended cut-off score of nine or greater.
The bi-relationships between psychological stress, negative affect and disordered eating has been well studied in western culture, while tri-relationship among them, i.e. how some of those factors influence these bi-relationships, has rarely been studied. However, there has been little related study in the different Chinese culture. This study was conducted to investigate the bi-relationships and tri-relationship between psychological stress, negative affect, and disordered eating attitudes and behaviors in young Chinese women.
A total of 245 young Chinese policewomen employed to carry out health and safety checks at the 2010 Shanghai World Expo were recruited in this study. The Chinese version of the Perceived Stress Scale (PSS-10), Beck Depression Inventory Revised (BDI-II), Beck Anxiety Inventory (BAI), and Eating Attitude Test (EAT-26) were administered to all participants.
The total scores of PSS-10, BDI-II and BAI were all highly correlated with that of EAT-26. The PSS-10 score significantly correlated with both BDI-II and BAI scores. There was no statistically significant direct effect from perceived stress to disordered eating (–0.012, 95%CI: –.038∼0.006, p = 0.357), however, the indirect effects from PSS-10 via affect factors were statistically significant, e.g. the estimated mediation effects from PSS to EAT-26 via depression and anxiety were 0.036 (95%CI: 0.022∼0.044, p<0.001) and 0.015 (95%CI: 0.005∼0.023, p<0.01), respectively.
Perceived stress and negative affects of depression and anxiety were demonstrated to be strongly associated with disordered eating. Negative affect mediated the relationship between perceived stress and disordered eating. The findings suggest that effective interventions and preventative programmes for disordered eating should pay more attention to depression and anxiety among the young Chinese female population.
The aim of the current study was to analyze the psychometric properties, factor structure, and internal consistency of the Spanish version of the Body Image Quality of Life Inventory (BIQLI-SP) as well as its test–retest reliability. Further objectives were to analyze different relationships with key dimensions of psychosocial functioning (ie, self-esteem, presence of psychopathological symptoms, eating and body image-related problems, and perceived stress) and to evaluate differences in body image quality of life due to gender.
Patients and methods
The sample comprised 417 students without any psychiatric history, recruited from the Pablo de Olavide University and the University of Seville. There were 140 men (33.57%) and 277 women (66.43%), and the mean age was 21.62 years (standard deviation = 5.12). After obtaining informed consent from all participants, the following questionnaires were administered: BIQLI, Eating Disorder Inventory-2 (EDI-2), Perceived Stress Questionnaire (PSQ), Self-Esteem Scale (SES), and Symptom Checklist-90-Revised (SCL-90-R).
The BIQLI-SP shows adequate psychometric properties, and it may be useful to determine the body image quality of life in different physical conditions. A more positive body image quality of life is associated with better self-esteem, better psychological wellbeing, and fewer eating-related dysfunctional attitudes, this being more evident among women.
The BIQLI-SP may be useful to determine the body image quality of life in different contexts with regard to dermatology, cosmetic and reconstructive surgery, and endocrinology, among others. In these fields of study, a new trend has emerged to assess body image-related quality of life.
body appreciation; wellbeing; self-esteem; social functioning; gender differences
To assess the psychometric properties of the Thai version of the 15-item Geriatric Depression Scale (TGDS-15) when screening for major depression (MDD) among geriatric outpatients (GOs) and long-term care (LTC) home residents in Thailand.
This was a cross-sectional study of 156 geriatric outpatients and 81 LTC home residents. All 237 participants were given a Mini-Mental State Examination, a MDD diagnosis according to the Mini-International Neuropsychiatric Interview, and completed a TGDS-15 questionnaire. Sensitivity, specificity, overall accuracy, and positive and negative predictive values were calculated. A comparison between the two groups was carried out. Differential Item Functioning (DIF) using logistic regression and factor analytic study were also applied.
Overall, 38.4% of the participants were found to have MDD. The TGDS-15 was found to perform better when used with the GOs than with the LTC home residents, revealing a sensitivity of 0.92 and a specificity of 0.87 in the GOs (cut-off score of ≥ 5), but a sensitivity of 100% and a specificity of 49% with the LTC home group (cut-off score of ≥ 8), when comparing only cognitively intact subjects. The negative predictive value (NPV) was very good for both groups, but the positive predictive value (PPV) for the GO group was much better than for those in the LTC group (83.3% vs. 31.2%). Seven uniform DIF items were found - 2 by gender and 4 by age. Cronbach’s alpha was higher for the GO group than for the LTC home residents. Factor analysis supported a two-factor solution, using the ‘depressed mood’ and ‘positive mood’ factors, which accounted for 46.55% of the total variance.
The TGDS-15 scale was effective at screening for MDD in elderly cognitively intact Thais, those in both GO and LTC settings, as the sensitivity and NPV were shown to be very good in both groups. However, in the LTC setting, the low specificity and PPV found leads to the need for a further assessment to be carried among the potentially depressed individuals, based on the GDS results. Taking the factor analytic study into account, a more suitable version of the GDS should be developed.
Geriatric Depression Scale; Elderly; Long-term care home; Thai
The concept of `mindfulness´ was operationalized primarily for patients with chronic stressors, while it is rarely used in reference to soldiers. We intended to validate a modified instrument on the basis of the Freiburg Mindfulness Inventory (FMI) to measure soldiers’ situational awareness (“mindfulness”) in stressful situations/missions. The instrument we will explore in this paper is termed the Conscious Presence and Self Control (CPSC) scale.
The CPSC and further instruments, i.e., Perceived Stress Scale (PSS), stressful military experiences (PCL-M), life satisfaction (BMLSS), Positive Life Construction (ePLC), and self-perceived health affections (VAS), were administered to 281 German soldiers. The soldiers were mainly exposed to explosive ordnance, military police, medical service, and patients with posttraumatic stress disorders.
The 10-item CPSC scale exhibited a one-factorial structure and showed a good internal consistence (Cronbach´s alpha = .86); there were neither ceiling nor bottom effects. The CPSC scores correlated moderately with Positive Life Construction and life satisfaction, and negatively with perceived stress and health affections. Regression analyses indicated that posttraumatic stress disorder symptoms (negative), and the development of effective strategies to deal with disturbing pictures and experiences (positive) were the best predictor of soldiers´ CPSC scores. Soldiers with health affections exhibiting impact upon their daily life had significantly lower CPSC scores than those without impairment (F=8.1; p < .0001).
As core conceptualizations of `mindfulness´ are not necessarily discussed in a military context, the FMI was adopted for military personnel populations, while its two factorial structure with the sub-constructs `acceptance´ and `presence´ was retained. The resulting 10-item CPSC scale had good internal consistence, sound associations with measures of health affections and life satisfaction, and thus can be used as a short and rapid measure in pre-post mission and interventional studies.
Mindfulness; Conscious presence; Soldiers; Trauma; Validation; Questionnaire
Anesthesiology may be stressful and most anesthesiologists develop mechanisms for coping. However, inexperienced trainee anesthesiologists seem to be vulnerable. We studied stress perception and job burnout in trainee anesthesiologists.
Responses to perceived stress scale (PSS) and Maslach Burnout Inventory (MBI) were evaluated in 159 trainee anesthesiologists.
In our results, when perceived stress was increased, emotional exhaustion and depersonalization increased but personal accomplishment decreased, as expected. Perceived stress was very high in the early years of training. There was a negative correlation between age and emotional exhaustion and depersonalization, but positive correlation with personal accomplishment. Female anesthesiologists had higher personal accomplishment, but lower depersonalization points than male anesthesiologists in our study. There was no statistical association between marital status, PSS, and MBI; ≥2 children group had a significant high personal accomplishment but low depersonalization and emotional exhaustion scores. Line regression analysis showed a statistically significant relationship between PSS and emotional exhaustion and between age and depersonalization.
Social factors such as gender and number of children affect the work life of our trainees.
Job burnout; Maslach burnout inventory; perceived stress
The present pilot study was designed to test the effects of a 12 week group-based Cognitive Behavioral Stress Management (CBSM) intervention on stress, quality of life, and symptoms in chronic fatigue syndrome (CFS). We hypothesized that participants randomized to CBSM would report improvements in perceived stress, mood, quality of life, and CFS symptomatology from pre-to-post intervention compared to those receiving a psychoeducational (PE) seminar control.
We recruited 69 persons with a bonafide diagnosis of CFS and randomized 44 to CBSM and 25 to PE. Participants completed the Perceived Stress Scale (PSS),Profile of Mood States (POMS), Quality of Life Inventory (QOLI), and a CDC-based CFS symptom checklist pre- and post-intervention.
Repeated Measures ANOVA revealed a significant group × time interaction for PSS, POMS-total mood disturbance, and QOLIscores, such that participants in CBSM evidenced greater improvements than those in PE. Participants in CBSM also reported decreases in severity of CFS symptoms vs. those in PE.
Results suggest that CBSM is beneficial for managing distress, improving quality of life, and alleviating CFS symptom severity.
CDC symptoms; chronic fatigue syndrome; quality of life; stress; stress management
The role of stress in reproduction, particularly during treatment for infertility, has been of considerable interest; however, few studies have objectively measured stress and anxiety over the course of the IVF cycle or compared the experience of first-time and repeat patients.
This prospective cohort pilot study enrolled 44 women undergoing IVF at a university-based clinic to complete the State-Trait Anxiety Inventory (STAI), Perceived Stress Scale (PSS) and Infertility Self-Efficacy Scale (ISES) at three time points prior to ovarian stimulation (T1), one day prior to oocyte retrieval (T2), and 5–7 days post embryo transfer (T3).
Mean STAI State scores were significantly elevated at all three time points (p<0.01). STAI State and PSS mean values did not change over time and did not differ in first-time vs. repeat patients. Self-efficacy (ISES) scores declined over time, with a greater decline for repeat patients. Of the 36 women who completed a cycle, 15 achieved clinical pregnancy. Using logistic regression modeling, all scores at T2 were correlated with pregnancy outcome with lower scores on the STAI State and PSS and higher scores on the ISES associated with higher pregnancy rates.
Stress and anxiety levels remained elevated across all cycles. Women with lower stress and anxiety levels on the day prior to oocyte retrieval had a higher pregnancy rate. These results emphasize the need to investigate stress reduction modalities throughout the IVF cycle.
The Body Image Scale (BIS) developed in collaboration with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Study Group is a brief questionnaire for measuring body image concerns in patients with cancer. This study sought to assess the reliability and validity of the Korean version of the Body Image Scale (K-BIS).
The participants consisted of 155 postoperative breast cancer patients (56 breast conserving surgery, 56 mastectomy, and 43 oncoplastic surgery). Subjects were evaluated using the K-BIS, the Body-Esteem Scale for Adolescents and Adults (BESAA), the Rosenberg Self-Esteem Scale (RSES), the Hospital Anxiety and Depression Scale (HADS), and the World Health Organization Quality of Life Scale Abbreviated Version (WHOQOL-BREF). Test-retest reliability and internal consistency were examined as a measure of reliability and validity was evaluated by convergent validity, discriminant validity and factor analysis.
Cronbach's α value was 0.943. The total score of the K-BIS was negatively correlated with the BESAA (r=0.301, p<0.001) and the body image facet in the WHOQOL-BREF (r=0.315, p<0.001). The total score of K-BIS positively correlated with the HADS (HAD-A: r=0.501, p<0.001, HAD-D: r=0.466, p<0.001). As for determining discriminant validity, scores were compared between the BCS subgroup, mastectomy subgroup, and oncoplastic surgery subgroup. Difference between the mastectomy subgroup and oncoplastic surgery subgroup was statistically significant (p=0.017). Factor analysis resulted in a single factor solution in three out of four anlyses, accounting for >59% variance.
The K-BIS showed good reliability and validity for assessment of body image in Korean breast cancer patients.
Body image; Breast cancer; Quality of life; Reliability; Validity; Korean