评估更新版本的荷兰多维综合社会心理筛查工具在冠心病患者和普通人群中的心理测量特性和有效性,根据欧洲心脏病学会的指南建议。
荷兰普通人群的678名参与者(Mage=48.2,SD=16.8;46%为男性)和最近接受经皮冠状动脉介入治疗的312名心脏病患者(Mage=65.9,SD=9.9;77%为男性)完成了综合社会心理筛查工具并验证了抑郁症问卷(PHQ-9)。焦虑(GAD-7),D型人格(DS14),敌意(CMHS),愤怒(STAS-T),创伤(SRIP),以及长期的工作和家庭压力(ERI,MMQ-6)。
验证性因素分析(CFA)证实,8个筛查的危险因素最好作为单独的实体进行测量。而不是更广泛的痛苦迹象。票据间协议,用组内系数(ICC)和筛查准确性指标(接受操作者特征[ROC]曲线,灵敏度,特异性,阳性和阴性预测值[PPV;NPV])对大多数筛查的危险因素均良好。PPV在焦虑等低患病率风险因素中很低,创伤,和抑郁症。
总的来说,当前版本的综合社会心理筛查工具在这两个人群中都有可接受的表现,与既定的完整问卷达成公平至卓越的协议。除了一些进一步完善的建议,筛选器可以在初级保健和心脏病学实践中实施。
To evaluate the psychometric properties and validity of the updated version of the Dutch multidimensional Comprehensive Psychosocial Screening Instrument in patients with coronary heart disease and the general population, based upon
guideline recommendations from the European Society for Cardiology.
678 participants (Mage = 48.2, SD = 16.8; 46% male) of the Dutch general population and 312 cardiac patients (Mage = 65.9, SD = 9.9; 77% male) who recently received percutaneous coronary intervention completed the Comprehensive Psychosocial Screening Instrument and validated questionnaires for depression (PHQ-9), anxiety (GAD-7), Type D personality (DS14), hostility (CMHS), anger (STAS-T), trauma (SRIP), and chronic work and family stress (ERI, MMQ-6).
Confirmatory factor analysis (CFA) confirmed that the eight screened risk factors were best measured as separate entities, rather than broader indications of distress. Inter-instrument agreement, assessed with the intraclass coefficient (ICC) and the screening accuracy indicators (receiving operator characteristic [ROC] curves, sensitivity, specificity, and the positive and negative predictive values [PPV; NPV]) were good for most screened risk factors. PPV was low in low prevalence risk factors like anxiety, trauma, and depression.
Overall, the current version of the Comprehensive Psychosocial Screening Instrument has an acceptable performance in both populations, with a fair to excellent level of agreement with established full questionnaires. Besides a few suggestions for further refinement, the screener may be implemented in primary care and cardiological practice.