Psychometric Limitations of the Center for Epidemiologic Studies-Depression Scale for Assessing Depressive Symptoms among Adults with HIV/AIDS: A Rasch Analysis.
Psychometric Limitations of the Center for Epidemiologic Studies-Depression Scale for Assessing Depressive Symptoms among Adults with HIV/AIDS: A Rasch Analysis.
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DOI：
10.1155/2016/2824595
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发表时间：
2016-01-01
影响因子：
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通讯作者：
Lee, Kathryn A
中科院分区：
文献类型：
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作者：
Gay, Caryl L;Kottorp, Anders;Lee, Kathryn A
流行病学研究中心抑郁量表(CES-D)是一种广泛使用的抑郁症状测量工具，但其心理测量学特性在成年艾滋病毒/艾滋病患者中尚未得到充分评估。本研究使用项目反应理论方法(Rasch分析)来评估CES-D在成人HIV/AIDS患者中与关键人口学和临床变量相关的效度和可靠性。对347名成年艾滋病毒/艾滋病患者(231名男性，93名女性，23名变性者，年龄范围22-77岁)进行了便利抽样，完成了CES-D。采用Rasch模型分析CES-D的评定量表功能、内部量表效度、人-反应效度、人与人分离效度、内部一致性、差异项目功能(DIF)和差异测试功能。CES-D得分普遍较高，并与几个人口统计学和临床变量有关。CES-D分为3个不同程度的抑郁，内部一致性可以接受，但缺乏单维度，5个条目显示与模型不匹配，15%的受访者表示不匹配，8个条目显示DIF与性别、种族或艾滋病诊断有关。剔除不匹配的条目对CES-D的实质和结构效度的改善微乎其微。在成人艾滋病毒/艾滋病患者中，应谨慎解读CES-D分数，特别是在比较不同性别和种族群体的分数时。
The Center for Epidemiological Studies-Depression (CES-D) scale is a widely used measure of depressive symptoms, but its psychometric properties have not been adequately evaluated among adults with HIV/AIDS. This study used an item response theory approach (Rasch analysis) to evaluate the CES-D's validity and reliability in relation to key demographic and clinical variables in adults with HIV/AIDS. A convenience sample of 347 adults with HIV/AIDS (231 males, 93 females, and 23 transgenders; age range 22-77 years) completed the CES-D. A Rasch model application was used to analyze the CES-D's rating scale functioning, internal scale validity, person-response validity, person-separation validity, internal consistency, differential item functioning (DIF), and differential test functioning. CES-D scores were generally high and associated with several demographic and clinical variables. The CES-D distinguished 3 distinct levels of depression and had acceptable internal consistency but lacked unidimensionality, five items demonstrated poor fit to the model, 15% of the respondents demonstrated poor fit, and eight items demonstrated DIF related to gender, race, or AIDS diagnosis. Removal of misfitting items resulted in minimal improvement in the CES-D's substantive and structural validity. CES-D scores should be interpreted with caution in adults with HIV/AIDS, particularly when comparing scores across gender and racial groups.