Testing the PHQ-9 Interview and Observational Versions (PHQ-9 OV) for MDS 3.0
Testing the PHQ-9 Interview and Observational Versions (PHQ-9 OV) for MDS 3.0
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DOI：
10.1016/j.jamda.2012.06.003
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发表时间：
2012-09-01
影响因子：
7.6
通讯作者：
Streim, Joel
中科院分区：
文献类型：
--
作者：
Saliba, Debra;DiFilippo, Suzanne;Streim, Joel
目的：为了测试的可行性和有效性的病人健康问卷-9项目访谈（PHQ-9）和新开发的病人健康问卷观察版（PHQ-9 OV）的筛查情绪disorder.Methods：PHQ-9进行了测试，作为国家最小数据集3.0（MDS 3.0）的评估研究的一部分，3822名居民计划MDS 2.0评估。来自8个州的71个社区养老院（NHs）的居民被随机纳入可行性样本（n = 3258）和验证样本（n = 418）。每个居民的沟通能力决定了PHQ-9面试或PHQ-9 OV最初是尝试。在验证样本中，训练有素的研究护士管理的仪器。对于验证样本中没有严重认知障碍（3 MS >= 30）的居民，使用加权kappa（kappa）测量PHQ-9与情感障碍和精神分裂症改良量表（m-SADS）之间的一致性。对于严重认知障碍（3 MS < 30）的居民，使用相关系数测量PHQ-9访谈或PHQ-9 OV与康奈尔痴呆抑郁量表（Cornell Scale）之间的一致性。工作人员的印象是从一个匿名调查邮寄给所有MDS assessors.Results：PHQ-9完成了86%的3258居民的可行性样本。在验证样本中，PHQ-9和m-SADS之间的一致性非常好（加权kappa = 0.69，95%CI = 0.61-0.76），而MDS 2.0和m-SADS之间的一致性较差（加权kappa = 0.15，95%CI = 0.06-0.25）。同样，在患有严重认知障碍的居民中，PHQ-9（0.63 vs 0.34）和PHQ-9 OV（0.84 vs 0.28）的PHQ与标准康奈尔量表的相关性均上级MDS 2.0。86%的受访者表示，PHQ-9提供了对居民情绪的新见解。完成PHQ-9访谈的平均时间为4 minutes.Discussion：与MDS 2.0观察项目相比，PHQ-9访谈与标准诊断评估有更大的一致性。对于无法完成访谈的居民，PHQ-9 OV也比MDS 2.0观察项目与抑郁症标准测量的一致性更高。此外，大多数NH居民能够完成PHQ-9，大多数接受调查的工作人员报告说，新方法改善了评估。爱思唯尔公司出版代表美国医疗主任协会，公司。
Objectives: To test the feasibility and validity of the Patient Health Questionnaire-9 item interview (PHQ-9) and the newly developed Patient Health Questionnaire Observational Version (PHQ-9 OV) for screening for mood disorder in nursing home populations.Methods: The PHQ-9 was tested as part of the national Minimum Data Set 3.0 (MDS 3.0) evaluation study among 3822 residents scheduled for MDS 2.0 assessments. Residents from 71 community nursing homes (NHs) in eight states were randomly included in a feasibility sample (n = 3258) and a validation sample (n = 418). Each resident's ability to communicate determined whether the PHQ-9 interview or the PHQ-9 OV was initially attempted. In the validation sample, trained research nurses administered the instruments. For residents in the validation sample without severe cognitive impairment (3 MS >= 30) agreement between PHQ-9 and the modified Schedule for Affective Disorders and Schizophrenia (m-SADS) was measured with weighted kappas (kappa). For residents with severe cognitive impairment (3MS < 30), agreement between PHQ-9 interview or PHQ-9 OV and the Cornell Scale for Depression in Dementia (Cornell Scale) was measured using correlation coefficients. Staff impressions were obtained from an anonymous survey mailed to all MDS assessors.Results: The PHQ-9 was completed in 86% of the 3258 residents in the feasibility sample. In the validation sample, the agreement between PHQ-9 and m-SADS was very good (weighted kappa = 0.69, 95% CI = 0.61-0.76), whereas agreement between MDS 2.0 and m-SADS was poor (weighted kappa = 0.15, 95% CI = 0.06-0.25). Likewise, in residents with severe cognitive impairment, PHQ correlations with the criterion standard Cornell Scale were superior to the MDS 2.0 for both the PHQ-9 (0.63 vs 0.34) and the PHQ-9 OV (0.84 vs 0.28). Eighty-six percent of survey respondents reported that the PHQ-9 provided new insight into residents' mood. The average time for completing the PHQ-9 interview was 4 minutes.Discussion: Compared with the MDS 2.0 observational items, the PHQ-9 interview had greater agreement with criterion standard diagnostic assessments. For residents who could not complete the interview, the PHQ-9 OV also had greater agreement with a criterion measure for depression than did the MDS 2.0 observational items. Moreover, the majority of NH residents were able to complete the PHQ-9, and most surveyed staff reported improved assessments with the new approach. Published by Elsevier Inc. on behalf of the American Medical Directors Association, Inc.