wording effects and the factor structure of the hospital anxiety depression scale in hivaids patients on antiretroviral treatment in south africa措辞效果和医院焦虑和抑郁量表的因素结构在南非在抗逆转录病毒治疗的条件.pdf

Wording Effects and the Factor Structure of the Hospital Anxiety Depression Scale in HIV/AIDS Patients on Antiretroviral Treatment in South Africa Edwin Wouters1,2*, Frederik le Roux Booysen2,3, Koen Ponnet1,4, Francis Baron Van Loon1 1 Department of Sociology and Research Centre for Longitudinal and Life Course Studies, University of Antwerp, Antwerp, Belgium, 2 Centre for Health Systems Research and Development, University of the Free State, Bloemfontein, Republic of South Africa, 3 Department of Economics, University of the Free State, Bloemfontein, Republic of South Africa, 4 Media ICT in Organisations and Societies (MIOS), University of Antwerp, Antwerp, Belgium Abstract Background: Given the immense burden of HIV/AIDS on health systems in sub-Saharan Africa and the intricate link between HIV/AIDS and mental health problems, health care providers need a valid and reliable instrument to assess mental health rapidly. The Hospital Anxiety and Depression Scale (HADS) may constitute such an instrument. The aims of this study were to: (1) examine the factor structure of the HADS in a population of South African HIV/AIDS patients on antiretroviral treatment (ART); and (2) identify and control the disturbing influence of systematic wording effects in vulnerable respondent groups. Methodology/Principal Findings: The translated scale was administered to 716 HIV/AIDS patients enrolled in the public sector ART program in South Africa. A combined confirmatory factor analysis and correlated-traits-correlated-methods framework was used to determine the preferred factor structure of the HADS, while controlling for the disturbing influence of systematic wording effects. When assessing the structure without a negative wording factor, all three factor structures displayed an acceptable fit to the data. The three-factor