Estudo psicométrico da Hospital Anxiety and Depression Scale com profissionais de saúde

Priscila Pereira da Silva  Lopes; Rafaela Schaefer; Juliana Nichterwitz Scherer

doi:10.11606/s1518-8787.2025059006420

Authors

Priscila Pereira da Silva Lopes Universidade do Vale do Rio dos Sinos. Programa de Pós-Graduação em Saúde Coletiva. São Leopoldo, RS, Brasil https://orcid.org/0000-0002-0330-5382
Rafaela Schaefer Universidade do Vale do Rio dos Sinos. Programa de Pós-Graduação em Saúde Coletiva. São Leopoldo, RS, Brasil https://orcid.org/0000-0002-1484-8067
Juliana Nichterwitz Scherer Universidade do Vale do Rio dos Sinos. Programa de Pós-Graduação em Saúde Coletiva. São Leopoldo, RS, Brasil https://orcid.org/0000-0002-9235-0416

DOI:

https://doi.org/10.11606/s1518-8787.2025059006420

Keywords:

Validation Study, Psychometrics, Anxiety, Depression, Health Care Workers, Primary Health Care

Abstract

OBJECTIVE: To assess the validity of the internal structure and reliability of the Brazilian version of the Hospital Anxiety and Depression Scale (HADS) for screening depressive and anxious symptoms in primary care health professionals. METHODS: A psychometric study carried out with health professionals from primary health care services in a municipality in Rio Grande do Sul, Brazil, in 2023. The quality of the HADS instrument was assessed by internal structural validity, using Exploratory Factor Analysis (EFA), Confirmatory Factor Analysis (CFA), and internal consistency, using Cronbach’s Alpha and McDonald’s Omega coefficients. RESULTS: 217 health professionals took part in the study, of both sexes and from different professional categories, such as doctors, nurses, nursing technicians and assistants, dentists and oral health assistants, and community health workers. The EFA showed the two-factor model, anxiety and depression, as originally proposed. The CFA confirmed that the two-dimensional model was a good fit for the sample investigated. The Alpha and Omega values were 0.833 and 0.838 for anxiety and 0.763 and 0.766 for depression, respectively. Both indicated acceptable reliability. CONCLUSIONS: The HADS is a valid and reliable instrument for screening symptoms of anxiety and depression in primary care professionals in Rio Grande do Sul, Brazil.

References

World Health Organization. Depression and other common mental disorders: global health estimates, Geneva: World Health Organization; 2017.

Guilland R, Klokner SG, Knapik J, Crocce-Carlotto PA, Ródio-Trevisan KR, Zimath SC, et al. Prevalência de sintomas de depressão e ansiedade em trabalhadores durante a pandemia da Covid-19. Trab Educ Saúde. 2022;20:e00186169. https://doi.org/10.1590/1981-7746-ojs00186.

Gray P, Senabe S, Naicker N, Kgalamono S, Yassi A, Spiegel JM. Workplace-based organizational interventions promoting mental health and happiness among healthcare workers: a realist review. Int J Environ Res Public Health. 2019 Nov;16(22):2. https://doi.org/10.3390/ijerph16224396.

Julio RD, Lourenção LG, Oliveira SM, Farias DHR, Gazetta CE. Prevalência de ansiedade e depressão em trabalhadores da Atenção Primária à Saúde. Cad Bras Ter Ocup. 2022;30:e2997. https://doi.org/10.1590/2526-8910.CTOAO22712997.

Søvold LE, Naslund JA, Kousoulis AA, Saxena S, Qoronfleh MW, Grobler C, et al. Prioritizing the mental health and well-being of healthcare workers: an urgent global public health priority. Front Public Health. 2021 May;9:679397. https://doi.org/10.3389/fpubh.2021.679397.

Tabur A, Elkefi S, Emhan A, Mengenci C, Bez Y, Asan O. Anxiety, Burnout and depression, psychological well-being as predictor of healthcare professionals’ turnover during the covid-19 pandemic: study in a pandemic hospital. Healthcare (Basel). 2022 Mar;10(3):1. https://doi.org/10.3390/healthcare10030525.

Enns V, Currie S, Wang J. Professional autonomy and work setting as contributing factors to depression and absenteeism in Canadian nurses. Nurs Outlook. 2015;63(3):269-77. https://doi.org/10.1016/j.outlook.2014.12.014.

Baptista MN, Borges L. Revisão integrativa de instrumentos de depressão em crianças/adolescentes e adultos na população Brasileira. Aval Psicol. 2016 ago;15(no spe):19-32.

DeSousa DA, Moreno AL, Gauer G, Manfro GG, Koller SH. Revisão sistemática de instrumentos para avaliação de ansiedade na população brasileira. Aval Psicol. 2013 dez;12:397-410.

Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983 Jun;67(6):361-70. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x.

Botega NJ, Bio MR, Zomignani MA, Garcia C Jr, Pereira WA. Transtornos do humor em enfermaria de clínica médica e validação de escala de medida (HAD) de ansiedade e depressão. Rev Saude Publica. 1995;29(5):359-63. https://doi.org/10.1590/S0034-89101995000500004.

Cassiani-Miranda CA, Scoppetta O, Cabanzo-Arenas DF. Validity of the Hospital Anxiety and Depression Scale (HADS) in primary care patients in Colombia. Gen Hosp Psychiatry. 2022;74:102-9. https://doi.org/10.1016/j.genhosppsych.2021.01.014.

Piffer L, Schmidt ML, Júnior JM. Ansiedade e depressão entre profissionais de enfermagem em UPA durante a pandemia da covid-19. Rev Psicol Saúde. 2021;13:173-85. https://doi.org/10.20435/pssa.v13i3.1565.

Tasnim R, Sujan MS, Islam MS, Ritu AH, Siddique MA, Toma TY, et al. Prevalence and correlates of anxiety and depression in frontline healthcare workers treating people with COVID-19 in Bangladesh. BMC Psychiatry. 2021 May;21(1):271. https://doi.org/10.1186/s12888-021-03243-w.

Pasquali L. Psicometria Rev Esc Enferm USP. 2009;43(spe):992-9. https://doi.org/10.1590/S0080-62342009000500002.

American Educational Research Association, American Psychological Association, National Council on Measurement in Education. Standards for educational and psychological testing. Washington, DC; 2014 [citado16 set 2024]. Disponível em: https://www.testingstandards.net/ uploads/7/6/6/4/76643089/standards_2014edition.pdf.

Lima DV. Research design: a contribution to the author. Online Braz J Nurs. 2011 Oct;10(2):17. https://doi.org/10.5935/1676-4285.20113648mismatch.

Brown TA. Confirmatory factor analysis for applied research. New York: The Guilford Press; 2015.

Hu LT, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Modeling. 1999;6(1):1-55. https://doi.org/10.1080/10705519909540118.

Khalesi N, Arabloo J, Khosravizadeh O, et al. Psychometric properties of the Persian version of the “Hospital Ethical Climate Survey”. J Med Ethics Hist Med. 2014 Sep;7:15.

Hair JF, Black WC, Babin BJ, et al. Análise multivariada de dados. 6a ed. Porto Alegre: Bookman; 2009.

Kline RB. Principles and practice of structural equation modeling. 2a ed. New York: Guilford; 2005.

Campo-Arias A, Oviedo HC. Propiedades psicométricas de una escala: la consistencia interna. Rev Salud Publica. 2008 dic;10(5):831-9.

Ventura-León JL, Caycho-Rodríguez T. El coeficiente Omega: un método alternativo para la estimación de la confiabilidad. Rev Latinoam Ciencias Sociales. 2014;15(1):625-7.

Pinar R, Celik R, Bahcecik N. Reliability and construct validity of the Health-Promoting Lifestyle Profile II in an adult Turkish population. Nurs Res. 2009;58(3):184-93. https://doi.org/10.1097/NNR.0b013e31819a8248.

Streiner DL. Starting at the beginning: an introduction to coefficient alpha and internal consistency. J Pers Assess. 2003 Feb;80(1):99-103. https://doi.org/10.1207/S15327752JPA8001_18.

Cosco TD, Doyle F, Ward M, McGee H. Latent structure of the Hospital Anxiety And Depression Scale: a 10-year systematic review. J Psychosom Res. 2012 Mar;72(3):180-4. https://doi.org/10.1016/j.jpsychores.2011.06.008.

Norton S, Cosco T, Doyle F, Done J, Sacker A. The Hospital Anxiety and Depression Scale: a meta confirmatory factor analysis. J Psychosom Res. 2013 Jan;74(1):74-81. https://doi.org/10.1016/j.jpsychores.2012.10.010.

Gough K, Hudson P. Psychometric properties of the Hospital Anxiety and Depression Scale in family caregivers of palliative care patients. J Pain Symptom Manage. 2009 May;37(5):797-806. https://doi.org/10.1016/j.jpainsymman.2008.04.012.

Lloyd M, Sugden N, Thomas M, McGrath A, Skilbeck C. The structure of the Hospital Anxiety and Depression Scale: theoretical and methodological considerations. Br J Psychol. 2023 May;114(2):457-75. https://doi.org/10.1111/bjop.12637.

Stott J, Spector A, Orrell M, Scior K, Sweeney J, Charlesworth G. Limited validity of the Hospital Anxiety and Depression Scale (HADS) in dementia: evidence from a confirmatory factor analysis. Int J Geriatr Psychiatry. 2017 Jul;32(7):805-13. https://doi.org/10.1002/gps.4530.

Schmidt DR, Dantas RA, Marziale MH. Ansiedade e depressão entre profissionais de enfermagem que atuam em blocos cirúrgicos. Rev Esc Enferm USP. 2011 Apr;45(2):487-93. https://doi.org/10.1590/S0080-62342011000200026.

Tan BY, Kanneganti A, Lim LJ, Tan M, Chua YX, Tan L, et al. Burnout and associated factors among health care workers in Singapore during the COVID-19 pandemic. J Am Med Dir Assoc. 2020 Dec;21(12):1751-1758.e5. https://doi.org/10.1016/j.jamda.2020.09.035.

Psychometric study of the Hospital Anxiety and Depression Scale with health professionals

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