Publication: Reliability and Validity of a Nepali-language Version of the Hospital Anxiety and Depression Scale (HADS)
Date
2015
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
In several languages and settings, the Hospital Anxiety and Depression Scale (HADS)
has demonstrated reliable and valid screening properties in psychiatry.
Objective
To develop a Nepali version of HADS with acceptable reliability and construct validity
for use among hospital patients and in the general population.
Method
The original English version was translated into Nepali using a forward-backward
translation protocol. Psychometric properties were tested by factor analysis and
Cronbach’s alpha. The translated scale was administered to three groups of adult
in-patients in a university hospital in three trials, and to a sample of adults from the
community in a fourth trial. Some of the 14 items were reworded reiteratively to
achieve viable semantic and statistical solutions.
Results
The two-factor solution with anxiety and depression subscales eventually explained
40.3% of the total variance. Cronbach’s alpha was 0.76 for anxiety (HADS-A) and
0.68 for depression (HADS-D). All seven HADS-A items showed at least acceptable
item-to-factor correlations (range 0.44-0.74), and full construct validity was achieved
for this subscale. Item-to-factor correlations for six HADS-D items were also at
least acceptable (range 0.42-0.70); one item (D4) had persistently low correlations
throughout all trials, although construct validity was still satisfactory.
Conclusion
Reiterated rewording of items guided by statistical testing resulted in a Nepali version
of HADS with satisfactory psychometric properties.
KEY WORDS
Item translation, psychometrics, psychopathology, screening, transcultural psychiatry.
Description
Risal A,1,2 Manandhar K,1,2 Linde M,2,3 Koju R,1 Steiner TJ,2,4 Holen A2,5
1Dhulikhel Hospital, Kathmandu University Hospital
Dhulikhel, Kavre, Nepal
2Department of Neuroscience
Norwegian University of Science and Technology
Trondheim, Norway
3Norwegian Advisory Unit on Headaches
St Olavs University Hospital
Trondheim, Norway
4Division of Brain Sciences
Imperial College London, London, UK
5Pain Unit, St Olavs University Hospital
Trondheim, Norway
Keywords
Item translation, Psychometrics, Psychopathology, Screening, Transcultural psychiatry