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Psychometric Evaluation of Patient Health Questionnaire 9 Hindi for Use with Patients with Cancer in Community
Tushti Bhardwaj1, Neha Arora2, Ambika Rajvanshi3
1Department of Social Work, Dr. Bhim Rao Ambedkar College (University of Delhi), New Delhi, India.
Objectives:
Patient Health Questionnaire 9 (PHQ-9) has previously undergone validation with patients with various types of cancer, but psychometric validation of PHQ-9 Hindi among patients with cancer receiving palliative care services in northern regions of India is required. This study aimed at psychometric validation of a culturally adapted version of PHQ-9 Hindi for early screening of depression among cancer patients receiving palliative care services in a community setting.
Materials And Methods:
A sample of adult patients (n = 228) with cancer receiving palliative care services in a community setting participated in the research. A 50% subset of the sample was contacted for repeat assessment twice, each after a period of 3-4 weeks. For validation, a previously adapted version of PHQ-9 Hindi, along with a demographic sheet, was employed to collect data. In addition, we used the recently validated Integrated Palliative Care Outcome Scale to assess the validity of PHQ-9 within palliative care settings. Exploratory and confirmatory factor analyses were conducted, followed by test-retest reliability, interclass correlation, construct validity and divergent validity examination.
Results:
The exploratory factor analysis revealed a two-factor solution consistent with the hypothesised model, yielding two sub-scales namely, physical and emotional concerns. The confirmatory factor indices within our sample were conclusive suggesting a relatively good fit between the hypothesised model and the observed data, thus confirming the cross-cultural validity of PHQ-9 Hindi. The physical sub-scale confirmed moderate internal consistency (α = 0.5) while the emotional sub-scale presented high internal consistency (α = 0.734). The associations between PHQ-9 Hindi with IPOS Hindi individual items were significant (P < 0.001).
Conclusion:
A psychometrically validated version of PHQ-9 Hindi has been presented to screen depression among patients with cancer in northern parts of India. Further research is required to adapt and check the validity of PHQ-9 in other regional languages among different populations across the country.
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