Adaptación y validación de la Patient Health Questionnaire for Depression and Anxiety (PHQ-4) en una muestra de quechua hablantes peruanos
DOI:
https://doi.org/10.52379/mcs.v8i1.361Palabras clave:
ansiedad, depresión, validez, quechua hablanteResumen
Introducción: El Patient Health Questionnaire for Depression and Anxiety (PHQ-4) es una medida de autoinforme ultrabreve de síntomas depresivos y ansiosos. El PHQ-4 no ha sido adaptado ni validado en la población quechua hablante. Objetivo: Este estudio tuvo como objetivo adaptar y validar el PHQ-4 en una muestra de población peruana quechua hablante en su variante Collao de Puno-Perú. Metodología: Participaron 221 personas hablantes de quechua variante collao (promedio de edad de 31,2 años, SD = 11,7, 47,1 % hombres y 52,9 % mujeres). Se evaluó la evidencia de validez basada en la estructura interna, mediante el análisis factorial confirmatorio (CFA), la fiabilidad con el método de consistencia interna y las características de dificultad y discriminación de los ítems en base a la Teoría de Respuesta al Ítem (IRT). Resultados: Los resultados indicaron que todos los ítems del PHQ-4 son relevantes, coherentes y claros para representar adecuadamente los síntomas de ansiedad y depresión. El resultado del AFC apoyó un modelo unifactorial, donde los ítems de ansiedad y depresión conforman una sola variable latente con una fiabilidad alta. Todos los ítems del PHQ-4 presentas buenos parámetros de discriminación y los parámetros de dificultad indican que los ítems son comparativamente difíciles. Por lo tanto, se necesita una mayor presencia del rasgo latente (ansiedad y depresión) para responder las categorías de respuesta más altas.Discusión: En conclusión, la PHQ-4 presentó buenas propiedades psicométricas como una medida de detección primaria rápida, confiable y válida para personas quechuahablantes que necesitan una evaluación profunda, monitoreo de los síntomas para diagnóstico y tratamiento para la ansiedad o depresión.
Descargas
Citas
Santomauro DF, Herrera AMM, Shadid J, Zheng P, Ashbaugh C, Pigott DM, et al. Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic. The Lancet 2021; 398(10312): 1700-12. https://doi.org/10.1016/S0140-6736(21)02143-7
World Health Organization. Depression and other common mental disorders: global health estimates. Switzerland: World Health Organization: 2017.
Vos T, Lim SS, Abbafati C, Abbas KM, Abbasi M, Abbasifard M, et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet 2020; 396(10258): 1204-22. https://doi.org/10.1016/S0140-6736(20)30925-9
World Health Organization. World mental health report: transforming mental health for all. Executive summary. Ginebra: World Health Organization, 2022.
Tomfohr-Madsen LM, Racine N, Giesbrecht GF, Lebel C, Madigan S. Depression and anxiety in pregnancy during COVID-19: A rapid review and meta-analysis. Psychiatry Res. 2021; 300: 113912. https://doi.org/10.1016/j.psychres.2021.113912
Villarreal-Zegarra D, Copez-Lonzoy A, Vilela-Estrada AL, Huarcaya-Victoria J. Depression, post-traumatic stress, anxiety, and fear of COVID-19 in the general population and health-care workers: prevalence, relationship, and explicative model in Peru. BMC Psychiatry 2021; 21: 1-14. https://doi.org/10.1186/s12888-021-03456-z
Villarreal-Zegarra D, Reátegui-Rivera CM, Otazú-Alfaro S, Yantas-Alcantara G, Soto-Becerra P, Melendez-Torres GJ. Estimated impact of the COVID-19 pandemic on the prevalence and treatment of depressive symptoms in Peru: an interrupted time series analysis in 2014–2021. Soc Psychiatry Psychiatr Epidemiol. 2023; 1-11. https://doi.org/10.1007/s00127-023-02446-8
Huarcaya-Victoria J, Elera-Fitzcarrald C, Crisol-Deza D, Villanueva-Zúñiga L, Pacherres A, Torres A, et al. Factors associated with mental health in Peruvian medical students during the COVID-19 pandemic: a multicentre quantitative study. Rev Colomb Psiquiatr (Engl Ed). 2021;S0034-7450(21)00108-6. https://doi.org/10.1016/j.rcp.2021.06.002
Quispe-Sancho A, Chambi-Macedo KL, Laurel-Vargas V, Huamani-Merma E, Cuzcano-Gonzales KV, Huaita-Rocha MA, et al. Depression, Anxiety, and Stress in Health Professionals Working During the COVID-19 Pandemic in Peru: An Analytical Cross-Sectional Study. Electron J Gen Med. 2021;18(6):em319. https://doi.org/10.29333/ejgm/11210
Instituto Nacional de Estadística e Informática. Perú. Estado de la población en el año del bicentenario, 2021. Lima: Instituto Nacional de Estadística e Informática; 2021.
Cjuno J, Figueroa-Quiñones J, Marca-Dueñas GG, Carranza-Esteban RF. Producción científica sobre depresión en poblaciones Quechua hablantes: una revisión narrativa. Ter Psicol. 2021;39(2):163-74. http://dx.doi.org/10.4067/s0718-48082021000200163
Tremblay J, Pedersen D, Errazuriz C. Assessing mental health outcomes of political violence and civil unrest in Peru. Int J Soc Psychiatry. 2009;55(5):449-63. https://doi.org/10.1177/0020764009103214
Pedersen D, Kienzler H, Gamarra J. Llaki and nakary: idioms of distress and suffering among the highland Quechua in the Peruvian Andes. Cult Med Psychiatry. 2010;34:279-300. https://doi.org/10.1007/s11013-010-9173-z
Espinosa Menéndez N, Galindo Rosero A, Bastidas Lopera W, Monsalve Rojas JE. Estado actual de la población víctima de desplazamiento forzado en cuanto al enfoque diferencial de su atención, el derecho a la integridad, la subsistencia mínima y al ingreso económico. Ágora. 2012;12(1):19-46. https://doi.org/10.21500/16578031.220
Gallegos M, Martino P, Caycho-Rodríguez T, Calandra M, Razumovskiy A, Arias-Gallegos WL, et al. ¿Qué es el síndrome pos-COVID-19? Definición y actualización. Gac Med Mex. 2022; 158(6): 451-55. https://doi.org/10.24875/gmm.22000144
Darghouth S, Pedersen D, Bibeau G, Rousseau C. Painful languages of the body: Experiences of headache among women in two Peruvian communities. Cult Med Psychiatry. 2006;30:271-97. https://doi.org/10.1007/s11013-006-9021-3
Abe A-M. Psychiatrists and traditional healers: unwitting partners in global mental health. Int J Cult Ment Health. 2012;5(2):148–9. https://doi.org/10.1080/17542863.2010.512732
Ramos-Vera C, Quispe Callo G, Basauri Delgado M, Vallejos Saldarriaga J, Saintila J. Factorial and network structure of the Reynolds Adolescent Depression Scale (RADS-2) in Peruvian adolescents. Plos one 2023;18(5):e0286081. https://doi.org/10.1371/journal.pone.0286081
Villarreal-Zegarra D, Copez-Lonzoy A, Bernabé-Ortiz A, Melendez-Torres GJ, Bazo-Alvarez JC. Valid group comparisons can be made with the Patient Health Questionnaire (PHQ-9): A measurement invariance study across groups by demographic characteristics. PloS one 2019;14(9):e0221717. https://doi.org/10.1371/journal.pone.0221717
Baños-Chaparro J, Ynquillay-Lima P, Delgado FL, Guillen FGF. Evidencias psicométricas del Patient Health Questionnarie-2 para la evaluación de síntomas depresivos en adultos peruanos. Rev Ciencias Médicas. 2021;25(5):1-9. URL.
Caycho-Rodríguez T, Vilca LW, Carbajal-León C, White M, Vivanco-Vidal A, Saroli-Araníbar D, et al. Coronavirus Anxiety Scale: New psychometric evidence for the Spanish version based on CFA and IRT models in a Peruvian sample. Death Stud. 2022;46(5):1090-9. https://doi.org/10.1080/07481187.2020.1865480
Caycho-Rodríguez T, Valencia PD, Vilca LW, Carbajal-León C, Vivanco-Vidal A, Saroli-Araníbar D, et al. Cross-cultural validation of the new version of the Coronavirus Anxiety Scale in twelve Latin American countries. Curr Psychol. 2022;1-18. https://doi.org/10.1007/s12144-021-02563-0
Zhong QY, Gelaye B, Zaslavsky AM, Fann JR, Rondon MB, Sánchez SE, Williams MA. Diagnostic validity of the generalized anxiety disorder-7 (GAD-7) among pregnant women. PloS one. 2015;10(4):e0125096. https://doi.org/10.1371/journal.pone.0125096
Carlos-Colchado EM, Chavez-Aburto LA, Dextre-Paye KJ, Mallqui-García SA, De La Cruz-Valdiviano CB. Escalas de Depresión, Ansiedad y Estrés (DASS-21): evidencias psicométricas en universitarios. Eureka. 2023;20(1):26-42. URL.
Kroenke K, Spitzer RL, Williams JB, Löwe B. An ultra-brief screening scale for anxiety and depression: the PHQ–4. Psychosomatics.2009;50(6):613-21. https://doi.org/10.1016/S0033-3182(09)70864-3
Kroenke K, Baye F, Lourens SG. Comparative validity and responsiveness of PHQ-ADS and other composite anxiety-depression measures. J Affect Disord.2019;246:437-43. https://doi.org/10.1016/j.jad.2018.12.098
Staples LG, Dear BF, Gandy M, Fogliati V, Fogliati R, Karin E, ... Titov. Psychometric properties and clinical utility of brief measures of depression, anxiety, and general distress: The PHQ-2, GAD-2, and K-6. Gen Hosp Psychiatry.2019;56:13-8. https://doi.org/10.1016/j.genhosppsych.2018.11.003
Lenz AS, Li C. Evidence for measurement invariance and psychometric reliability for scores on the PHQ-4 from a rural and predominately Hispanic community. Meas Eval Couns Dev. 2022;55(1):17-29. https://doi.org/10.1080/07481756.2021.1906157
American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. Washington, DC: American psychiatric association; 2013
Byers AL, Yaffe K, Covinsky KE, Friedman MB, Bruce ML. High occurrence of mood and anxiety disorders among older adults: The National Comorbidity Survey Replication. Arch Gen Psychiatry. 2010;67(5):489-96. https://doi.org/10.1001/archgenpsychiatry.2010.35
Cummings CM, Caporino NE, Kendall PC. Comorbidity of anxiety and depression in children and adolescents: 20 years after. Psychol Bull. 2014;140(3):816–45. https://doi.org/10.1037/a0034733
Löwe B, Wahl I, Rose M, Spitzer C, Glaesmer H, Wingenfeld K, et al. A 4-item measure of depression and anxiety: validation and standardization of the Patient Health Questionnaire-4 (PHQ-4) in the general population. J Affect Disord. 2010;122(1-2):86-95. https://doi.org/10.1016/j.jad.2009.06.019
Kim HW, Shin C, Lee SH, Han C. Standardization of the Korean version of the Patient Health Questionnaire-4 (PHQ-4). Clin Psychopharmacol Neurosci. 2021;19(1):104-11. https://doi.org/10.9758/cpn.2021.19.1.104
Khubchandani J, Brey R, Kotecki J, Kleinfelder J, Anderson J. The psychometric properties of PHQ-4 depression and anxiety screening scale among college students. Arch Psychiatr Nurs. 2016;30(4):457-62. https://doi.org/10.1016/j.apnu.2016.01.014
Rodríguez-Muñoz MDLF, Ruiz-Segovia N, Soto-Balbuena C, Le HN, Olivares-Crespo ME, Izquierdo-Méndez N. The psychometric properties of the patient health questionnaire-4 for pregnant women. Int J Environ Res Public Health. 2020;17(20):7583. https://doi.org/10.3390/ijerph17207583
Mills SD, Fox RS, Pan TM, Malcarne VL, Roesch SC, Sadler GR. Psychometric evaluation of the patient health questionnaire–4 in Hispanic Americans. Hisp J Behav Sci. 2015;37(4):560-71. https://doi.org/10.1177/0739986315608126
Kocalevent RD, Finck C, Jimenez-Leal W, Sautier L, Hinz A. Standardization of the Colombian version of the PHQ-4 in the general population. BMC Psychiatry. 2014;14(1):1-8. https://doi.org/10.1186/1471-244X-14-205
Renovanz M, Soebianto S, Tsakmaklis H, Keric N, Nadji-Ohl M, Beutel M, et al. Evaluation of the psychological burden during the early disease trajectory in patients with intracranial tumors by the ultra-brief Patient Health Questionnaire for Depression and Anxiety (PHQ-4). Support Care Cancer. 2019;27:4469-77. https://doi.org/10.1007/s00520-019-04718-z
Mitchell AJ, Coyne JC. Do ultra-short screening instruments accurately detect depression in primary care? A pooled analysis and meta-analysis of 22 studies. Br J Gen Pract. 2007;57(535): 144-51. URL.
Kroenke K, Spitzer RL, Williams JB, Monahan PO, Löwe B. Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Ann Intern Med Clin. 2007;146(5):317-25. https://doi.org/10.7326/0003-4819-146-5-200703060-00004
Nipp RD, El?Jawahri A, D'Arpino SM, Chan A, Fuh CX, Johnson PC, et al. Symptoms of posttraumatic stress disorder among hospitalized patients with cancer. Cancer. 2018;124(16):3445-53. https://doi.org/10.1002/cncr.31576
Whooley MA, Caska CM, Hendrickson BE, Rourke MA, Ho J, Ali S. Depression and inflammation in patients with coronary heart disease: findings from the Heart and Soul Study. Biological Psychiatry. 2007;62(4):314-20. https://doi.org/10.1016/j.biopsych.2006.10.016
Zhang WR, Wang K, Yin L, Zhao WF, Xue Q, Peng M, et al. Mental health and psychosocial problems of medical health workers during the COVID-19 epidemic in China. Psychother Psychosom. 2020;89(4):242-50. https://doi.org/10.1159/000507639
Bowen N, Guo S. Structural equation modeling. Oxford: Oxford University Press, Inc; 2012.
Bean GJ, Bowen NK. Item response theory and confirmatory factor analysis: Complementary approaches for scale development. J Evid Based Soc Work. 2021;18(6):597-618. https://doi.org/10.1080/26408066.2021.1906813
Wirth RJ, Edwards MC. Item factor analysis: Current approaches and future directions. Psychol Methods. 2007;12(1):58–79. https://doi.org/10.1037/1082-989X.12.1.58
Chalmers RP. mirt: A multidimensional item response theory package for the R environment. J Stat Softw. 2012;48:1-29. https://doi.org/10.18637/jss.v048.i06
Meijer RR, Sijtsma K, Smid NG. Theoretical and empirical comparison of the Mokken and the Rasch approach to IRT. Appl Psychol Meas. 1990;14(3):283-98. https://doi.org/10.1177/014662169001400306
Zamora-Araya JA, Smith-Castro V, Montero-Rojas E, Moreira-Mora TE. Advantages of the Rasch Model for Analysis and Interpretation of Attitudes: The Case of the Benevolent Sexism Subscale. Revista Evaluar. 2018; 18(3):1-13. https://doi.org/10.35670/1667-4545.v18.n3.22201
Encina López F, Buongermini Méndez R, Michel Kolm K, Torales Benítez J. Determinación de salud auto-percibida en una población rural del Paraguay implementando el cuestionario de Goldberg -GHQ12- en guaraní. An. Fac. Cienc. Méd. 2013;46(2):15–24. URL.
Vecchio EA, Dickson M, Zhang Y. Indigenous mental health and climate change: A systematic literature review. J Clim Chang Health. 2022;6:100121. https://doi.org/10.1016/j.joclim.2022.100121
Carranza Esteban RF, Mamani-Benito O, Cjuno J, Tito-Betancur M, Lingán-Huamán SK, Arias-Chávez D. Translation and validation of the WHO-5 General well-being index into native language Quechua of the Peruvian South. Heliyon. 2023;9(6):e16843. https://doi.org/10.1016/j.heliyon.2023.e16843
Löwe B, Kroenke K, Gräfe K. Detecting and monitoring depression with a two-item questionnaire (PHQ-2). J Psychosom Res. 2005;58(2):163-71. https://doi.org/10.1016/j.jpsychores.2004.09.006
Kroenke K, Spitzer RL, Williams JB. The Patient Health Questionnaire-2: validity of a two-item depression screener. Med Care. 2003;41(11):1284-92. https://doi.org/10.1097/01.mlr.0000093487.78664.3c
López Guerra V, Aguirre Mejia ÁJ, Guerrero Alcedo JM. Propiedades psicométricas y estructura factorial del cuestionario de salud del paciente PHQ-4 en estudiantes universitarios ecuatorianos. Rev Cubana Enferm. 2022;38(3):e4885. URL.
Hernández A, Hidalgo MD, Hambleton RK, Gómez Benito J. International test commission guidelines for test adaptation: A criterion checklist. Psicothema. 2020;32(3):390-8. https://doi.org/10.7334/psicothema2019.306
Aiken LR. Three coefficients for analyzing the reliability and validity of ratings. Educ Psychol Meas. 1985;45(1):131-42. https://doi.org/10.1177/0013164485451012
Brown TA. Confirmatory Factor Analysis for Applied Research, Second Edition. Guilford Publications; 2015.
Kline RB. Principles and Practice of Structural Equation Modeling (4th ed.). The Guilford Press; 2015.
Schumacker RE, Lomax RG. A Beginner’s Guide to Structural Equation Modeling: Fourth Edition (4th ed.). Routledge; 2015.
Cronbach LJ. Coefficient alpha and the internal structure of tests. Psychometrika. 2015;16(3):297–334. https://doi.org/10.1007/BF02310555
McDonald RP. Test Theory: A Unified Treatment. Taylor & Francis; 1999.
Raykov T, Hancock GR. Examining change in maximal reliability for 63multiple-component measuring instruments. Br J Math Stat Psychol. 2005;58(1):65–82. https://doi.org/10.1348/000711005X38753
Hambleton RK, Swaminathan H, Rogers J. Fundamentals of item response theory. Sage; 1991.
Samejima F. Graded response model. In Van der Linden WJ, Hambleton RK, eds. Handbook of modern Item Response Theory. New York, NY: Springer; 1997, pp. 85–100.
Cai L, Monroe S. A New Statistic for Evaluating Item Response Theory Models for Ordinal Data. California: University of California; 2014.
Maydeu-Olivares A, Joe H. Assessing Approximate Fit in Categorical Data Analysis. Multivariate Behav Res. 2014;49(4):305–28. https://doi.org/10.1080/00273171.2014.911075
Maydeu-Olivares A. Goodness-of-Fit Assessment of Item Response Theory Models. Measurement. 2013;11(3):71–101. https://doi.org/10.1080/15366367.2013.831680
Lubbe D, Schuster C. A Graded Response Model Framework for Questionnaires with Uniform Response Formats. Appl Psychol Meas. 2019;43(4):290–302. https://doi.org/10.1177/0146621618789394
Rosseel Y. lavaan: An R Package for Structural Equation Modeling. J Stat Softw. 2012;48(2):1–36. https://doi.org/10.18637/jss.v048.i02
Finney SJ, DiStefano C. Nonnormal and categorical data in structural equation modeling. In: Structural equation modeling: A second course, 2nd ed. Charlotte, NC, US: IAP Information Age Publishing; 2013. p. 439–92.
Malgaroli M, Calderon A, Bonanno GA. Networks of major depressive disorder: A systematic review. Clin Psychol Rev. 2021; 85:102000. https://doi.org/10.1016/j.cpr.2021.102000
Giuliani M, Gorini A, Barbieri S, Veglia F, Tremoli E. Examination of the best cut-off points of PHQ-2 and GAD-2 for detecting depression and anxiety in Italian cardiovascular inpatients. Psychol Health. 2021;36(9):1088-1101. https://doi.org/10.1080/08870446.2020.1830093
Klein MC, Ciotoli C, Chung H. Primary care screening of depression and treatment engagement in a university health center: a retrospective analysis. J Am Coll Health. 2011;59(4):289-95. https://doi.org/10.1080/07448481.2010.503724
Mulvaney-Day N, Marshall T, Downey Piscopo K, Korsen N, Lynch S, Karnell LH, et al. Screening for behavioral health conditions in primary care settings: a systematic review of the literature. J Gen Intern Med. 2018;33:335-46. https://doi.org/10.1007/s11606-017-4181-0
Descargas
Publicado
Número
Sección
Licencia
Derechos de autor 2024 Renzo Felipe Carranza Esteban, Oscar Mamani-Benito, Julio Cjuno, Madona Tito-Betancur, Tomás Caycho-Rodríguez, Lindsey W. Vilca, Julio Torales, Iván Barrios
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.