Abstract
BackgroundThe Hospital Anxiety and Depression Scale (HADS) is a widely used instrument to measure psychological morbidity in cancer patients. This study aimed to translate and test the reliability and validity of the Iranian version of the HADS.MethodsThe English language version of the HADS was translated into Persian (Iranian language) and was used in this study. The questionnaire was administered to a consecutive sample of 167 breast cancer patients and statistical analysis was performed to test the reliability and validity of the HADS.ResultsIn general the Iranian version of the HADS was found to be acceptable to almost all patients (99%). Cronbach's alpha coefficient (to test reliability) has been found to be 0.78 for the HADS anxiety sub-scale and 0.86 for the HADS depression sub-scale. Validity as performed using known groups comparison analysis showed satisfactory results. Both anxiety and depression sub-scales discriminated well between sub-groups of patients differing in clinical status as defined by their disease stage.ConclusionThis preliminary validation study of the Iranian version of the HADS proved that it is an acceptable, a reliable and valid measure of psychological distress among cancer patients.
Highlights
The Hospital Anxiety and Depression Scale (HADS) is a widely used instrument to measure psychological morbidity in cancer patients
The Hospital Anxiety and Depression Scale (HADS) is a brief and widely used instrument to measure psychological distress in cancer patients and it is available in many languages for example French, German, Dutch, Italian, Spanish, Chinese, and Arabic
The HADS well discriminated between sub-groups of patients as defined by their disease stage indicating that anxiety and depression scores were significantly higher in patients with advanced disease (P < 0.0001 on both subscales)
Summary
The Hospital Anxiety and Depression Scale (HADS) is a widely used instrument to measure psychological morbidity in cancer patients. The Hospital Anxiety and Depression Scale (HADS) is a brief and widely used instrument to measure psychological distress in cancer patients and it is available in many languages for example French, German, Dutch, Italian, Spanish, Chinese, and Arabic. It has been shown that the HADS gives clinically meaningful results as a psychological screening tool, in clinical group comparisons and in studies with several aspects of disease and quality of life. A recent review of the literature on the validity of the HADS clearly indicates that it is a well-performed questionnaire in assessing the symptom severity and caseness of anxiety disorders and depression in both somatic, psychiatric and primary care patients and even in the general population.
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