Chinese Primary Care Patients Research Articles

Validation of Patient Health Questionnaire for depression screening among primary care patients in Taiwan

Purpose The aim of this study was to determine the reliability and validity of a Chinese version of the Patient Health Questionnaire (PHQ-9) for the purpose of screening major depressive disorder (MDD) among primary care patients in Taiwan. Method A total of 1954 primary care patients completed the PHQ-9. Patients (n = 1532) were interviewed using the Schedule for Clinical Assessments in Neuropsychiatry and 17-item of Hamilton Rating Scale. Subsample cases were retested within 2 weeks. Results The PHQ-9 had a good internal consistency ( α = .80) and test-retest reliability (intraclass correlation coefficient = 0.87). A principal component factor analysis yielded 1-factor structure, which accounted for a total of 42.0% of the variance. The PHQ-9 was significantly correlated with the external validators such as the 17-item of Hamilton Rating Scale and the Short Form of the Quality of Life Enjoyment and Satisfaction Questionnaire ( P < .001). Using the Schedule for Clinical Assessments in Neuropsychiatry interview as the criterion standard, a PHQ-9 score of 10 or higher had a sensitivity of 0.86 and a specificity of 0.94 for recognizing MDD. The screening accuracy of the 2 items version, PHQ-2, was also satisfactory (scores ≥2: sensitivity 0.88; specificity 0.82). The single-question screen, PHQ-1 (depressed mood), was 78% sensitive and 93% specific for detecting MDD (score ≥2). Conclusion The PHQ-9 and its 2 subscales, PHQ-2 and PHQ-1, seem reliable and valid for detecting MDD among Chinese primary care patients.

Detection of Depression with Different Interpreting Methods Among Chinese and Latino Primary Care Patients: A Randomized Controlled Trial

Language barriers may contribute to the under-detection of depression in Latinos and Asians. A total of 782 English, Spanish, and Chinese-speaking primary care patients were enrolled in a randomized controlled trial. Language discordant patients were randomized to Remote Simultaneous Medical Interpreting (RSMI) or usual and customary (U&C) interpreting. The Beck Depression Inventory-Fast Screen (BDI-FS) was administered. Patients were tracked for 1 year. A total of 462 patients completed the BDI-FS. Thirty-three percent had a positive (> or = 4) screen. Twenty-seven percent of BDI-FS positive patients were diagnosed with depression. Among BDI-FS positive patients, Chinese-speakers were less likely to be diagnosed compared with English speakers (31% vs. 10%, P < 0.05). There was a trend towards greater diagnosis with RSMI (27% detection with RSMI vs. 20% U&C, P = 0.41). The diagnosis of depression among BDI-FS positive patients in our population was low, particularly among Chinese-speakers. RSMI could be an important part of a multi-faceted approach to improving the detection of depression.

Reciprocal relationship between fear of falling and depression in elderly Chinese primary care patients

Objectives: The objective of the current study is to investigate the link between depression and fear of falling in Hong Kong Chinese older adults in primary are settings. Method: Using longitudinal data collected on 321 Chinese primary care patients 65 years of age and older, the authors investigated the reciprocal relationship between fear of falling and depression and examined whether functional disability and social functioning mediated the link between fear of falling and depression. Participants were recruited from three primary care units in Hong Kong. Subjects were assessed in Cantonese by two trained assessors with Minimum Data Set-Home Care twice over a period of one year. Results: Findings revealed that fear of falling at baseline significantly predicted depression at 12 month follow-up assessment after age, gender, marital status, education and depression at baseline were adjusted, but depression at baseline did not predict fear of falling at 12 months after fear of falling at baseline was adjusted. Moreover, social functioning mediated the impact of fear of falling on depression. Conclusion: The findings presented here indicate that fear of falling potentially increases the risk of depression in Chinese older adults in primary care settings.

Symptom Characteristics of Kidney-YinDeficiency and Kidney-YangDeficiency in Hong Kong Chinese Midlife Women

The Journal of Alternative and Complementary MedicineVol. 14, No. 5 LETTERS TO THE EDITORSymptom Characteristics of Kidney-Yin Deficiency and Kidney-Yang Deficiency in Hong Kong Chinese Midlife WomenRun Qiu Chen, Ke Jian Cao, Tai Hing Lam, and Chit Ming WongRun Qiu ChenSearch for more papers by this author, Ke Jian CaoSearch for more papers by this author, Tai Hing LamSearch for more papers by this author, and Chit Ming WongSearch for more papers by this authorPublished Online:19 Jun 2008https://doi.org/10.1089/acm.2007.7202AboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail FiguresReferencesRelatedDetailsCited byHealth-related quality of life among Chinese primary care patients with different lower urinary tract symptoms: a latent class analysis14 January 2021 | Quality of Life Research, Vol. 30, No. 5Association of Menopausal Symptoms with Different Constitutions in Climacteric Women28 August 2018 | Complementary Medicine Research, Vol. 25, No. 6Yang Deficiency Body Constitution Acts as a Predictor of Diabetic Retinopathy in Patients with Type 2 Diabetes: Taichung Diabetic Body Constitution StudyEvidence-Based Complementary and Alternative Medicine, Vol. 2015Reliability and validity of the Korean standard pattern identification for stroke (K-SPI-Stroke) questionnaire26 April 2012 | BMC Complementary and Alternative Medicine, Vol. 12, No. 1Construction of a traditional Chinese medicine syndrome-specific outcome measure: the Kidney Deficiency Syndrome questionnaire (KDSQ)6 June 2012 | BMC Complementary and Alternative Medicine, Vol. 12, No. 1BCQ–: A Body Constitution Questionnaire to Assess Yin-Xu18 December 2012 | Complementary Medicine Research, Vol. 19, No. 6Development of a Valid and Reliable Phlegm Pattern Questionnaire Young-Jae Park, Jae-Sung Park, Min-Yong Kim, and Young-Bae Park29 August 2011 | The Journal of Alternative and Complementary Medicine, Vol. 17, No. 9An evidence-based validation of traditional Chinese medicine syndromesComplementary Therapies in Medicine, Vol. 18, No. 5 Volume 14Issue 5Jun 2008 Information© 2008 Mary Ann Liebert, Inc.To cite this article:Run Qiu Chen, Ke Jian Cao, Tai Hing Lam, and Chit Ming Wong.Symptom Characteristics of Kidney-Yin Deficiency and Kidney-Yang Deficiency in Hong Kong Chinese Midlife Women.The Journal of Alternative and Complementary Medicine.Jun 2008.457-460.http://doi.org/10.1089/acm.2007.7202Published in Volume: 14 Issue 5: June 19, 2008Online Ahead of Print:June 4, 2008PDF download

The Association of Body Mass Index with Health-Related Quality of Life: An Exploratory Study in a Multiethnic Asian Population

Objectives To evaluate the association between body mass index (BMI) and health-related quality of life (HRQoL) in a multiethnic Asian population in Singapore, and to explore if the World Health Organization (WHO) recommendation of alternative BMI cutoffs for Asians could be further strengthened by evidence of higher risk of impaired HRQoL using these criteria. Methods Consenting English, Chinese, Malay and Tamil-speaking primary care patients (age ≥ 21 years) were interviewed using English/their respective mother tongue versions of the EQ-5D/EQ-VAS, Health Utilities Index (HUI2 & HUI3) and the SF-6D. We first evaluated the relationship between BMI and HRQoL (overall and individual attributes for each instrument) using multiple linear/logistic regression (where appropriate) to adjust for factors known to affect HRQoL. We next reorganized BMI into five categories (reflecting the differences in cutoffs between International/Asian classifications) and evaluated if median HRQoL scores were significantly different across these categories. Results Among 411 participants [response rate: 87%; median age: 51 years; obese: 19% (International); 33% (Asian)], after adjusting for sociodemographic and other factors, a tendency for underweight and obese subjects to report lower overall HRQoL scores was observed for most instruments. At the individual attribute level, obese subjects reported significantly lower HUI2 pain scores (regression coefficient: −0.035, P = 0.029) and greater odds of reporting problems for SF-6D role-limitations (odds ratio: 2.9, P = 0.005). Median overall HRQoL scores were not significantly different across the five BMI categories. Conclusion Consistent with available studies, obese subjects reported worse HRQoL than normal-weight subjects. That underweight subjects also reported worse HRQoL is interesting and requires confirmation. HRQoL was similar in Asians using either WHO criteria.

Predictors of Cancer Screening Among Low-Income Primary Care Patients

Although population-based studies report lower rates of cancer screening among racial/ethnic minorities than among Whites in the U.S., few studies have examined predictors of screening among low-income Hispanic, Black, and Chinese primary care patients. We examined utilization of mammography, Pap smear, digital rectal examination, fecal occult blood testing, sigmoidoscopy/colonoscopy, and prostate-specific antigen testing in 833 patients from 2 community health centers in New York City, ascertaining relationships between use of screening and race/ethnicity, income, education, years in the U.S., insurance, cancer risk perception, family disease history, and physician recommendation. Despite similar access to primary care, Hispanics and Blacks reported higher utilization rates of all screening tests than Chinese (p<.01). Physician recommendation and more years in the U.S. were associated with greater use of all screening services (p<.001), with physician recommendation most strongly associated with screening. Interventions to enhance screening by at-risk groups should emphasize both physician recommendation and culturally-sensitive patient education.

Reciprocal relationship between pain and depression in elderly Chinese primary care patients

Pain and depression are common in old age but the reciprocal relationship between pain and depression has not been established in a single study. Moreover, few studies have addressed this issue in a primary care setting. The purposes of this study were to examine the reciprocal relationship between pain and depression and to identify whether social support, functional disability or social functioning mediated the link between pain and depression among Hong Kong Chinese elderly primary care patients. Subjects were 318 patients assessed by a trained assessor with MDS-HC at baseline and these subjects were randomly selected from attendants of three randomly selected elderly health centers in Hong Kong. These patients were re-assessed one year after baseline evaluation. Multiple regression analyses revealed that pain at baseline significantly predicted depression at 12-month follow-up assessment when age, gender, martial status, education, and depression at baseline were adjusted for, but depression at baseline was not associated with pain at 12-months after baseline measure while controlling for age, gender, martial status, education, and pain at baseline. However, depression did predict the onset of pain. Moreover, social support, physical disability or social functioning did not mediate the impact of pain on depression. These data suggest that pain is an important predictor of depression in elderly primary care patients. Therefore, aged care service practitioners must take this risk factor into consideration in their preventive intervention and treatment for psychological well-being.

Construct Validity of the EQ-5D in Low-Income Chinese American Primary Care Patients

Although the EQ-5D has been used with increasing frequency to measure health-related quality of life, to date, the measure's validity has not been examined in Chinese American immigrants. We evaluated the construct validity of the EQ-5D by testing its performance with respect to sociodemographic and clinical characteristics of the population and comparing responses on the EQ dimensions with the SF-36 subscales. The study surveyed low-income Chinese patients attending a community health center in New York City's Chinatown. Participants received self-administered versions of the EQ-5D and SF-36 and additional questions regarding demographic and clinical information. 856 patients were approached and data were collected from 523 patients (61%). Analysis of the EQ-5D responses by sociodemographic and clinical variables found significant differences among categories of age, gender, marital status, number of medical problems, self-rated health, and specific medical problems. Correlations between similar dimensions and subscale scores were stronger between the two measures than dissimilar ones. Patients without impairments on a given EQ dimension tended to have higher SF-36 subscale scores than patients reporting 'any' impairment (i.e. some/moderate or severe). The results provide initial support for the construct validity of the EQ-5D in our sample. Further studies should compare the performance of the EQ-5D with other preference-based measures in Chinese persons and examine the valuations that both low-income and Chinese persons place on core aspects of health.

A comparison of the validity of GHQ-12 and CHQ-12 in Chinese primary care patients in Manchester

The present study compares the efficacy of the GHQ-12 and the Chinese Health Questionnaire (CHQ-12) in Cantonese speaking Chinese primary-care patients living in Greater Manchester, using relative operating characteristic (ROC) analysis. We did not find that the Chinese version offered any advantage over the conventional version of the GHQ in this population. Stepwise discriminant analysis however confirmed the value of individual items in the former pertaining to specific somatic symptoms and interpersonal relationships in differentiating cases from non-cases. Information biases, arising from the lack of a reliability study on the second-stage case identifying interview and the unique linguistic characteristics of the Chinese language may have affected the overall validity indices of the questionnaires. The study also examines the effects of using different criteria to define a case, and shows that with increasing levels of severity, there is an improvement in the diagnostic performance of the two questionnaires as reflected by areas under ROC curves and traditional validity indices. Possible explanations of these findings are discussed. The scoring method proposed by Goodchild & Duncan-Jones (1985) when used on these questionnaires had no demonstrable advantage over the conventional scoring method.