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      Análise fatorial confirmatória da Depression Anxiety Stress Scale em pessoas com Doença Renal Crónica Translated title: Análisis factorial confirmatório da Depression Anxiety Stress Scale en enfermedad renal crónica Translated title: Confirmatory Factor Analysis of the Depression Anxiety Stress Scale in Chronic Kidney Disease

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          Abstract

          CONTEXTO: A Depression Anxiety Stress Scale (DASS) foi desenvolvida por Lovibond e Lovibond, em 1995, para avaliar os sintomas da ansiedade e da depressão. A versão portuguesa da DASS com 21 itens (DASS-21) confirmou ter propriedades idênticas às da versão original. OBJETIVO: Confirmar a estrutura da DASS-21 em pessoas com doença renal crónica em programa de hemodiálise. MÉTODO: Estudo metodológico. Foi obtida uma amostra representativa de 159 pessoas com doença renal cónica, em programa de hemodiálise, em duas clínicas e num serviço de nefrologia de um Centro Hospitalar, todos em Lisboa, Portugal. Foi realizada colheita de dados de maio a junho de 2015. Desenvolveu-se uma análise fatorial confirmatória com recurso ao software AMOS. Utilizaram-se os seguintes parâmetros: rácio entre o Qui quadrado e os graus de liberdade (Χ2/g.l), goodness-of-fit index (GFI), comparative fit index (CFI), Tucker-Lewis index (TLI) e root mean square error of approximation (RMSEA). RESULTADOS: Obteve-se Χ²/g.l=1,980, GFI=0,84, CFI=0,87, TLI=0,85 e RMSEA=0,08, o que demostra ser um bom ajustamento para a hipótese da solução de dois fatores. Não se confirma a solução proposta na versão original e na versão portuguesa (três fatores). CONCLUSÕES: A versão portuguesa da DASS-21 apresenta dois fatores, e é válida para medir stresse/ansiedade e depressão, em pessoas com doença renal crónica.

          Translated abstract

          CONTEXTO: La Escala de Depresión Ansiedad Estrés (DASS) fue desarrollada por Lovibond y Lovibond en 1995 con el objetivo de evaluar los síntomas de ansiedad y depresión. La versión en portugués de la DASS con 21 artículos (DASS-21) confirmó que tiene propiedades similares a la versión original. OBJETIVO: Confirmar la estructura de la DASS-21 en las personas con enfermedad renal crónica en hemodiálisis. MÉTODO: Estudio metodológico. Se obtuvo una muestra representativa de 159 personas con enfermedad renal crónica sometidos a hemodiálisis en dos clínicas en laciudad de Lisboa y en el servicio de nefrología de un hospital también en Lisboa, Portugal. La cosecha se realizó entre mayo y junio de 2015. Se desarrolló un análisis factorial confirmatorio mediante el software AMOS. Los parámetros utilizados fueron: relación de la chi-cuadrado y los grados de libertad (Χ2 / gl) goodness-of-fit index (GFI), comparative fit index (CFI), Tucker-Lewis index (TLI) y lo root mean square error of approximation (RMSEA). RESULTADOS: Se obtuvieron Χ² / df = 1,980, GFI = 0,84, CFI = 0,87, TLI = 0,85 y RMSEA = 0,08, lo que demuestra ser un buen ajuste a la hipótesis de la solución de dos factores. No se ha confirmado la solución propuesta en la versión original ni en la versión en Inglés (tres factores). CONCLUSIONES: La versión portuguesa de la DASS 21 tiene dos factores, y es válido para medir el estrés / ansiedad y la depresión en personas con enfermedad renal crónica.

          Translated abstract

          BACKGROUND: The Depression Anxiety Stress Scale (DASS) was developed by Lovibond & Lovibond in 1995 with the objective of evaluating the symptoms of anxiety and depression. The Portuguese version of the DASS with 21 items (DASS-21) confirmed having identical properties as those of the original version. AIM: Confirm the structure of DASS-21 in people with chronic kidney disease on dialysis. METHOD: Methodological study. A representative sample of 159 people with chronic kidney disease on dialysis was obtained in two clinics in the Lisbon region and a nephrology department in a Lisbon hospital center, Portugal. Data collection occurred from may to june 2015. A confirmatory factor analysis was developed using the AMOS software. The following parameters were used: ratio between Chi squared and the degrees of freedom (Χ²/g.l), goodness-of-fit index (GFI), comparative fit index (CFI), Tucker-Lewis index (TLI) and root mean square error of approximation (RMSEA). RESULTS: The following was obtained: Χ²/g.l=1,980, GFI=0,84, CFI=0,87, TLI=0,85 and RMSEA=0,08, which shows being a good adjustment for the hypothesis of the solution of two factors. The solution proposed in the original version and in the Portuguese version is not confirmed (three factors). CONCLUSIONS: The portuguese version of the DASS presents two factors and is valid for measuring Stress/Anxiety and Depression, in people with chronic kidney disease.

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          Validation of the depression anxiety stress scales (DASS) 21 as a screening instrument for depression and anxiety in a rural community-based cohort of northern Vietnamese women

          Background Depression and anxiety are recognised increasingly as serious public health problems among women in low- and lower-middle income countries. The aim of this study was to validate the 21-item Depression Anxiety and Stress Scale (DASS21) for use in screening for these common mental disorders among rural women with young children in the North of Vietnam. Methods The DASS-21 was translated from English to Vietnamese, culturally verified, back-translated and administered to women who also completed, separately, a psychiatrist-administered Structured Clinical Interview for DSM IV Axis 1 diagnoses of depressive and anxiety disorders. The sample was a community-based representative cohort of adult women with young children living in Ha Nam Province in northern Viet Nam. Cronbach’s alpha, Exploratory Factor Analyses (EFA) and Receiver Operating Characteristic (ROC) analyses were performed to identify the psychometric properties of the Depression, Anxiety, and Stress subscales and the overall scale. Results Complete data were available for 221 women. The internal consistency (Cronbach’s alpha) of each sub-scale and the overall scale were high, ranging from 0.70 for the Stress subscale to 0.88 for the overall scale, but EFA indicated that the 21 items all loaded on one factor. Scores on each of the three sub-scales, and the combinations of two or three of them were able to detect the common mental disorders of depression and anxiety in women with a sensitivity of 79.1% and a specificity of 77.0% at the optimal cut off of >33. However, they did not distinguish between those experiencing only depression or only anxiety. Conclusions The total score of the 21 items of the DASS21-Vietnamese validation appears to be comprehensible and sensitive to detecting common mental disorders in women with young children in primary health care in rural northern Vietnam and therefore might also be useful to screen for these conditions in other resource-constrained settings.
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            Psychometric evaluation and normative data for the depression, anxiety, and stress scales-21 (DASS-21) in a nonclinical sample of U.S. adults.

            Health care professionals are coming under increased pressure to empirically monitor patient outcomes across settings as a means of improving clinical practice. Within the psychiatric and primary care communities, many have begun utilizing brief psychometric measures of psychological functioning to accomplish these goals. The purpose of this study was to evaluate the psychometric properties and clinical utility of the Depression, Anxiety, and Stress Scales-21-item version (DASS-21), and contribute normative data to facilitate interpretation using a sample of U.S. adults (N = 503). Item-scale convergence was generally supported, although assumptions of item-scale divergence were not met. Only 86%, 50%, and 43% of Depression, Anxiety, and Stress items, respectively, correlated significantly greater with their hypothesized scales than other scales. Internal consistency reliability was acceptable for all scales and comparable to existing research (αs = .91, .80, and .84 for Depression, Anxiety, and Stress, respectively). Scale-level correlations were greater than what has been reported elsewhere (range of rs = .68 to .73), and principal components analysis supported the extraction of only one component accounting for 47% of the item-level variance. However, confirmatory factor analysis (CFA) favored a three-factor structure when compared to a one-factor model. The implications for the health care professions are discussed.
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              Contribuição para o Estudo da Adaptação Portuguesa das Escalas de Ansiedade, Depressão e Stress (EADS) de 21 itens de Lovibond e Lovibond

              A ansiedade e depressão são claramente distintas do ponto de vista fenomenológico mas empiricamente tem sido difícil separar os dois construtos. O modelo tripartido foi desenvolvido para clarificar a relação entre ansiedade e depressão. A escala aqui estudada propõe-se avaliar empiricamente a ansiedade depressão e stress segundo o modelo tripartido: mais especificamente o objectivo do presente estudo é adaptar as escalas de depressão ansiedade e stress de 21 itens numa perspectiva conservadora, ou seja, privilegiou-se um modelo de construção com base na teoria tal como os autores sugerem, tentando encontrar uma solução em língua Portuguesa semelhante à original. A Depression Anxiety Stress Scales (DASS) que aqui designaremos de Escalas de Ansiedade Depressão e Stress (EADS-21) em que o número designa o número de itens, constituem uma escala de 21 itens distribuídos em número igual pelas três dimensões: Depressão, Ansiedade e Stress. Os sujeitos respondem em que medida experimentaram cada sintoma na última emana assinalando numa escala de frequência de quatro pontos. Participaram 200 sujeitos, idade M=19,79, DP=1,11, variando entre os 18 e os 23 anos, que construíram uma amostra de conveniência. Os resultados apontam para uma estrutura semelhante à Australiana apontando para a possibilidade de ser utilizada em Português. A variância comum às duas variáveis-ansiedade e depressão é de cerca de 27% o que constitui uma aproximação satisfatória ao objectivo da utilização destas escalas que é de reduzir a variância comum.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rpesm
                Revista Portuguesa de Enfermagem de Saúde Mental
                Revista Portuguesa de Enfermagem de Saúde Mental
                Sociedade Portuguesa de Enfermagem de Saúde Mental (Porto, , Portugal )
                1647-2160
                August 2017
                : 0
                : spe5
                : 13-18
                Affiliations
                [04] Leiria orgnameInstituto Politécnico de Leiria orgdiv1Escola Superior de Saúde Portugal jcrgomes@ 123456ipleiria.pt
                [01] Lisboa orgnameCentro Hospitalar Lisboa Central
                [02] Oeiras orgnameUniversidade Atlântica Portugal lmsousa@ 123456uatlantica.pt
                [03] Lisboa orgnameUniversidade Católica Portuguesa orgdiv1Escola de Enfermagem de Lisboa Portugal cristina_marques@ 123456ics.lisboa.ucp.pt
                [05] Luanda orgnameEscola de Saúde Multiperfil Angola helena.jose@ 123456multiperfil.co.ao
                Article
                S1647-21602017000200003
                10.19131/rpesm.0161
                62ad9c8c-d446-4d26-b488-d93fd8a8bdc9

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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                Insuficiencia Renal Crónica,Depresión,Ansiedad,Estudios de validación,Insuficiência Renal Crónica,Depressão,Ansiedade,Estudos de validação,Chronic Renal Insufficiency,Depression,Anxiety,Validation studies

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