Psychometric Properties of the Slovenian Version of the Cardiac Depression Scale

Introduction

The aim of this study was to translate the Cardiac Depression Scale into the Slovenian language and test its validity and reliability on Slovenian patients with heart disease.

Methods

A total of 272 patients with heart disease who underwent elective coronary angiography at Celje General Hospital participated in this study. We used the Slovenian Cardiac Depression Scale (S-CDS), the Spielberger State Anxiety Inventory (STAI-S), and the Center for Epidemiologic Studies Depression Scale-20 (CES-D) to collect data. An exploratory and confirmatory factor analysis, internal consistency, test-retest reliability, and concurrent validity were performed.

Results

Cronbach's alpha for the total scale was 0.92 and the test-retest reliability was 0.71. Exploratory factor analysis confirmed six factors, accounting for 61% of the total variance. The confirmatory factor analysis indicated that a two- and one-factor solution had acceptable goodness-of-fit measures. However, we kept a more parsimonious one-factor method, given a high correlation between the two factors and the theoretical background in previous studies. Concurrent validation against the CES-D and the STAI-S showed moderate to strong correlations.

Conclusions

The S-CDS is a reliable and valid instrument for screening for depression in Slovenian patients with heart disease.

Depression and cardiovascular disease

PURPOSE OF REVIEW

The purpose of this review is to outline the relationship between cardiovascular disease (CVD) and depression, both as a cause of and a result of CVD.

RECENT FINDINGS

The prevalence of depression seems to be increasing in the general population.It is likely that depression will be even more of a problem for CVD patients in the post-COVID-19 pandemic era.New studies confirm the independent association of depression with later incident CVD, although perhaps not as strong as suggested by some previous studies.Depression seems to be becoming even more prevalent in CVD patients, with new data for stroke and peripheral arterial disease patients.Cardiologists rarely screen for depression and most do not believe that they have a responsibility for detecting or treating depression.There are new data suggesting that patients who are more in control of their lives have better outcomes and that change is possible.

SUMMARY

Depression is preventable and treatable. It is imperative to detect and manage depression in CVD patients. Additional research is required to see whether or not comprehensive patient screening for depression translates into both better quality of life and improved clinical outcomes.

Psychometric properties of the Arabic version of the cardiac depression scale tested on Jordanian patients with cardiovascular diseases

BACKGROUND

The Cardiac Depression Scale (CDS) is an instrument to screen for depression, specifically in patients with cardiovascular diseases (CVD). The purpose of this study was to evaluate the psychometric properties of the Arabic version of the CDS in the Jordanian population.

METHOD

A cross-sectional design was used for 304 participants diagnosed with CVD. An exploratory factor analysis (EFA) was performed to explore the underlying structure of the new Arabic version of the CDS tool.

RESULTS

Cronbach's alpha for the total scale was 0.87. An EFA suggested a two-factor solution. The first factor has 18 items, measuring "My tolerance" of CVD, and the second factor has seven items, measuring "My activities" in the context of CVD. Based on the EFA simple structure, one item was removed due to its low factor loading (< 0.3). A confirmatory factor analysis (CFA) supported a two-factor model with the root mean square error of approximation (RMSEA = 0.06), comparative fit index (CFI = 0.856), and Tucker-Lewis index (TLI = 0.83) indicating acceptable fit. The Cronbach's alpha values for the first and second factors were 0.86 and 0.84, respectively.

CONCLUSION

The Arabic version of the CDS is a reliable and valid instrument to screen for depression among Jordanian patients with CVD.

Depression in Nonhospitalized Jordanian Patients With Coronary Artery Disease

BACKGROUND

Patients with coronary artery disease (CAD) are likely to experience depression, which contributes to the burden of disease and is a risk factor for mortality. Patients in outpatient clinics in Jordan are not routinely screened for depression. Significant relationships among patient characteristics must be determined to ascertain the predictors of depression.

PURPOSE

The aims of this research were to assess the level of depression symptoms in nonhospitalized patients with CAD; to examine the relationships between depression and relevant sociodemographic, self-reported health history, and patient health perception variables; and to identify possible predictors of depression in Jordan.

METHODS

This cross-sectional study recruited a convenience sample (N = 174) of nonhospitalized outpatients who had been diagnosed with CAD. Self-reported demographic, health history, and health perception information (independent variables) were provided by the participants. The depression scores (dependent variable) for the participants were assessed using the Cardiac Depression Scale. Data were analyzed using descriptive statistics, the chi-square test, Pearson's correlations, and multiple linear regressions.

RESULTS

Half of the participants reported mild to moderate depression, with 37% reporting severe depression. Predictors of depression included gender (being female), having a concomitant chronic disease, prior surgery, irregular exercise, impaired sexual activity, and self-perceived poor psychological health.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

To improve patient outcomes, clinical personnel should screen patients with CAD for depression and offer a combined pharmaceutical and therapeutic treatment intervention. An easy-to-administer instrument to detect depression may be included in the standard patient checkup routine used in clinics. Several patient characteristics were found to significantly affect depression and health outcomes.

Cross-cultural adaptation methods of instruments in the nursing area

OBJECTIVE

To analyze scientific publications in order to identify the cross-cultural adaptation methods of instruments that are mainly applied in nursing.

METHOD

Integrative review, in the electronic sources Medline - Pubmed, Cinahl, Lilacs, Scopus and Web of Science. 96 peer-reviewed papers, published between 2010 and 2015 were selected.

RESULTS

The articles that composed the sample were published in 59 different journals, 15.2% were Brazilian. The largest number of publications was concentrated in 2015 (31.2%), 28 countries appeared on the list which is led by Brazil (33.3%), followed by China (10.4%). It was used 26 different guidelines, however the one proposed by Beaton and their collaborators was mentioned in 47 (49.0%) articles and the Brislin's in 12 (12.5%).

CONCLUSION

This review does not allow us to define the most appropriate method, however all methods applied agreed on the use of back translation. In addition, many studies in different languages and countries showed the international acceptability of the method developed by Beaton et al.

Translation and validation of the Cardiac Depression Scale to Arabic

BACKGROUND

The Cardiac Depression Scale (CDS) has been designed to measure depressive symptoms in patients with heart disease. There is no Arabic version of the CDS. We translated and validated the CDS in an Arabic sample of patients with heart disease.

METHODS

Forward and back translation of the CDS was followed by assessment of cultural relevance and content validity. The Arabic version of the CDS (A-CDS) and the Arabic version of the Hospital Anxiety and Depression Scale (A-HADS) were then administered to 260 Arab in-patients with heart disease from 18 Arabic countries. Construct validity was assessed using exploratory factor analysis with polychoric correlations. Internal consistency was assessed using ordinal reliability alpha and item-to-factor polychoric correlations. Concurrent validity was assessed using Pearson's correlation coefficient between the A-CDS and the depression subscale of the A-HADS (A-HADS-D).

RESULTS

Cultural relevance and content validity of the A-CDS were satisfactory. Exploratory factor analysis revealed three robust factors, without cross-loadings, that formed a single dimension. Internal consistency was high (ordinal reliability alpha for the total scale and the three factors were .94, .91, .86, and .87, respectively; item-to-factor correlations ranged from .77 to .91). Concurrent validity was high (r=.72). The A-CDS demonstrated a closer to normal distribution of scores than the A-HADS-D.

LIMITATIONS

Sensitivity and specificity of the A-CDS were not objectively assessed.

CONCLUSIONS

The A-CDS appears to be a valid and reliable instrument to measure depressive symptoms in a representative sample of Arab in-patients with heart disease.

Psychometric properties of the cardiac depression scale in patients with coronary heart disease

BACKGROUND

This study examined the psychometric properties of the Cardiac Depression Scale (CDS) in a sample of coronary heart disease (CHD) patients.

METHODS

A total of 152 patients were diagnosed with coronary heart disease and were administered the CDS along with the Beck Depression Inventory- 2 (BDI-2) and the State Trait Anxiety Inventory (STAI) 3.5-months after cardiac hospitalization.

RESULTS

The CDS's factorial composition in the current sample was similar to that observed in the original scale. Varimax-rotated principal-components analyses extracted six factors, corresponding to mood, anhedonia, cognition, fear, sleep and suicide. Reliability analyses yielded internal consistency α - coefficients for the six subscales ranging from 0.62 to 0.82. The CDS showed strong concurrent validity with the BDI-II (r = 0.64). More patients were classified as severely depressed using the CDS. Both the CDS and the BDI-2 displayed significantly strong correlations with the STAI (r = 0.61 and r = 0.64), respectively.

CONCLUSIONS

These findings encourage the use of the CDS for measuring the range of depressive symptoms in those with CHD 3.5 months after cardiac hospitalization.