Psychometric properties of the Norwegian version of the General Health Questionnaire (GHQ-30) among older people living at home

Meta-Analysis of Factor Analyses of the General Health Questionnaire – Short Forms GHQ-28 and GHQ-30

Abstract. Two meta-analyses of exploratory factor analyses of the General Health Questionnaire short forms, GHQ-28 ( N = 26,848, k = 40) and GHQ-30 ( N = 43,151  k = 25), were conducted to determine the consistent factors found in each test and any common factors across them. Five databases (PsycINFO, PubMed, BASE, Semantic, and Google Scholar) were searched in 2021. Reproduced correlations derived from the original studies’ factor matrices and aggregated across studies were factor analyzed for the meta-analyses. For the GHQ-28, the standard four subscales of somatic, anxiety, social dysfunction, and depression were clearly identified and strongly supported by a four-factor structure. For the GHQ-30, a four-factor solution identified factors of anxiety, depression, social dysfunction, and social satisfaction, the first three factors shared a number of items with the same scales found in the GHQ-28. These shared factors appear similar across tests and should help bridge research using the GHQ-30 and the GHQ-28. Confirmatory factor analyses supported the four-factor models in both tests. The four standard subscales of GHQ-28 were strongly supported and can be recommended. The three similar factors in the GHQ-30, as well as the social satisfaction factor, appear reasonable to use.

Assessing the general health, increase in mental and physical workload among administrative staff of the University of Nigeria due to the COVID-19 pandemic

The coronavirus disease 2019 (COVID-19) pandemic has changed the global workloads and general well-being of employees, especially in the university system. The object of this study is to evaluate the mental health and effect of increase in workload on the general well-being of the administrative staff of the University of Nigeria, Nsukka, on the resumption of academic activities after the lockdown due to COVID-19. A total of 73 randomly selected administrative staff were involved in the study. Three sets of instruments, the demographic questionnaire, National Aeronautics and Space Administration-Task Load Index, and General Health Questionnaire, were used to obtain information on the demographic characteristics, workload, and level of mental disorder among the respondents due to COVID-19. The generalized linear regression model, 1-way analysis of variance, independent samples t test, and contingency coefficient were used to analyze the data. The results revealed that high workload is significantly associated with high risk of mental and general health disorders among the respondents. The married, divorced, widowed, older, and females staff with >2 children are the most vulnerable to mental disorder, physical workload, frustration, and general health challenges. The younger staff, those with at most 2 children, and those who are still single experience lower mental and general health disorder and are more resilient. Significant and comprehensive health and administrative support should be provided for the overall well-being of the staff.

The General Health Questionnaire-28 (GHQ-28) as an outcome measurement in a randomized controlled trial in a Norwegian stroke population

BACKGROUND

Several studies have documented the variety of post-stroke psychosocial challenges, which are complex, multifaceted, and affect a patient's rehabilitation and recovery. Due to the consequences of these challenges, psychosocial well-being should be considered an important outcome of the stroke rehabilitation. Thus, a valid and reliable instrument that is appropriate for the stroke population is required. The factor structure of the Norwegian version of GHQ-28 has not previously been examined when applied to a stroke population. The purpose of this study was to explore the psychometric properties of the GHQ-28 when applied in the stroke population included in the randomized controlled trial; "Psychosocial well-being following stroke", by evaluating the internal consistency, exploring the factor structure, construct validity and measurement invariance.

METHODS

Data were obtained from 322 individuals with a stroke onset within the past month. The Kaiser-Meyer-Olkin (KMO) test was used to test the sampling adequacy for exploratory factor analysis, and the Bartlett's test of sphericity was used to test equal variances. Internal consistency was analysed using Cronbach's alpha. The factor structure of the GHQ-28 was evaluated by exploratory factor analysis (EFA), and a confirmatory factor analysis (CFA) was used to determine the goodness of fit to the original structure of the outcome measurement. Measurement invariance for two time points was evaluated by configural, metric and scalar invariance.

RESULTS

The results from the EFA supported the four-factor dimensionality, but some of the items were loaded on different factors compared to those of the original structure. The differences resulted in a reduced goodness of fit in the CFA. Measurement invariance at two time points was confirmed.

CONCLUSIONS

The change in mean score from one to six months on the GHQ-28 and the factor composition are assumed to be affected by characteristics in the stroke population. The results, when applying the GHQ-28 in a stroke population, and sub-factor analysis based on the original factor structure should be interpreted with caution.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT02338869 , registered 10/04/2014.

The nurse-patient relationship in the New Public Management era, in public home care: A focused ethnography

AIM

The aim of this study was to gain deeper understandings of nurse-patient relationships in the New Public Management era, by exploring beliefs and practices of nurses and patients in Norwegian public home care.

BACKGROUND

Organization of Norwegian home care services is based on New Public Management-ideologies, which have led to a rigidly formalized and task-oriented nursing practice that may jeopardize individual nursing care. Nurse-patient relationships have several positive effects on patients' health and well-being, but organizational boundaries and time pressure affect the quality of relationships.

DESIGN

Focused ethnography.

METHODS

Data were collected between November 2015-July 2016 using participant observation and semi-structured interviews with 10 nurses and eight patients in six different home care areas, in two Norwegian municipalities. Data analysis was based on Roper and Shapiras framework.

FINDINGS

Findings demonstrate the continued importance of nurse-patient relationships in contemporary home care, while identifying extensive variations in the degree of closeness and emotional involvement. Organizational boundaries, time constraints, high workload, and disharmony between nurses "competence and patients" complex illnesses, influence practice in ways that reduce the significance of nurse-patient relationships and affect conditions under which they develop and evolve. Facing a system nurses perceive to function suboptimal, they govern practices based on their own professional assessments, and findings indicate cultural patterns in the way both nurses and patients prioritize to safeguard nurse-patient relationships.

CONCLUSION

Home care cultures based on traditional nursing values continue, despite New Public Management influences, but a transition into New Public Management culture may, over time, influence the quality of nurse-patient relationships and meanings attributed to them.

Who often feels lonely? A cross-sectional study about loneliness and its related factors among older home-dwelling people

AIM AND OBJECTIVES

To investigate the prevalence of individuals who often feel lonely among a sample of Norwegian older home-dwelling people aged ≥65 years old, as well as to identify any possible factors explaining their loneliness.

BACKGROUND

Loneliness is known to be common among older people. To identify those older adults who are lonely, and to acquire knowledge about the complexity of their loneliness, is important to provide them with adequate help and support.

DESIGN

This study employed a cross-sectional design.

METHOD

A questionnaire was mailed to a randomised sample of 6,033 older home-dwelling persons aged ≥65 years. A total of 2,052 persons returned the questionnaire and were included in the study. The questionnaire consisted of questions asking whether the subjects often felt lonely or not, as well as health-related and background questions and instruments to measure the participants' sense of coherence, mental problems, nutritional screening and self-care ability. The data were analysed using univariate and multivariate statistical methods.

RESULTS

A total of 11.6% of the participants reported often feeling lonely. Six factors emerged to be independently associated with often feeling lonely among the respondents: Living alone, not being satisfied with life, having mental problems, a weak sense of coherence, not having contact with neighbours and being at risk for undernutrition.

CONCLUSIONS

The study shows that often feeling lonely among older home-dwelling persons is a health-related problem that includes social, psychological and physical aspects. Moreover, these persons have limited resources to overcome feelings of loneliness.

IMPLICATIONS FOR PRACTICE

Lasting loneliness among older home-dwelling persons requires an overall, person-centred and time-consuming approach by nurses. Nurses with advanced knowledge on geriatric nursing may be required to offer appropriate care and support. Healthcare leaders and politicians should offer possibilities for adequate assessment, support and help.

Resilience factors play an important role in the mental health of parents when children survive acute lymphoblastic leukaemia

AIM

Childhood cancer is a tremendous stressor that requires parents to adapt to new challenges, and research has mainly focused on psychopathology and rarely on a resource-oriented perspective, such as resilience. This study assessed resilience factors among parents of children surviving acute lymphoblastic leukaemia and parents of healthy children. We also explored the association between parental resilience and mental health.

METHODS

The study compared 57 parents of 40 children from eight to 15 years of age in remission from acute lymphoblastic leukaemia and 63 parents of 42 healthy children. The Resilience Scale for Adults and the General Health Questionnaire were used to assess parental resilience and mental health.

RESULTS

Parents of children surviving acute lymphoblastic leukaemia showed significantly lower levels of resilience than parents of healthy children, but no significant difference was found for mental health. Certain resilience factors were positively associated with mental health, especially for mothers, such as family cohesion, good perception of self and being able to plan their future.

CONCLUSION

Resilience factors may help to protect parents' mental health, especially mothers, when their child has survived acute lymphoblastic leukaemia and should be considered in a clinical setting. Further research on resilience factors for fathers is needed.

Psychometric properties of Antonovsky’s 29-item Sense of Coherence scale in research on older home-dwelling Norwegians

Aim: The aim of this study was to test the homogeneity and construct validity of the Sense of Coherence 29-item scale (SOC-29) among older home-dwelling Norwegians. Methods: A postal questionnaire, consisting of background variables, five health-related questions, the SOC-29, and three other instruments measuring mental health, self-care ability, and risk for undernutrition, was sent to 6033 home-dwelling older people (65+ years) in southern Norway. A total of 2069 participants were included. Homogeneity was assessed with Cronbach’s alpha coefficient and item-to-total correlations. The construct validity was assessed with “the known-groups technique,” a linear stepwise regression analysis with SOC score serving as the dependent variable and with confirmatory factor analysis. Results: With a Cronbach’s alpha coefficient of 0.91 and statistically significant item-to-total correlations, the SOC-29 was found to be homogeneous. Construct validity was supported because the SOC-29 could separate known groups with expected high and low scores. The factors that could predict SOC were mental health, self-care ability, feeling lonely, being active, and chronic disease or handicap. Evidence of construct validity was displayed in a confirmatory factor analysis that confirmed SOC-29 as one theoretical construct with the three dimensions, comprehensibility, manageability, and meaningfulness. Conclusions: The Norwegian version of the SOC-29 is a reliable and valid instrument for use in research among older people. The results confirm that SOC has a particularly strong relationship with mental health and self-care ability.

The combined influence of hardiness and cohesion on mental health in a military peacekeeping mission: A prospective study

A large number of studies have shown that hardiness and cohesion are associated with mental health in a military context. However, most of them are presented without controlling for baseline mental health symptoms, which is their most significant source of error. The present study investigates the combined effect of hardiness and cohesion in a prospective design, controlling for baseline levels of symptoms among Norwegian personnel serving in a peacekeeping operation in Kosovo. Multivariate regression analyses were performed in which self-reported mental health complaints were regressed on our explanatory variables. Our findings suggest that both cohesion and hardiness contributed to increased stress resiliency, as measured by a lower level of reported mental health complaints. Our baseline measure of mental health accounted for a larger proportion of the variance than our other predictors. A significant interaction between cohesion and hardiness suggested a combined effect, over and above the individual contributions of the predictors. For individuals who scored high on hardiness, cohesion levels did not influence levels of mental health complaints. Individuals who scored low on hardiness, on the other hand, reported lower levels of mental health complaints when cohesion levels were high.