Testing gender invariance of the Hospital Anxiety and Depression Scale using the classical approach and Bayesian approach

Purpose Measurement invariance is an important attribute for the Hospital Anxiety and Depression Scale (HADS). Most of the confirmatory factor analysis (CFA) studies on the HADS adopt the classical maximum likelihood approach. The restrictive assumptions of exact zero cross-loadings and residual correlations in the classical approach can lead to inadequate model fit and biased parameter estimates. The present study adopted both the classical approach and the alternative Bayesian approach to examine the measurement and structural invariance of the HADS across gender. Methods A Chinese sample of 326 males and 427 females was used to examine the two-factor model of the HADS across gender. Configural and scalar invariance of the HADS were evaluated using the classical approach with the robust weighted least square estimator and the Bayesian approach with zero-mean, small variance informative priors for cross-loadings and residual correlations. Results Acceptable and excellent model fits were found for the two-factor model under the classical and Bayesian approaches, respectively. The two-factor model displayed scalar invariance across gender using both approaches. In terms of structural invariance, females showed a significantly higher mean in the anxiety factor than males under both approaches. Conclusion The HADS demonstrated measurement invariance across gender and appears to be a well-developed instrument for assessment of anxiety and depression. The Bayesian approach is an alternative and flexible tool that could be used in future invariance studies.postprin

Re-examining the factor structure and psychometric properties of the Mini-Mental Adjustment to Cancer Scale in a sample of 364 Chinese cancer patients

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Measuring Engagement at Work: Validation of the Chinese Version of the Utrecht Work Engagement Scale

Background: Work engagement is a positive work-related state of fulfillment characterized by vigor, dedication, and absorption. Previous studies have operationalized the construct through development of the Utrecht Work Engagement Scale. Apart from the original three-factor 17-item version of the instrument (UWES-17), there exists a nine-item shortened revised version (UWES-9). Purpose: The current study explored the psychometric properties of the Chinese version of the Utrecht Work Engagement Scale in terms of factorial validity, scale reliability, descriptive statistics, and construct validity. Method: A cross-sectional questionnaire survey was conducted in 2009 among 992 workers from over 30 elderly service units in Hong Kong. Results: Confirmatory factor analyses revealed a better fit for the three-factor model of the UWES-9 than the UWES-17 and the one-factor model of the UWES-9. The three factors showed acceptable internal consistency and strong correlations with factors in the original versions. Engagement was negatively associated with perceived stress and burnout while positively with age and holistic care climate. Conclusion: The UWES-9 demonstrates adequate psychometric properties, supporting its use in future research in the Chinese context. © 2011 The Author(s).published_or_final_versionSpringer Open Choice, 21 Feb 201

The associations between diurnal cortisol patterns, self-perceived social support, and sleep behavior in Chinese breast cancer patients

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Effectiveness of body–mind–spirit intervention on well‐being, functional impairment and quality of life among depressive patients – a randomized controlled trial

Aim The aim of the study was to examine the efficacy of body–mind–spirit Intervention in improving the outcomes (well-being, quality of life and functional impairment) among depressive patients. Background Depressive disorders lead to significant dysfunction, disability and poor quality of life among sufferers. Body–mind–spirit intervention has been associated with improvements in the outcomes; however, few studies have examined this among depressive patients. Design True experimental pre–post equivalent groups design was adopted with longitudinal measurement of outcomes. Methods Participants were 120 adult depressive patients visiting the psychiatric outpatient department in a District Hospital in India. The participants were randomly assigned to either the body–mind–spirit group or the treatment-as-usual group between July 2011–January 2013. The treatment-as-usual group (n = 64) received only routine treatment (antidepressants and structured psycho-education) in the hospital. The body–mind–spirit group (n = 56) received four weekly body–mind–spirit group sessions in addition to the routine treatment. Outcome measures on depression, well-being, functional impairment and quality of life were evaluated for both groups at baseline and at four follow-up assessments in the 1st, 2nd, 3rd and 6th month. Treatment effects of the body–mind–spirit intervention were analysed by repeated-measures analysis of covariance. Findings Compared with the treatment-as-usual group, the body–mind–spirit group showed significant reduction in depression and functional impairment, and significant improvement in the well-being and quality of life scores over the 6-month study period. Conclusion The present findings provided evidence for the effectiveness of integrating a complementary therapy such as the body–mind–spirit intervention with conventional treatment in improving prospective outcomes among the depressive patients.postprin

Dimensionality of the Center for Epidemiologic Studies Depression Scale: an exploratory bi-factor analytic study

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Diurnal cortisol slope mediates the association between affect and memory retrieval in older adults with mild cognitive impairment: a path-analytical study

Background: Memory deficits are linked to dysfunctional HPA axis activity and negative affect in older adults. This study evaluated the mediating effect of the diurnal cortisol pattern on the relationship between affect and memory in older people with mild cognitive impairment (MCI). Methods: This longitudinal study recruited 189 Chinese older adults with MCI from elderly centers in Hong Kong. The participants completed assessments of affect, salivary cortisol, and digit spans at baseline; neurocognitive assessments on verbal fluency, memory retrieval, and digit spans at 6-month follow-up; and instrumental activities of daily living (IADL) at 1-year follow-up. Structural equation modeling examined the direct and indirect effects of negative affect on memory and IADL via diurnal cortisol pattern. Results: Controlling for covariates, negative affect significantly predicted flattened diurnal cortisol slopes (β = 0.17, p < 0.05) but not memory or IADL (p = 0.23 – 0.91) directly. Diurnal cortisol slopes negatively predicted memory retrieval (β = −0.20, p < 0.05), which in turn positively predicted IADL (β = 0.22, p < 0.01). The indirect effect from negative affect to IADL via cortisol slope and memory retrieval was significant and negative (αβγ = −0.05, 95% bootstrapped CI = −0.248 to −0.001). Discussion: The present study established certain temporal linkages among affect and cortisol slopes at baseline, memory retrieval at 6 months, and functional decline 1 year later in older adults with MCI. Flattened diurnal cortisol slopes might mediate the detrimental effects of negative affect on memory retrieval and functioning across 1 year