Cognitive testing of the PHQ-9 for depression screening among pregnant and postpartum women in Kenya

Velloza, Jennifer; Njoroge, John; Ngure, Kenneth; Thuo, Nicholas; Kiptinness, Catherine; Momanyi, Richard; Ayub, Snaidah; Gakuo, Stephen; Mugo, Nelly; Simoni, Jane M.; Heffron, Renee

doi:10.1186/s12888-020-2435-6

Cited by 24 publications

(38 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In Kenya, Cognitive testing of the PHQ-9 has been conducted for depression screening among pregnant and postpartum women. 41 Results showed that most participants preferred to answer the PHQ-9 in Kiswahili ( N = 15; 52%). Overall, participants found the scale acceptable as an interviewer-administered tool.…”

Section: Discussionmentioning

confidence: 99%

Testing the EPDS and PHQ-9 Among Peripartum Adolescents in Nairobi, Kenya: a Mixed-Methods Study

Kumar

Huang

Othieno

et al. 2021

Clinical Medicine Insights: Psychiatry

View full text Add to dashboard Cite

Background: Cognitive interviewing is a well-recognised methodology to identify clinical and commonsensical relevance of mental health questionnaire items by our research participants. Depression is amongst the most common condition impacting pregnant and parenting adolescents in sub-Saharan Africa (SSA). In Kenya, studies have reported depression prevalence estimates of 12-50% in peripartum adolescents. While young people prefer using English, there has not been enough data to point to how well they respond to Kiswahili translations of the commonly used tools. Method: Thirty-two participants between ages 14-18 years were approached and through informed consent for them to participate. We used Edinburgh Postnatal Depression Scale (EPDS) and Patient Health Questionnaire-9 (PHQ-9) in English and Kiswahili versions to carry out the interviews and were coded along with 4 domains of comprehension, retrieval, judgement, and patient response. The interviews were discussed within the team and tables were shared between 3 raters for further consensus. The interview transcripts were analyzed manually using thematic analysis. We used the findings from the interviews to make modifications to the existing English versions of EPDS and PHQ-9 and to modify Kiswahili versions too. Discussion: We found that adolescents had challenges in fully understanding items in both sets of tools however, EPDS was better received than PHQ-9. Psychometrically, the EPDS English version and Kiswahili versions fared better than the PHQ-9 English and Kiswahili versions. PHQ-9 presented considerable issues with regards to semantic clarity however had simpler response options in comparison to EPDS which was more experientially appropriate, but response options were not simple. On our thematic analysis, we felt that the adolescents were significantly challenged by the new, unanticipated pregnancy or motherhood experience. Poverty, poor partner support, discord with parents and distress in the family, and traumatic end of supportive and helpful relationships were the notable problems. We believe the cultural and linguistic modifications made on these tools would make them more suitable to be validated with a sample of pregnant adolescents. Conclusion: While sensitive cross-cultural translations for the commonly used open access depression tools is critical, it is also pertinent to understand whether these are developmentally appropriate. Our participants had multiple psychosocial and material challenges that necessitate measures sensitive to their age, social context, and health experiences. Additionally, we felt that both the tools may not be suitable for self-administration and may need the involvement of a case worker or community health worker.

show abstract

Section: Discussionmentioning

confidence: 99%

Testing the EPDS and PHQ-9 Among Peripartum Adolescents in Nairobi, Kenya: a Mixed-Methods Study

Kumar

Huang

Othieno

et al. 2021

Clinical Medicine Insights: Psychiatry

View full text Add to dashboard Cite

show abstract

“…Conceptually, when examining the emotional status of patients, the two subscales are scored separately, yet in practice, the overlap between these scales is inevitable. The determination of the two common mental disorders; anxiety and depression in this instrument will probable present an added credit, unlike other screening tools which predominantly assess only the depression in HIV patients (38)(39)(40). A recent study on WLHIV in Kenya using PHQ-9 has suggested a further studies which would take in to consideration the anxiety-related mood of the WLHIV (40).…”

Section: Discussionmentioning

confidence: 99%

A validation study of the Hospital Anxiety and Depression Scale (HADS) in WLHIV

Yousuf¹,

Musa²,

Isa³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Hospital Anxiety and Depression Scale (HADS) is a self-assessment tool that measures anxiety and depression and is mostly used in hospital settings. The purpose of this study is to test the validity and reliability of the Somali version of HADS in selected two hospitals in eastern Ethiopia. Method: From the WLHIV who attend the ART service, 357 women were included in the study and assessed with this tool. The English language of HADS was translated into the Somali version and used for this study. Statistical analysis was computed to examine the validity and measure the reliability of the study. Result This version of HADS was found to be acceptable for people living with HIV. To test the reliability, the internal consistency was found to be 0.83 for the anxiety sub-scale and 0.84 for the depression sub-scale. The Somali version of HADS has shown good internal consistency with its metric properties similar to international literature. By two-factor analysis, the Varimax rotation has shown high factor loading in both sub-scales (Anxiety and depression). Conclusion Therefore, this version can be used to screen the anxiety and depression of patients living with HIV. Therefore, the findings of this validation study show that the Somali version of the HADS is a valid and reliable tool to measure depression and anxiety and can be used to screen people living with HIV.

show abstract

“…Yet, the type of screening tool and their decision process determines their choice to accept the screening. As several studies has published that women understandings and decision manners commonly regulates their response and acceptance of the screening (38–40). Thus, in order to reduce the frequent challenges of integrating mental health with the comprehensive HIV care and minimize the unmet need of HIV women to be screened for depression, recent findings suggest that ART attendees should be invited for depression screening and eligible clients should be linked for further examination and treatment (41).…”

Section: Discussionmentioning

confidence: 99%

Willingness and acceptability of anxiety and depression screening among women living with HIV in Ethiopia

Yousuf

Arifin²,

Musa³

et al. 2020

Preprint

View full text Add to dashboard Cite

Introduction: Integration of related health services, such as screening of depression in HIV care is crucial for improving the quality of care and enhancing the use of scarce resources in developing countries. However, commonly these interrelated health services are commonly provided separately and there are many missed opportunities. Little is known about the client-related non-implementation issues. This study aims at examining the acceptability of anxiety and depression screening among women living with HIV. Material and methods: This was a facility based cross-sectional study which included women living with HIV attending two hospitals in Jijiga town, Ethiopia. The study participants were identified using systematic random sampling method. An exit interview was conducted with the use of a pretested questionnaire. The gathered data was analysed using SPSS version 23 and multivariate logistic regression model was used to determine factors associated with the factors associated with the acceptance of anxiety and depression screening. Results: A total of 409 women participated in this study. Though, only 115 (28.1%) were aware about the existence of anxiety and depression screening, 357 (87.3%) accepted to receive the screening for anxiety and depression. Requisite of partner approval was the most common reason for not accepting the screening of anxiety and depression 21 (40.4%). When used multivariate logistic regression model; holding college level education, divorced and were living without partner, being self employed by occupation, aware of the existing screening service, source of information from health care providers and history of previous screening were significantly associated with acceptance of depression screening. Conclusion: This research has shown that women participant living with HIV were willing to undergo the screening for depression, hence future interventions should focus on the integration of mental health screening in HIV clinical setup. Key words: Depression, HIV, AIDS, acceptability, screening.

show abstract

Cognitive testing of the PHQ-9 for depression screening among pregnant and postpartum women in Kenya

Cited by 24 publications

References 47 publications

Testing the EPDS and PHQ-9 Among Peripartum Adolescents in Nairobi, Kenya: a Mixed-Methods Study

Testing the EPDS and PHQ-9 Among Peripartum Adolescents in Nairobi, Kenya: a Mixed-Methods Study

A validation study of the Hospital Anxiety and Depression Scale (HADS) in WLHIV

Willingness and acceptability of anxiety and depression screening among women living with HIV in Ethiopia

Contact Info

Product

Resources

About