The potential of the GHQ-12 questionnaire in assessing psychological impairment on a health-care workers population facing Covid-19: an item response theory-based analysis

Abstract

BackgroundThe General Health Questionnaire (GHQ) is a widely used tool, both in clinical and research settings, due to its brevity and easy administration. Researchers often adopt a dichotomous measurement method, considering a total score above or below a certain threshold. This leads to an extreme simplification of the gathered data and therefore to the loss of clinical details.In a multi-step evaluation study aimed at assessing health care workers’ mental health during the Covid-19 pandemic, the GHQ-12 proved to be the most effective tool to detect psychological distress compared to other scales adopted. These results led to deepening the understanding of the GHQ-12 properties through a statistical study, by focusing on items’ properties and characteristics. MethodsGHQ-12 responses were analyzed using Item Response Theory (IRT), a suitable method for scale assessment. Instead of considering the single overall score, in which each item accounts equally, it focuses on individual items’ characteristics. Moreover, IRT models were applied combined with the latent class (LC) analysis, aiming to the determination of subgroups of individuals according to their level of psychological distress. ResultsGHQ-12 was administered to 990 health-care workers and responses were scored using the binary method (0-0-1-1). We applied the 2-PL (two-parameters logistic) model, finding that the items showed different ways of responses and features. The latent class analysis classified subjects into three sub-groups according to their responses to the GHQ-12 only: 47% of individuals with general well-being, 38% expressing signs of discomfort without severity and 15% of subjects with a high level of impairment. Such a result almost reproduces subjects’ classification obtained after administering the six questionnaires of the study protocol.ConclusionsAccurate statistical techniques and a deep understanding of the latent factors underlying the GHQ-12 resulted in a more effective usage of such psychometric questionnaire – i.e. a more refined gathering of data and a significant time and resource efficiency.We underlined the need to maximize the extraction of data from questionnaires and the necessity of them being less lengthy and repetitive.

Piloting a narrative‐mantra multi‐clinician group for mental health clinicians at a child and adolescent mental health service in London, UK

“…Studies pertaining to the reliability and validity of the GHQ‐12 include Comotti et al. 's (2022) multi‐step evaluation of GHQ‐12 to measure the psychological distress of 990 healthcare workers in Italy. They concluded that it is more effective in detecting psychological distress than other measures.…”