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Examination of the construct validity of the Swedish version of Hospital Anxiety and Depression Scale in breast cancer patients

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Abstract

Purpose

To examine the construct validity of the Swedish version of Hospital Anxiety and Depression Scale (HAD) in women with breast cancer.

Method

Acquired data on HAD from 727 women who recently had breast cancer surgery, were aged 20–63 years and worked before diagnosis, and had no previous breast cancer (n = 725) were subjected to confirmatory factor analysis examining the viability of three hypothesized measurement models.

Results

The analysis showed adequate fit to the data for both bi-dimensional and three-factorial models of HAD. The single-factorial model, however, was shown to have inferior fit to the data. Substantive correlations were found between anxiety and depression in the bi-dimensional model, and negative affectivity and anxiety in the three-factorial model of HAD.

Conclusions

The findings support the utility of scoring procedure based on the original bi-dimensional model, but add indication of co-occurrence of anxiety and depression in this patient population. The discriminant validity of a third factor of negative affectivity in a three-factorial model, however, remains unclear.

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Acknowledgments

The study was funded by the Swedish Research Council, the Swedish Cancer Society, Health Care Science Post-Graduate School at Karolinska Institutet, and the Swedish Council for Working Life and Social Research (2006-0920 and 2009-1758).

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Authors and Affiliations

  1. Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden

    Fredrik Saboonchi, Agneta Wennman-Larsen, Kristina Alexanderson & Lena-Marie Petersson

  2. Red Cross University College, Stockholm, Sweden

    Fredrik Saboonchi

  3. Stress Research Institute, University of Stockholm, Stockholm, Sweden

    Fredrik Saboonchi

  4. Sophiahemmet University College, Stockholm, Sweden

    Agneta Wennman-Larsen

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  1. Fredrik Saboonchi
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Correspondence to Fredrik Saboonchi.

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Saboonchi, F., Wennman-Larsen, A., Alexanderson, K. et al. Examination of the construct validity of the Swedish version of Hospital Anxiety and Depression Scale in breast cancer patients. Qual Life Res 22, 2849–2856 (2013). https://doi.org/10.1007/s11136-013-0407-8

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