The use of culturally adapted and translated depression screening questionnaires with South Asian haemodialysis patients in England
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Authors
Sharma, ShivaniNorton, Sam
Bhui, Kamaldeep
Mooney, Roisin
Caton, Emma
Bansal, Tarun
Day, Clara
Davenport, Andrew
Duncan, Neill
Kalra, Philip A.
Gane, Maria Da Silva
Randhawa, Gurch
Warwick, Graham
Wellsted, David
Yaqoob, Magdi
Farrington, Ken
Affiliation
University of HertfordshireKing's College London
University of Oxford
Bradford Teaching Hospitals, NHS Foundation Trust
University Hospitals Birmingham NHS Foundation Trust
Royal Free and University College Hospital Medical School
Imperial College Healthcare NHS Trust
Salford Royal NHS Foundation Trust
East and North Hertfordshire NHS Trust
University of Bedfordshire
Leicester General Hospital
Barts Health NHS Trust
Issue Date
2023-04-07
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Depression is common amongst patients receiving haemodialysis (HD). Assessment and intervention when faced with language and cultural barriers is challenging. To support clinician decisions, we conducted a cross-sectional study to assess the use of culturally adapted and translated versions of commonly-used depression screening questionnaires with South Asian patients receiving HD in England. Patients completed adapted versions of the Patient Health Questionnaire (PHQ-9), the Centre for Epidemiological Studies Depression Scale Revised (CESD-R), and the Beck Depression Inventory II (BDI-II). All questionnaires were available in Gujarati, Punjabi, Urdu, and Bengali. A comparative sample of white-Europeans completed the questionnaires in English. The research was based across 9 National Health Service (NHS) Trusts in England. Structural validity of translated questionnaires was assessed using confirmatory factor analysis. Diagnostic accuracy was explored in a subgroup of South Asians against ICD-10 categories using the Clinical Interview Schedule Revised (CIS-R) with receiver operating curve (ROC) analysis. 229 South Asian and 120 white-European HD patients participated. A single latent depression factor largely accounted for the correlations between items of the PHQ-9, CESD-R and BDI-II. Issues with measurement equivalence implied that scores on the translations may not be comparable with the English language versions. Against CIS-R based ICD-10 diagnosis of depression, sensitivity was modest across scales (50-66.7%). Specificity was higher (81.3-93.8%). Alternative screening cut-offs did not improve positive predictive values. Culturally adapted translations of depression screening questionnaires are useful to explore symptom endorsement amongst South Asian patients. However, data indicate that standard cut-off scores may not be appropriate to classify symptom severity. Use of the CIS-R algorithms for optimal case identification requires further exploration in this setting. Strategies to encourage recruitment of under-represented groups in renal research are also warranted, especially for in-depth discussions related to psychological care needs.Citation
Sharma S, Norton S, Bhui K, Mooney R, Caton E, Bansal T, Day C, Davenport A, Duncan N, Kalra PA, Da Silva-Gane M, Randhawa G, Warwick G, Wellsted D, Yaqoob M, Farrington K (2023) 'The use of culturally adapted and translated depression screening questionnaires with South Asian haemodialysis patients in England', PLoS ONE, 18 (4), e0284090Publisher
PLOSJournal
PLoS ONEPubMed ID
37027453PubMed Central ID
PMC10081747Type
ArticleLanguage
enISSN
1932-6203EISSN
1932-6203Sponsors
This work was supported by the National Institute for Health Research (NIHR; www.nihr.ac.uk) (Research for Patient Benefit programme PB-PG-1112-29078; award to SS, KB, CD, AD, ND, MDS-G, GR, GW, DW, MY, KF)ae974a485f413a2113503eed53cd6c53
10.1371/journal.pone.0284090
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