Validity and reliability of Kessler Psychological Distress Scale for Brazilian elderly: a cross-sectional study

Lins, Gabriella Oliveira de Albuquerque; Lima, Nathália Angel da Silva; Sousa, Girliani Silva de; Guimarães, Fernanda Jorge; Frazão, Iracema da Silva; Perrelli, Jaqueline Galdino Albuquerque

doi:10.1590/0034-7167-2020-0365

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 74 (Suppl 2) • 2021 • https://doi.org/10.1590/0034-7167-2020-0365 copy

Validity and reliability of Kessler Psychological Distress Scale for Brazilian elderly: a cross-sectional study

Validez y confiabilidad de la Escala de Estrés Psicológico de Kessler para ancianos brasileños: un estudio transversal

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to verify the validity and reliability of the Psychological Distress Scale for screening mental distress.

Methods:

a cross-sectional study with 75 elderly people. Psychological Distress scale and Self Reporting Questionnaire were used. Criterion validity was verified using Spearman’s correlation and diagnostic accuracy measures. Cronbach’s alpha coefficient was used to investigate reliability.

Results:

the total internal consistency of the Psychological Distress Scale was α=0.844. Concurrent validity between this instrument and the Self Reporting Questionnaire was ρ=0.722 (p<0.001). The best cut-off point for screening mental distress among elderly people was a total score greater than 14, with sensitivity equal to 75.47% and specificity equal to 85.0%.

Conclusions:

the scale was robust for screening mental distress, given its high reliability, in terms of homogeneity, and adequate criterion validity, whose best cut-off point for screening was a score greater than 14.

Descriptors:
Suicide; Stress; Psychological; Mental Disorders; Aged; Nursing

Kessler Psychological Distress Scale Items - K10	α^* * Total Cronbach’s alpha of the scale;	α^ Total Cronbach’s alpha of the scale if that item is excluded.
	0.844
1. In the past 4 weeks, about how often did you feel tired out for no good reason?		0.839
2. In the past 4 weeks, about how often did you feel nervous?		0.837
3. In the past 4 weeks, about how often did you so feel nervous that nothing could calm you down?		0.837
4. In the past 4 weeks, about how often did you feel hopeless?		0.839
5. In the past 4 weeks, about how often did you feel restless or fidgety?		0.834
6. In the past 4 weeks, about how often did you feel so restless you could not sit still?		0.834
7. In the past 4 weeks, about how often did you feel depressed?		0.818
8. In the past 4 weeks, about how often did you feel that everything was an effort?		0.824
9. In the past 4 weeks, about how often did you feel so sad that nothing could cheer you up?		0.819
10. In the past 4 weeks, about how often did you feel worthless?		0.814

K10 score	Sensitivity (%)	95% CI	Specificity (%)	95% CI
≥10	100.00	93.3 - 100.0	0.00	0.0 - 16.8
>10	100.00	93.3 - 100.0	20.00	5.7 - 43.7
>11	98.11	89.9 - 100.0	35.00	15.4 - 59.2
>12	90.57	79.3 - 96.9	60.00	36.1 - 80.9
>13	83.02	70.2 - 91.9	75.00	50.9 - 91.3
>14	75.47	61.7 - 86.2	85.00	62.1 - 96.8
>15	58.49	44.1 - 71.9	90.00	68.3 - 98.8
>16	45.28	31.6 - 59.6	90.00	68.3 - 98.8
>17	39.62	26.5 - 54.0	95.00	75.1 - 99.9
>18	35.85	23.1 - 50.2	95.00	75.1 - 99.9
>19	28.30	16.8 - 42.3	100.00	83.2 - 100.0
>41	0.00	0.0 - 6.7	100.00	83.2 - 100.0

Independent variables	Mental distress		p value^* * Chi-square test;	OR^ OR - Odds Ratio;	95% Confidence Interval
Independent variables	Yes	No	p value^* * Chi-square test;	OR^ OR - Odds Ratio;	Lower limit	Upper limit
Income less than a minimum wage			0.039	--	--	--
Yes	6	0
No	37	30
Retirement			0.005	0.170	0.044	0.649
Yes	26	27
No	17	3
Difficulty sleeping^* ***** SRQ Item - 20.			0.032	2.909	1.080	7.834
Yes	32	15
No	11	15
Scare easily ^* ***** SRQ Item - 20.			0.018	3.241	1.206	8.707
Yes	25	9
No	18	21
Hand tremors ^* ***** SRQ Item - 20.			0.015	4.821	1.253	18.554
Yes	15	3
No	28	27
Nervousness/tension/concern^* ***** SRQ Item - 20.			<0.001	12.750	3.627	44.819
Yes	39	13
No	4	17
Digestion difficulties^* ***** SRQ Item - 20.			0.029	2.947	1.100	7.900
Yes	24	9
No	19	21
Sadness^* ***** SRQ Item - 20.			<0.001	11.083	2.339	52.517
Yes	19	2
No	24	28
Frequent crying^* ***** SRQ Item - 20.			0.003	6.480	1.700	24.694
Yes	18	3
No	25	27
Loss of interest in life^* ***** SRQ Item - 20.			0.001	--	--	--
Yes	13	0
No	30	30
Frequent tiredness^* ***** SRQ Item - 20.			<0.001	18.962	2.357	152.553
Yes	17	1
No	26	29
Tired from small efforts^* ***** SRQ Item - 20.			0.011	3.462	1.301	9.208
Yes	30	13
No	12	18
Unpleasant feelings in the stomach ^* ***** SRQ Item - 20.			0.013	3.378	1.265	9.025
Yes	31	12
No	13	17

Variables	Median	Mean scores	p value^* * Mann-Whitney U test.
Scores (K10)
Sex
Male	13.0	25.63	0.019
Female	15.0	39.94	0.019
Retirement
Yes	14.0	33.61	0.026
No	16.5	45.98	0.026
Suicide risk
Yes	22.5	58.67	<0.001
No	15.0	32.74	<0.001
Common Mental Disorder
Yes	16.0	44.29	<0.001
No	12.0	17.68	<0.001
Scores (SRQ - 20)
Sex
Male	5.0	25.33	0.016
Female	6.5	40.02	0.016
Suicide risk
Yes	14.0	62.58	<0.001
No	6.0	31.97	<0.001
Mental distress
Yes	8.0	48.19	<0.001
No	4.0	20.97	<0.001
Major depression
Yes	16.0	66.00	<0.001
No	6.0	33.92	<0.001
Minor depression
Yes	9.0	48.23	0.034
No	6.0	34.57	0.034

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[1] Corresponding author: Jaqueline Galdino Albuquerque Perrelli E-mail: jaqueline.albuquerque@ufpe.br