Validación de constructo de la escala Zung en pacientes con falla cardíaca
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dic 30, 2021
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Lyda Zoraya Rojas Sánchez
Silvia Juliana Trujillo-Cáceres
https://orcid.org/0000-0002-7626-3822
Juliana Alexandra Hernández Vargas
https://orcid.org/0000-0001-6183-252X
Adriana Milena Jurado
https://orcid.org/0000-0002-3137-8319
Luis Eduardo Echeverría
https://orcid.org/0000-0001-5784-3859
Sergio Alejandro Gómez-Ochoa
https://orcid.org/0000-0002-1396-5042
Zayne Milena Roa-Díaz
https://orcid.org/0000-0002-0847-0969
https://orcid.org/0000-0002-7626-3822
Juliana Alexandra Hernández Vargas
https://orcid.org/0000-0001-6183-252X
Adriana Milena Jurado
https://orcid.org/0000-0002-3137-8319
Luis Eduardo Echeverría
https://orcid.org/0000-0001-5784-3859
Sergio Alejandro Gómez-Ochoa
https://orcid.org/0000-0002-1396-5042
Zayne Milena Roa-Díaz
https://orcid.org/0000-0002-0847-0969
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Resumen
Introducción: La escala Zung para depresión ha sido previamente utilizada en pacientes con falla cardíaca; sin embargo, en nuestro conocimiento no se encuentra evidencia de su validez para la versión en español y su uso en población adulta con falla cardíaca en Colombia. Objetivo: Determinar la validez de constructo de la escala Zung para depresión en su versión original y proponer una versión abreviada para pacientes adultos con falla cardíaca.
Materiales y Métodos: Estudio de corte transversal, realizado en 200 pacientes de una clínica de falla y trasplante cardiaco, en quienes se aplicó Zung Self-Rating Depression Scale. Se evaluó la consistencia interna por medio del alfa de Cronbach y el análisis factorial fue utilizado para identificar las dimensiones del instrumento.
Resultados: La consistencia interna de la versión original de la escala (20 ítems) fue de α=0.811. El análisis de factores mostró una estructura compuesta por tres factores que explican el 51.59% de la varianza total. La nueva versión abreviada (13 ítems) obtuvo un α=0.819 y los ítems correlacionaron con un único factor que explicó el 33.54% de la varianza total.
Discusión: Nuestros hallazgos son similares a los encontrados por otros autores en diferentes poblaciones a la estudiada.
Conclusiones: Se evidenció validez de constructo tanto para la escala Zung para depresión en su versión original como para la abreviada creada en la población estudiada. Sin embargo, se requieren estudios adicionales que verifiquen estos hallazgos en una muestra representativa y que otros aspectos de la psicometría sean evaluados.
Keywords
Validation Study; Psychiatric Status Rating Scales; Depression; Heart Failure.Estudio de Validación; Escalas de Valoración Psiquiátrica; Depresión; Insuficiencia cardíaca.Estudos de Validacão; Escalas de Graduacão Psiquiátrica; Depressão; Insuficiência cardíaca.
References
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2. Freedland KE, Carney RM, Rich MW, Steinmeyer BC, Rubin EH. Cognitive behavior therapy for depression and self-care in heart failure patients a randomized clinical trial. JAMA Intern Med. 2015;175(11):1773-82. http://dx.doi.org/10.1001/jamainternmed.2015.5220
3. Rutledge T, Reis VA, Linke SE, Greenberg BH, Mills PJ. Depression in heart failure a meta-analytic review of prevalence, intervention effects, and associations with clinical outcomes. J Am Coll Cardiol. 2006;48(8):1527-37. http://dx.doi.org/10.1016/j.jacc.2006.06.055
4. Mbakwem AC, Aina OF. Comparative study of depression in hospitalized and stable heart failure patients in an urban Nigerian teaching hospital. Gen Hosp Psychiatry. 2008;30:435-40. https://doi.org/10.1016/j.genhosppsych.2008.04.008
5. Newhouse A, Jiang W. Heart failure and depression. Heart Fail Clin. 2014;10(2):295-304. https://doi.org/10.1016/j.hfc.2013.10.004
6. Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Jr., Drazner MH, et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013;62(16):e147-239. https://doi.org/10.1016/j.jacc.2013.05.019
7. Shafer AB. Meta-analysis of the Factor Structures of Four Depression Questionnaires. J Clin Psychol. 2006;62(1):123-46. https://doi.org/10.1002/jclp.20213
8. Ruiz-grosso P, Mola CLD, Vega-dienstmaier JM, Arevalo JM. Validation of the Spanish Center for Epidemiological Studies Depression and Zung Self-Rating Depression Scales: A Comparative Validation Study. PloS ONE. 2012;7(10):E45413-E. https://doi.org/ 10.1371/journal.pone.0045413
9. Kourkoveli P, Rammos S, Parissis J. Depressive Symptoms in Patients with Congenital Heart Disease : Incidence and Prognostic Value of Self-Rating Depression Scales. Congenit Heart Dis. 2015;10:240-7. https://doi.org/ 10.1111/chd.12200
10. Parissis J, Karavidas A, Farmakis D, Papoutsidakis N, Matzaraki V, Arapi S, et al. Efficacy and safety of functional electrical stimulation of lower limb muscles in elderly patients with chronic heart failure: A pilot study. Eur J Prev Cardiol. 2015;22(7):831-6. https://doi.org/ 10.1177/2047487314540546
11. Suzuki T, Shiga T, Kuwahara K. Impact of clustered depression and anxiety on mortality and rehospitalization in patients with heart failure. J Cardiol. 2014;64(6):456-62. https://doi.org/1 0.1016/j.jjcc.2014.02.031
12. Cogollo Z, Díaz CE, Campo A. Exploración de la validez de constructo de la escala de Zung para depresión en adolescentes escolarizados. Colomb Med (Cali). 2006;37(2):102-6.
13. Lezama Meneses SR. Propiedades psicométricas de la escala de Zung para síntomas depresivos en población adolescente escolarizada colombiana. Psychol. 2012;6(1):91-101.
14. Campo-Arias A, Díaz-Martínez LA, Rueda-Jaimes GE, Barros-Bermúdez JA. Validación de la escala de Zung para depresión en universitarias de Bucaramanga, Colombia. Rev Colomb Psiquiatr. 2005;34(1):54-62.
15. Díaz LA, Campo A, Rueda GE, Barros JA. Propuesta de una versión abreviada de la escala de Zung para depresión. Colmb Med (Cali). 2005;36(3):168-72.
16. Campo A, Díaz LA, Rueda GE. Validez de la escala breve de Zung para tamizaje del episodio depresivo mayor en la población general de Bucaramanga, Colombia. Biomédica. 2006;26:415-23. https://doi.org/
17. Campo-Arias A, Díaz-Martínez L, Rueda-Jaimes G, Cadena L, Hernández N. Validation of Zung’s self-rating depression scale among the Colombian general population. Soc Behav Pers. 2006;34:87-94. https://doi.org/10.7705/biomedica.v26i3.360
18. Albert NM, Fonarow GC, Abraham WT, Gheorghiade M, Greenberg BH, Nunez E, et al. Depression and clinical outcomes in heart failure: an OPTIMIZE-HF analysis. Am J Med. 2009;122(4):366-73. https://doi.org/ 10.1016/j.amjmed.2008.09.046
19. Martensson J, Stromberg A, Dahlstrom U, Karlsson JE, Fridlund B. Patients with heart failure in primary health care: effects of a nurse-led intervention on health-related quality of life and depression. Eur J Heart Fail. 2005;7(3):393-403. https://doi.org/ 10.1016/j.ejheart.2004.01.016.
20. Floyd FJ, Widaman KF. Factor Analysis in the Development and Refinement of Clinical Assessment Instruments. Psychological assessment. 1995;7(3):286-99.
21. Zung WW. A Self-Rating Depression. Arch Gen Psychiatry. 1965;12:63-70. https://doi.org/ 10.1001/archpsyc.1965.01720310065008
22. Zung WW. From Art to Science Seeet. Arch Gen Psychiatry. 1973;29(3):328-37. https://doi.org/10.1001/archpsyc.1973.04200030026004
23. Romera I, Delgado-cohen H, Perez T, Caballero L, Gilaberte I. Factor analysis of the Zung self-rating depression scale in a large sample of patients with major depressive disorder in primary care. BMC Psychiatry. 2008;8(4):1-8. https://doi.org/10.1186/1471-244X-8-4
24. Cronbach JL. Coefficient alpha and the internal structre of test. Psychometrika. 1951;16(3):297-8.
25. Kaiser HF. An Index of Factorial Simplicity. Phsychometrika. 1974;39(1):31-2.
26. Bartlett MS. Tests of Significance in Factor Analysis. British Journal of Statistical Psychology. 1950;3(2):77-85.
27. Gorsuch RL. Exploratory factor analysis: its role in item analysis. J Pers Assess. 1997;68(3):532-60. https://doi.org/10.1207/s15327752jpa6803_5.
28. Van der Wal M, Tuinebreijer WE, Bloemen MC, Verhaegen PD, Middelkoop E, van Zuijlen PP. Rasch analysis of the Patient and Observer Scar Assessment Scale (POSAS) in burn scars. Qual Life Res. 2012;21(1):13-23. https://doi.org/10.1007/s11136-011-9924-5
29. Rojas Sánchez LZ, Hernández Vargas JA, Trujillo Cáceres SJ, Roa Díaz ZM, Jurado Arenales AM, Toloza Pérez YG. Usefulness of the Diagnosis Decreased Cardiac Output (00029); in Patients With Chronic Heart Failure. Int J Nurs Knowl. 2017;28(4):192-8. https://doi.org/ 10.1111/2047-3095.12148
30. Perez Adel P, Fernandez, II, Ojeda FB, Gonzalez RD, Gaos Meizoso MT. Zung scale factor invariance in male coronary patients and healthy people. Span J Psychol. 2013;16:E72. https://doi.org/10.1017/sjp.2013.62.
31. Díaz-Martínez L, Barros-Bermúdez J, Cadena L, Rueda-Jaimes G, Hernández N, Campo-Arias A. Factor analysis of the Zung’ self-rating depression scale among the general population from Bucaramanga, Colombia: a gender comparison. Arch Health. 2008;3:7-12.
32. Michalakeas CA, Parissis JT, Douzenis A, Nikolaou M, Varounis C, Andreadou I, et al. Effects of sertraline on circulating markers of oxidative stress in depressed patients with chronic heart failure: a pilot study. J Card Fail. 2011;17(9):748-54. https://doi.org/ 10.1016/j.cardfail.2011.05.004
33. Corbineau S, Breton M, Mialet-Perez J, Costemale-Lacoste JF. Major depression and heart failure: Interest of monoamine oxidase inhibitors. Int J Cardiol. 2017;247:1-6. https://doi.org/ 10.1016/j.ijcard.2017.07.005
34. Ghosh RK, Ball S, Prasad V, Gupta A. Depression in heart failure: Intricate relationship, pathophysiology and most updated evidence of interventions from recent clinical studies. Int J Cardiol. 2016;224:170-7. https://doi.org/10.1016/j.ijcard.2016.09.063
2. Freedland KE, Carney RM, Rich MW, Steinmeyer BC, Rubin EH. Cognitive behavior therapy for depression and self-care in heart failure patients a randomized clinical trial. JAMA Intern Med. 2015;175(11):1773-82. http://dx.doi.org/10.1001/jamainternmed.2015.5220
3. Rutledge T, Reis VA, Linke SE, Greenberg BH, Mills PJ. Depression in heart failure a meta-analytic review of prevalence, intervention effects, and associations with clinical outcomes. J Am Coll Cardiol. 2006;48(8):1527-37. http://dx.doi.org/10.1016/j.jacc.2006.06.055
4. Mbakwem AC, Aina OF. Comparative study of depression in hospitalized and stable heart failure patients in an urban Nigerian teaching hospital. Gen Hosp Psychiatry. 2008;30:435-40. https://doi.org/10.1016/j.genhosppsych.2008.04.008
5. Newhouse A, Jiang W. Heart failure and depression. Heart Fail Clin. 2014;10(2):295-304. https://doi.org/10.1016/j.hfc.2013.10.004
6. Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Jr., Drazner MH, et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013;62(16):e147-239. https://doi.org/10.1016/j.jacc.2013.05.019
7. Shafer AB. Meta-analysis of the Factor Structures of Four Depression Questionnaires. J Clin Psychol. 2006;62(1):123-46. https://doi.org/10.1002/jclp.20213
8. Ruiz-grosso P, Mola CLD, Vega-dienstmaier JM, Arevalo JM. Validation of the Spanish Center for Epidemiological Studies Depression and Zung Self-Rating Depression Scales: A Comparative Validation Study. PloS ONE. 2012;7(10):E45413-E. https://doi.org/ 10.1371/journal.pone.0045413
9. Kourkoveli P, Rammos S, Parissis J. Depressive Symptoms in Patients with Congenital Heart Disease : Incidence and Prognostic Value of Self-Rating Depression Scales. Congenit Heart Dis. 2015;10:240-7. https://doi.org/ 10.1111/chd.12200
10. Parissis J, Karavidas A, Farmakis D, Papoutsidakis N, Matzaraki V, Arapi S, et al. Efficacy and safety of functional electrical stimulation of lower limb muscles in elderly patients with chronic heart failure: A pilot study. Eur J Prev Cardiol. 2015;22(7):831-6. https://doi.org/ 10.1177/2047487314540546
11. Suzuki T, Shiga T, Kuwahara K. Impact of clustered depression and anxiety on mortality and rehospitalization in patients with heart failure. J Cardiol. 2014;64(6):456-62. https://doi.org/1 0.1016/j.jjcc.2014.02.031
12. Cogollo Z, Díaz CE, Campo A. Exploración de la validez de constructo de la escala de Zung para depresión en adolescentes escolarizados. Colomb Med (Cali). 2006;37(2):102-6.
13. Lezama Meneses SR. Propiedades psicométricas de la escala de Zung para síntomas depresivos en población adolescente escolarizada colombiana. Psychol. 2012;6(1):91-101.
14. Campo-Arias A, Díaz-Martínez LA, Rueda-Jaimes GE, Barros-Bermúdez JA. Validación de la escala de Zung para depresión en universitarias de Bucaramanga, Colombia. Rev Colomb Psiquiatr. 2005;34(1):54-62.
15. Díaz LA, Campo A, Rueda GE, Barros JA. Propuesta de una versión abreviada de la escala de Zung para depresión. Colmb Med (Cali). 2005;36(3):168-72.
16. Campo A, Díaz LA, Rueda GE. Validez de la escala breve de Zung para tamizaje del episodio depresivo mayor en la población general de Bucaramanga, Colombia. Biomédica. 2006;26:415-23. https://doi.org/
17. Campo-Arias A, Díaz-Martínez L, Rueda-Jaimes G, Cadena L, Hernández N. Validation of Zung’s self-rating depression scale among the Colombian general population. Soc Behav Pers. 2006;34:87-94. https://doi.org/10.7705/biomedica.v26i3.360
18. Albert NM, Fonarow GC, Abraham WT, Gheorghiade M, Greenberg BH, Nunez E, et al. Depression and clinical outcomes in heart failure: an OPTIMIZE-HF analysis. Am J Med. 2009;122(4):366-73. https://doi.org/ 10.1016/j.amjmed.2008.09.046
19. Martensson J, Stromberg A, Dahlstrom U, Karlsson JE, Fridlund B. Patients with heart failure in primary health care: effects of a nurse-led intervention on health-related quality of life and depression. Eur J Heart Fail. 2005;7(3):393-403. https://doi.org/ 10.1016/j.ejheart.2004.01.016.
20. Floyd FJ, Widaman KF. Factor Analysis in the Development and Refinement of Clinical Assessment Instruments. Psychological assessment. 1995;7(3):286-99.
21. Zung WW. A Self-Rating Depression. Arch Gen Psychiatry. 1965;12:63-70. https://doi.org/ 10.1001/archpsyc.1965.01720310065008
22. Zung WW. From Art to Science Seeet. Arch Gen Psychiatry. 1973;29(3):328-37. https://doi.org/10.1001/archpsyc.1973.04200030026004
23. Romera I, Delgado-cohen H, Perez T, Caballero L, Gilaberte I. Factor analysis of the Zung self-rating depression scale in a large sample of patients with major depressive disorder in primary care. BMC Psychiatry. 2008;8(4):1-8. https://doi.org/10.1186/1471-244X-8-4
24. Cronbach JL. Coefficient alpha and the internal structre of test. Psychometrika. 1951;16(3):297-8.
25. Kaiser HF. An Index of Factorial Simplicity. Phsychometrika. 1974;39(1):31-2.
26. Bartlett MS. Tests of Significance in Factor Analysis. British Journal of Statistical Psychology. 1950;3(2):77-85.
27. Gorsuch RL. Exploratory factor analysis: its role in item analysis. J Pers Assess. 1997;68(3):532-60. https://doi.org/10.1207/s15327752jpa6803_5.
28. Van der Wal M, Tuinebreijer WE, Bloemen MC, Verhaegen PD, Middelkoop E, van Zuijlen PP. Rasch analysis of the Patient and Observer Scar Assessment Scale (POSAS) in burn scars. Qual Life Res. 2012;21(1):13-23. https://doi.org/10.1007/s11136-011-9924-5
29. Rojas Sánchez LZ, Hernández Vargas JA, Trujillo Cáceres SJ, Roa Díaz ZM, Jurado Arenales AM, Toloza Pérez YG. Usefulness of the Diagnosis Decreased Cardiac Output (00029); in Patients With Chronic Heart Failure. Int J Nurs Knowl. 2017;28(4):192-8. https://doi.org/ 10.1111/2047-3095.12148
30. Perez Adel P, Fernandez, II, Ojeda FB, Gonzalez RD, Gaos Meizoso MT. Zung scale factor invariance in male coronary patients and healthy people. Span J Psychol. 2013;16:E72. https://doi.org/10.1017/sjp.2013.62.
31. Díaz-Martínez L, Barros-Bermúdez J, Cadena L, Rueda-Jaimes G, Hernández N, Campo-Arias A. Factor analysis of the Zung’ self-rating depression scale among the general population from Bucaramanga, Colombia: a gender comparison. Arch Health. 2008;3:7-12.
32. Michalakeas CA, Parissis JT, Douzenis A, Nikolaou M, Varounis C, Andreadou I, et al. Effects of sertraline on circulating markers of oxidative stress in depressed patients with chronic heart failure: a pilot study. J Card Fail. 2011;17(9):748-54. https://doi.org/ 10.1016/j.cardfail.2011.05.004
33. Corbineau S, Breton M, Mialet-Perez J, Costemale-Lacoste JF. Major depression and heart failure: Interest of monoamine oxidase inhibitors. Int J Cardiol. 2017;247:1-6. https://doi.org/ 10.1016/j.ijcard.2017.07.005
34. Ghosh RK, Ball S, Prasad V, Gupta A. Depression in heart failure: Intricate relationship, pathophysiology and most updated evidence of interventions from recent clinical studies. Int J Cardiol. 2016;224:170-7. https://doi.org/10.1016/j.ijcard.2016.09.063
Cómo citar
Rojas Sánchez, L. Z., Trujillo-Cáceres, S. J., Hernández Vargas, J. A., Jurado, A. M., Echeverría, L. E., Gómez-Ochoa, S. A., & Roa-Díaz, Z. M. (2021). Validación de constructo de la escala Zung en pacientes con falla cardíaca. Investigación En Enfermería: Imagen Y Desarrollo, 23. https://doi.org/10.11144/Javeriana.ie23.vcez
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