TY - JOUR
T1 - Psychometric evaluation of PHQ–9 and GAD–7 among community health volunteers and nurses/midwives in Kenya following a nation-wide telephonic survey
AU - Odero, Sabina Adhiambo
AU - Mwangi, Paul
AU - Odhiambo, Rachel
AU - Mumbua Nzioka, Brenda
AU - Shumba, Constance
AU - Ndirangu-Mugo, Eunice
AU - Abubakar, Amina
N1 - Funding Information:
The authors thank all study participants for their contribution to this research. The authors are grateful to the Nursing Council of Kenya and the County Departments of Health in all the 47 counties for their support in study implementation. The authors appreciate the Ministry of Health, Kenya for the support they accorded us in study set up. Thanks to our team members; Margaret Kabue and Vibian Angwenyi for their contribution to study set up and data collection. The authors would also like to thank Agnes Shihemi for her support in funding acquisition and setting up the study. Finally, the authors thank all the field enumerators (Tom Joe Omollo, Kennedy Otieno, Martha Nasambu, Kevin Wekesa, Monica Wanjiru, Maurine Okoth, Damaris Nguyo, Ann Muisyo, Lydia Mugure, Grace Nthunya, Vincent Adenyo, and Nipher Ongachi) for their diligent work during data collection.
Funding Information:
This work was funded by Johnson and Johnson Foundation [Grant Number 63773339]. The content is solely the responsibility of the authors and does not necessarily represent the official views of Johnson and Johnson Foundation. AA’s work is also supported by the Office of The Director, National Institutes of Health (OD), the National Institute of Biomedical Imaging and Bioengineering (NIBIB), the National Institute of Mental Health (NIMH), and the Fogarty International Center (FIC) of the National Institutes of Health under award number U54TW012089 (AA and AK Waljee).
Publisher Copyright:
Copyright © 2023 Odero, Mwangi, Odhiambo, Mumbua Nzioka, Shumba, Ndirangu-Mugo and Abubakar.
PY - 2023
Y1 - 2023
N2 - Background: Nurses/midwives and Community Health Volunteers (CHVs) are exposed to chronic stressors putting them at risk of developing mental health problems. This has been exacerbated by the COVID-19 pandemic. There is limited empirical evidence of the burden of mental health problems among health care workers partly due to the lack of adequately standardized and validated measures for use among health care workers in Sub-Saharan Africa. This study aimed to perform the psychometric evaluation of the PHQ-9 and GAD-7 administered to nurses/midwives and CHVs across 47 counties in Kenya. Methods: Between June and November 2021, a national survey on mental well-being and resilience among nurses/midwives and CHVs was conducted via telephone interviews. The survey had a total sample size of 1907 nurses/midwives and 2027 CHVs. Cronbach’s alpha and MacDonalds’ omega were used to evaluate the scale’s internal consistency. Confirmatory Factor Analysis (CFA) was used to test the one-factor structure of the scales. Multi-group CFA was applied to evaluate the generalizability of the scales across the Swahili and English versions, and among male and female health workers. The Spearman correlation was used to assess the tools’ divergent and convergent validity. Results: The internal consistency of PHQ-9 and GAD-7 was good, with alpha and omega values above 0.7 across study samples. CFA results indicated a one-factor structure of the PHQ-9 and GAD-7 for both nurses/midwives and CHVs. Multi-group CFA showed that both scales were unidimensional across both language and sex. The PHQ-9 and GAD-7 were positively correlated with perceived stress, burnout, and post-traumatic stress disorder, indicating convergent validity. The PHQ-9 and GAD-7 were also significantly positively correlated with resilience and work engagement, supporting divergent validity. Conclusion: The PHQ-9 and GAD-7 are unidimensional, reliable, and valid tools for screening depression and anxiety among nurses/midwives and CHVs. The tools can be administered in a similar population or study setting using either Swahili or English.
AB - Background: Nurses/midwives and Community Health Volunteers (CHVs) are exposed to chronic stressors putting them at risk of developing mental health problems. This has been exacerbated by the COVID-19 pandemic. There is limited empirical evidence of the burden of mental health problems among health care workers partly due to the lack of adequately standardized and validated measures for use among health care workers in Sub-Saharan Africa. This study aimed to perform the psychometric evaluation of the PHQ-9 and GAD-7 administered to nurses/midwives and CHVs across 47 counties in Kenya. Methods: Between June and November 2021, a national survey on mental well-being and resilience among nurses/midwives and CHVs was conducted via telephone interviews. The survey had a total sample size of 1907 nurses/midwives and 2027 CHVs. Cronbach’s alpha and MacDonalds’ omega were used to evaluate the scale’s internal consistency. Confirmatory Factor Analysis (CFA) was used to test the one-factor structure of the scales. Multi-group CFA was applied to evaluate the generalizability of the scales across the Swahili and English versions, and among male and female health workers. The Spearman correlation was used to assess the tools’ divergent and convergent validity. Results: The internal consistency of PHQ-9 and GAD-7 was good, with alpha and omega values above 0.7 across study samples. CFA results indicated a one-factor structure of the PHQ-9 and GAD-7 for both nurses/midwives and CHVs. Multi-group CFA showed that both scales were unidimensional across both language and sex. The PHQ-9 and GAD-7 were positively correlated with perceived stress, burnout, and post-traumatic stress disorder, indicating convergent validity. The PHQ-9 and GAD-7 were also significantly positively correlated with resilience and work engagement, supporting divergent validity. Conclusion: The PHQ-9 and GAD-7 are unidimensional, reliable, and valid tools for screening depression and anxiety among nurses/midwives and CHVs. The tools can be administered in a similar population or study setting using either Swahili or English.
KW - GAD-7
KW - PHQ-9
KW - anxiety
KW - community health volunteers
KW - depression
KW - nurses/midwives
KW - reliability
KW - validity
UR - http://www.scopus.com/inward/record.url?scp=85162031513&partnerID=8YFLogxK
U2 - 10.3389/fpsyt.2023.1123839
DO - 10.3389/fpsyt.2023.1123839
M3 - Article
AN - SCOPUS:85162031513
SN - 1664-0640
VL - 14
JO - Frontiers in Psychiatry
JF - Frontiers in Psychiatry
M1 - 1123839
ER -
