ABSTRACT

This study aimed to develop a self-rating anxiety inventory for maintenance haemodialysis patients (AI-MHD) and perform preliminary validation to provide a simple, effective, and highly specific practical tool for effective anxiety disorder screening in haemodialysis patients. Based on existing general anxiety disorder screening scales and common symptoms of MHD patients as a reference and after expert discussions and preliminary validation at a single dialysis centre, a self-rating AI-MHD containing 12 items was developed. Subsequently, the AI-MHD was applied in 4 dialysis centres and compared with GAD-7 and HADS-A. Further multicentre validation showed that Cronbach's alpha for the scale was 0.918; the AI-MHD score not only significantly differed between the anxiety disorders group and the non-anxiety disorders group (p<0.001) but also correlated with GAD-7 and HADS-A scores (p<0.001). In addition, the Kaiser-Meyer-Olkin (KMO) score was 0.847, and Bartlett’s test of sphericity was significant (x²=849.45, p<0.001). The anxiety disorder detection rate was 93%, and the specificity was 90%, which were significantly better than the screening results using the GAD-7 and HADS-A scales in the same groups. Although there were limitations, such as the sample size and regionality, the AI-MHD showed good efficacy and reliability in rating anxiety in MHD patients.

摘要

本研究旨在为维持性血液透析患者（AI-MHD）开发焦虑自评量表，并进行初步验证，为血液透析患者有效筛查焦虑症提供简单、有效且高度特异性的实用工具。以现有的一般性焦虑障碍筛查量表和MHD患者的常见症状为参考，经过专家讨论和单一透析中心初步验证，制定了包含12个项目的自评AI-MHD。随后，AI-MHD 应用于 4 个透析中心，并与 GAD-7 和 HADS-A 进行了比较。进一步的多中心验证表明，该量表的 Cronbach α 系数为 0.918；AI-MHD 评分不仅在焦虑症组和非焦虑症组之间存在显着差异（p<0. 001) 但也与 GAD-7 和 HADS-A 评分相关 (p<0.001)。此外，Kaiser-Meyer-Olkin (KMO) 得分为 0.847，Bartlett 球形检验显着（x² =849.45，p<0.001)。焦虑障碍检出率为93%，特异性为90%，明显优于同组GAD-7和HADS-A量表的筛查结果。尽管存在样本量和区域性等限制，但 AI-MHD 在评估 MHD 患者的焦虑方面表现出良好的有效性和可靠性。