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Psychometric properties of the German version of the Depressive and Anxious Avoidance in Prolonged Grief Questionnaire (DAAPGQ).

ABSTRACT: The Depressive and Anxious Avoidance in Prolonged Grief Questionnaire (DAAPGQ) was developed to measure depressive and anxious avoidance behaviors, which, according to cognitive-behavioral models, are supposed to play an important role in the development and maintenance of prolonged grief. The present study aimed to develop a German version of the DAAPGQ and evaluate its psychometric properties and validity within a representative sample of the German general population (N = 2531). The German-language DAAPGQ was developed using a forward-backward translation procedure. Then, a subsample of individuals who reported having lost a significant other (N = 1371) of a representative sample was assessed with the German DAAPGQ, along with information on sociodemographic characteristics, prolonged grief symptom severity (PG-13), general anxiety (GAD-2) and depression (PHQ-2). The factor structure of the DAAPGQ was evaluated using confirmatory factor analyses, reliability by calculating internal consistency on subscale level and convergent validity by correlations between DAAPQG subscale sores with PG-13, GAD-2 and PHQ-2 sum scores. As expected, a two-factor model with correlated latent variables showed good fit to the data, replicating findings from the original version. Internal consistency was high for both subscales (Cronbach's α .86 and .95, respectively). Convergent validity was established by theoretically expected and statistically significant positive correlations of DAAPGQ subscales with symptom severity of prolonged grief, depression, and anxiety and negative correlations with time since loss. Furthermore, the addition of depressive and anxious avoidance significantly improved the prediction of prolonged grief symptom severity over sociodemographic and loss-related information. In sum, our results suggest that the German-language DAAPGQ is a reliable and valid measure of depressive and anxious avoidance and a useful tool to improve our knowledge on the role of avoidance in prolonged grief. We also provide descriptive data to improve the applicability of the DAAPGQ for individual diagnostics.

SUBMITTER: Treml J

PROVIDER: S-EPMC8354469 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BACKGROUND:The Helping Alliance Questionnaire (HAQ) is a frequently used and highly relevant instrument to assess the therapeutic alliance. The questionnaire was translated into German by Bassler and colleagues (1995) and is available for patients (HAQ-P) and therapists (HAQ-T). Whereas the HAQ-P has been tested regarding psychometrics, the HAQ-T has not. This study aimed at further investigating the psychometric properties of both the HAQ-P and HAQ-T. We hypothesized that the instrument is reliable and shows factorial as well as convergent validity. METHODS:Within the framework of a multisite, randomized-controlled clinical trial, comparing the efficacy of Cognitive Behavioral Analyses System of Psychotherapy (CBASP) and supportive psychotherapy (SP) in the treatment of early onset persistently depressed outpatients, the HAQ was filled out by patients (n?=?255) and therapists (n?= 81). 66.0% of patients were female; average age at randomization was 44.9 years (SD?=?11.8). Several confirmatory factor analyses were conducted to test different structures for the HAQ. In addition, correlations between the HAQ and the Inventory of Interpersonal Problems (IIP) were calculated to test for convergent validity. RESULTS:Goodness of fit indices for both a model with two different but strongly related factors named 'relation to the patient/ therapist ' and 'satisfaction with therapeutic outcome' and a second model with only one global helping alliance factor were comparable: Chi-Square-based indices rejected the models; RMSEA closely approached the threshold of good model fit, and CFI/ TLI and SRMR suggested that both models sufficiently fit the data. The internal consistency (Cronbach's ?) calculated for the different scales of the HAQ ranges between questionable to good. Finally, the HAQ scores were significantly related to some of the IIP scores. CONCLUSIONS:The German versions of the HAQ offer sufficient reliable instruments for the quick assessment of different facets of the therapeutic alliance. The HAQ global scores can be used as indicators for the global impression of the patients and therapists perception of the quality of the therapeutic alliance. However, the small correlations found between the IIP and the HAQ puts the question of external validity into perspective. TRIAL REGISTRATION:This study analysed data from a RCT which was registered on ClinicalTrials.com ( NCT00970437 ). First submitted on September 1, 2009.

Project description:BackgroundWhereas the majority of bereaved persons recover from their grief without professional assistance, a minority develops pathological grief reactions. Etiological models postulate that dysfunctional cognitions may perpetuate such reactions. The Grief Cognitions Questionnaire (GCQ) assesses thoughts after bereavement in nine interrelated domains. A short form (GCQ-SF) with four domains is often used. However, an evaluation of the psychometric properties of the GCQ-SF and its utility compared to the GCQ is lacking and these instruments have not been validated in German.MethodGerman bereaved persons (time since loss 35.3 ± 34.6 months) responded to an online survey containing the GCQ, measures of grief severity, grief rumination, symptoms of depression and anxiety, and optimism and pessimism. 585 participants (18-78 years, 88% women) were included. Item analyses and confirmatory factor analyses were conducted. Correlations between the GCQ and GCQ-SF and grief rumination, optimism and pessimism assessed construct validity. Criterion-related validity was assessed by comparing whether the correlation of the GCQ (and the GCQ-SF) with grief severity was higher than with anxious and depressive symptoms. Logistic regression and receiver-operator characteristics (ROC) compared the questionnaires on their ability to predict probable prolonged grief 'caseness' (ICG ≥ 25, time since loss ≥6 months).ResultsInternal consistencies for both questionnaires were identical and excellent (α = 0.96). Confirmatory factor analyses obtained a satisfactory fit for models with nine and four correlated subscales and respective higher-order factor models. The GCQ and the GCQ-SF correlated higher with grief severity than with other measures of psychopathology. The logistic regression showed a significant association between the GCQ-SF and prolonged grief 'caseness'. Of the remaining subscales of the GCQ, only one subscale ('Others') contributed to the prediction. The ROC analyses showed nearly identical areas under the curve.ConclusionThe translated GCQ and GCQ-SF demonstrated very good psychometric properties. The correlations with grief severity highlight the questionnaires' clinical relevance. The questionnaires possessed identical diagnostic specificity and sensitivity. Whenever a timesaving assessment of the most typical grief-specific cognitions is important, the GCQ-SF represents an alternative to the GCQ. The original GCQ may still be superior when a more detailed description of a bereaved person's cognitions is desirable.

Project description:BackgroundPatient safety culture involves leader and staff interaction, routines, attitudes, practices and awareness that influence risks of adverse events in patient care. The Safety Attitudes Questionnaire (SAQ) is an instrument to measure safety attitudes among health care providers. The instrument aims to identify possible weaknesses in clinical settings and motivate quality improvement interventions leading to reductions in medical errors. The Ambulatory Version of the SAQ (SAQ-A) was developed to measure safety climate in the primary care setting. The original version of the SAQ includes six major patient safety factors: Teamwork climate, Safety climate, Job satisfaction, Perceptions of management, Working conditions, and Stress recognition. Patients in nursing homes are particularly vulnerable to adverse events. We present the psychometric properties of the Norwegian translation of the SAQ-A for the nursing home setting.MethodsThe study was conducted in five nursing homes in Tønsberg, Norway, in February 2016. A total of 463 employees working more than 20% received a paper version of the translated SAQ-A adapted to the Norwegian nursing home setting and responded anonymously. Filled-in questionnaires were scanned and transferred to an SPSS file. SPSS was used to estimate Cronbach alphas, corrected item-total correlations, item-to-own and item-to-other correlations, and item-descriptive statistics. The confirmatory factor analysis was done by AMOS.ResultsOf the 463 health care providers, 288 (62.2%) responded to the questionnaire. The confirmatory factor analysis showed that the total model of the six factors Teamwork climate, Safety climate, Job satisfaction, Perceptions of management, Working conditions, and Stress recognition had acceptable goodness-of-fit values in the nursing home setting.ConclusionsThe results of our study indicate that the Norwegian translated version of the SAQ-A, with the confirmed six factor model, is an appropriate tool for measuring patient safety climate in the nursing home setting. Future research should study whether there is an association between patient safety climate in nursing homes and occurrence of adverse events among the patients.

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Psychometric properties of the German version of the Depressive and Anxious Avoidance in Prolonged Grief Questionnaire (DAAPGQ).

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