Dataset Information

Development of a brief screening tool for women's mental health assessment in refugee settings: A psychometric evaluation.

ABSTRACT: The detection of common mental disorders in humanitarian crisis settings requires a screening tool that is feasible to use as well as sensitive and specific. The Self-Report Questionnaire, developed by the World Health Organization in 1994 to detect presence or absence of common mental health disorders, has frequently been used among conflict-affected and refugee populations. Our goal was to identify a highly predictive and reliable subset of items to serve as a screening tool that can be used in busy, over-crowded, and low-resource primary health care settings to identify women who need mental health attention.We analyzed the responses on a version of the Self-Report Questionnaire expanded to include two suicidality items from 810 displaced women living in refugee camps in Rwanda. Screening items were selected and evaluated for predictive ability using logistic regression in a cross-validation process, sensitivity and specificity using receiver operating characteristic curve analysis, and internal consistency analysis.A five-item screening tool resulted. Those items are "Do you feel unhappy?", Do you feel easily nervous, tense, or worried?", "Have you lost interest in things?", "Do you have trouble thinking clearly?" and "Has the thought of ending your life been on your mind?".The Self-Report Questionnaire-5 may be an important tool for identifying common mental disorders as well as suicide ideation and behaviors when assessing mental health among women in crisis situations. Further evaluation of this tool is warranted.

SUBMITTER: Bell SA

PROVIDER: S-EPMC4912842 | biostudies-other | 2015 Jul

REPOSITORIES: biostudies-other

ACCESS DATA

Publications

Development of a brief screening tool for women's mental health assessment in refugee settings: A psychometric evaluation.

Bell Sue Anne SA Lori Jody J Redman Richard R Seng Julia J

International journal of nursing studies 20150409 7

<h4>Background and purpose</h4>The detection of common mental disorders in humanitarian crisis settings requires a screening tool that is feasible to use as well as sensitive and specific. The Self-Report Questionnaire, developed by the World Health Organization in 1994 to detect presence or absence of common mental health disorders, has frequently been used among conflict-affected and refugee populations. Our goal was to identify a highly predictive and reliable subset of items to serve as a sc ...[more]

PMID: 25892280

Similar Datasets

Project description:Study objectivesWe evaluated the performance of the Insomnia Severity Index-3 (ISI-3) as a short screening tool to identify clinically significant insomnia derived from the 7-item ISI in an older primary care population.MethodsWe used results from two surveys including the 7-item ISI: Sample 1 (n = 3197) and Sample 2 (n = 247) individuals aged ≥60 years with a diagnosis of osteoarthritis from electronic health records. The 7 items were: difficulty falling asleep, difficulty staying asleep, waking too early, sleep satisfaction, sleep interference with daytime functioning, noticeability of sleep problems by others, and worry about sleep. The ISI-3 included items with highest item-total correlations to the 7-item ISI from Sample 1. A 7-item ISI score ≥15 was defined as clinically significant insomnia and served as the primary criterion for the ISI-3. We derived operating characteristics to determine the diagnostic accuracy and cut-points to maximize sensitivity and specificity for both samples.ResultsThe items with the highest item-total correlations were: sleep dissatisfaction, sleep interference with daily functioning, and worry about sleep problems (r = 0.78-0.81); while difficulty falling asleep, difficulty staying asleep, waking too early and noticeability of sleep problems by others showed lower correlations (r = 0.60-0.74). The ISI-3 achieved high discriminant validity in identifying insomnia (AUC = 0.97-0.98). An ISI-3 score of ≥7 maximized sensitivity (0.94-0.97) and specificity (0.88-0.91) with kappa = 0.68-0.71, 89.1-91.5% agreement.ConclusionsThe ISI-3 can effectively screen for insomnia to trigger a more thorough diagnostic evaluation including the 7-item ISI for research or clinical purposes. Future validation studies are needed in other community and clinical populations.Clinical trialThis manuscript describes secondary analyses of data two National Institutes on Aging-funded clinical trials (ClinicalTrials.gov identifier: NCT01142349, NCT02946957).

Project description:BACKGROUND:Integrating care for common mental disorders (CMDs) such as depression, anxiety and alcohol abuse into primary healthcare (PHC) should assist in reducing South Africa (SA)'s quadruple burden of disease. CMDs compromise treatment adherence, health behaviour change and self-management of illnesses. Appropriate identification of mental disorders in primary care can be facilitated by brief, easy-to-administer screening that promotes high specificity. OBJECTIVES:To establish the criterion-based validity of a seven-item Brief Mental Health (BMH) screening tool for assessing positive symptoms of CMDs in primary care patients. METHODS:A total of 1 214 participants were recruited from all patients aged ?18 years visiting 10 clinics as part of routine care in the Newcastle subdistrict of Amajuba District in KwaZulu-Natal Province, SA, over a period of 2 weeks. Consenting patients provided basic biographical information prior to screening with the BMH tool. PHC nurses remained blind to this assessment. PHC nurse-initiated assessment using the Adult Primary Care (APC) guidelines was the gold standard against which the performance of the BMH tool was compared. A specificity standard of 80% was used to establish cut-points. Specificity was favoured over sensitivity to ensure that those who did not have CMD symptoms were excluded, as well as to reduce over-referrals. RESULTS:Of the participants, 72% were female. The AUD-C (alcohol abuse) performed well (area under the curve (AUC) 0.91 (95% confidence interval (CI) 0.88 - 0.95), cut-point ?4, Cronbach alpha 0.87); PHQ-2 (depression) performed reasonably well (AUC 0.72 (95% CI 0.65 - 0.78), cut-point ?3, alpha 0.71); and GAD-2 (anxiety) performance was acceptable (AUC 0.69 (95% CI 0.58 - 0.80), cut-point ?3, alpha 0.62). Using the higher cut-off scores, patients who truly did not have CMD symptoms had negative predictive values (NPVs) of >90%. Overall, 26% of patients had CMD positive symptoms relative to 8% using the APC guidelines. CONCLUSIONS:Using a higher specificity index, the positive predictive value and NPV show that at higher cut-point values the BMH not only helps identify individuals with alcohol misuse, depression and anxiety symptoms but also identifies a majority of those who do not have symptoms (true negatives), thus not overburdening nurses with false positives needing assessment. Research is needed to assess whether use of such a short and valid screening tool is generalisable to other clinic contexts as well as how mental health screening should best be introduced into routine clinic functioning and practice.

Dataset Information

Development of a brief screening tool for women's mental health assessment in refugee settings: A psychometric evaluation.

Publications

Development of a brief screening tool for women's mental health assessment in refugee settings: A psychometric evaluation.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets