Depression inventory for maintenance hemodialysis patients: a cross-cultural adaptation and psychometric evaluation in Turkey

BACKGROUND: There is a clear need for more effective screening tools for patients undergoing hemodialysis, especially considering the wide variation in depression screening options and the lack of a gold standard assessment tool for this specific population. This study aims to examine the validity and reliability of the Turkish version of the Depression Inventory for Maintenance Hemodialysis Patients (DI-MHD). METHODS: This was a methodological study of the translation, cultural adaptation, and psychometric validation of the DI-MHD. Two hundred eighty-three patients from two hemodialysis units in Turkey were recruited for the study using convenience sampling. The following data were collected from the participants: descriptive characteristics, DI-MHD scores, Beck Depression Inventory (BDI) scores, and inflammatory biomarkers. The BDI was used as a reference instrument to evaluate the concurrent validity of the DI-MHD. Exploratory and confirmatory factor analyses were implemented to test the construct validity. The test‒retest method was used to test the reliability and consistency of the scale over time. IBM SPSS version 22.0 and AMOS 24.0 were used for analysis. RESULTS: Exploratory factor analysis revealed a dominant single factor explaining 37.21% of the total variance (extracted variance = 33.52%). Although confirmatory factor analysis demonstrated acceptable fit for the correlated four-factor and second-order models, high latent factor correlations (φ = 0.677-1.052) and strong higher-order loadings (0.708-1.041) indicated limited discriminant validity among dimensions. Therefore, the one-factor model was retained as the most parsimonious and theoretically coherent solution. CONCLUSION: The Turkish version of the DI-MHD is a valid and reliable tool that can be used to evaluate and classify the depression levels of patients in hemodialysis units. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov NCT. First registration date: 2025-02-20.