What question did this study set out to answer?

This study aims to evaluate the psychometric properties of the Turkish version of the DI-MHD for hemodialysis patients.

May 7, 2026Open Access

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

Key Points

This study aims to evaluate the psychometric properties of the Turkish version of the DI-MHD for hemodialysis patients.
Methodological study with 283 patients from two hemodialysis units in Turkey.
Translation, cultural adaptation, and validation of the DI-MHD were performed.
Test-retest reliability, exploratory and confirmatory factor analyses were conducted using IBM SPSS and AMOS for evaluation.
Exploratory factor analysis revealed a single factor explaining 37.21% of total variance.
Confirmatory factor analysis confirmed the one-factor model as the most parsimonious solution.
The Turkish version of the DI-MHD was found to be a valid and reliable tool for assessing depression in hemodialysis patients.

Abstract

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.

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