Psychometric evaluation of the Hospital Anxiety and Depression Scale (HADS) among female cardiac patients

OBJECTIVES: To examine the dimensionality, structure, and reliability of the HADS among female cardiac patients. DESIGN: Data were collected by self-administered questionnaires at two times - admission to hospital and at 2-month follow-up. METHOD: Confirmatory factor analysis was used to examine the dimensionality and structure of the HADS. Internal consistency was assessed by computing Cronbach alpha. Pearson product-moment correlation coefficients were calculated to assess test-retest reliability. RESULTS: A two-factor model, in which the subscales were permitted to correlate, was found to provide a good fit to the scale's 14 items compared to single factor and orthogonal two-factor models. These two factors explained 41.4% of the total variance. The anxiety and depression subscales were moderately correlated (r =.60), with good internal consistency and test-retest reliability found for the subscales and total HADS scores. CONCLUSIONS: These results provide support for the HADS as a reliable measure for the assessment of anxiety and depression symptomatology among female cardiac patients.