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Psychometric Validation of the PHQ-9 in Ostomy Patients and Their Informal Caregivers: Evidence From A European Multicenter Study.

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Τίτλος: Psychometric Validation of the PHQ-9 in Ostomy Patients and Their Informal Caregivers: Evidence From A European Multicenter Study.
Συγγραφείς: Iovino P; Department of Health Sciences, University of Florence, Florence, Italy., Vellone E; Department of Biomedicine and Prevention University of Rome Tor Vergata, Rome, Italy.; Faculty of Nursing and Midwifery, Wroclaw Medical University, Wroclaw, Poland., Rasero L; Department of Health Sciences, University of Florence, Florence, Italy., Manara DF; Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, Milan, Italy., Villa G; Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, Milan, Italy.
Πηγή: Nursing open [Nurs Open] 2026 Jun; Vol. 13 (6), pp. e70599.
Τύπος έκδοσης: Journal Article; Multicenter Study; Observational Study; Validation Study
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: John Wiley & Sons, Inc Country of Publication: United States NLM ID: 101675107 Publication Model: Print Cited Medium: Internet ISSN: 2054-1058 (Electronic) Linking ISSN: 20541058 NLM ISO Abbreviation: Nurs Open Subsets: MEDLINE
Imprint Name(s): Original Publication: [Hoboken, NJ] : John Wiley & Sons, Inc., [2014]-
Ιατρικοί όροι (MeSH): Psychometrics*/standards , Psychometrics*/instrumentation , Psychometrics*/methods , Caregivers*/psychology , Caregivers*/statistics & numerical data , Ostomy*/psychology , Ostomy*/adverse effects , Depression*/diagnosis , Depression*/psychology , Patient Health Questionnaire*/standards, Quality of Life/psychology ; Humans ; Female ; Middle Aged ; Male ; Aged ; Reproducibility of Results ; Surveys and Questionnaires ; Italy ; Factor Analysis, Statistical
Περίληψη: Introduction: Depressive symptoms are highly prevalent among individuals with an ostomy and their informal caregivers, negatively affecting quality of life and healthcare outcomes. Although the Patient Health Questionnaire-9 (PHQ-9) is widely used for depression screening, its psychometric properties have not previously been examined simultaneously in ostomy patients and their informal caregivers, limiting its applicability in this clinical context.
Aim: To evaluate the validity, reliability and measurement invariance of the PHQ-9 in a European sample of ostomy patients and their informal caregivers.
Method: This secondary analysis used data from a multicenter observational study including 523 ostomy patients (63.9% males, mean age 68.65 years) and 252 informal caregivers (80.6% females, mean age 58.7 years) recruited from outpatient clinics across Italy. Structural validity was examined using confirmatory factor analysis, comparing unidimensional and bidimensional models. Measurement invariance across patients and caregivers was assessed using multigroup confirmatory factor analysis. Internal consistency was assessed using omega coefficients and construct validity was tested through correlations with ostomy-specific and generic quality of life measures.
Results: Confirmatory factor analysis supported a bidimensional structure of the PHQ-9, reflecting somatic and cognitive symptoms for both patients and caregivers, with excellent model fit. Internal consistency was adequate, with omega coefficients ranging from 0.71 to 0.88. Construct validity was supported by significant negative correlations between PHQ-9 scores and quality of life measures. Scalar measurement invariance was established, indicating the PHQ-9 functions equivalently in patients and caregivers.
Conclusion: The PHQ-9 is a valid and reliable instrument for assessing depressive symptoms in patients with ostomy and their caregivers and can be confidently used for depression screening in both clinical and community care settings.
Implications for the Profession And/or Patient Care: Its use in routine nursing practice can support early identification and management of depression in both clinical and community care contexts.
Impact: This is the first study validating the PHQ-9 in patients with ostomy and their caregivers. The PHQ-9 showed excellent validity and reliability and scalar measurement invariance was demonstrated across patients and caregivers. The PHQ-9 can support nurse-led depression screening in ostomy care settings.
Reporting Method: This study was reported in accordance with the COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) reporting guideline for studies on measurement properties.
Patient or Public Contribution: No patient or public contribution.
(© 2026 The Author(s). Nursing Open published by John Wiley & Sons Ltd.)
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Grant Information: 2.16.22 Centre of Excellence for Nursing Scholarship; 2016/U0114 Lega Italiana Lotta contro I Tumori
Contributed Indexing: Keywords: caregivers; depression; factor analysis; ostomy; patient health questionnaire 9; patient reported outcome measures; psychometrics; statistical; validation studies as topic
Entry Date(s): Date Created: 20260616 Date Completed: 20260616 Latest Revision: 20260726
Update Code: 20260726
PubMed Central ID: PMC13271098
DOI: 10.1002/nop2.70599
PMID: 42301755
Βάση Δεδομένων: MEDLINE
Περιγραφή
ISSN:2054-1058
DOI:10.1002/nop2.70599