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

Abstract

BackgroundThere 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).MethodsThis 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.ResultsExploratory 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 (phi = 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.ConclusionThe 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.