Psychometric properties of the Nepali language version of the Depression Anxiety Stress Scales (DASS-21).
Deependra Kaji Thapa, Denis Visentin, Rachel Kornhaber and 1 others
PMID 34161668WHAT IT FOUND
In 794 older adults in Nepal, a translated depression, anxiety and stress questionnaire was consistent and linked to lower quality of life.
But its items did not cleanly separate depression, anxiety and stress, so use it as a general emotional distress screen.
Key findings
01The Nepali DASS-21 had good internal consistency, with Cronbach's alpha 0.95 overall, 0.93 for depression, 0.79 for anxiety and 0.91 for stress.
02The intended depression, anxiety and stress subscales did not emerge cleanly; a model adding a general distress factor fit better than the original three-factor model.
03DASS-21 scores were negatively associated with all four quality-of-life domains, supporting convergent validity.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
No independently administered diagnostic interview was used, and no clinical diagnostic group was included, so the scale was not validated against diagnoses. The sample was only community-dwelling older adults aged 60 years or over, so results may not apply to younger adults or clinical populations. The cross-sectional design did not assess test-retest reliability over time. The original three-factor structure was not well supported, and some anxiety items may have been interpreted as physical symptoms rather than anxiety. Many participants could not read or write, and responses were collected by interview, so item understanding and translation may affect results.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not use this scale to diagnose or cleanly separate depression, anxiety and stress in Nepali-speaking older adults. The original three-factor structure did not fit well, and a general distress factor fit better, so the subscale scores are not specific enough on their own.