Cross-cultural adaptation and validation of the self-reporting questionnaire among HIV+ individuals in a rural ART program in southern Uganda

Figures & data

Figure 1 Scree plot representing the eigenvalues of components obtained in a principal-component analysis of the Self-Reporting Questionnaire in 200 HIV-positive individuals attending a rural antiretroviral therapy program in southern Uganda.

Table

Original Self-Reporting Questionnaire

Back-translated Self-Reporting Questionnaire

Do you often have headaches? Is your appetite poor? Do you sleep badly? Are you easily frightened? Do your hands shake? Do you feel nervous, tense, or worried? Is your digestion poor? Do you have trouble thinking clearly? Do you feel unhappy? Do you cry more than usual? Do you find it difficult to enjoy your daily activities? Do you find it difficult to make decisions? Is your daily work suffering? Are you unable to play a useful role in life? Have you lost interest in things? Do you feel that you are a worthless person? Has the thought of ending your life been on your mind? Do you feel tired all the time? Do you have uncomfortable feelings in your stomach? Are you easily tired?

Do you often have persistent headaches? Is your appetite poor? Do you sleep badly? Are you easily frightened? Do your hands shake? Do you feel nervous, tense, or worried? Do you often experience constipation, heartburn, or bloating of the stomach after having your meals?* Do you have difficulties with your thinking, for example, do you think too much?* Do you feel unhappy? Do you get a feeling of wanting to cry but you cannot?* Do you find it difficult to enjoy your daily activities? Do you find difficulty in deciding on what activities (household chores) you will perform on a given day?* Do you have trouble completing your daily tasks?* Are you unable to play a useful role in life? Have you lost interest in things you used to enjoy? Do you feel that you are a worthless person? Has the thought of ending your life been on your mind? Do you feel tired all the time? Do you have uncomfortable feelings in your stomach? Are you easily tired?

Note:

* SRQ items that were fully revised to capture the idioms of distress in this population.

Table 1 Sociodemographic characteristics of HIV-positive individuals attending a rural antiretroviral therapy program in southern Uganda

Variable	Number (n = 200)	Percentage
Gender
Male	66	33.00
Female	134	67.00
Age (years)
18–20	5	2.50
21–30	36	18.00
31–40	75	37.50
41–50	47	23.50
>50	37	18.50
Marital status
Single	36	18.00
Married	79	39.50
Separated/divorced	43	21.50
Widowed	42	21.00
Education level
No formal education	43	21.50
Primary education	120	60.00
Secondary education and above	37	18.50
Occupation
Unemployed	51	25.50
Peasant farmer	84	42.00
Self-employed	54	27.00
Civil servant	10	5.00
Income
Earn more than a dollar per day	34	17.00
Earn less than a dollar per day	166	83.00

Table 2 Factor loadings using rotated varimax principal-component analysis of Self-Reporting Questionnaire items

Component	Factor 1	Factor 2
1. Do you often have headaches?	–	0.49
2. Is your appetite poor?	–	–
3. Do you sleep badly?	–	0.57
4. Are you easily frightened?	–	0.57
5. Do your hands shake?	–	0.48
6. Do you feel nervous, tense, or worried?	–	0.52
7. Is your digestion poor?	–	–
8. Do you have trouble thinking clearly?	0.45	–
9. Do you feel unhappy?	0.40	–
10. Do you cry more than usual?	0.54	–
11. Do you find it difficult to enjoy your daily activities?	0.80	–
12. Do you find it difficult to make decisions?	0.46	–
13. Is your daily work suffering?	0.55	–
14. Are you unable to play a useful role in life?	0.66	–
15. Have you lost interest in things?	0.50	–
16. Do you feel that you are a worthless person?	0.40	–
17. Has the thought of ending your life been on your mind?	–	–
18. Do you feel tired all the time?	–	0.44
19. Do you have uncomfortable feelings in your stomach?	–	0.47
20. Are you easily tired?	–	0.56

Note: Factor loadings below 0.4 were suppressed during the rotational matrix analysis.

Figure 2 Receiver-operating-characteristic (ROC) curve of the locally adapted Luganda version of the Self-Reporting Questionnaire for detection of a current depressive episode ascertained using the Mini International Neuropsychiatric Interview in 200 HIV-infected individuals in a rural antiretroviral therapy program in southern Uganda.

Note: Area under ROC curve = 0.9517.

Figure 3 Receiver-operating-characteristic (ROC) curve of the locally adapted Luganda version of the Self-Reporting Questionnaire for detection of any depression (current and in the past) within 200 HIV-infected individuals in a rural antiretroviral therapy program in southern Uganda.

Note: Area under ROC curve = 0.7456.

Table 3 Sensitivity and specificity of the Self-Reporting Questionnaire at different cutoff points in detecting current depression and any depression ascertained by the Mini International Neuropsychiatric Interview

Diagnosis	Cutoff	Sensitivity (%)	Specificity (%)	Predictive values		% of cases correctly classified
				Positive	Negative
Current depression	≥5	84.00	89.14	52.50	97.50	91.50
	≥6	84.00	93.14	59.38	96.43	92.00
	≥7	76.00	94.29	64.29	95.93	92.00
	≥8	72.00	94.21	68.00	95.40	91.50
	≥9	72.00	95.40	68.00	95.43	92.50
	≥10	72.00	96.00	68.00	96.00	93.00
Any depression	≥4	83.33	75.66	51.95	93.50	77.50
	≥5	77.08	86.84	64.91	92.31	84.50
	≥6	75.00	90.13	70.59	91.95	86.50
	≥7	68.75	90.13	68.75	90.13	85.00
	≥9	56.25	93.42	72.97	87.12	84.50