Measurement Properties and Optimal Cutoff Point of the WHO-5 Among Chinese Healthcare Students

References

• Beddington J, Cooper CL, Field J, et al. The mental wealth of nations. Nature. 2008;455(7216):1057–1060. doi:10.1038/4551057a
   PubMed Web of Science ®Google Scholar
• Faruk MO, Alam F, Chowdhury KUA, Soron TR. Validation of the Bangla WHO-5 Well-being Index. Glob Ment Health. 2021;8:e26. doi:10.1017/gmh.2021.26
   Web of Science ®Google Scholar
• Finan PH, Garland EL. The role of positive affect in pain and its treatment. Clin J Pain. 2015;31(2):177–187. doi:10.1097/ajp.0000000000000092
   PubMed Web of Science ®Google Scholar
• Rasmussen HN, Scheier MF, Greenhouse JB. Optimism and physical health: a meta-analytic review. Ann Behav Med. 2009;37(3):239–256. doi:10.1007/s12160-009-9111-x
   PubMed Web of Science ®Google Scholar
• Chida Y, Steptoe A. Positive psychological well-being and mortality: a quantitative review of prospective observational studies. Psychosom Med. 2008;70(7):741–756. doi:10.1097/PSY.0b013e31818105ba
   PubMed Web of Science ®Google Scholar
• Bolier L, Haverman M, Westerhof GJ, Riper H, Smit F, Bohlmeijer E. Positive psychology interventions: a meta-analysis of randomized controlled studies. BMC Public Health. 2013;13:119. doi:10.1186/1471-2458-13-119
   PubMed Web of Science ®Google Scholar
• Kubzansky LD, Huffman JC, Boehm JK, et al. Positive psychological well-being and cardiovascular disease: JACC Health Promotion Series. J Am Coll Cardiol. 2018;72(12):1382–1396. doi:10.1016/j.jacc.2018.07.042
   PubMed Web of Science ®Google Scholar
• Howell RT, Kern ML, Lyubomirsky S. Health benefits: meta-analytically determining the impact of well-being on objective health outcomes. Health Psychol Rev. 2007;1(1):83–136. doi:10.1080/17437190701492486
   Google Scholar
• Liu X, Ping S, Gao W. Changes in undergraduate students’ psychological well-being as they experience university life. Int J Environ Res Public Health. 2019;16(16):2864. doi:10.3390/ijerph16162864
   PubMed Web of Science ®Google Scholar
• Holm-Hadulla RM, Klimov M, Juche T, Möltner A, Herpertz SC. Well-being and mental health of students during the COVID-19 pandemic. Psychopathology. 2021;54(6):291–297. doi:10.1159/000519366
   PubMed Web of Science ®Google Scholar
• Sheldon E, Simmonds-Buckley M, Bone C, et al. Prevalence and risk factors for mental health problems in university undergraduate students: a systematic review with meta-analysis. J Affect Disord. 2021;287:282–292. doi:10.1016/j.jad.2021.03.054
   PubMed Web of Science ®Google Scholar
• Sattar K, Yusoff MSB, Arifin WN, Yasin MAM, Nor MZM. A scoping review on the relationship between mental wellbeing and medical professionalism. Med Educ Online. 2023;28(1):2165892. doi:10.1080/10872981.2023.2165892
   PubMed Web of Science ®Google Scholar
• Wang CY, Pan RY, Wan XY, et al. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int J Environ Res Public Health. 2020;17(5):1729. doi:10.3390/ijerph17051729
   PubMed Web of Science ®Google Scholar
• Cao WJ, Fang ZW, Hou GQ, et al. The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Res. 2020;287:112934. doi:10.1016/j.psychres.2020.112934
   PubMed Web of Science ®Google Scholar
• Moreira de Sousa J, Moreira CA, Telles-Correia D. Anxiety, depression and academic performance: a study amongst Portuguese medical students versus non-medical students. Acta Med Port. 2018;31(9):454–462. doi:10.20344/amp.9996
   PubMed Web of Science ®Google Scholar
• Quek TT, Tam WW, Tran BX, et al. The global prevalence of anxiety among medical students: a meta-analysis. Int J Environ Res Public Health. 2019;16(15):2735. doi:10.3390/ijerph16152735
   PubMed Web of Science ®Google Scholar
• Zeng W, Chen R, Wang X, Zhang Q, Deng W. Prevalence of mental health problems among medical students in China: a meta-analysis. Medicine. 2019;98(18):e15337. doi:10.1097/md.0000000000015337
   PubMed Web of Science ®Google Scholar
• Cooke PJ, Melchert TP, Connor K. Measuring well-being: a review of instruments. Couns Psychol. 2016;44(5):730–757. doi:10.1177/0011000016633507
   Web of Science ®Google Scholar
• Zigmond AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand. 1983;67(6):361–370. doi:10.1111/j.1600-0447.1983.tb09716.x
   PubMed Web of Science ®Google Scholar
• Melzack R. The short-form McGill Pain Questionnaire. Pain. 1987;30(2):191–197. doi:10.1016/0304-3959(87)91074-8
   PubMed Web of Science ®Google Scholar
• McIntyre RS, Alda M, Baldessarini RJ, et al. The clinical characterization of the adult patient with bipolar disorder aimed at personalization of management. World Psychiatry. 2022;21(3):364–387. doi:10.1002/wps.20997
   PubMed Web of Science ®Google Scholar
• Tennant R, Hiller L, Fishwick R, et al. The Warwick-Edinburgh Mental Well-being Scale (WEMWBS): development and UK validation. Health Qual Life Out. 2007;5(1):63. doi:10.1186/1477-7525-5-63
   PubMed Web of Science ®Google Scholar
• Taggart F, Friede T, Weich S, Clarke A, Johnson M, Stewart-Brown S. Cross cultural evaluation of the Warwick-Edinburgh Mental Well-being Scale (WEMWBS)-a mixed methods study. Health Qual Life Out. 2013;11:27. doi:10.1186/1477-7525-11-27
   PubMed Web of Science ®Google Scholar
• Diener E. Subjective well-being: the science of happiness and a proposal for a national index. Am Psychol. 2000;55(1):34–43. doi:10.1037/0003-066X.55.1.34
   PubMed Web of Science ®Google Scholar
• Smyth R, Nielsen I, Zhai Q. Personal Well-being in urban China. Soc Indic Res. 2010;95(2):231–251. doi:10.1007/s11205-009-9457-2
   Web of Science ®Google Scholar
• Chan DW, Chan L-K, Sun X. Developing a brief version of Ryff’s scale to assess the psychological well-being of adolescents in Hong Kong. Eur J Psychol Assess. 2019;35(3):414–422. doi:10.1027/1015-5759/a000403
   Web of Science ®Google Scholar
• Wellbeing measures in primary health care/the DepCare Project: report on a WHO meeting: Stockholm, Sweden, 12–13 February 1998. World Health Organization. Regional Office for Europe; ‎1998‎. Available from: https://iris.who.int/handle/10665/349766. Accessed January 30, 2021.
   Google Scholar
• Topp CW, Østergaard SD, Søndergaard S, Bech P. The WHO-5 Well-Being Index: a systematic review of the literature. Psychother Psychosom. 2015;84(3):167–176. doi:10.1159/000376585
   PubMed Web of Science ®Google Scholar
• Sibai AM, Chaaya M, Tohme RA, Mahfoud Z, Al-Amin H. Validation of the Arabic version of the 5-item WHO Well Being Index in elderly population. Int J Geriatr Psychiatry. 2009;24(1):106–107. doi:10.1002/gps.2079
   PubMed Web of Science ®Google Scholar
• de Souza CM, Hidalgo MP. World Health Organization 5-item well-being index: validation of the Brazilian Portuguese version. Eur Arch Psychiatry Clin Neurosci. 2012;262(3):239–244. doi:10.1007/s00406-011-0255-x
   PubMed Web of Science ®Google Scholar
• Lee GL, Fan GK, Chan SW. Validation of Chinese and English versions of the Holistic Well-being Scale in patients with cancer. Support Care Cancer. 2015;23(12):3563–3571. doi:10.1007/s00520-015-2736-3
   PubMed Web of Science ®Google Scholar
• Bonsignore M, Barkow K, Jessen F, Heun R. Validity of the five-item WHO Well-Being Index (WHO-5) in an elderly population. Eur Arch Psychiatry Clin Neurosci. 2001;251(Suppl 2):27–31. doi:10.1007/bf03035123
   Google Scholar
• Guðmundsdóttir HB, Olason DP, Guðmundsdóttir DG, Sigurðsson JF. A psychometric evaluation of the Icelandic version of the WHO-5. Scand J Psychol. 2014;55(6):567–572. doi:10.1111/sjop.12156
   PubMed Web of Science ®Google Scholar
• Awata S, Bech P, Yoshida S, et al. Reliability and validity of the Japanese version of the World Health Organization-Five Well-Being Index in the context of detecting depression in diabetic patients. Psychiatry Clin Neurosci. 2007;61(1):112–119. doi:10.1111/j.1440-1819.2007.01619.x
   PubMed Web of Science ®Google Scholar
• Suhaimi AF, Makki SM, Tan KA, Silim UA, Ibrahim N. Translation and validation of the Malay version of the WHO-5 Well-Being Index: reliability and validity evidence from a sample of type 2 diabetes mellitus patients. Int J Environ Res Public Health. 2022;19(7):4415. doi:10.3390/ijerph19074415
   PubMed Web of Science ®Google Scholar
• Cichoń E, Kiejna A, Kokoszka A, et al. Validation of the Polish version of WHO-5 as a screening instrument for depression in adults with diabetes. Diabetes Res Clin Pract. 2020;159:107970. doi:10.1016/j.diabres.2019.107970
   PubMed Web of Science ®Google Scholar
• Perera BPR, Jayasuriya R, Caldera A, Wickremasinghe AR. Assessing mental well-being in a Sinhala speaking Sri Lankan population: validation of the WHO-5 well-being index. Health Qual Life Out. 2020;18(1):305. doi:10.1186/s12955-020-01532-8
   PubMed Web of Science ®Google Scholar
• Lucas-Carrasco R. Reliability and validity of the Spanish version of the World Health Organization-Five Well-Being Index in elderly. Psychiatry Clin Neurosci. 2012;66(6):508–513. doi:10.1111/j.1440-1819.2012.02387.x
   PubMed Web of Science ®Google Scholar
• Chongwo E, Ssewanyana D, Nasambu C, et al. Validation of a Swahili version of the World Health Organization 5-item well-being index among adults living with HIV and epilepsy in rural coastal Kenya. Glob Health Res Policy. 2018;3:26. doi:10.1186/s41256-018-0081-z
   PubMedGoogle Scholar
• Löve J, Andersson L, Moore CD, Hensing G. Psychometric analysis of the Swedish translation of the WHO well-being index. Qual Life Res. 2014;23(1):293–297. doi:10.1007/s11136-013-0447-0
   PubMed Web of Science ®Google Scholar
• Eser E, Çevik C, Baydur H, et al. Reliability and validity of the Turkish version of the WHO-5, in adults and older adults for its use in primary care settings. Prim Health Care Res Dev. 2019;20:e100. doi:10.1017/s1463423619000343
   PubMed Web of Science ®Google Scholar
• de Wit M, Pouwer F, Gemke RJ. Validation of the WHO-5 Well-Being Index in adolescents with type 1 diabetes. Diabetes Care. 2007;30(8):2003–2006. doi:10.2337/dc07-0447
   PubMed Web of Science ®Google Scholar
• Fung SF, Kong CYW, Liu YM, et al. Validity and psychometric evaluation of the Chinese version of the 5-Item WHO Well-Being Index. Front Public Health. 2022;10:872436. doi:10.3389/fpubh.2022.872436
   PubMed Web of Science ®Google Scholar
• Chan L, Liu RKW, Lam TP, Chen JY, Tipoe GL, Ganotice FA. Validation of the World Health Organization Well-Being Index (WHO-5) among medical educators in Hong Kong: a confirmatory factor analysis. Med Educ Online. 2022;27(1):2044635. doi:10.1080/10872981.2022.2044635
   PubMed Web of Science ®Google Scholar
• Saracci R. The World Health Organisation needs to reconsider its definition of health. BMJ. 1997;314(7091):1409–1410. doi:10.1136/bmj.314.7091.1409
   PubMedGoogle Scholar
• Streiner DL, Norman GR, Cairney J. Health Measurement Scales: A Practical Guide to Their Development and Use. Oxford University Press; 2014.
   Google Scholar
• Deyo RA, Diehr P, Patrick DL. Reproducibility and responsiveness of health status measures. Statistics and strategies for evaluation. Control Clin Trials. 1991;12(4 Suppl):142S–158S. doi:10.1016/s0197-2456(05)80019-4
   PubMedGoogle Scholar
• Kline P. An Easy Guide to Factor Analysis. New York: Routledge; 1994.
   Google Scholar
• Mundfrom DJ, Shaw DG, Ke TL. Minimum sample size recommendations for conducting factor analyses. Int J Test. 2005;5(2):159–168. doi:10.1207/s15327574ijt0502_4
   Google Scholar
• Association WM. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191–2194. doi:10.1001/jama.2013.281053
   PubMed Web of Science ®Google Scholar
• The Chinese version of the WHO (Five) in characters used in PR China. Psychiatric Research Unit, WHO Collaborating Center for Mental Health. Available from: https://www.psykiatri-regionh.dk/who-5/Documents/WHO5_Chinese_PR.pdf. Accessed January 30, 2021.
   Google Scholar
• Spitzer RL, Kroenke JBWWK. Instructions for Patient Health Questionnaire (PHQ) and GAD-7 Measures. Available from: https://www.phqscreeners.com/. Accessed January 30, 2021.
   Google Scholar
• Sapra A, Bhandari P, Sharma S, Chanpura T, Lopp L. Using Generalized Anxiety Disorder-2 (GAD-2) and GAD-7 in a Primary Care Setting. Cureus. 2020;12(5):e8224. doi:10.7759/cureus.8224
   PubMed Web of Science ®Google Scholar
• Kroenke K, Spitzer RL, Williams JB. The Patient Health Questionnaire-2: validity of a two-item depression screener. Med Care. 2003;41(11):1284–1292. doi:10.1097/01.Mlr.0000093487.78664.3c
   PubMed Web of Science ®Google Scholar
• Löwe B, Wahl I, Rose M, et al. A 4-item measure of depression and anxiety: validation and standardization of the Patient Health Questionnaire-4 (PHQ-4) in the general population. J Affect Disord. 2010;122(1–2):86–95. doi:10.1016/j.jad.2009.06.019
   PubMed Web of Science ®Google Scholar
• Kroenke K, Spitzer RL, Williams JB, Löwe B. An ultra-brief screening scale for anxiety and depression: the PHQ-4. Psychosomatics. 2009;50(6):613–621. doi:10.1176/appi.psy.50.6.613
   PubMed Web of Science ®Google Scholar
• Luo Y, Fei S, Gong B, Sun T, Meng R. Understanding the mediating role of anxiety and depression on the relationship between perceived stress and sleep quality among health care workers in the COVID-19 response. Nat Sci Sleep. 2021;13:1747–1758. doi:10.2147/nss.S313258
   PubMed Web of Science ®Google Scholar
• Meng R, Dong L, Dzierzewski JM, et al. The RU_SATED as a measure of sleep health: cross-cultural adaptation and validation in Chinese healthcare students. BMC Psychology. 2023;11(1):200. doi:10.1186/s40359-023-01203-5
   PubMedGoogle Scholar
• Zhu Y, Jiang C, Yang Y, et al. Depression and anxiety mediate the association between sleep quality and self-rated health in healthcare students. Behav Sci. 2023;13(2):82. doi:10.3390/bs13020082
   PubMedGoogle Scholar
• Jiang C, Ma H, Luo Y, et al. Validation of the Chinese version of the Perceived Stress Scale-10 integrating exploratory graph analysis and confirmatory factor analysis. Gen Hosp Psychiatry. 2023;84:194–202. doi:10.1016/j.genhosppsych.2023.07.008
   PubMed Web of Science ®Google Scholar
• Jiang C, Zhu Y, Luo Y, et al. Validation of the Chinese version of the Rosenberg Self-Esteem Scale: evidence from a three-wave longitudinal study. BMC Psychology. 2023;11(1):345. doi:10.1186/s40359-023-01293-1
   PubMedGoogle Scholar
• Rosseel Y. Lavaan: an R package for structural equation modeling. J Stat Softw. 2012;48:1–36. doi:10.18637/jss.v048.i02
   Web of Science ®Google Scholar
• Kelley K. MBESS: the MBESS R package. 2022. Available from: https://CRAN.R-project.org/package=MBESS. Accessed January 30, 2023.
   Google Scholar
• Gamer M, Lemon J, Singh IFP. irr: various coefficients of interrater reliability and agreement. 2019. Available from: https://CRAN.R-project.org/package=irr. Accessed January 30, 2023.
   Google Scholar
• Jorgensen TD, Pornprasertmanit S, Schoemann AM, Rosseel Y. Useful tools for structural equation modeling. 2022. Available from: https://CRAN.R-project.org/package=semTools. Accessed January 30, 2023.
   Google Scholar
• Sachs MC. plotROC: a tool for plotting ROC curves. J Stat Softw. 2017;79(2):1–19. doi:10.18637/jss.v079.c02
   PubMedGoogle Scholar
• Dziura JD, Post LA, Zhao Q, Fu Z, Peduzzi P. Strategies for dealing with missing data in clinical trials: from design to analysis. Yale J Biol Med. 2013;86(3):343–358.
   PubMedGoogle Scholar
• Finney SJ, DiStefano C. Nonnormal and Categorical Data in Structural Equation Models. Structural Equation Modeling: A Second Course. Greenwich, CT: Information Age; 2006.
   Google Scholar
• Mokkink LB, Terwee CB, Patrick DL, et al. The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes. J Clin Epidemiol. 2010;63(7):737–745. doi:10.1016/j.jclinepi.2010.02.006
   PubMed Web of Science ®Google Scholar
• Hair JF, Black WC, Babin BJ, Anderson RE. Multivariate Data Analysis: Pearson New International Edition. 7th ed. London, UK: Pearson Higher Education; 2014.
   Google Scholar
• Kline RB. Principles and Practice of Structural Equation Modeling. 4th ed. New York, NY, USA: Guilford Publications; 2016.
   Google Scholar
• Edwards MC, Houts CR, Wirth RJ. Measurement invariance, the lack thereof, and modeling change. Qual Life Res. 2018;27(7):1735–1743. doi:10.1007/s11136-017-1673-7
   PubMed Web of Science ®Google Scholar
• Cheung GW, Rensvold RB. Evaluating goodness-of-fit indexes for testing measurement invariance. Struct Equ Modeling. 2002;9(2):233–255. doi:10.1207/S15328007SEM0902_5
   Web of Science ®Google Scholar
• Putnick DL, Bornstein MH. Measurement invariance conventions and reporting: the state of the art and future directions for psychological research. Dev Rev. 2016;41:71–90. doi:10.1016/j.dr.2016.06.004
   PubMed Web of Science ®Google Scholar
• Doan T, Ha V, Strazdins L, Chateau D. Healthy minds live in healthy bodies - effect of physical health on mental health: evidence from Australian longitudinal data. Curr Psychol. 2022;42:18702–18713. doi:10.1007/s12144-022-03053-7
   Web of Science ®Google Scholar
• Schober P, Boer C, Schwarte LA. Correlation coefficients: appropriate use and interpretation. Anesth Analg. 2018;126(5):1763–1768. doi:10.1213/ane.0000000000002864
   PubMed Web of Science ®Google Scholar
• DeVon HA, Block ME, Moyle-Wright P, et al. A psychometric toolbox for testing validity and reliability. J Nurs Scholarsh. 2007;39(2):155–164. doi:10.1111/j.1547-5069.2007.00161.x
   PubMed Web of Science ®Google Scholar
• Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med. 2016;15(2):155–163. doi:10.1016/j.jcm.2016.02.012
   PubMed Web of Science ®Google Scholar
• Weir JP. Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM. J Strength Cond Res. 2005;19(1):231–240. doi:10.1519/15184.1
   PubMed Web of Science ®Google Scholar
• Walter SD. The partial area under the summary ROC curve. Stat Med. 2005;24(13):2025–2040. doi:10.1002/sim.2103
   PubMed Web of Science ®Google Scholar
• Zweig MH, Campbell G. Receiver-operating characteristic (ROC) plots: a fundamental evaluation tool in clinical medicine. Clin Chem. 1993;39(4):561–577. doi:10.1093/clinchem/39.4.561
   PubMed Web of Science ®Google Scholar
• Ng SS, Lo AW, Leung TK, et al. Translation and validation of the Chinese version of the short Warwick-Edinburgh Mental Well-being Scale for patients with mental illness in Hong Kong. East Asian Arch Psychiatry. 2014;24(1):3–9.
   PubMedGoogle Scholar
• Dong A, Chen X, Zhu L, et al. Translation and validation of a Chinese version of the Warwick–Edinburgh Mental Well-being Scale with undergraduate nursing trainees. J Psychiatr Ment Health Nurs. 2016;23(9–10):554–560. doi:10.1111/jpm.12344
   PubMed Web of Science ®Google Scholar
• Chen FF. Sensitivity of goodness of fit indexes to lack of measurement invariance. Struct Equ Modeling. 2007;14(3):464–504. doi:10.1080/10705510701301834
   Web of Science ®Google Scholar
• Lai K, Green SB. The problem with having two watches: assessment of fit when RMSEA and CFI disagree. Multivariate Behav Res. 2016;51(2–3):220–239. doi:10.1080/00273171.2015.1134306
   PubMed Web of Science ®Google Scholar
• Shi D, DiStefano C, Maydeu-Olivares A, Lee T. Evaluating SEM model fit with small degrees of freedom. Multivariate Behav Res. 2022;57(2–3):179–207. doi:10.1080/00273171.2020.1868965
   PubMed Web of Science ®Google Scholar
• Hansen CP, Amiri M. Combined detection of depression and anxiety in epilepsy patients using the Neurological Disorders Depression Inventory for Epilepsy and the World Health Organization well-being index. Seizure. 2015;33:41–45. doi:10.1016/j.seizure.2015.10.008
   PubMed Web of Science ®Google Scholar
• Mergl R, Seidscheck I, Allgaier AK, Möller HJ, Hegerl U, Henkel V. Depressive, anxiety, and somatoform disorders in primary care: prevalence and recognition. Depress Anxiety. 2007;24(3):185–195. doi:10.1002/da.20192
   PubMed Web of Science ®Google Scholar
• Lara-Cabrera ML, Betancort M, Muñoz-Rubilar A, Rodríguez-Novo N, Bjerkeset O, De Las Cuevas C. Psychometric properties of the WHO-5 Well-Being Index among nurses during the COVID-19 pandemic: a cross-sectional study in three countries. Int J Environ Res Public Health. 2022;19(16):10106. doi:10.3390/ijerph191610106
   PubMed Web of Science ®Google Scholar
• Awata S, Bech P, Koizumi Y, et al. Validity and utility of the Japanese version of the WHO-Five Well-Being Index in the context of detecting suicidal ideation in elderly community residents. Int Psychogeriatr. 2007;19(1):77–88. doi:10.1017/s1041610206004212
   PubMed Web of Science ®Google Scholar
• Mirowsky J, Ross CE. Age and depression. J Health Soc Behav. 1992;33(3):187–205. doi:10.2307/2137349
   PubMed Web of Science ®Google Scholar
• Stone AA, Schwartz JE, Broderick JE, Deaton A. A snapshot of the age distribution of psychological well-being in the United States. PNAS. 2010;107(22):9985–9990. doi:10.1073/pnas.1003744107
   PubMed Web of Science ®Google Scholar