Validation of the Patient Health Questionnaire-4 for longitudinal mental health evaluation in elite Para athletes.

Autor: Meidl V; Department of Orthopedics and Trauma Surgery, Center of Surgery, Medical Center-Albert-Ludwigs-University of Freiburg, Freiburg, Germany., Dallmann P; Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany., Leonhart R; Department of Psychology, Albert-Ludwigs-University of Freiburg, Freiburg, Germany., Bretthauer B; Department of Orthopedics and Trauma Surgery, Center of Surgery, Medical Center-Albert-Ludwigs-University of Freiburg, Freiburg, Germany., Busch A; Department of Orthopedics and Trauma Surgery, Center of Surgery, Medical Center-Albert-Ludwigs-University of Freiburg, Freiburg, Germany.; Outpatient Clinic, Sport Medicine & Sports Orthopedics, University of Potsdam, Potsdam, Germany.; Division Physiotherapy, Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland., Kubosch EJ; Department of Orthopedics and Trauma Surgery, Center of Surgery, Medical Center-Albert-Ludwigs-University of Freiburg, Freiburg, Germany., Wrobel N; Institute for Exercise and Occupational Medicine, Center for Medicine, Medical Center-Albert-Ludwigs-University of Freiburg, Freiburg, Germany., Hirschmüller A; Department of Orthopedics and Trauma Surgery, Center of Surgery, Medical Center-Albert-Ludwigs-University of Freiburg, Freiburg, Germany.; ALTIUS Swiss Sportmed Center AG, Rheinfelden, Switzerland.
Jazyk: angličtina
Zdroj: PM & R : the journal of injury, function, and rehabilitation [PM R] 2024 Feb; Vol. 16 (2), pp. 141-149. Date of Electronic Publication: 2023 Aug 25.
DOI: 10.1002/pmrj.13011
Abstrakt: Background: Despite the increasing amount of research regarding mental health in elite athletes in recent years, athletes with impairments are hardly represented. Due to this lack of data and the significant need of athlete-specific mental health screening tools, a continuous mental health monitoring program for elite Para athletes was implemented.
Objective: Validation of the Patient Health Questionnaire-4 (PHQ-4) as a suitable tool for continuous mental health evaluation in elite Para athletes.
Design: A 43-week prospective observational cohort study.
Setting: Online questionnaire, provided weekly via web browser and mobile app.
Participants: Seventy-eight Para athletes preparing for Paralympic Summer and Winter Games.
Interventions: Not applicable.
Main Outcome Measures: Weekly PHQ-4 scores, stress level, and mood.
Results: With a mean weekly response rate of 82.7% (SD = 8.0), 2149 PHQ-4, 2159 stress level and 2153 mood assessments were completed. Mean PHQ-4 score among all participating athletes was 1.2 (SD = 1.8; 95% confidence interval [CI], [1.1-1.3]). Individual weekly scores ranged from 0 to 12 and showed significant floor effects, with 54% of the scores being zero. PHQ-4 scores were significantly higher among female athletes and team sport members (p < .001). Internal consistency of the PHQ-4 was satisfying, Cronbach's α being 0.839. There were significant cross-sectional as well as longitudinal correlations of PHQ-4 and stress level as well as mood values (p < .001). 39.7% of all athletes (n = 31) had at least one positive screen for mental health symptoms.
Conclusions: The PHQ-4 was shown to be a valid tool for mental health surveillance in elite Para athletes. Significant correlations of the PHQ-4 and stress level as well as mood were shown. High weekly response rates among participating athletes indicated good acceptance of the program. The weekly monitoring allowed for the identification of individual fluctuations and could identify potential athletes at risk for mental health problems when combined with clinical follow-up.
(© 2023 The Authors. PM&R published by Wiley Periodicals LLC on behalf of American Academy of Physical Medicine and Rehabilitation.)
Databáze: MEDLINE
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