Validity And Reliability Of The Patient Health Questionnaire-9 (PHQ-9) Instrument For Screening Depression in Patients with Stage 5 Chronic Kidney Disease (End-Stage Renal Disease)

Abstract

Depression is one of the most common comorbidities among patients with stage 5 chronic kidney disease (CKD) and has a significant impact on quality of life, treatment adherence, morbidity, and mortality. Early detection of depression in this population is essential. However, diagnosis is often challenging due to the overlap between somatic symptoms of advanced CKD and depressive symptoms. This overlap may lead to underdiagnosis and delayed intervention. Therefore, a simple, valid, and reliable screening instrument is needed for routine clinical practice. This study aimed to evaluate the validity and reliability of the Patient Health Questionnaire-9 (PHQ-9) as a screening tool for depression in patients with stage 5 CKD. A descriptive-analytic design was used, focusing on psychometric testing of the instrument. Item validity was examined using item–total correlation analysis, while internal consistency reliability was assessed using Cronbach’s alpha coefficient. The results showed that item–total correlation values ranged from 0.524 to 0.886, indicating good validity for all questionnaire items. Reliability testing produced a Cronbach’s alpha value of 0.928, demonstrating excellent internal consistency. These findings indicate that the PHQ-9 is a valid and reliable instrument for screening depression in patients with stage 5 CKD. The implementation of PHQ-9 in clinical settings can support healthcare providers in early identification of depressive symptoms, enable timely psychosocial interventions, and contribute to improved quality of life and clinical outcomes for patients with advanced chronic kidney disease in both primary and referral healthcare facilities.