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Evaluating Differential Item Functioning of the CES-D Scale According to Caregiver Status and Cultural Context in Korean Women

Heeseung Choi, PhD, MPH, RN, is an assistant professor in the Department of Health Systems Science at the University of Illinois at Chicago College of Nursing, Chicago, Illinois, hchoi20{at}uic.edu

Louis Fogg

Louis Fogg is a research assistant professor, in the Department of Occupational Therapy at the University of Illinois at Chicago College of Applied Health Sciences, Chicago, Illinois

Eunice E. Lee

Eunice E. Lee, PhD, RN, is an assistant professor in the Department of Health Systems Science at the University of Illinois at Chicago College of Nursing, Chicago, Illinois

Michelle Choi Wu

Michelle Choi Wu is a postdoctoral fellow in the Department of Health Systems Science at the University of Illinois at Chicago College of Nursing, Chicago, Illinois

BACKGROUND: Proper evaluation of the generalizability of an instrument is critical for its use across different social contexts such as caregiver status. OBJECTIVE: To examine the differential item functioning of the Center for Epidemiologic Studies Depression (CES-D) Scale, patterns of response to each item of the CES-D Scale attributable to caregiver status was assessed. STUDY DESIGN: Using a cross-study comparison method, a sample of 58 matched pairs of Korean American caregivers and noncaregivers was used for matched moderated regression analysis on the CES-D Scale. RESULTS: The authors identified three items that vary according to caregiver status in the present study: Item 2 (My appetite was poor), Item 4 (I felt that I was as good as other people), and Item 14 (I felt lonely). CONCLUSIONS: Beyond assessing the level of depression through total CES-D scores, it is important to examine variations in the items of the CES-D Scale across different social contexts. J Am Psychiatr Nurses Assoc, 2009; 15(4), 240-248. DOI: 10.1177/1078390309343713

Key Words: cross-cultural issues • depression • rating scale and scales

Journal of the American Psychiatric Nurses Association, Vol. 15, No. 4, 240-248 (2009)
DOI: 10.1177/1078390309343713


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