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아동 청소년을 위한 한국판 우울 평가 도구(K-PHQ-9A) 타당화

A Validation of the Korean Version of the Patient Health Questionnaire-9 (K-PHQ-9A) among Child and Adolescents

김보경|김도희|주혜선|이나빈|심기선
(사)위기관리이론과실천 (Crisis and Emergency Management: Theory and Praxis)|2024.07|Crisisonomy|제20권 제7호|pp. 145-164|DOI 10.14251/crisisonomy.2024.20.7.145

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참고문헌

키워드

우울depressionPHQ-9아동청소년child and adolescentsK-PHQ-9AK-PHQ-2APHQ-9APHQ-2A

초록

본 연구는 아동 청소년의 우울 증상을 측정하는 도구인 PHQ-9A를 한국판으로 타당화하고자 하였다. 이를 위하여 번안-역번안 절차를 통해 한국판 우울 평가 도구(K-PHQ-9A)를 제작하여 문항양호도와요인구조를 확인하고, 그 신뢰도와 타당도를 검증하였다. 이를 위하여 일생 중 충격적인 사건 경험이있는 아동과 그들의 보호자 356쌍, 청소년 533명을 대상으로 온라인 설문 통해 자료를 수집하였다. 분석결과, K-PHQ-9A는 2요인 모델이 가장 적합한 것으로 나타났으며 높은 신뢰도와 타당도를 확인하였다. 그리고, 임상 현장에서 효율적인 활용을 위하여 2문항으로 구성된 K-PHQ-2A를 구성하여 신뢰도를확인한 결과 우수하게 나타났다. 추가적으로, ROC 곡선 분석을 통해 우울증상의 임상 절단점을 확인한결과 K-PHQ-9A는 아동과 청소년 모두 9점으로 나타났으며, K-PHQ-2A는 아동은 2점, 청소년은 3점이최적의 절단점으로 나타났다. 본 연구 결과를 토대로 연구의 의의와 제한점에 대하여 함께 논의하였다.

Abstract

The purpose of this study was to examine the validity and reliability of the Patient Health Questionnaire-9A (PHQ-9A) as a screening tool for depression among children and adolescents in Korea. To validate the PHQ-9A in Korea, item analysis, confirmatory factor analysis (CFA), Cronbach's alpha, and Receiver Operating Characteristic (ROC) analysis were conducted with 356 pairs of children and their caregivers, and 533 adolescents who had experienced traumatic events. Confirmatory factor analysis supported the two-factor structure of the K-PHQ-9A. All items showed adequate internal consistency and were adequately related to depression, anxiety, and posttraumatic stress disorder, supporting good concurrent validity. Furthermore, ROC curve analysis was conducted to identify the clinical cut-off points for depression. The optimal cut-off point for the K-PHQ-9A was found to be 9 points for both children and adolescents, while for the K-PHQ-2A, it was found to be 2 points for children and 3 points for adolescents. The results were also discussed in relation to the potential utility of the instrument.

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