Muhammad Irfan, Mifrah Rauf Sethi, Imran Khan, Naila Riaz Awan, Fauzia Naz, Urooj Saleem, Farooq Naeem.
Translation And Validation In Pashto (1): Hospital Anxiety And Depression Scale.
J Postgrad Med Inst Jan ;31(4):387-93.

Objective: To translate and validate the hospital anxiety and depression scale (HADS) in Pashto. Methodology: This study was conducted in Peshawar from July 2015 to January 2016 on 216 participants. The participants consisted of two groups; students (n=111) and patients (n=105). Mean age of the sample was 21.8 ±5.6 years. Majority were females [n=132 (61.1%)], unmarried [n=181, (83.2%)], and were educated to a level of intermediate or higher [n= 201, (93.1%)]. Three bilingual experts, using forward-backward method, translated HADS from English to Pashto. Both, English and Pashto version of HADS were given to the participants separately to find out concurrent validity of HADS (Pashto version). Pashto version of Bradford Somatic Inventory (BSI) was used to explore relationship of somatic symptoms with anxiety and depressive symptoms (measured through HADS). Results: HADS Pashto version, well discriminated between both groups of participants. Patient group of participants had significantly higher scores of anxiety and depression as compared to students group (p value =0.000). The factorial validity of the Pashto version of HADS showed that it is a two-factor instrument. The Cronbach’s alpha (α=0.7) of the Pashto version of HADS was sufficient. Regarding concurrent validity, the results showed a significant correlation between English and Pashto version of HADS (r =.716; p value=.000) while there was a positive correlation between anxiety and depressive symptoms (HADS; Pashto version) and somatic symptoms (BSI) (p value =.000). Conclusion: Pashto version of HADS can be used in both community as well as clinical settings because of its reliability and validity in measuring anxiety and depression.

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