The factor structure of the General Health Questionnaire (GHQ): a scaled version for general practice in Spain.

BACKGROUND: The 28-item version of the General Health Questionnaire (GHQ-28) developed by Goldberg and Hillier in 1979 is constructed on the basis of a principal components analysis of the GHQ-60. When used on a Spanish population, a translation of the GHQ-28 developed for an English population may lead to worse predictive values. METHODS: We used our Spanish sample to replicate the entire process of construction of the GHQ-28 administered in a primary-care setting. RESULTS: Two shorter versions were proposed: one with six scales and 30 items, and the other with four scales and 28 items. CONCLUSIONS: The resulting GHQ-28 was a successful adaptation for use on the Spanish sample. When compared with the original version, only 21 items were the same. Moreover, contrary to the English version, which groups sleep problems and anxiety in the same scale, a scale with items related exclusively to 'Sleep disturbances' was found.

Validation of the Spanish version of the geriatric depression scale (GDS) in primary care.

OBJECTIVE: To estimate the predictive value of the 30-question Geriatric Depression Scale (GDS) in Spanish and calculate the most adequate cut-point for its use in Primary Health Care consultations. METHOD: 218 patients over the age of 64 treated at three health centers of Area 10 in Madrid were selected. In the first phase, the subjects completed the GDS, the Mini-Mental State Examination (MMSE) and a questionnaire on health and socio-demographic variables. They were later interviewed using the Geriatric Mental Schedule (GMS), used as the gold standard by doctors who were unaware of the results of the GDS. Two categories were contemplated according to the results of the GMS: cases of depression (diagnosis of psychotic or neurotic depression) and non-psychiatric cases (no psychiatric diagnosis, although isolated symptoms could be present). RESULTS: 192 aged subjects were interviewed using the GDS and the GMS. Of these, 103 were considered "non-cases of depression" and 60 others made up the "cases of psychotic/neurotic depression" group. For the most effective cut-point (9/10), sensitivity was 86.7% and specificity 63.1%. Considering a prevalence of depression of 30%, the predictive value for positives was 50.2% and for negatives 91.7%. The Cronbach alpha coefficient was 0.82, and the area below the ROC curve obtained was 0.85. Those patients with cognitive deterioration had a mean GDS score similar to those that did not present deterioration (11.16 vs 10.52; p > 0.05). CONCLUSIONS: The Geriatric Depression Scale is valid as a screening test in Primary Care consultations due to its high sensitivity and negative predictive value. The most effective Spanish GDS cut-point (9/10) is lower than that obtained in the original English version (10/11).

[Job satisfaction among primary care professional in area 10 Insalud, Madrid]. / Satisfaccion laboral de los profesionales de Atención Primaria del Area 10 del Insalud de Madrid.

BACKGROUND: The implementation of a total quality model requires ascertaining the degree of employee job satisfaction. Our aim is to ascertain the overall degree of satisfaction and determine its components employed in Primary Care District No. 10. METHODS: Descriptive cross-sectional study conducted in Spanish National Health Institute Primary Health Care District No. 10 in Madrid. A total of 668 health care and non health care professionals are employed in this District. A Font Rojas satisfaction questionnaire adapted by J. Aranaz was used to gauge the degree of job satisfaction on a 1-5 scale (1 being the lowest degree of satisfaction and 5 the highest). RESULTS: Eighty percent of the population answered the questionnaire. The average satisfaction mark was 3.12 (Standard Error SE = 0.017). The aspects ranked the lowest were the stress involved in the job, averages 2.30 (SE = 0.041) and professional promotion an average of 2.42 (SE = 0.038). The aspect valued most highly was that of professional skill, averaging 4.01 (SE = 0.058). CONCLUSIONS: These professional are satisfied to an average degree with their work. On comparing this study with one conducted in this same District in 1992, we have drawn the conclusion that the aspects of work-related stress and professional promotion continue to be those ranked the lowest, which should lead to corrective measures being taken on the part of the management teams.