Psychometric Properties of the Beck Depression Inventory (BDI-II) in Cancer Patients: Cancer Patients from Butaro Ambulatory Cancer Center, Rwanda

BACKGROUND: The prevalence of depressive disorders remains high in patients with cancer and their diagnosis and treatment remain an epidemiologic concern. Without proper screening and diagnosis, the necessary care and follow-up would not be possible for these patients who need potential support to increase their quality of mental health. Hence, the screening tools for depression are prominent in diagnosing this mental health disorder; however, there are few studies conducted for assessing psychometric properties of Beck Depression Inventory (BDI-II) amongst the cancer patients from developing countries. We, therefore, determined psychometric properties of the BDI-II among cancer patients from Butaro Ambulatory Cancer Center (BACC). METHODS: Cross-sectional study design was conducted among 425 cancer patients from the BACC, Rwanda. Confirmatory and exploratory factor (CFA) analyses were performed to compare the fit indices of three-factor and two-factor models of the BDI-II. The eligible participants were administered the BDI-II instrument. RESULTS: Average scores of depression was 16.3 (SD=9.8). Results showed an adequate consistency (Cronbach’s α=0.904) and high correlations with the subscales of this instrument. Our findings showed that the area under the curve of the receiver operating characteristics analysis of BDI-II was 0.805. Our CFA results revealed that three-factor model (χ(2)=1699.921, p<0.001) represented a better model fit than the two-factor model of BDI-II (χ(2)=2115.397, p<0.001). In addition, the goodness of fit indices were tested and showed that the Beck’s three-factor model had a better performance than the two-factor model. Kaiser–Meyer–Olin (KMO) measure of 0.916 demonstrated that the factor structure or sampling was adequate for analysis and the Bartlett’s test of sphericity was highly significant (χ(2)=3780, p<0.001) and this revealed that the items of BDI-II were significantly correlated and sufficiently large. CONCLUSION: BDI-II presented a good reliability and validity that represent adequate psychometric properties. Its sensitivity and specificity were suitable. This psychometric measure is important in diagnosing and treating depression in cancer patients.