BackgroundContext-specific measures with adequate external validity are needed to appropriately determine psychosocial effects related to screening for cognitive impairment.MethodsTwo-hundred adults aged ≥65 y recently completing routine, standardized cognitive screening as part of their Medicare annual wellness visit were administered an adapted version of the Psychological Consequences of Screening Questionnaire (PCQ), composed of negative (PCQ-Neg) and positive (PCQ-Pos) scales. Measure distribution, acceptability, internal consistency, factor structure, and external validity (construct, discriminative, criterion) were analyzed.ResultsParticipants had a mean age of 73.3 y and were primarily female and socioeconomically advantaged. Most had a normal cognitive screening result (99.5%, n = 199). Overall PCQ scores were low (PCQ-Neg: [Formula: see text]= 1.27, possible range 0–36; PCQ-Pos: [Formula: see text] = 7.63, possible range 0–30). Both scales demonstrated floor effects. Acceptability was satisfactory, although the PCQ-Pos had slightly more item missingness. Both scales had Cronbach alphas >0.80 and a single-factor structure. Spearman correlations between the PCQ-Neg with general measures of psychological distress (Impacts of Events Scale–Revised, Perceived Stress Scale, Kessler Distress Scale) ranged from 0.26 to 0.37 ( P’s < 0.001); the correlation with the World Health Organization–Five Well-Being Index was −0.19 ( P < 0.01). The PCQ-Neg discriminated between those with and without a self-reported subjective cognitive complaint ([Formula: see text] = 2.73 v. 0.89, P < 0.001) and was associated with medical visit satisfaction ( r = −0.24, P < 0.001) on the Patient Satisfaction Questionnaire. The PCQ-Pos predicted self-reported willingness to engage in future screening ([Formula: see text] = 8.00 v. 3.00, P = 0.03).ConclusionsThe adapted PCQ-Neg is an overall valid measure of negative psychological consequences of cognitive screening; findings for the PCQ-Pos were more variable. Future studies should address measure performance among diverse samples and those with abnormal screening results.HighlightsThe PCQ scale is an overall valid measure of psychological dysfunction related to cognitive screening in older adults receiving normal screen results. PCQ scale performance should be further validated in diverse populations and those with abnormal cognitive screening results. The adapted PCQ may be useful to both health research and policy stakeholders seeking improved assessment of psychological impacts of cognitive screening.

中文翻译：

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初级保健认知筛查筛查问卷 (PCQ) 心理后果的调整和验证


背景需要具有足够外部效度的针对特定情境的措施，以适当确定与认知障碍筛查相关的心理社会影响。方法对 200 名年龄≥65 岁的成年人最近完成常规标准化认知筛查（作为医疗保险年度健康访问的一部分）进行了改编版本筛查问卷（PCQ）的心理后果，由阴性（PCQ-Neg）和阳性（PCQ-Pos）量表组成。分析了测量分布、可接受性、内部一致性、因素结构和外部效度（建构、判别、标准）。结果参与者的平均年龄为 73.3 岁，主要为女性且具有社会经济优势。大多数人的认知筛查结果正常（99.5%，n = 199）。总体 PCQ 分数较低（PCQ-Neg：[公式：参见文本]= 1.27，可能范围 0-36；PCQ-Pos：[公式：参见文本]= 7.63，可能范围 0-30）。两种量表都显示了地板效应。尽管 PCQ-Pos 的项目缺失稍微多一些，但可接受性令人满意。两个量表的 Cronbach alphas >0.80 和单因素结构。 PCQ-Neg 与心理困扰的一般测量（事件影响量表 - 修订版、感知压力量表、凯斯勒痛苦量表）之间的 Spearman 相关性范围为 0.26 至 0.37（P's < 0.001）；与世界卫生组织五福祉指数的相关性为-0.19 ( P < 0.01)。 PCQ-Neg 区分了那些有或没有自我报告的主观认知投诉的人（[公式：见文字] = 2.73 v. 0.89，P < 0.001），并且与就诊满意度相关（ r = -0.24，P % 3C 0.001) 患者满意度调查问卷。 PCQ-Pos 预测了自我报告的参与未来筛查的意愿（[公式：见文字] = 8.00 v. 3.00，P = 0.03）。 结论 改编后的 PCQ-Neg 是认知筛查负面心理后果的总体有效衡量标准； PCQ-Pos 的结果变化较大。未来的研究应该解决不同样本和筛查结果异常样本之间的测量表现。要点 PCQ 量表是对接受正常筛查结果的老年人中与认知筛查相关的心理功能障碍的总体有效测量。 PCQ 量表的表现应在不同人群和认知筛查结果异常的人群中进一步验证。改编后的 PCQ 可能对寻求改进认知筛查心理影响评估的健康研究和政策利益相关者有用。