The Factor Structure of the Hospital Anxiety Depression Scale Adapted for Korean Preschool Teacher Candidates During the Coronavirus Disease 2019 Pandemic

Abstract

Background: The coronavirus disease 2019 pandemic has remarkably challenged preschool teacher candidates, triggering concerns for their psychological well-being and mental health. Valid and reliable instruments to assess elements of mental health are thus required. The self-rating Hospital Anxiety Depression Scale demonstrates promise as an instrument for the identification and quantification of the states of anxiety and depression in non-psychiatric patients. The Hospital Anxiety Depression Scale is widely applied in both clinical and research contexts. However, no psychometric evaluations have been performed for this instrument with non-clinical samples such as preschool teacher candidates in South Korea. This study purposed to establish the factor structure of the Hospital Anxiety Depression Scale and to validate its Korean version and was conducted online with a sample of preschool teacher candidates during the peak of the coronavirus disease 2019 lockdown. Methods: Data were collected from 359 undergraduates currently enrolled in a 4-year early childhood education degree program at a private university in Korea. The sample was randomly split to perform exploratory factor analysis and then confirmatory factor analysis respectively to test competing models hypothesized to reflect the factor structure of the Hospital Anxiety Depression Scale. Results: Supplemental revisions based on confirmatory factor analysis modification indices demonstrated that a correlated 2-factor model with 1 cross-loaded item offered the best fit to the data with adequate internal reliability estimates. Conclusion: Overall, this study confirms the validity and factor structure of the Korean version of the Hospital Anxiety Depression Scale, which is deemed an acceptable instrument that can be used to measure the symptoms of depression and anxiety in Korean preschool teacher candidates.