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Table 2 Overview of the self-rated health measurement tools identified in the scoping review

From: Measuring self-rated health status among resettled adult refugee populations to inform practice and policy – a scoping review

Measurement focus Measurement name, Author & Year Design/use No. of studies tool cited in Composition Completion time (CT); Language Availability (LA) Publically available Reliability testing in refugee population group Validity testing in refugee population group
General Health Medical Outcomes Study Short Form - Ware & Sherbourne (1992) Designed for use in clinical practice and research, and general population surveys. 18 Several versions: 36, 20, 12 or 6 items measuring perceived mental & physical health status across 8 health concepts in past month. 5–10 min to complete depending on version. Available in 50 languages. Yes SF-6: Afghani(1)
SF-12: Russian(2)
SF-20: Bosnian(3)
SF-36: Bosnian(4)
SF-12: Russian(2)
General Health WHO Quality of Life-BREF - WHO (1998) Designed to assess self-rated quality of life across different cultures. Appropriate for large research studies, clinical trials, medical care. 6 26 items measuring 4 quality of life domains (physical health, psychological health, social relationships & environment) in past 2 weeks. Responses scored on 5-point Likert scale. 10–15 min to complete. Available in multiple languages No Somalian(5).
Liberian, Togolese, Sierra-Leonean(6).
Somalian(8)
General Health New Mexico Refugee Symptom Checklist-121 - Hollifield et al. (2009) Designed for use within non-clinical refugee research. 2 121 items; 12 subscales assessing distressing physical and emotional symptoms in past year. Responses scored on 5-point Likert severity scale. 60–90 min to complete. Available in multiple languages No Kurdish & Vietnamese(7) Kurdish & Vietnamese(7)
General Health Personal Wellbeing Index - Cummins (2003) Designed to be a cross-cultural instrument of quality of life. 2 8 items assessing life satisfaction (eg.health, community belonging, future security, religion & spirituality). Responses scored on 11 point Likert satisfaction scale. 5–10 min to complete. Available in multiple languages Yes Afghani & Kurdish(8) No
General Health World Health Organisation Disability Assessment Schedule 2.0 - WHO (2004) Designed to be used within clinical, community and general populations. 1 36 items measuring quality of life (eg. mobility, self-care, interpersonal). Responses scored on 5-point Likert scale. 5–20 min to complete. Available in multiple languages. No Sudanese(9) No
Common Mental Disorders Hopkins Symptom Checklist-25 - Mollica et al. (1987) Originally designed for use in Western clinical settings. Indochinese version developed to screen anxiety & depression in clinical refugee samples. 62 25 items; 15 anxiety and 10 depression symptoms. Responses scored on a 4-point scale. An average-item score > 1.75 indicates clinically significant distress. 5–10 min to complete. Available in multiple languages (eg. English, Amharic, Bosnian, Cambodian, Dari, Khmer, Laotian, Pashto, Vietnamese, Tibetan) No African
(10) (11, 12) (13) (14) (15) (16)
Nth & Sth East Asian
(17)(18)(19)(20)(21)(22)(25)
Middle Eastern
(12)(13)(14)(18)(19)(20)
Southern & Eastern Europe
(24)(12)(13)(14)(22)(18)(3)
Central American
(13)(19)
Tibetan(17).
Cambodian, Laotian, Vietnamese(18).
Syrian(20).
Common Mental Disorders General Health Questionnaire - Goldberg & Blackwell (1970) Designed for identifying psychiatric illness in Western general practice patients. 11 Several versions: 60, 30, 28 or 12 items measure depression, anxiety, social impairment, & hypochondriasis. Responses scored on 4 point Likert scale indicating presence or absence of symptoms. Cutoff scores vary according to version. 2–10 min to complete depending on version. Available in 38 languages. No Somalian(21)
Bosnian(22)
Kosovan(23)
Bhutanese(24)
No
Common Mental Disorders Centre for Epidemiologic Studies-Depression Scale - Radloff et al. (1977) Designed to measure current depressive symptoms in general populations. 10 20-item measure assessing symptoms of depression in past week. Responses scored on 4-point Likert scale. Suggested cut-off >16. 10–20 min to complete. Available in multiple languages. Yes Iraqi(25)
Syrian(28)
Iraqi, Lebanese, Yemenese(26)
Arabic(27)
Bosnian(28)
No
Common Mental Disorders Beck Depression Inventory - Beck (1961) Designed to detect/assess/monitor changes in depressive symptoms in clinical setting by trained professionals. 9 21 items of depression rated from 0 to 3 in terms of intensity. Suggested cut offs: minimal depression <10; mild-moderate depression 10–18; mod to severe depression 19–29; severe depression 30–63. 10–15 min to complete. Available in multiple languages. Yes Hmong(29)
Syrian(30)
Somalian(29)
Hmong(37)
Common Mental Disorders Kessler Psychological Scale - Kessler & Mroczek (1994) Developed to screen for distress/mental illness in Western populations. Has been adopted in Western and non-Western countries as a screening & outcome measure in primary care and mental health settings. 8 10 or 6 items measuring psychological distress over previous 4 weeks. Responses scored on 5 point Likert scale. Recommended cut-off scores: low to mild distress (10–20); moderate (22–29); severe (> = 30). 10 mins to complete. Available in multiple languages. Yes Iraqi(31, 32)
Kurdish(39)
Afghani(33)
Malian(34)
No
Common Mental Disorders Symptom Checklist-90 - Derogatis & Cleary (1977) Designed as mental health screening tool for Western clinical samples. 8 90 items; 10 subscales asking about anxiety, depression, somatization, hostility, interpersonal sensitivity, phobic anxiety, paranoid ideation, obsessive-compulsive ideation, psychoticism in past week. Responses scored on 5 point scale of distress. 15–30 min to complete. Available in multiple languages. No No Hmong(35)
Common Mental Disorders Self-Reporting Questionnaire - WHO (1995) Designed as psychiatric screening instrument for use in primary health care and/or community settings in low/middle income countries. 5 Depending on version, Items range from 5 to 20 asking about psychological and somatic symptoms in the past 30 days. Optimal cut-off considered to be 7/8. 5–10 min to complete. Available in multiple languages. Yes No No
Common Mental Disorders Internalized Stigma of Mental Illness Scale - Ristcher et al. (2003) Designed to measure internalized stigma within Western clinical samples. 3 29 items; 5 subscales measuring subjective experience of stigma. Responses scored on 4 point Likert scale. Higher total scores indicate greater internalized stigma. Completion time: n/a. Available in multiple languages. Yes Iraqi, Lebanese, Yemeni(39) Iraqi, Lebanese, Yemeni(39)
Common Mental Disorders Afghan Symptom Checklist - Miller et al. (2006) Designed to measure psychological distress within non-clinical samples of Afghanis. 2 23 items measuring well-being and distress in the previous 2 weeks. Responses scored on 5 point Likert scale. 10 mins to complete. Available in English & Dari. No Afghani(1) No
Common Mental Disorders Hospital Anxiety & Depression Scale - Zigmond & Snaith (1983) Designed for use in Western clinical & research settings. 2 14 items measuring cognitive & emotional aspects of depression and anxiety. Responses on 4-point Likert scale. 5 mins to complete. Available in multiple languages. No No No
Common Mental Disorders Augmented Anxiety Sensitivity Index -Hinton et al. (2006) Designed to measure culturally specific fears within Cambodian refugee outpatients in USA. 1 ASI: 16 items assessing fear of different anxiety symptoms. Responses scored on 5-point Likert scale. Augmented ASI: ASI with 9-item addendum assessing anxiety-related concerns. Completion time: n/a. Available in English & Cambodian. No Cambodian(36) No
Common Mental Disorders Beck Anxiety Inventory - Beck (1988) Designed to measure anxiety in adults and adolescents in clinical & research settings. 1 21 items of anxiety rated from 0 to 3 with total possible score of 63. Suggested cut-offs: 0–7: minimal anxiety; 8–15: mild anxiety; 16–25: moderate anxiety; >26: severe anxiety. 5–10 min to complete. Available in multiple languages. Yes No No
Common Mental Disorders Depression, Anxiety Stress Scale - Lovibond & Lovibond (1995) Designed to measure symptoms of depression, anxiety & stress in community settings. 1 20-item measure assessing symptoms of depression in past week. Responses scored on a 4-point Likert scale. Suggested cut-off >16. 10–20 min to complete. Available in multiple languages. Yes Arabic(34) No
Common Mental Disorders General Perceived Self-Efficacy Scale - Schwarzer & Jerusalem (1995) Designed to assess self-efficacy within Western non-clinical/clinical populations. 1 10 items assessing ability to cope with daily hassles and flexibility to adapt after experiencing stressful life event(s). Responses scored on 4 point Likert scale. Higher scores indicate stronger patient’s belief in self-efficacy. 2–10 min to complete depending on version. Available in multiple languages. No Afghani, Kurdish(8) No
Common Mental Disorders Mental Health Inventory - Veit & Ware (1983) Designed for use in general Western populations to detect mental health disorders. 1 18 items, consisting of two subscales: psychological distress (22 items) and psychological wellbeing (16 items). Responses scored on 6-point Likert scale. Higher scores reflect better mental health. 5–10 min to complete. Available in multiple languages. Yes Bosnian(37) No
Common Mental Disorders Patient Health Questionnaire - Spitzer & Williams (1994) Designed to measure depression & severity in Western clinical samples. 1 9 items measuring depressive disorder according to the DSM-IV. Responses scored on 4-point Likert scale indicating degree of severity. 5 mins to complete. Available in multiple languages. No No No
Common Mental Disorders Refugee Health Screener-15 -- Hollifield et al. (2013) Designed to screen common mental disorders in clinical samples of refugees. 1 15 items assessing distress, anxiety and depression. Items include 1 coping item, 13 symptom items and 1 distress thermometer. Responses scored on 5 point scale. Suggested cut-offs >12 or >5 on distress thermometer (postive cases). 5–10 min to complete. Available in 11 languages. Yes Burmese, Bhutanese, Iraqi(38) Burmese, Bhutanese, Iraqi(46)(39)
Common Mental Disorders Sheehan Disability Inventory - Sheehan (1983) Designed to assess functional impairment associated with anxiety disorder diagnosis in Western clinical samples. 1 3 items measuring impairment due to the disruption of daily activities in the areas of work, social life, family and home life due to current psychiatric symptoms. Responses scored on analogue scale from 1 to 10 with 10 being the lowest possible level of functioning. 5–10 min to complete. Available in 48 languages. Yes No No
Common Mental Disorders Vietnamese Depression Scale -Kinzie et al. (1982) Designed to measure depression among clinical samples of Vietnamese refugees. 1 15 items assessing depression and physical & psychological symptoms associated with depression. 6 depression items are culturally specific for Vietnamese population. Uses 3- and 4-point Likert scales. Optimal cut-off ≥13. 5–10 min to complete. Available in English & Vietnamese. No Vietnamese(40, 41) Vietnamese(48)(49)
Trauma/PTSD Harvard Trauma Questionnaire -Mollica et al. (1992) Designed for clinical samples of refugees. Must be modified and adapted to the characteristics of each cultural group. 62 4 parts: Part 1-measures 17 trauma items. Part 2- respondent describe most traumatic experience/event experienced during their refugee experience. Part 3- assesses likelihood of head injury. Part 4-measures 30 trauma symptoms. Scores of 2.5 or above considered “positive” for PTSD in Indochinese populations. 50–60 min to complete. Available in multiple languages. No African
(11)(12)(14)(15)(16)(42) (43)
Nthn & Sth East Asian
(11)(17)(20)(22)(44)(45)(46)
Middle Eastern
(12)(14)(21)(24)(44)(45)(54)
Sthn & Eastern Europe(12)(44)(14)(45)(17)
Central American(27)
Cambodian, Laotian & Vietnamese(52)(53)
Sub-Saharan Africa(50)
Chechen & Afghan(12)
Trauma/PTSD Posttraumatic Diagnostic Scale (PDS) -- Foa et al. (1996) Designed to provide brief self-report measure of PTSD in both clinical and research settings. 15 4 parts. Part 1-checklist of traumatic events that respondent may have experienced or witnessed. Part 2-Respondents indicate which event has disturbed them the most in past month. Part 3–17 PTSD symptoms items experienced in past month. Responses scored on 4-point Likert scale (0-not at all or only one time to 3-five or more times a week or almost always). 20 mins to complete. Language availability: English Yes Turkish, Iranian, Sri-Lankan, Bosnian, Afghani(46)
Iraqi(23)(46)
Asian, European, African(46)
Iraq, Lebanese, & Arab(33)
Ugandan & Somalian(47)
Syrian(28)
Asian, European, & African(60)
Kosovar(48)
Rwandan(49)
Trauma/PTSD Post Migration Living Difficulties Scale - Silove et al. (1998) Designed to assess current life stressors of asylum-seekers. 10 23 items to assess recent adverse life experiences typical of migration (eg. delays in processing applications, access to health & welfare, & stressor elated to resettlement). Responses scored on 5-point scale. 10–20 min to complete.
Languages: English.
No No Tamil(50)
Trauma/PTSD Posttraumatic Symptom Disorder Checklist - Weathers et al. (1993)
PCL-90
Designed to measure PTSD among non-clinical sample in USA. 7 17 items assessing DSM-IV PTSD symptoms. Responses on 5 point Likert scale as to how much these have been bothered by each item in past month. Some training is required to administer test. 5–10 min to complete. Language availability: English, Yes No Somali & Oromo(51)
Darfuri(52)
Trauma/PTSD Impact of Events Scale-Revised - Horowitz et al. (1979) Designed to measure current subjective distress related to a specific event among Western clinic samples. 5 15 items related to a particular event. 7 items measure intrusiveness & 8 items measure avoidance. Responses scored on 4-point Likert scale according to how often each item has occurred in past 7 days. 45–60 min to complete. Available in multiple languages. Yes Chechyan, Afghani & West African(12).
Middle Eastern(53).
Bosnian(54).
Middle East, Central Africa, Sth Asia & Sth E Europe(10).
Somalian(55)
Chechyan, Afghani & West African(12)
Trauma/PTSD Comprehensive Trauma Inventory-104 - Hollifield et al. (2005) Designed for use within community samples of refugee. 4 104 items; 12 scales assessing range of traumatic events (eg psychological & physical injury, detention, intentional abuse, deprivation, discrimination). Responses scored on 5-point Likert scale whether or not the event was experienced and, if so, how much impact the event had. 60 mins to complete. Available in English, Kurdish, Vietnamese. Yes Kurdish & Cambodian(56) Kurdish & Cambodian(70)
Trauma/PTSD Cumulative Trauma Disorder Scale - Kira et al. (2012) Designed for use within clinical & non-clinical samples of refugees. 4 15 items measuring trauma symptoms (eg depression, anxiety, somatization) in previous month. Responses on 5 point scale. 10 mins to complete. Languages: English, No Iraqi, Lebanese & Yemeni(57)
Arabic(34)
Iraqi(71)
Trauma/PTSD HADStress - Westermeyer et al. (2010) Designed to measure somatic symptoms within community sample of Somali refugees living in USA. 4 4 items measuring somatic symptoms: headaches, appetite change, dizziness and sleep problems. Responses on 0–4 scale with higher scores indicating more somatic symptoms. Cut off score of >3 recommended. 10 mins to complete. Languages: English, No No Somalian(58)
Ethiopian(59)
Trauma/PTSD Post Traumatic Growth Inventory - Tedeschi & Calhoun (1996) Designed to assess positive outcomes among traumatized non- clinic Western samples. 3 21 item assessing positive outcomes among those who have experienced traumatic events. Responses scored on 6 point scale. 5–10 min to complete. Available in multiple languages. Yes Arabic(67)
Yugoslavian(60)
Arabic(67)
Bosnian(61)
Trauma/PTSD Posttraumatic Symptom Scale - Holen et al. (1983) Designed in sample of German Armed Forces following a UN peace keeping mission to Cambodia to determine causes and scale of stress reactions. 3 10 or 16 items measuring PTSD symptoms in past 7 days according to DSM-III criteria. Presence or absence of symptoms is rated in Yes/No format. Sum of positive items used as total score. 10 mins to complete. Languages: English Yes Bosnian(62) No
Trauma/PTSD Annihilation Anxiety Scale - Kira et al. (2012) Designed for use in clinical settings as well as in research with severely traumatized populations, such as refugees. 2 3 items that assess annihilation anxiety. Responses are scored on 5 point Likert scale. 5 mins to complete. Languages: English, No Iraqi, Lebanese & Yemeni(34) Iraqi, Lebanese & Yemeni(34)
Trauma/PTSD Health Leaflet -Sondergaard et al. (2003) Designed to measure PTSD within community samples of refugees 2 15 items to screen for PTSD. Yes/No responses to items consisting of psychological symptoms, network and attitude towards the future in the new country and persecution. Suggested cut off = 10. 10 mins to complete. Languages: n/a. No No Iraqi(63)
Trauma/PTSD Minnesota Multiphasic Personality Inventory-2 and Minnesota Multiphasic Personality Inventory-2-RF - Tellegen & Ben-Porath (2008) Designed to assess personality traits and psychopathology among Western clinic samples. 2 MMPI-2: 567 items measuring personality and psychopathology, consisting of 8 validity scales, 10 clinical scales & 15 content scales. Responses are recorded as True/False.
MMPI-2-RF: 338 items from MMPI-2, including 9 validity scales.
25–90 min to complete depending on version. Available in multiple languages. Yes No Korean(64)
Vietnamese(65)
Trauma/PTSD Traumatic Life Events Questionnaire - Kubany (2000) Designed in general clinic western population for use in research, primary care or emergency rooms. 2 23-items measuring 22 types of potentially traumatic events. Responses scored on Likert scale range from “never” to “more than 5 times” and whether fear, helplessness or horror was present (“yes/no”). 10–15 min to complete. Available in English & Spanish. No No No
Trauma/PTSD Cambodian Somatic Symptom & Syndrome Inventory - Hinton et al. (2013) Designed for use in clinical samples of Cambodian refugees. Very specific to Cambodians. 1 23 items; 2 subscales assessing somatic symptoms & cultural syndromes in past week. Somatic subscale (12 items) & syndrome scale (11 items). Responses scored on 5 point Likert scale asking how much he/she was bothered by certain somatic symptoms & syndromes. 10 mins to complete.
Languages: English & Cambodian.
No Cambodian(66) Cambodian(80)
Trauma/PTSD Dissociative Experiences Scale - Carlson & Putnam (1986) Designed to measure dissociation in normal & clinic Western populations 1 28 items that assesses dissociative symptoms. Each item asks about the frequency (from Never to Always) that a particular dissociative symptom is experienced.
Scores of >20 indicate probable posttraumatic or dissociative disorders.
10 mins to complete. Available in multiple languages. Yes Ethiopian(51)
Bosnian(67)
No
Trauma/PTSD Posttraumatic Stress Disorder Interview for Vietnamese Refugees - Doa et al. (2012) Designed to assess trauma among clinic samples of Vietnamese refugees. 1 Part A: 30 items assessing pre-migration, migration, encampment, post-migration traumas. Yes/No response. ‘Yes’ response to Part A item(s), respondent proceeds to Part B which assesses PTSD criteria. Completion time: n/a. Available in English & Vietnamese. No Vietnamese(68) Vietnamese(82)
Trauma/PTSD Primary Care Post-Traumatic Stress Disorder Screen - Prins et al. (2003) Designed for use in primary care and other medical settings. 1 5 items assessing dimensions of PTSD (re-experiencing, numbing, avoidance, hyperarousal) with Yes/No response options. 5 mins to complete. Language availability: English, Yes No No
Trauma/PTSD Resettlement Stressor Scale - Clarke et al. (1993) Designed to measure stressors faced within a community sample of Cambodian refugee adolescents. 1 32 items assessing trauma events in migration/present settlement. Responses scored on 5-point scale. 10–20 min to complete. Avail in English & Cambodian. Yes No Cambodian(69)
Trauma/PTSD War Trauma Scale -Clarke et al. (1993) Designed for use within clinical samples of Cambodian adolescent refugees that had lived through the Pol Pot regime. 1 42 items measuring traumatic experiences inflicted by Pol Pot regime. Items are all worded in relation to Pol Pot era. 20–30 min to complete. Available in English & Cambodian. No Cambodian(83) Cambodian(83)
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