Tailoring anxiety assessment for Parkinson's disease: The Chinese Parkinson anxiety scale with cultural and situational anxiety considerations

Abstract

Recognizing the gap in mental health assessment, particularly in evaluating anxiety among Parkinson's disease (PD) patients, with an emphasis on cultural context and PD-specific situational anxiety. This study aimed to refine the Parkinson Anxiety Scale (PAS) and emphasized the importance of health equity by addressing cultural context and PD-specific situational anxiety. The revised version, named the Chinese Parkinson Anxiety Scale (CPAS), was developed to include PD-specific situational anxiety and culturally relevant items, addressing the unique challenges faced by the Eastern PD population. The CPAS was designed to reflect Eastern cultural nuances and PD-specific anxiety factors. Involving 138 PD patients and 122 healthy controls, the study assessed participants using the CPAS, Beck Anxiety Inventory (BAI), and Activities of Daily Living (ADL) scale. The scale's reliability (i.e., internal consistency and test-retest reliability) and validity (i.e., construct, concurrent, convergent, and discriminate validity) were rigorously evaluated. The CPAS demonstrated excellent internal consistency (Cronbach's alpha = 0.954) and test-retest reliability (Intraclass Correlation Coefficient = 0.77). It showed significant concurrent validity, evidenced by notable differences between PD patients and healthy controls. The scale also exhibited convergent solid validity with the BAI (r = 0.585; p < 0.001) and acceptable discriminant validity with the ADL (r = −0.086; p = 0.166). The inclusion of PD situational anxiety items was a key addition, showing a more significant impact on PD patients than the original scale factors. With its robust psychometric properties and culturally sensitive approach, the CPAS emerges as a comprehensive tool for assessing anxiety in the Chinese PD population, advancing both clinical care and health equity.