ArticleBelitung nursing journal2026
Psychological distress: Bifactor modeling of the DASS-21 in Chilean healthcare workers.
Article in Belitung nursing journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The Depression, Anxiety, and Stress Scale (DASS-21) is widely used to assess mental health symptoms; however, its dimensionality in working populations, particularly healthcare workers, remains under debate. Objective: This study aimed to examine the dimensional structure of the DASS-21 among Chilean healthcare workers to evaluate its suitability as a screening measure of psychological distress in occupational contexts exposed to crises, emergencies, or disasters. Methods: A cross-sectional survey was conducted in 2021 using a non-probabilistic convenience sample of 239 healthcare workers from a hospital in northern Chile. Confirmatory factor analyses were conducted to test four competing models (unidimensional, three correlated factors, second order, and bifactor) using structural equation modeling. Model fit was evaluated using RMSEA, CFI, and TLI, complemented by auxiliary bifactor indices (ECV, ωH, ωHS, PUC, ARPB). Results: All models showed acceptable fit (RMSEA = 0.038-0.065; CFI = 0.974-0.992; TLI = 0.971-0.990). Although the bifactor model demonstrated the best global fit, auxiliary indices supported the dominance of a general factor (ECV = 0.87; ωH = 0.94), with limited reliable variance attributable to the specific factors (ωHS ≤ 0.16). Measurement invariance across sex was supported. Conclusions: In this non-clinical sample characterized by low symptom severity, the DASS-21 operates primarily as an essentially unidimensional measure of psychological distress. From a nursing practice perspective, the total score may be used as a parsimonious screening indicator to support early detection, monitoring, and preventive mental health strategies among healthcare workers.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.