Measurement
Outcome measures
‘Psychological distress’ was measured with the 12-item General Health Questionnaire (GHQ-12). The GHQ23,24 is a generic self- assessment measure of poor mental health, developed for screening of mental health problems in a community setting. The GHQ-1225 assesses psychological distress, such as anxiety and depression. A GHQ-12 score was obtained by summing item scores. Psychological distress was defined as scores of