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c
teristics
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sin
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tes
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K
ey
w
o
r
d
s
:
Dem
o
g
r
ap
h
ic
f
ac
to
r
Facto
r
s
tr
u
ctu
r
e
GHQ
-
12
Me
n
tal
h
ea
lth
Pro
s
p
ec
tiv
e
b
io
lo
g
y
teac
h
er
s
T
h
is i
s
a
n
o
p
e
n
a
c
c
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ss
a
rticle
u
n
d
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r th
e
CC B
Y
-
SA
li
c
e
n
se
.
C
o
r
r
e
s
p
o
nd
ing
A
uth
o
r
:
Sit
i Z
u
b
aid
ah
Dep
ar
tm
en
t o
f
B
io
lo
g
y
,
Facu
lt
y
o
f
Ma
th
e
m
atics a
n
d
Natu
r
al
Scien
ce
s
,
Un
iv
er
s
itas
Neg
er
i M
alan
g
St.
Sem
ar
an
g
,
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.
5
,
Ma
lan
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,
E
ast J
av
a,
I
n
d
o
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E
m
ail:
s
iti.zu
b
aid
ah
.
f
m
ip
a@
u
m
.
ac
.
id
1.
I
NT
RO
D
UCT
I
O
N
T
h
e
g
lo
b
al
h
ea
lth
q
u
esti
o
n
n
ai
r
e
(
GHQ)
was
f
ir
s
t
d
ev
elo
p
ed
b
y
Go
ld
b
e
r
g
to
ass
ess
a
p
e
r
s
o
n
'
s
s
elf
-
r
ep
o
r
ted
m
en
tal
h
ea
lth
co
n
d
itio
n
[
1
]
–
[
3
]
.
T
h
er
e
a
r
e
s
ev
e
r
al
v
er
s
io
n
s
o
f
GHQ
b
ased
o
n
th
e
n
u
m
b
e
r
o
f
item
s
in
clu
d
in
g
GHQ1
,
GHQ1
2
,
G
HQ2
0
,
GHQ2
8
,
GHQ3
0
,
an
d
GHQ6
0
as
th
e
o
r
ig
in
al
v
er
s
io
n
[
4
]
,
[
5
]
.
Ho
wev
er
,
th
e
m
o
s
t
p
o
p
u
lar
s
h
o
r
t
v
e
r
s
io
n
u
s
ed
is
GHQ1
2
f
o
r
a
n
u
m
b
er
o
f
r
ea
s
o
n
s
,
n
am
el
y
ea
s
e
o
f
u
s
e,
r
ep
o
r
tin
g
f
o
r
m
at
[
6
]
–
[
9
]
,
s
im
p
licity
[
1
0
]
,
[
1
1
]
,
g
o
o
d
r
eliab
ilit
y
[
1
2
]
,
[
1
3
]
,
an
d
g
o
o
d
s
p
ec
if
icity
[
1
4
]
,
[
1
5
]
.
On
th
e
o
th
er
h
a
n
d
,
alth
o
u
g
h
th
is
in
s
tr
u
m
en
t
h
as
b
ee
n
wid
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ap
p
lied
in
d
if
f
er
e
n
t
p
o
p
u
latio
n
s
in
v
ar
io
u
s
co
u
n
tr
ies,
b
o
th
b
ased
o
n
ag
e
g
r
o
u
p
s
in
clu
d
in
g
teen
a
g
er
s
[
8
]
an
d
m
atu
r
e
[
1
6
]
as
well
as
o
cc
u
p
atio
n
al
g
r
o
u
p
s
s
u
ch
as
teac
h
er
s
[
4
]
an
d
civ
il
s
er
v
an
ts
[
1
]
,
h
o
wev
er
,
th
e
s
tr
u
ctu
r
e
o
f
GHQ1
2
is
s
till
u
n
co
n
v
i
n
cin
g
an
d
p
r
o
n
e
to
co
n
tr
o
v
e
r
s
y
[
1
7
]
,
[
1
8
]
.
T
h
e
o
r
ig
in
al
v
e
r
s
io
n
o
f
th
e
GHQ1
2
was
u
n
id
im
en
s
io
n
al,
u
n
f
o
r
t
u
n
ately
,
th
er
e
is
litt
le
to
s
u
p
p
o
r
t
th
e
f
in
d
in
g
s
u
s
in
g
s
u
ch
a
s
in
g
le
f
ac
t
o
r
[
1
9
]
,
[
2
0
]
.
T
h
e
u
n
id
im
e
n
s
io
n
al
v
er
s
io
n
is
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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6
I
n
t J Pu
b
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Hea
lth
Sci
,
Vo
l.
14
,
No
.
1
,
Ma
r
ch
20
25
:
1
37
-
1
4
7
138
q
u
esti
o
n
ab
le
r
e
g
ar
d
i
n
g
its
ab
ilit
y
to
p
r
o
v
id
e
s
u
f
f
icien
t
in
f
o
r
m
atio
n
[
1
9
]
.
Me
a
n
wh
ile,
a
n
u
m
b
er
o
f
o
th
er
s
tu
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ies
p
r
o
ject
GHQ1
2
in
to
t
wo
o
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th
r
ee
f
ac
to
r
s
[
4
]
,
[
5
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.
T
h
er
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o
r
e
,
ex
p
l
o
r
atio
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a
n
d
v
e
r
if
icatio
n
o
f
th
e
f
ac
to
r
s
tr
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ctu
r
e
o
f
th
e
GHQ
-
1
2
s
h
o
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ld
b
e
ex
am
in
e
d
in
n
ew
p
o
p
u
l
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s
to
en
s
u
r
e
its
r
eliab
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is
s
im
ilar
to
th
at
o
f
th
e
o
r
ig
in
a
l
v
er
s
io
n
.
I
n
I
n
d
o
n
esia,
litt
le
r
esear
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as
f
o
cu
s
ed
o
n
th
e
im
p
lem
en
t
atio
n
o
f
GHQ1
2
[
2
1
]
,
[
2
2
]
.
I
n
ad
d
itio
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,
th
er
e
ar
e
lim
itatio
n
s
th
at
cu
r
r
en
tly
p
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t
its
u
s
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in
th
e
co
n
tex
t
o
f
s
tu
d
en
t
B
io
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g
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teac
h
er
s
.
First,
r
esear
ch
b
y
Pra
b
o
wo
et
a
l
.
[
2
2
]
co
v
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s
th
e
f
em
ale
p
o
p
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latio
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in
th
e
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o
f
th
e
p
an
d
e
m
ic
an
d
An
jar
a
et
a
l
.
[
2
1
]
in
clu
d
es
clin
ical
p
atien
ts
.
I
n
th
is
s
tu
d
y
,
we
ex
p
lo
r
e
d
th
e
p
o
p
u
latio
n
o
f
p
r
o
s
p
ec
tiv
e
B
io
lo
g
y
teac
h
er
s
tu
d
e
n
ts
.
Seco
n
d
,
th
e
av
e
r
ag
e
a
g
e
o
f
t
h
e
s
am
p
le
in
Pra
b
o
wo
et
a
l
.
[
2
2
]
r
esear
c
h
is
2
9
y
ea
r
s
o
ld
an
d
An
jar
a
et
a
l
.
[
2
1
]
s
tu
d
y
is
4
6
y
ea
r
s
o
ld
,
o
u
r
p
o
p
u
latio
n
is
r
e
p
r
esen
ted
b
y
t
ea
ch
er
ca
n
d
id
ates
wh
o
a
r
e
m
u
ch
y
o
u
n
g
er
b
y
an
av
er
ag
e
o
f
2
0
y
ea
r
s
.
On
th
e
o
th
er
h
an
d
,
th
e
r
e
ar
e
asp
ec
ts
th
at
n
ee
d
to
b
e
c
o
n
s
id
er
ed
wh
en
u
s
in
g
q
u
esti
o
n
n
air
es,
f
o
r
ex
am
p
le,
th
e
ch
ar
ac
ter
is
tics
o
f
th
e
r
esear
ch
s
am
p
le,
th
e
n
ee
d
f
o
r
v
alid
ated
lan
g
u
ag
e
tr
an
s
latio
n
s
,
an
d
th
e
p
s
y
ch
o
m
etr
i
c
p
r
o
p
er
ties
o
f
t
h
e
in
s
tr
u
m
en
t
[
4
]
.
Ps
y
ch
o
m
etr
ic
p
r
o
p
er
ties
m
ay
v
ar
y
a
m
o
n
g
g
r
o
u
p
s
with
d
if
f
er
en
t
c
u
ltu
r
es
[
7
]
.
T
h
u
s
,
it
wo
u
ld
b
e
a
m
is
tak
e
to
tr
a
n
s
late
p
s
y
ch
o
m
etr
ic
f
in
d
in
g
s
o
b
t
ain
ed
f
r
o
m
an
ad
u
lt
p
o
p
u
latio
n
to
a
s
tu
d
en
t
teac
h
e
r
p
o
p
u
latio
n
as
in
th
is
s
tu
d
y
.
T
h
is
d
ef
icien
cy
i
n
d
icate
s
th
e
n
ee
d
f
o
r
r
esear
c
h
to
d
etec
t
th
e
f
ac
to
r
s
tr
u
ctu
r
e
o
f
GHQ1
2
th
r
o
u
g
h
in
v
esti
g
atio
n
s
o
f
p
r
o
s
p
ec
tiv
e
B
io
lo
g
y
teac
h
er
s
.
Alth
o
u
g
h
is
s
u
es
r
elate
d
to
m
en
tal
h
ea
lth
ar
e
c
o
m
m
o
n
am
o
n
g
m
a
n
y
g
r
o
u
p
s
,
co
n
ce
r
n
s
ab
o
u
t
s
tu
d
en
t
teac
h
e
r
s
an
d
th
eir
im
p
ac
t
o
n
th
eir
ac
a
d
em
i
c
wo
r
k
ar
e
o
f
in
d
iv
id
u
al
a
n
d
s
o
cial
s
ig
n
if
ica
n
ce
[
2
3
]
.
Dis
cu
s
s
io
n
s
o
f
m
en
tal
h
ea
lth
an
d
em
o
tio
n
al
c
o
m
p
eten
ce
o
f
p
r
o
s
p
ec
tiv
e
teac
h
er
s
h
av
e
b
ec
o
m
e
a
m
ajo
r
co
n
ce
r
n
[
2
4
]
–
[
2
7
]
.
Fac
to
r
s
th
at
ca
u
s
e
p
r
o
s
p
ec
tiv
e
te
ac
h
e
r
s
to
ex
p
er
ie
n
ce
m
en
tal
h
ea
lth
ar
e
b
e
h
av
io
r
m
an
ag
em
en
t,
ex
ce
s
s
iv
e
lear
n
in
g
l
o
ad
,
an
d
lack
o
f
s
u
p
p
o
r
t
f
r
o
m
th
e
en
v
ir
o
n
m
en
t
[
2
8
]
,
[
2
9
]
.
T
h
e
en
v
ir
o
n
m
en
tal
co
n
te
x
t
ca
n
h
a
v
e
an
im
p
ac
t
o
n
th
e
lev
el
o
f
m
en
tal
h
ea
lth
o
f
p
r
o
s
p
ec
tiv
e
tea
ch
er
s
[
3
0
]
.
An
o
th
e
r
m
ain
f
ac
to
r
is
t
h
e
lo
w
r
ea
d
i
n
e
s
s
o
f
p
r
o
s
p
ec
tiv
e
teac
h
er
s
wh
en
f
ac
e
d
with
p
r
ess
u
r
e
in
teac
h
in
g
a
n
d
class
r
o
o
m
m
an
ag
em
en
t
[
3
1
]
.
T
h
e
tr
a
n
s
itio
n
f
r
o
m
p
r
o
s
p
ec
tiv
e
teac
h
e
r
to
ed
u
ca
to
r
is
p
a
r
ticu
lar
ly
v
u
ln
er
ab
le
to
m
en
tal
h
ea
lth
d
ec
lin
e
[3
2]
.
Pre
p
a
r
in
g
m
en
tal
h
ea
lth
s
u
p
p
o
r
t f
o
r
th
is
g
r
o
u
p
is
cr
u
cial
to
en
s
u
r
in
g
teac
h
er
s
ar
e
p
r
ep
ar
ed
to
d
ea
l
with
s
tr
ess
in
th
e
class
r
o
o
m
[
3
3
]
.
I
t
s
h
o
u
ld
b
e
n
o
ted
th
at
th
is
r
esear
ch
f
o
c
u
s
es
o
n
s
u
p
p
o
r
tin
g
th
e
av
ailab
ilit
y
o
f
in
s
tr
u
m
e
n
ts
to
ev
alu
ate
th
e
m
en
tal
h
ea
lth
o
f
p
r
o
s
p
ec
tiv
e
B
io
lo
g
y
teac
h
er
s
as
an
ef
f
o
r
t
to
d
iag
n
o
s
e
an
d
p
r
e
v
en
t th
e
o
cc
u
r
r
en
ce
o
f
m
en
tal
h
ea
lt
h
d
is
o
r
d
er
s
wh
en
th
ey
b
ec
o
m
e
n
o
v
ice
teac
h
er
s
.
I
n
ad
d
itio
n
to
th
e
u
n
k
n
o
wn
f
a
cto
r
s
tr
u
ctu
r
e
o
f
th
e
GHQ1
2
,
s
tr
u
ctu
r
al
in
v
ar
ian
ce
am
o
n
g
d
e
m
o
g
r
ap
h
ic
f
ac
to
r
s
h
as
also
n
o
t
b
ee
n
id
en
tifie
d
.
I
n
o
th
er
wo
r
d
s
,
n
o
r
esear
ch
h
as
y
et
th
o
r
o
u
g
h
ly
test
ed
th
e
p
s
y
ch
o
m
etr
i
c
p
r
o
p
er
ties
o
f
t
h
e
GHQ1
2
at
th
e
item
lev
el
i
n
a
p
o
p
u
latio
n
o
f
p
r
o
s
p
ec
tiv
e
b
io
l
o
g
y
teac
h
er
s
.
T
o
f
ill
th
is
g
ap
,
th
e
p
r
esen
t
s
u
r
v
ey
u
s
es
th
e
GHQ1
2
to
an
aly
ze
t
h
e
f
ac
to
r
ial
s
tr
u
c
tu
r
e,
r
ig
o
r
o
u
s
ly
test
p
s
y
ch
o
m
e
tr
ics,
an
d
m
ea
s
u
r
e
th
e
m
en
tal
h
ea
lth
o
f
p
r
o
s
p
ec
tiv
e
b
io
l
o
g
y
teac
h
er
s
tu
d
en
ts
as
s
o
ciate
d
with
d
em
o
g
r
a
p
h
ic
f
a
cto
r
s
.
Dem
o
g
r
ap
h
ic
f
a
c
t
o
r
s
i
n
c
l
u
d
i
n
g
a
g
e
,
g
e
n
d
e
r
,
a
n
d
l
e
v
e
l
o
f
e
d
u
c
a
t
i
o
n
h
a
v
e
c
o
n
s
i
s
t
e
n
t
l
y
b
e
e
n
i
d
e
n
t
i
f
i
e
d
a
s
h
a
v
i
n
g
a
n
a
s
s
o
c
i
a
t
i
o
n
w
i
t
h
l
e
v
e
l
s
o
f
d
e
p
r
e
s
s
i
o
n
[
3
4
]
,
[
3
5
]
,
s
o
i
t
n
e
e
d
s
t
o
b
e
m
a
p
p
e
d
a
s
a
p
o
t
e
n
t
i
a
l
p
r
e
d
i
c
t
o
r
o
f
m
e
n
t
a
l
h
e
a
l
t
h
.
T
h
u
s
,
th
is
s
tu
d
y
h
as
th
r
ee
m
ain
o
b
jectiv
es
as
f
o
llo
ws:
i
)
ex
am
in
e
th
e
f
ac
to
r
s
tr
u
ctu
r
e
o
f
GHQ1
2
th
r
o
u
g
h
e
x
p
lo
r
at
o
r
y
f
ac
to
r
a
n
aly
s
is
(
E
FA
)
an
d
co
n
f
ir
m
at
o
r
y
f
ac
to
r
an
aly
s
is
(
C
FA
)
;
ii
)
test
th
e
i
n
ter
n
al
co
n
s
is
ten
cy
o
f
th
e
GHQ1
2
;
iii
)
m
ea
s
u
r
in
g
th
e
lev
el
o
f
m
e
n
tal
h
ea
lth
o
f
p
r
o
s
p
ec
tiv
e
teac
h
er
s
tu
d
en
ts
a
n
d
its
r
elatio
n
s
h
ip
with
d
em
o
g
r
ap
h
ic
ch
ar
ac
ter
is
tics
.
T
h
is
r
esear
c
h
is
ex
p
ec
te
d
to
p
r
o
v
id
e
b
r
o
a
d
er
em
p
ir
ical
d
ata
in
th
e
d
ev
elo
p
m
en
t
o
f
th
e
GHQ1
2
an
d
p
r
o
m
o
te
it
in
in
d
ep
en
d
e
n
t
m
en
tal
h
ea
lth
ass
ess
m
en
ts
i
n
th
e
p
o
p
u
latio
n
o
f
p
r
o
s
p
ec
tiv
e
teac
h
e
r
s
in
I
n
d
o
n
esia.
I
t
ca
n
n
o
t
b
e
d
en
ie
d
th
at
i
n
cr
ea
s
in
g
r
esear
ch
o
n
m
en
tal
h
ea
lth
h
as
also
h
ad
an
im
p
ac
t
o
n
in
cr
ea
s
in
g
d
em
an
d
f
o
r
v
alid
an
d
r
eliab
le
r
e
s
ea
r
ch
in
s
tr
u
m
en
ts
f
o
r
a
n
u
m
b
er
o
f
v
u
ln
er
a
b
le
g
r
o
u
p
s
.
T
h
i
s
e
v
a
l
u
a
t
i
o
n
i
s
v
e
r
y
i
m
p
o
r
t
a
n
t
a
s
a
b
a
s
i
s
f
o
r
p
l
a
n
n
i
n
g
,
i
m
p
l
e
m
e
n
t
i
n
g
a
n
d
a
s
s
e
s
s
i
n
g
h
o
w
p
r
o
s
p
e
c
t
i
v
e
t
e
a
c
h
e
r
s
c
a
n
r
e
c
e
i
v
e
s
o
c
i
a
l
e
m
o
t
i
o
n
a
l
l
e
a
r
n
i
n
g
e
d
u
c
a
t
i
o
n
a
s
m
e
n
t
a
l
h
e
a
l
t
h
s
u
p
p
o
r
t
a
p
p
r
o
p
r
i
a
t
e
l
y
[
3
6
]
–
[
3
8
]
.
2.
M
E
T
H
O
D
2
.
1
.
P
r
o
ce
du
re
T
h
is
r
esear
ch
h
as
r
ec
eiv
e
d
e
th
ical
ap
p
r
o
v
al
f
r
o
m
th
e
u
n
i
v
er
s
ity
wh
er
e
th
e
p
r
in
cip
al
i
n
v
esti
g
ato
r
wo
r
k
s
.
Af
ter
o
b
tain
in
g
th
e
ap
p
r
o
v
al,
a
p
r
elim
in
ar
y
s
tu
d
y
w
as
ca
r
r
ied
o
u
t
in
v
o
lv
in
g
f
o
u
r
p
r
o
s
p
ec
tiv
e
teac
h
er
s
as
p
o
ten
tial
p
ar
ticip
an
ts
to
o
b
tain
in
f
o
r
m
atio
n
o
n
t
h
e
r
ea
d
ab
ilit
y
o
f
th
e
GHQ1
2
in
s
tr
u
m
en
t
as
s
h
wo
n
in
T
ab
le
1
.
T
h
e
r
esear
ch
e
r
s
f
ir
s
t
m
et
d
ir
ec
tly
with
t
h
e
p
ar
tici
p
an
ts
to
ex
p
lain
th
e
p
u
r
p
o
s
e
o
f
th
e
r
esear
ch
,
th
e
s
ca
le
u
s
ed
,
an
d
h
o
w
to
r
esp
o
n
d
.
I
n
th
is
p
r
elim
in
ar
y
s
tu
d
y
,
th
e
f
ir
s
t
r
esear
ch
er
n
o
ted
s
ev
er
a
l
th
in
g
s
s
u
ch
as
th
e
tim
e
r
eq
u
ir
e
d
,
as
well
as
s
tat
em
en
ts
th
at
wer
e
s
till
co
n
s
id
er
ed
am
b
ig
u
o
u
s
an
d
d
if
f
icu
lt
f
o
r
p
ar
ticip
a
n
ts
to
u
n
d
er
s
tan
d
.
Fro
m
th
ese
r
esu
lts
,
it
was
r
ev
ea
led
th
at
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K
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[
4
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,
b
u
t
l
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t
h
a
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e
p
o
r
t
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d
b
y
M
o
n
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z
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r
i
e
t
a
l
.
[
3
9
]
w
h
i
c
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i
s
o
n
l
y
1
0
m
i
n
u
t
e
s
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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Hea
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N:
2252
-
8
8
0
6
R
ev
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A
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139
Af
ter
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p
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elim
in
a
r
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s
tu
d
y
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a
m
ain
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u
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tu
d
y
p
r
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am
wh
o
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ap
p
o
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ts
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h
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g
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taf
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p
er
s
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n
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th
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p
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in
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e
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r
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Nex
t,
th
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in
cip
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a
s
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r
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Go
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F
o
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lin
k
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at
p
a
r
ticip
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ts
n
ee
d
ed
to
f
ill
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t
to
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e
teac
h
in
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s
taf
f
.
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h
u
s
,
p
ar
ticip
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ts
wer
e
r
ec
r
u
ited
th
r
o
u
g
h
o
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lin
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p
o
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ts
in
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ed
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p
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n
am
ely
th
e
W
h
atsap
p
g
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o
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p
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wh
ich
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e
s
en
t b
y
teac
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in
g
s
taf
f
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s
t
u
d
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em
s
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I
n
th
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p
o
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t,
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a
n
u
m
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ex
p
lan
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ch
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r
ch
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b
jectiv
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an
d
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illi
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g
in
s
tr
u
ctio
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s
.
T
h
e
f
ir
s
t
p
ag
e
o
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th
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Go
o
g
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F
o
r
m
co
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ar
ticip
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is
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ch
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u
s
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r
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o
m
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leted
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u
esti
o
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air
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is
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n
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en
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T
h
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leted
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air
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to
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atica
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s
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b
m
itted
to
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o
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y
m
o
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s
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d
k
e
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t
co
n
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id
en
tial.
T
h
e
s
u
r
v
ey
p
er
io
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et
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p
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ately
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m
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u
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1
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to
J
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ly
1
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2
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2
3
to
p
r
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lex
ib
ilit
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in
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e
tim
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to
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s
u
r
v
ey
.
T
o
av
o
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u
p
lica
te
p
ar
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ts
,
th
e
Go
o
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F
o
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s
et
to
o
n
ly
p
r
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v
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e.
I
n
t
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tal,
1
,
2
5
5
q
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esti
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air
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wer
e
co
llected
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d
6
9
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h
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wer
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clu
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at
th
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d
id
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t m
ee
t t
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e
in
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s
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cr
iter
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T
ab
le
1
.
E
FA r
esu
lts
f
o
r
t
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s
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d
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o
p
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latio
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G
H
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1
2
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F
a
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F
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D
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r
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S
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o
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t
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l
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r
t
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7
3
6
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t
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t
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m 5
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n
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st
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7
5
7
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t
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C
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6
0
1
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t
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E
n
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to
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3
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t
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3
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5
2
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t
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1
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t
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9
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0
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7
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u
m
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t
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1
4
5
8
.
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8
1
K
M
O
0
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9
1
2
B
a
r
t
l
e
t
t
’
s
t
e
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t
o
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7
.
0
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/
6
6
S
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g
.
<
0
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0
0
1
2
.
2
.
P
a
rt
icipa
nts
T
h
is
r
esear
ch
em
p
lo
y
ed
a
n
o
n
-
r
an
d
o
m
p
u
r
p
o
s
iv
e
s
am
p
lin
g
t
ec
h
n
iq
u
e.
T
h
e
in
clu
s
io
n
cr
iter
ia
ap
p
lie
d
in
o
u
r
r
esear
ch
ar
e
as
f
o
llo
ws:
i
)
s
tu
d
en
ts
s
tu
d
y
in
g
i
n
th
e
b
io
lo
g
y
e
d
u
ca
tio
n
s
tu
d
y
p
r
o
g
r
a
m
;
ii
)
ag
r
ee
to
th
e
in
f
o
r
m
e
d
co
n
s
en
t
p
r
o
v
id
e
d
a
n
d
r
etu
r
n
th
e
co
m
p
lete
q
u
esti
o
n
n
air
e;
iii
)
d
id
n
o
t
r
ep
o
r
t
h
av
in
g
ex
p
er
ien
ce
d
m
en
tal
o
r
co
n
s
cio
u
s
d
is
o
r
d
er
s
in
th
e
last
m
o
n
th
.
Par
ticip
an
ts
in
v
o
lv
ed
in
th
is
r
esear
ch
wer
e
1
,
1
8
6
b
io
lo
g
y
ed
u
ca
tio
n
s
tu
d
e
n
ts
(
8
5
.
9
2
% f
e
m
ale)
.
W
h
en
th
e
s
u
r
v
e
y
was c
o
n
d
u
cte
d
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th
e
p
a
r
ticip
an
ts
ag
e
d
less
th
an
2
0
y
ea
r
s
wer
e
o
n
ly
3
8
2
s
tu
d
e
n
ts
(
3
2
.
2
1
%).
A
to
tal
o
f
1
1
3
(
9
.
5
3
%)
p
ar
ticip
an
ts
wer
e
s
tu
d
en
ts
w
h
o
wer
e
wo
r
k
in
g
.
J
u
d
g
in
g
f
r
o
m
th
e
y
e
ar
o
f
s
tu
d
y
,
1
3
9
n
ew
s
tu
d
en
ts
(
1
1
.
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2
%)
,
3
8
7
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ec
o
n
d
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y
ea
r
s
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d
en
ts
(
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2
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%),
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0
1
th
ir
d
-
y
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r
s
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d
en
ts
(
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3
.
8
1
%),
2
2
4
f
o
u
r
th
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ye
ar
s
tu
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e
n
ts
(
1
8
.
8
9
%),
an
d
3
5
f
if
th
-
y
ea
r
s
tu
d
e
n
ts
(
2
.
9
5
%).
W
e
f
o
llo
wed
eth
ical
co
n
s
id
er
atio
n
s
p
er
t
h
e
Helsin
k
i
Dec
lar
atio
n
,
ev
e
n
th
o
u
g
h
we
d
id
n
o
t
h
a
v
e
f
o
r
m
al
et
h
ical
clea
r
an
ce
.
B
ef
o
r
e
p
a
r
ticip
atin
g
i
n
th
e
r
esear
ch
,
all
p
a
r
ticip
an
ts
wer
e
f
u
lly
in
f
o
r
m
ed
a
b
o
u
t
th
e
s
tu
d
y
'
s
p
u
r
p
o
s
e,
p
r
o
ce
d
u
r
es
an
d
p
o
ten
tial
r
is
k
s
.
T
h
e
p
u
r
p
o
s
e
o
f
th
e
s
tu
d
y
was
co
m
m
u
n
icate
d
to
th
e
p
ar
ticip
an
ts
,
an
d
we
g
u
ar
an
t
ee
d
th
at
th
eir
r
esp
o
n
s
es
wo
u
ld
b
e
k
e
p
t
an
o
n
y
m
o
u
s
.
W
e
em
p
h
asized
th
at
p
ar
ticip
atio
n
was
v
o
lu
n
tar
y
a
n
d
th
at
p
ar
ticip
an
ts
co
u
ld
wi
th
d
r
aw
f
r
o
m
th
e
s
tu
d
y
at
an
y
tim
e
an
d
f
o
r
an
y
r
ea
s
o
n
.
I
n
ad
d
itio
n
,
all
p
ar
ticip
an
ts
wer
e
s
ec
u
r
e,
an
d
th
ey
wer
e
n
eith
er
p
h
y
s
ically
n
o
r
m
en
ta
lly
m
is
tr
ea
ted
.
2
.
3
.
M
ea
s
urem
ent
T
h
e
q
u
esti
o
n
n
air
e
g
iv
en
to
s
t
u
d
en
ts
in
clu
d
es
two
m
ain
p
ar
t
s
,
n
am
ely
g
en
er
al
s
itu
atio
n
an
d
GHQ1
2
.
Gen
er
al
s
itu
atio
n
s
in
clu
d
e
wo
r
k
in
g
s
tatu
s
,
g
en
d
er
(
m
ale
an
d
f
em
ale)
,
ag
e
(
less
th
an
2
0
y
ea
r
s
o
r
eq
u
al
to
o
r
m
o
r
e
th
an
2
0
y
ea
r
s
)
,
a
n
d
y
e
ar
o
f
s
tu
d
y
(
f
r
esh
m
an
,
s
ec
o
n
d
y
ea
r
,
t
h
ir
d
y
ea
r
,
f
o
u
r
th
y
e
ar
,
an
d
f
if
th
y
ea
r
)
.
(
GHQ1
2
)
ad
ap
te
d
f
r
o
m
L
ee
a
n
d
Kim
[
4
]
.
T
h
is
q
u
esti
o
n
n
air
e
h
as
b
ee
n
tr
an
s
lated
f
r
o
m
E
n
g
lis
h
to
I
n
d
o
n
esian
u
s
in
g
th
e
b
ac
k
-
to
-
b
ac
k
tr
an
s
l
atio
n
m
eth
o
d
.
T
h
e
tr
a
n
s
latio
n
r
esu
lts
ar
e
v
alid
ated
b
y
ex
p
er
t
lectu
r
er
s
in
th
e
f
ield
s
o
f
ev
alu
atio
n
an
d
lan
g
u
ag
e.
T
h
is
q
u
esti
o
n
n
a
ir
e
co
n
tai
n
s
1
2
item
s
,
s
co
r
ed
o
n
a
4
-
p
o
i
n
t
L
ik
er
t
s
ca
le
f
r
o
m
1
(
s
tr
o
n
g
l
y
d
is
ag
r
ee
)
to
4
(
s
tr
o
n
g
ly
a
g
r
ee
)
[
5
]
.
T
h
u
s
,
th
e
s
co
r
es
o
b
tain
ed
r
an
g
e
f
r
o
m
1
2
to
4
8
with
h
i
g
h
er
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
14
,
No
.
1
,
Ma
r
ch
20
25
:
1
37
-
1
4
7
140
s
co
r
es
in
d
icatin
g
wo
r
s
e
c
o
n
d
i
tio
n
s
.
GHQ
lev
els
ar
e
d
iv
id
e
d
in
to
4
ca
teg
o
r
ies
ad
ap
ted
f
r
o
m
L
iu
et
a
l
.
[
4
0
]
,
n
am
ely
1
2
-
2
0
(
h
ea
lth
y
)
,
2
1
-
2
9
(
f
air
ly
h
ea
lth
y
)
,
3
0
-
3
8
(
u
n
h
ea
lth
y
)
,
an
d
3
9
-
4
8
(
v
er
y
u
n
h
ea
lt
h
y
)
.
2
.
4
.
S
t
a
t
is
t
ica
l a
na
ly
s
is
T
h
e
1
,
1
8
6
p
ar
ticip
an
ts
wer
e
d
iv
id
ed
i
n
to
th
r
ee
p
ar
ts
wit
h
th
e
f
o
llo
win
g
d
etails.
T
h
e
f
ir
s
t
2
2
0
p
ar
ticip
an
ts
wer
e
tak
en
f
o
r
th
e
ex
p
lo
r
atio
n
s
tag
e
o
f
th
e
f
ac
to
r
ial
s
tr
u
ctu
r
e
o
f
th
e
s
tu
d
e
n
t p
o
p
u
latio
n
o
f
B
io
lo
g
y
teac
h
er
ca
n
d
id
ates.
T
h
e
n
e
x
t
2
1
6
p
ar
ticip
an
ts
wer
e
u
s
ed
f
o
r
th
e
f
ac
t
o
r
ial
co
n
f
ir
m
ato
r
y
an
aly
s
is
s
tag
e.
T
h
e
f
in
al
7
5
0
p
ar
ticip
an
ts
wer
e
p
r
ep
ar
ed
to
m
ea
s
u
r
e
th
e
GHQ1
2
s
co
r
es
o
f
p
r
o
s
p
ec
tiv
e
b
i
o
lo
g
y
teac
h
er
s
tu
d
en
ts
an
d
th
ei
r
r
elatio
n
s
h
ip
with
d
e
m
o
g
r
ap
h
ic
f
ac
t
o
r
s
.
T
h
e
a
n
aly
s
is
u
s
ed
in
th
e
f
ir
s
t
s
tag
e
is
E
FA
th
r
o
u
g
h
m
ain
f
ac
to
r
an
aly
s
is
(
PC
A)
.
T
est
th
e
ad
eq
u
ac
y
o
f
s
am
p
lin
g
u
s
in
g
th
e
B
ar
tlett
test
an
d
K
aiser
–
Me
y
er
–
Olk
in
(
KM
O)
.
T
h
e
n
u
m
b
e
r
o
f
f
a
c
t
o
r
s
r
e
t
a
i
n
e
d
w
a
s
a
s
s
e
s
s
e
d
b
a
s
e
d
o
n
e
i
g
e
n
v
a
l
u
e
s
>
1
.
T
h
e
v
a
r
i
m
a
x
r
o
t
a
t
i
o
n
t
e
c
h
n
i
q
u
e
w
a
s
u
s
e
d
t
o
i
n
t
e
r
p
r
e
t
t
h
e
r
o
t
a
t
i
o
n
s
t
r
u
c
t
u
r
e
.
I
t
e
m
s
a
r
e
r
e
t
a
i
n
e
d
i
f
t
h
e
i
t
e
m
l
o
a
d
i
n
g
f
a
c
t
o
r
v
a
l
u
e
i
s
e
q
u
a
l
t
o
o
r
m
o
r
e
t
h
a
n
0
.
5
[
5
]
.
Facto
r
ial
(
C
FA)
was
co
n
d
u
cted
to
ass
ess
v
ar
io
u
s
laten
t
s
tr
u
ctu
r
e
m
o
d
els
o
f
GHQ1
2
.
T
h
e
m
o
d
el
o
b
tain
ed
f
r
o
m
th
e
r
esu
lts
o
f
t
h
is
r
esear
ch
was
e
v
alu
ated
f
o
r
s
u
itab
ilit
y
u
s
in
g
a
n
u
m
b
er
o
f
in
d
ices
i
n
clu
d
in
g
ch
i
s
q
u
ar
e
(
χ
2
)
<3
[
4
1
]
;
c
o
m
p
ar
ativ
e
f
it
in
d
e
x
(
C
FI)
0
.
9
0
[
4
2
]
;
g
o
o
d
n
ess
-
of
-
f
it
i
n
d
ex
(
GFI
)
0
.
9
0
;
s
tan
d
ar
d
ized
r
o
o
t
m
ea
n
s
q
u
a
r
e
r
esid
u
al
(
SR
MR)
<0
.
0
8
[
4
3
]
,
r
o
o
t
m
ea
n
s
q
u
a
r
e
er
r
o
r
o
f
ap
p
r
o
x
im
atio
n
(
R
MSE
A)
<0
.
0
8
[
4
4
]
.
T
o
p
r
o
v
e
th
at
th
e
p
r
o
p
o
s
ed
m
o
d
el
h
as
a
s
a
tis
f
ac
to
r
y
m
o
d
el
f
it
co
m
p
ar
ed
to
o
th
e
r
alter
n
ativ
e
m
o
d
els,
th
is
r
es
ea
r
ch
was
also
c
o
m
p
ar
e
d
with
s
ev
er
al
o
th
e
r
m
o
d
els,
f
o
r
ex
am
p
le
th
e
u
n
id
im
en
s
io
n
al
m
o
d
el
b
y
Go
ld
b
er
g
[
2
]
,
two
f
ac
to
r
s
ar
e
co
r
r
elate
d
b
y
An
d
r
ich
an
d
Sc
h
o
u
b
r
o
ec
k
[
4
5
]
an
d
Go
u
v
eia
et
a
l
.
[
4
6
]
as
well
as
a
th
r
ee
-
f
ac
to
r
m
o
d
el
co
r
r
e
lated
b
y
Gr
ae
tz
[
4
7
]
,
Ma
r
tin
[
4
8
]
,
W
o
r
s
ley
an
d
Gr
ib
b
in
[
4
9
]
,
an
d
L
ee
a
n
d
Ki
m
[
4
]
.
A
lo
wer
Ak
aik
e'
s
in
f
o
r
m
atio
n
cr
iter
io
n
(
AI
C
)
in
d
icat
es
a
b
etter
m
o
d
el
f
it
[
4
]
.
Me
a
n
wh
ile,
in
ter
n
al
co
n
s
is
ten
cy
is
ca
lcu
lated
u
s
in
g
t
h
r
ee
p
a
r
am
eter
s
,
n
am
el
y
th
e
ass
ess
m
en
t
o
f
th
e
av
er
ag
e
v
a
r
ian
ce
r
elate
d
to
th
e
ex
tr
ac
ted
f
ac
to
r
s
(
AVE
)
0
.
5
0
[
5
0
]
,
c
o
m
p
o
s
ite
r
eliab
ilit
y
(
C
R
)
0
.
6
0
[
5
1
]
,
an
d
C
r
o
n
b
a
ch
α
0
.
7
0
[
5
2
]
s
u
g
g
ested
in
th
is
r
esear
ch
m
o
d
el
.
Fin
ally
,
we
s
u
m
m
ar
ized
th
e
GHQ1
2
s
co
r
es
o
f
p
r
o
s
p
ec
tiv
e
b
io
lo
g
y
teac
h
er
s
with
d
escr
ip
tiv
e
an
d
in
f
er
en
tial
s
tatis
tics
.
Descr
ip
ti
v
e
s
tatis
tics
in
th
e
f
o
r
m
o
f
f
r
e
q
u
en
cies
an
d
p
er
ce
n
tag
es
ar
e
u
s
ed
f
o
r
ca
teg
o
r
ica
l
(
d
em
o
g
r
ap
h
ic)
d
ata,
wh
ile
th
e
m
ea
n
an
d
s
tan
d
ar
d
d
ev
iatio
n
ar
e
f
o
r
th
e
s
co
r
es
f
o
r
ea
ch
f
ac
to
r
an
d
th
e
to
tal
GHQ1
2
.
Un
p
air
e
d
t
-
test
to
ca
l
cu
late
GHQ1
2
tr
aits
r
elate
d
t
o
f
ac
to
r
s
o
f
wo
r
k
in
g
s
tatu
s
,
g
en
d
er
,
an
d
a
g
e.
On
e
-
way
ANOV
A
was u
s
ed
to
d
if
f
er
en
tiate
GHQ1
2
s
co
r
es b
y
y
e
ar
o
f
s
tu
d
y
.
3.
RE
SU
L
T
S AN
D
D
I
SCU
SS
I
O
N
3
.
1
.
E
F
A
o
f
t
he
G
H
Q
-
12
T
h
e
r
esu
lts
o
f
E
FA
s
h
o
w
a
K
MO
v
alu
e
o
f
0
.
9
1
2
an
d
th
e
B
ar
tlett
te
s
t
with
χ
2/
d
f
=
1
2
7
7
.
0
6
2
/6
6
)
as
s
h
wo
n
in
T
ab
le
1
.
T
h
is
r
esu
lt
is
g
r
ea
ter
th
an
th
e
r
ec
o
m
m
en
d
ed
0
.
6
an
d
is
s
tati
s
tically
s
ig
n
if
ican
t
(
p
-
v
alu
e
<0
.
0
0
1
)
[
5
3
]
.
B
ased
o
n
eig
en
v
alu
es
an
d
ex
a
m
in
atio
n
o
f
th
e
s
cr
ee
p
l
o
t,
two
f
ac
to
r
s
wer
e
f
o
u
n
d
to
ex
p
lain
th
e
p
o
p
u
latio
n
o
f
p
r
o
s
p
ec
tiv
e
b
io
lo
g
y
teac
h
er
s
.
Facto
r
1
co
n
s
i
s
ts
o
f
6
item
s
in
clu
d
in
g
item
s
2
,
5
,
6
,
7
,
9
,
1
2
(
f
ac
to
r
l
o
ad
in
g
f
r
o
m
0
.
5
3
to
0
.
7
7
)
with
a
c
o
n
tr
ib
u
tio
n
o
f
4
9
.
7
1
%
o
f
v
ar
ia
n
ce
.
Facto
r
2
also
co
n
s
is
ts
o
f
6
item
s
in
clu
d
in
g
item
s
1
,
3
,
4
,
8
,
1
0
,
1
1
(
f
ac
to
r
lo
ad
in
g
f
r
o
m
0
.
5
5
to
0
.
7
9
)
with
a
co
n
tr
ib
u
tio
n
o
f
9
.
0
7
%
o
f
v
ar
ian
ce
.
I
n
to
tal,
th
e
co
n
tr
i
b
u
tio
n
o
f
th
ese
two
f
ac
to
r
s
ca
n
ex
p
lain
th
e
GHQ
o
f
p
r
o
s
p
ec
tiv
e
b
io
lo
g
y
teac
h
er
s
b
y
5
8
.
7
8
%.
3
.
2
.
Co
nfir
m
a
t
o
ry
f
a
ct
o
r
a
n
a
ly
s
is
E
v
alu
atio
n
ca
r
r
ie
d
o
u
t
with
(
C
FA)
u
s
in
g
two
co
r
r
elate
d
m
o
d
els
ac
h
iev
ed
t
h
e
b
est
s
u
itab
ilit
y
as
p
r
esen
ed
in
Fig
u
r
e
1
.
M
o
r
e
d
etails,
r
ate
χ
2
,
c
o
m
p
ar
ativ
e
f
it
in
d
ex
(
C
FI)
,
g
o
o
d
n
ess
-
of
-
f
it
in
d
ex
(
GFI
)
,
r
o
o
t
m
ea
n
s
q
u
a
r
e
e
r
r
o
r
o
f
a
p
p
r
o
x
im
atio
n
(
R
MSE
A)
,
s
tan
d
a
r
d
i
ze
d
r
o
o
t
m
ea
n
s
q
u
ar
e
r
esid
u
al
(
SR
MR)
ac
h
iev
e
v
alu
e
2
.
1
0
6
,
0
.
9
4
5
,
0
.
9
2
2
,
0
.
0
7
2
,
an
d
0
.
0
2
8
.
B
ased
o
n
th
e
c
r
iter
ia
u
s
ed
in
th
is
r
esear
ch
,
it
ca
n
b
e
s
aid
th
at
th
e
f
it
is
v
er
y
s
atis
f
ac
to
r
y
ac
r
o
s
s
all
m
o
d
el
f
it
in
d
ices.
Acr
o
s
s
s
am
p
les,
th
e
o
v
er
all
f
it
in
d
ices
o
f
th
e
eig
h
t
-
f
ac
to
r
m
o
d
els
wer
e
ex
am
in
ed
ac
r
o
s
s
s
am
p
les
u
s
in
g
v
ar
io
u
s
f
it
in
d
ices.
T
h
e
r
esu
lts
s
h
o
w
th
at
all
s
in
g
le,
two
,
an
d
th
r
ee
-
f
ac
to
r
m
o
d
els
ar
e
q
u
ite
ap
p
r
o
p
r
iate
an
d
ac
ce
p
tab
le.
Ho
wev
er
,
th
e
ev
alu
atio
n
ca
r
r
ied
o
u
t
u
s
in
g
th
e
m
en
tio
n
ed
m
o
d
el
f
it
in
d
ices
r
ev
ea
led
th
at
th
e
th
r
ee
m
o
d
els
p
r
o
p
o
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ed
in
th
is
s
tu
d
y
ac
h
iev
e
d
th
e
b
est
f
it
in
th
e
p
o
p
u
latio
n
o
f
p
r
o
s
p
ec
tiv
e
b
io
lo
g
y
T
ea
c
h
er
s
tu
d
e
n
ts
.
Ak
aik
e'
s
in
f
o
r
m
atio
n
cr
iter
io
n
(
AI
C
)
s
tatis
t
ics
f
u
r
th
er
co
n
f
ir
m
e
d
th
e
s
u
p
er
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r
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it
o
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t
h
e
p
r
o
p
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ed
th
r
ee
-
f
ac
to
r
m
o
d
el
(
m
o
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el
8
)
,
as
its
AI
C
was
1
6
1
.
4
9
5
,
w
h
ich
was
lo
wer
th
an
th
e
o
th
er
m
o
d
els te
s
ted
in
th
i
s
s
tu
d
y
as p
r
s
en
ted
i
n
T
ab
le
2
.
I
n
ter
n
al
c
o
n
s
is
ten
cy
with
ex
tr
ac
ted
f
ac
to
r
s
(
AVE
)
,
(
C
R
)
,
an
d
c
r
o
n
b
ac
h
'
s
α
also
s
h
o
wed
en
co
u
r
ag
in
g
r
esu
lts
with
s
co
r
es
as
s
h
wo
n
i
n
T
ab
le
3
.
T
h
e
AVE
v
alu
es
o
b
tain
ed
wer
e
0
.
4
7
1
a
n
d
0
.
4
0
5
,
wh
ile
th
e
C
R
an
d
c
r
o
n
b
ac
h
α
v
alu
es
r
ea
ch
ed
m
o
r
e
th
an
0
.
8
0
.
I
n
to
tal,
th
e
C
r
o
n
b
ac
h
α
v
alu
e
f
o
r
GHQ1
2
with
th
e
two
co
r
r
elate
d
m
o
d
els is
0
.
8
9
3
in
th
e
g
o
o
d
ca
teg
o
r
y
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
R
ev
a
lid
a
tio
n
o
f th
e
g
l
o
b
a
l
h
ea
lth
q
u
esti
o
n
n
a
ir
e
-
1
2
:
fa
ct
o
r
a
n
a
lysi
s
…
(
A
d
is
ti R
a
tn
a
p
u
r
i
)
141
Fig
u
r
e
1
.
T
wo
-
f
ac
to
r
co
r
r
elate
d
GHQ1
2
m
o
d
el
f
o
r
b
io
lo
g
y
p
r
o
s
p
ec
tiv
e
teac
h
er
s
T
ab
le
2
.
Go
o
d
n
ess
-
of
-
f
it in
d
ic
es f
o
r
GHQ
-
12
m
o
d
els in
C
FA
M
o
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e
l
s
k
χ
2
df
χ
2
/
d
f
C
F
I
G
F
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R
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EA
R
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R
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[
2
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k
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G
o
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[
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P
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t
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1
.
4
9
5
T
ab
le
3
.
I
n
ter
n
al
co
n
s
is
ten
cy
o
f
GHQ
1
2
with
2
-
f
ac
to
r
m
o
d
el
D
i
me
n
si
o
n
s
/
F
a
c
t
o
r
s
I
t
e
ms
M
a
r
k
AVE
CR
C
r
o
n
b
a
c
h
D
e
p
r
e
ss
i
o
n
2
0
.
5
5
7
0
.
4
7
1
0
.
8
4
0
0
.
8
4
3
5
0
.
8
1
9
6
0
.
7
1
0
7
0
.
5
9
5
9
0
.
7
3
6
12
0
.
6
6
7
S
o
c
i
a
l
d
y
sf
u
n
c
t
i
o
n
1
0
.
5
5
6
0
.
4
0
5
0
.
8
0
1
0
.
8
0
0
3
0
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5
3
9
4
0
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6
3
6
8
0
.
7
3
7
10
0
.
7
1
6
11
0
.
6
0
9
To
t
a
l
G
H
Q
1
2
0
.
8
9
3
3
.
3
.
Ass
o
cia
t
io
n wit
h G
H
Q
-
1
2
f
a
c
t
o
rs
T
h
e
to
tal
(
GHQ)
s
co
r
e
f
o
r
p
r
o
s
p
ec
tiv
e
b
io
lo
g
y
teac
h
e
r
s
is
2
7
.
8
0
5
.
8
5
p
o
in
ts
.
Sco
r
es
f
o
r
d
ep
r
ess
io
n
an
d
s
o
cial
d
y
s
f
u
n
ctio
n
ea
ch
a
m
o
u
n
ted
to
1
4
.
5
3
3
.
3
1
d
an
1
3
.
2
6
3
.
0
3
.
T
h
e
r
esu
lts
o
f
th
is
s
tu
d
y
also
s
h
o
w
th
at
o
n
ly
8
.
1
3
% o
f
s
tu
d
en
ts
ar
e
cla
s
s
if
ied
as h
ea
lth
y
,
5
7
.
4
7
% h
av
e
an
ad
eq
u
ate
lev
el
o
f
g
en
er
al
h
ea
lth
,
3
0
.
4
0
% a
r
e
class
if
ied
as
u
n
h
ea
lth
y
,
an
d
a
n
o
th
er
4
%
ar
e
class
if
ied
as
v
er
y
u
n
h
ea
lth
y
.
I
n
o
th
e
r
wo
r
d
s
,
o
n
e
-
th
ir
d
o
f
th
e
p
ar
ticip
an
ts
s
h
o
wed
wo
r
r
y
in
g
g
en
er
al
h
ea
lth
as sh
wo
n
in
T
a
b
le
4
.
T
ab
le
4
.
An
aly
s
is
o
f
GHQ1
2
d
eg
r
ee
s
S
c
o
r
e
G
H
Q
l
e
v
e
l
N
f
(
%)
12
-
20
H
e
a
l
t
h
y
61
8
.
1
3
21
-
29
P
r
e
t
t
y
h
e
a
l
t
h
y
4
3
1
5
7
.
4
7
30
-
38
N
o
t
h
e
a
l
t
h
y
2
2
8
3
0
.
4
0
39
-
48
V
e
r
y
u
n
h
e
a
l
t
h
y
30
4
.
0
0
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
14
,
No
.
1
,
Ma
r
ch
20
25
:
1
37
-
1
4
7
142
In
m
o
r
e
d
etail,
f
em
ale
s
tu
d
en
t
s
h
av
e
h
ig
h
er
GHQ1
2
s
co
r
es
th
an
m
ale
s
tu
d
e
n
ts
,
b
o
th
o
n
f
ac
to
r
s
1
,
2
an
d
to
tal.
T
h
e
r
esu
lts
o
f
s
ta
tis
tical
an
aly
s
is
s
h
o
w
th
at
th
e
d
if
f
e
r
en
ce
s
b
etwe
en
th
e
t
wo
ar
e
s
ig
n
if
ican
t.
Me
an
wh
ile,
ev
en
th
o
u
g
h
s
tu
d
en
ts
ar
e
o
f
ag
e
<2
0
s
h
o
we
d
h
ig
h
er
GHQ1
2
s
co
r
es
th
an
th
e
g
en
er
al
g
r
o
u
p
2
0
b
u
t d
id
n
o
t sh
o
w
a
s
ig
n
if
ican
t
d
if
f
er
en
ce
.
J
u
d
g
in
g
f
r
o
m
th
e
s
tatu
s
asp
ec
t,
s
tu
d
en
ts
with
s
tu
d
y
o
n
l
y
s
tatu
s
s
h
o
w
p
o
o
r
er
g
e
n
er
al
h
ea
lth
t
h
an
s
tu
d
en
ts
wh
o
also
wo
r
k
.
Ho
wev
er
,
th
e
r
esu
lts
o
f
th
e
u
n
p
air
ed
t
-
test
s
h
o
wed
th
at
o
n
ly
f
ac
to
r
1
(
d
ep
r
ess
io
n
)
was
s
ig
n
if
ican
tly
d
if
f
er
en
t.
Fin
ally
,
r
eg
ar
d
in
g
GHQ1
2
s
co
r
e
s
b
ased
o
n
y
ea
r
o
f
s
tu
d
y
,
f
o
u
r
th
y
ea
r
s
tu
d
en
ts
h
ad
lo
wer
s
co
r
es
co
m
p
a
r
ed
t
o
th
e
o
th
e
r
g
r
o
u
p
s
,
b
u
t
th
er
e
wer
e
n
o
s
ig
n
if
ican
t
d
if
f
er
en
ce
s
eith
er
i
n
ea
ch
f
ac
to
r
o
r
i
n
to
tal
as sh
wo
n
in
T
ab
l
e
5
.
T
ab
le
5
.
C
o
m
p
a
r
is
o
n
o
f
GHQ
s
co
r
es with
d
if
f
er
en
t
d
em
o
g
r
a
p
h
ic
ch
ar
ac
ter
is
tics
V
a
r
i
a
b
l
e
s
N
F
a
c
t
o
r
1
F
a
c
t
o
r
2
To
t
a
l
M
e
a
n
SD
t/F
M
e
a
n
SD
t/F
M
e
a
n
SD
t/F
G
e
n
d
e
r
F
e
mal
e
6
4
7
1
4
.
6
6
3
.
2
9
2
.
6
6
1
*
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1
3
.
3
7
3
.
0
2
2
.
4
1
2
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2
8
.
0
3
5
.
8
1
2
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7
5
6
*
*
M
a
l
e
1
0
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1
3
.
7
3
3
.
3
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2
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5
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t
a
t
u
s
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t
u
d
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l
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4
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3
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3
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5
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4
S
t
u
d
y
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n
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w
o
r
k
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1
3
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3
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.
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5
Y
e
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r
o
f
st
u
d
y
1
99
1
4
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4
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24
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7
I
n
th
is
s
tu
d
y
,
we
also
p
r
ed
icte
d
GHQ1
2
as
a
f
u
n
ctio
n
o
f
d
e
m
o
g
r
ap
h
ic
ch
a
r
ac
ter
is
tics
,
wh
er
e
g
en
e
r
al
h
ea
lth
was
th
e
d
ep
en
d
en
t
v
a
r
iab
le,
wh
ile
g
e
n
d
er
,
ag
e
,
s
tatu
s
,
an
d
y
ea
r
s
o
f
s
tu
d
y
we
r
e
p
r
e
d
icto
r
s
.
T
h
e
ca
lcu
latio
n
r
esu
lts
s
h
o
w
th
e
f
o
llo
win
g
e
q
u
atio
n
:
R
=0
.
1
3
5
;
R
2
=0
.
0
1
8
;
Du
r
b
in
–
W
atso
n
co
ef
f
icien
t
=0
.
0
3
7
;
Gen
d
er
:
β
=−
0
.
0
9
5
,
t=−
2
.
5
9
4
,
P=0
.
0
1
0
.
I
n
o
th
er
w
o
r
d
s
,
o
n
l
y
g
en
d
e
r
is
a
s
ig
n
if
ican
t
p
r
ed
i
cto
r
o
f
p
o
o
r
g
e
n
er
al
h
ea
lth
.
L
ea
r
n
i
n
g
s
tatu
s
(
β
=−
0
.
0
5
7
,
t=
−1
.
5
4
7
,
P=0
.
1
2
2
)
,
ag
e
(
β
=−
0
.
0
5
0
,
t=
−1
.
2
3
6
,
P=
0
.
2
1
7
)
,
an
d
y
ea
r
s
o
f
s
tu
d
y
(
β =−
0
.
0
2
7
,
t=−
0
.
6
8
2
,
P
=
0
.
4
9
5
)
tak
e
n
o
u
t
o
f
th
e
eq
u
a
tio
n
.
3
.
4
.
Dis
cus
s
io
n
T
h
is
s
tu
d
y
test
ed
th
e
p
s
y
ch
o
m
etr
ic
p
r
o
p
er
ties
o
f
th
e
I
n
d
o
n
es
ian
v
er
s
io
n
o
f
th
e
(
GHQ1
2
)
an
d
u
s
ed
it
to
r
esear
ch
p
r
o
s
p
ec
tiv
e
b
io
lo
g
y
teac
h
er
s
.
Alth
o
u
g
h
p
r
e
v
io
u
s
ly
th
er
e
wer
e
r
esear
ch
r
ep
o
r
ts
o
n
GHQ1
2
in
th
e
I
n
d
o
n
esian
p
o
p
u
latio
n
[
2
1
]
,
[
2
2
]
,
h
o
wev
e
r
,
as
f
a
r
as
we
k
n
o
w,
th
is
is
th
e
f
ir
s
t
s
tu
d
y
u
s
in
g
E
FA
an
d
C
FA
f
o
r
p
r
o
s
p
ec
tiv
e
b
io
lo
g
y
teac
h
er
s
.
W
e
s
tu
d
ied
th
e
f
ac
to
r
s
tr
u
ctu
r
e
o
f
th
e
I
n
d
o
n
e
s
i
a
n
v
e
r
s
i
o
n
o
f
t
h
e
G
H
Q
1
2
t
o
p
r
o
v
i
d
e
m
o
r
e
e
m
p
i
r
i
c
a
l
e
v
i
d
e
n
c
e
a
b
o
u
t
t
h
e
G
H
Q
1
2
i
n
s
t
r
u
m
e
n
t
a
n
d
p
r
o
g
r
e
s
s
i
n
m
e
a
s
u
r
i
n
g
m
e
n
t
a
l
h
e
a
l
t
h
i
n
B
i
o
l
o
g
y
t
e
a
c
h
e
r
c
a
n
d
i
d
a
t
e
s
a
s
a
v
u
l
n
e
r
a
b
l
e
g
r
o
u
p
t
h
a
t
i
s
r
a
r
e
l
y
e
x
p
o
s
e
d
.
E
FA
o
f
th
e
GHQ1
2
in
o
u
r
s
am
p
le
r
esu
lted
in
th
e
e
x
tr
ac
ti
o
n
o
f
two
f
ac
to
r
s
lab
e
led
as
d
ep
r
ess
io
n
(
f
ac
to
r
1
)
an
d
s
o
cial
d
y
s
f
u
n
cti
o
n
(
f
ac
to
r
2
)
.
B
o
th
ex
p
lain
ed
5
8
.
7
8
%
o
f
th
e
o
v
er
all
v
ar
ian
c
e,
an
d
4
9
.
7
1
%
an
d
9
.
0
7
%,
r
esp
ec
tiv
ely
.
T
h
ese
r
e
s
u
lts
r
ar
ely
s
ee
m
to
b
e
co
n
s
i
s
ten
t
with
p
r
ev
io
u
s
r
esear
ch
,
o
n
ly
a
f
ew
s
tu
d
ies
h
av
e
r
ea
c
h
ed
th
e
s
am
e
c
o
n
cl
u
s
io
n
,
n
am
ely
two
f
ac
to
r
s
[
4
5
]
,
[
5
4
]
,
[
5
5
]
.
T
h
is
E
FA
r
esu
lt
w
as
o
b
tain
ed
b
ec
au
s
e
it
was
ex
tr
ac
ted
b
ased
o
n
eig
en
v
alu
e
c
r
iter
ia
w
ith
o
u
t
b
ei
n
g
d
r
iv
en
b
y
th
eo
r
y
[
5
6
]
.
R
esear
ch
c
o
n
d
u
cted
b
y
An
d
r
ich
&
Sch
o
u
b
r
o
ec
k
[
4
5
]
f
o
u
n
d
two
d
im
en
s
io
n
s
b
ased
o
n
a
co
llectio
n
o
f
p
o
s
itiv
e
an
d
n
eg
ativ
e
wo
r
d
s
.
Me
an
wh
ile,
Sch
r
n
itz
e
t
a
l
.
[
5
5
]
an
d
Po
liti
et
a
l
.
[
5
4
]
f
o
u
n
d
two
f
ac
to
r
s
,
n
am
ely
an
x
iety
/d
ep
r
ess
io
n
/d
y
s
p
h
o
r
ia
an
d
s
o
cial
d
y
s
f
u
n
ctio
n
/s
o
cial
p
er
f
o
r
m
an
ce
.
I
n
o
th
er
w
o
r
d
s
,
t
h
e
two
-
fa
cto
r
s
tr
u
ctu
r
e
b
etter
f
its
th
e
GHQ1
2
in
a
s
am
p
le
o
f
p
r
o
s
p
ec
tiv
e
b
io
lo
g
y
teac
h
er
s
.
T
h
e
d
if
f
er
e
n
ce
s
in
f
ac
to
r
s
o
b
tain
ed
f
r
o
m
a
n
u
m
b
er
o
f
s
tu
d
ies
v
a
r
y
b
o
th
in
ter
m
s
o
f
item
d
is
tr
ib
u
ti
o
n
an
d
f
ac
to
r
n
am
in
g
,
p
er
h
ap
s
in
f
lu
en
ce
d
b
y
n
o
r
m
s
an
d
s
o
ci
o
-
cu
ltu
r
al
v
alu
es.
Ou
r
C
FA
f
in
d
in
g
s
b
y
co
m
p
ar
in
g
s
ev
en
o
th
er
m
o
d
els
[
2
]
,
[
4
]
,
[
4
5
]
–
[
4
9
]
s
h
o
ws
th
at
o
n
ly
th
e
m
o
d
el
we
p
r
o
p
o
s
ed
as
an
E
FA
r
esu
lt
with
a
g
o
o
d
g
o
o
d
n
ess
-
of
-
f
i
t
in
d
ex
.
C
FA
u
s
es
m
an
y
f
itn
ess
in
d
ices
s
o
th
e
r
esu
lts
ar
e
m
o
r
e
ac
cu
r
a
te
th
an
E
FA
[
5
7
]
.
T
h
u
s
,
th
e
o
v
e
r
al
l
C
FA
r
ev
ea
led
th
at
th
e
o
r
ig
in
al
u
n
id
im
en
s
io
n
al
m
o
d
el
as
th
e
in
itial
f
o
r
m
o
f
th
e
GHQ1
2
,
an
d
th
e
two
-
f
ac
t
o
r
an
d
th
r
ee
-
f
ac
to
r
m
u
ltid
im
e
n
s
io
n
al
m
o
d
els
as
d
ev
elo
p
m
e
n
ts
in
th
e
c
u
r
r
en
t
s
tu
d
y
,
p
r
o
v
ed
to
b
e
less
s
u
ita
b
le
with
lo
w
in
cr
em
e
n
tal
in
d
ices.
Viewe
d
f
r
o
m
o
th
er
asp
ec
ts
,
th
e
co
r
r
elatio
n
b
etwe
en
th
e
two
f
ac
t
o
r
s
is
m
o
d
er
ate,
r
e
f
lectin
g
th
e
lo
w
am
o
u
n
t
o
f
co
v
ar
ian
ce
.
T
h
ese
r
esu
lts
f
u
r
th
er
s
u
p
p
o
r
t
th
at
th
e
two
-
f
ac
to
r
m
o
d
el
in
o
u
r
s
tu
d
y
ca
n
b
e
th
e
b
est
ex
p
lan
atio
n
o
f
m
en
tal
h
ea
lth
in
a
s
am
p
le
o
f
p
r
o
s
p
ec
tiv
e
b
io
lo
g
y
teac
h
er
s
.
T
h
e
f
in
d
in
g
s
in
t
h
is
s
tu
d
y
s
h
o
w
th
e
GHQ1
2
with
s
atis
f
ac
to
r
y
in
ter
n
al
co
n
s
is
ten
cy
f
o
r
p
r
o
s
p
ec
tiv
e
b
io
lo
g
y
teac
h
er
s
in
I
n
d
o
n
esia,
wh
ich
is
s
im
ilar
to
s
co
r
es
r
ep
o
r
ted
in
o
t
h
er
p
o
p
u
lati
o
n
s
[
4
]
.
R
eliab
ilit
y
esti
m
ates
v
ia
C
r
o
n
b
ac
h
alp
h
a
an
d
C
R
f
o
r
ea
c
h
f
ac
to
r
a
n
d
th
e
t
o
tal
r
an
g
e
d
f
r
o
m
g
o
o
d
to
v
er
y
g
o
o
d
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
R
ev
a
lid
a
tio
n
o
f th
e
g
l
o
b
a
l
h
ea
lth
q
u
esti
o
n
n
a
ir
e
-
1
2
:
fa
ct
o
r
a
n
a
lysi
s
…
(
A
d
is
ti R
a
tn
a
p
u
r
i
)
143
Me
an
wh
ile,
th
e
AVE
v
alu
e
i
s
lo
wer
th
an
th
e
r
ec
o
m
m
en
d
ed
v
alu
e
.
A
l
o
w
AVE
r
elate
s
m
o
r
e
to
a
r
u
le
o
f
th
u
m
b
th
a
n
to
a
s
tatis
tical
test
i
n
g
p
r
o
ce
d
u
r
e;
f
o
r
ex
am
p
le
d
if
f
er
en
t sam
p
lin
g
[5
8]
.
T
h
is
r
esear
ch
in
v
o
lv
e
d
r
esp
o
n
d
en
ts
wh
o
wer
e
m
o
s
tly
wo
m
e
n
,
ag
ed
2
0
y
ea
r
,
ju
s
t
s
tu
d
y
in
g
with
o
u
t
wo
r
k
in
g
,
an
d
in
t
h
e
s
ec
o
n
d
y
e
ar
.
Ou
r
r
esu
lts
s
h
o
wed
th
at
th
er
e
wer
e
s
ig
n
if
ican
t
d
if
f
e
r
en
ce
s
b
etwe
en
m
en
an
d
wo
m
en
o
n
th
e
f
ac
to
r
s
a
n
d
o
v
e
r
all
s
co
r
es.
I
n
o
th
er
wo
r
d
s
,
b
ei
n
g
f
em
ale
was
s
ig
n
if
ican
tly
as
s
o
ciate
d
with
b
o
th
d
ep
r
ess
io
n
an
d
s
o
cial
d
y
s
f
u
n
ctio
n
f
ac
to
r
s
co
r
es.
T
h
e
r
esu
l
ts
o
f
th
is
r
esear
ch
ar
e
in
lin
e
with
a
n
u
m
b
e
r
o
f
p
r
ev
io
u
s
s
tu
d
ies
[
5
9
]
–
[
6
1
]
,
b
u
t it
co
n
tr
ad
icts
o
th
er
r
esear
ch
[
6
2
]
–
[
6
4
]
.
Pro
wse
et
a
l
.
[
6
5
]
r
e
p
o
r
ted
th
at
wo
m
en
wer
e
m
o
r
e
lik
el
y
to
r
e
p
o
r
t
p
h
y
s
ical
an
d
em
o
tio
n
al
s
y
m
p
t
o
m
s
r
elate
d
to
s
tr
ess
ex
p
er
ie
n
ce
d
th
an
m
en
.
Me
n
r
ep
o
r
tin
g
lo
w
lev
el
s
o
f
s
tr
ess
ar
e
less
lik
ely
to
b
e
ac
tiv
e
in
eli
m
in
atin
g
an
d
m
an
a
g
in
g
s
tr
ess
[
6
6
]
.
Ap
ar
t
f
r
o
m
th
at,
it
is
v
iewe
d
f
r
o
m
an
o
t
h
er
asp
ec
t,
n
am
ely
w
o
r
k
.
Stu
d
e
n
ts
wh
o
s
im
u
ltan
eo
u
s
ly
wo
r
k
h
av
e
lo
wer
s
tr
ess
lev
els
th
an
th
o
s
e
wh
o
o
n
ly
s
tu
d
y
d
ep
r
e
s
s
io
n
f
ac
to
r
s
.
On
th
e
s
o
cial
d
y
s
f
u
n
ctio
n
f
ac
to
r
,
s
tu
d
en
ts
wh
o
also
wo
r
k
also
s
h
o
w
lo
wer
s
co
r
es
th
an
th
o
s
e
wh
o
o
n
ly
s
tu
d
y
,
b
u
t
th
is
is
n
o
t
s
ig
n
if
ican
t.
A
p
o
s
s
ib
le
ex
p
lan
atio
n
th
at
ca
n
b
e
p
u
t
f
o
r
war
d
is
th
at
s
tu
d
e
n
ts
wh
o
s
im
u
ltan
eo
u
s
ly
wo
r
k
e
x
p
er
ien
ce
b
en
e
f
its
s
u
ch
as
s
o
cial
s
u
p
p
o
r
t
wh
ic
h
ca
n
b
e
ass
o
ciate
d
with
im
p
r
o
v
e
d
ac
a
d
em
ic
p
e
r
f
o
r
m
an
c
e
at
u
n
iv
er
s
ity
a
n
d
m
en
tal
h
ea
lth
[
6
7
]
,
[
6
8
]
.
Stu
d
en
ts
wh
o
s
im
u
ltan
eo
u
s
ly
wo
r
k
also
n
o
te
o
t
h
er
p
o
s
itiv
e
th
in
g
s
s
u
c
h
as
in
ter
p
er
s
o
n
al
s
k
ills
,
b
etter
ti
m
e
m
an
ag
em
en
t,
an
d
q
u
ite
h
ig
h
s
elf
-
co
n
f
id
e
n
ce
[
6
9
]
.
Stu
d
en
ts
wh
o
wo
r
k
ca
n
h
av
e
th
e
a
b
il
ity
to
v
iew
th
em
s
elv
es so
as to
av
o
id
d
e
p
r
ess
io
n
an
d
ca
r
r
y
o
u
t so
cial
f
u
n
ctio
n
s
[
7
0
]
.
T
h
e
ad
v
an
ta
g
e
o
f
th
is
r
esear
c
h
is
th
at
th
e
C
FA
r
e
s
u
lts
s
h
o
w
th
at
th
e
p
r
o
p
o
s
ed
m
o
d
el
is
b
etter
th
an
th
e
o
th
er
s
ev
en
m
o
d
els
f
o
r
co
m
p
ar
is
o
n
[
2
]
,
[
4
]
,
[
4
5
]
–
[
4
9
]
.
T
h
u
s
,
we
ac
c
u
r
ately
i
d
en
tifie
d
an
d
d
eter
m
in
e
d
th
e
f
ac
to
r
s
tr
u
ctu
r
e
o
f
th
e
GHQ
-
1
2
.
Ho
wev
er
,
th
e
r
e
ar
e
lim
itatio
n
s
th
at
n
ee
d
to
b
e
c
o
n
s
id
er
e
d
.
First,
p
r
o
s
p
ec
tiv
e
b
io
lo
g
y
teac
h
er
s
a
r
e
in
clu
d
ed
in
th
e
o
cc
u
p
atio
n
al
g
r
o
u
p
th
at
is
v
u
ln
er
a
b
le
to
m
en
tal
h
ea
lth
d
is
o
r
d
er
s
,
an
d
it
is
co
n
f
ir
m
e
d
th
at
s
tu
d
e
n
ts
wh
o
a
r
e
b
elo
w
th
e
th
r
esh
o
ld
f
o
r
s
h
o
win
g
g
o
o
d
m
en
tal
h
ea
lth
ar
e
l
ess
th
an
1
0
%
o
f
th
e
to
tal
p
ar
ticip
an
ts
.
T
h
u
s
,
E
FA
an
d
C
FA
f
in
d
in
g
s
n
ee
d
to
b
e
in
ter
p
r
ete
d
with
ca
u
tio
n
,
an
d
m
a
y
n
o
t
a
p
p
l
y
t
o
d
i
f
f
e
r
e
n
t
g
r
o
u
p
s
.
S
e
c
o
n
d
,
g
e
n
d
e
r
i
m
b
a
l
a
n
c
e
w
h
e
r
e
w
o
m
e
n
o
u
t
n
u
m
b
e
r
m
e
n
.
T
h
e
r
e
a
s
o
n
f
o
r
t
h
i
s
g
e
n
d
e
r
i
m
b
a
l
a
n
c
e
m
a
y
b
e
d
u
e
t
o
s
o
c
i
e
t
y
'
s
p
e
r
s
p
e
c
t
i
v
e
w
h
i
c
h
v
i
e
w
s
b
e
i
n
g
a
b
i
o
l
o
g
y
t
e
a
c
h
e
r
a
s
a
w
o
m
a
n
'
s
j
o
b
.
T
e
s
t
i
n
g
t
h
e
G
H
Q
1
2
w
i
t
h
a
l
a
r
g
e
a
n
d
b
a
l
a
n
c
e
d
s
a
m
p
l
e
o
f
m
e
n
a
n
d
w
o
m
e
n
w
i
l
l
p
r
o
v
i
d
e
m
o
r
e
a
c
c
u
r
a
t
e
p
s
y
c
h
o
m
e
t
r
i
c
e
v
i
d
e
n
c
e
.
T
h
i
r
d
,
o
u
r
s
a
m
p
l
i
n
g
s
t
r
a
t
e
g
y
o
f
o
n
l
y
s
t
u
d
e
n
t
s
f
o
r
w
h
o
m
t
h
e
i
r
s
t
u
d
y
p
r
o
g
r
a
m
h
a
d
g
i
v
e
n
p
e
r
m
i
s
s
i
o
n
m
a
y
t
h
u
s
n
o
t
r
e
s
u
l
t
i
n
a
r
a
n
d
o
m
s
a
m
p
l
e
.
M
o
r
e
r
e
s
e
a
r
c
h
w
i
t
h
r
a
n
d
o
m
s
a
m
p
l
e
s
i
s
n
e
e
d
e
d
t
o
a
c
h
i
e
v
e
f
u
r
t
h
e
r
a
n
a
l
y
s
i
s
,
a
s
w
e
l
l
a
s
v
e
r
i
f
y
t
h
e
r
e
l
i
a
b
i
l
i
t
y
a
n
d
v
a
l
i
d
i
t
y
o
f
t
h
e
G
H
Q
-
1
2
,
e
s
p
e
c
i
a
l
l
y
i
t
s
h
i
g
h
A
V
E
v
a
l
u
e
s
.
T
h
ese
GHQ1
2
p
s
y
ch
o
m
etr
ic
r
esu
lts
h
av
e
im
p
o
r
tan
t
im
p
licatio
n
s
f
o
r
th
e
d
iag
n
o
s
is
an
d
ass
ess
m
en
t
o
f
m
en
tal
h
ea
lth
p
r
o
b
lem
s
am
o
n
g
p
r
o
s
p
ec
tiv
e
b
io
lo
g
y
teac
h
er
s
in
I
n
d
o
n
esia.
T
h
is
r
esear
ch
p
r
o
v
id
es
a
r
eliab
le
an
d
v
alid
in
s
tr
u
m
e
n
t
th
at
ca
n
b
e
u
s
ed
to
r
ec
o
g
n
ize
m
en
t
al
h
ea
lth
co
n
d
itio
n
s
an
d
m
ea
s
u
r
e
th
e
s
u
cc
ess
o
f
in
ter
v
en
tio
n
s
to
r
e
d
u
ce
th
e
im
p
ac
t
o
f
m
en
tal
h
ea
lth
d
is
o
r
d
er
s
in
p
r
o
s
p
ec
tiv
e
teac
h
er
s
.
T
h
e
I
n
d
o
n
esian
v
er
s
io
n
o
f
th
e
q
u
esti
o
n
n
ai
r
e
ca
n
also
b
e
a
s
am
p
le
s
ize
f
o
r
n
o
n
-
clin
i
c
al
p
o
p
u
latio
n
s
th
er
e
b
y
ad
d
i
n
g
p
r
ac
tical
v
alu
e
to
th
e
GHQ1
2
.
4.
CO
NCLU
SI
O
N
T
h
is
r
esear
ch
ad
d
r
ess
es
th
e
g
ap
r
eg
ar
d
in
g
th
e
ab
s
en
ce
o
f
r
esear
ch
test
in
g
th
e
p
s
y
ch
o
m
etr
ic
p
r
o
p
er
ties
o
f
t
h
e
GHQ1
2
in
r
elatio
n
to
p
r
o
s
p
ec
tiv
e
b
io
lo
g
y
teac
h
er
s
in
I
n
d
o
n
esia.
T
h
e
f
i
n
d
in
g
s
o
f
t
h
is
s
tu
d
y
s
u
g
g
est
th
at
th
e
GHQ1
2
is
b
est
u
n
d
e
r
s
to
o
d
as
a
two
-
f
ac
to
r
r
ath
er
th
an
a
u
n
id
im
e
n
s
io
n
al
a
n
d
th
r
ee
-
f
ac
to
r
to
o
l.
E
FA
r
esu
lts
r
ev
ea
led
two
f
ac
t
o
r
s
,
n
am
ely
d
ep
r
ess
io
n
a
n
d
s
o
cial
d
y
s
f
u
n
ctio
n
,
an
d
co
n
f
ir
m
ed
with
C
FA
th
at
th
is
m
o
d
el
o
f
f
er
ed
t
h
e
b
e
s
t
f
it
to
th
e
d
ata.
T
h
is
r
esear
ch
also
p
r
o
v
id
es
in
f
o
r
m
atio
n
r
e
g
ar
d
in
g
t
h
e
in
ter
n
al
co
n
s
is
ten
cy
o
f
t
h
e
I
n
d
o
n
esian
v
er
s
io
n
o
f
GHQ1
2
th
r
o
u
g
h
s
atis
f
ac
to
r
y
c
r
o
n
b
ac
h
alp
h
a,
AVE
an
d
C
E
.
T
h
u
s
,
th
e
I
n
d
o
n
esian
v
er
s
io
n
o
f
th
e
GHQ1
2
ca
n
b
e
u
s
ed
as
an
ef
f
ec
tiv
e
to
o
l
to
m
ea
s
u
r
e
m
en
tal
h
ea
lth
d
is
o
r
d
er
s
o
f
p
r
o
s
p
ec
tiv
e
b
i
o
lo
g
y
teac
h
er
s
.
Fu
r
th
er
m
o
r
e,
th
is
r
esear
ch
also
p
r
o
v
id
es
in
f
o
r
m
ati
o
n
th
at
th
e
m
ajo
r
ity
o
f
p
r
o
s
p
ec
tiv
e
b
io
lo
g
y
teac
h
er
s
ar
e
in
p
o
o
r
m
e
n
tal
h
ea
lth
.
J
u
d
g
in
g
f
r
o
m
d
em
o
g
r
a
p
h
ic
f
ac
to
r
s
,
th
er
e
ar
e
s
ig
n
if
ican
t
d
if
f
er
en
ce
s
b
etwe
en
m
en
an
d
w
o
m
en
.
Gen
d
e
r
w
as
th
e
o
n
ly
s
ig
n
if
ican
t
p
r
ed
ict
o
r
o
f
m
en
tal
h
ea
lth
in
o
u
r
p
o
p
u
latio
n
.
RE
F
E
R
E
NC
E
S
[
1
]
K
.
O
p
a
r
e
-
A
sam
o
a
h
,
J.
E.
A
m
u
a
h
,
J
.
T.
D
o
n
g
d
e
m,
S
.
F
.
M
a
j
e
e
d
,
Z.
F
.
M
a
h
a
m
a
,
a
n
d
D
.
N
.
Za
k
a
r
i
a
,
“
T
h
e
1
2
-
i
t
e
m
g
e
n
e
r
a
l
h
e
a
l
t
h
q
u
e
st
i
o
n
n
a
i
r
e
f
a
c
t
o
r
i
a
l
st
r
u
c
t
u
r
e
,
s
o
c
i
o
d
e
m
o
g
r
a
p
h
i
c
a
n
d
w
o
r
k
-
r
e
l
a
t
e
d
f
a
c
t
o
r
s
o
f
g
h
a
n
a
i
a
n
n
u
r
ses
a
n
d
t
h
e
i
r
a
ss
o
c
i
a
t
i
o
n
w
i
t
h
s
t
r
e
ss
:
A
c
r
o
ss
-
se
c
t
i
o
n
a
l
s
t
u
d
y
,
”
I
n
t
e
r
n
a
t
i
o
n
a
l
J
o
u
r
n
a
l
o
f
A
f
ri
c
a
N
u
rsi
n
g
S
c
i
e
n
c
e
s
,
v
o
l
.
1
9
,
p
.
1
0
0
6
2
5
,
2
0
2
3
,
d
o
i
:
1
0
.
1
0
1
6
/
j
.
i
j
a
n
s.
2
0
2
3
.
1
0
0
6
2
5
.
[
2
]
D
.
P
.
G
o
l
d
b
e
r
g
,
“
T
h
e
d
e
t
e
c
t
i
o
n
o
f
p
s
y
c
h
i
a
t
r
i
c
i
l
l
n
e
ss
b
y
q
u
e
st
i
o
n
n
a
i
r
e
;
A
t
e
c
h
n
i
q
u
e
f
o
r
t
h
e
i
d
e
n
t
i
f
i
c
a
t
i
o
n
a
n
d
a
s
sessme
n
t
o
f
n
o
n
-
p
sy
c
h
o
t
i
c
p
sy
c
h
i
a
t
r
i
c
i
l
l
n
e
ss
.
,
”
T
h
e
d
e
t
e
c
t
i
o
n
o
f
p
s
y
c
h
i
a
t
r
i
c
i
l
l
n
e
ss
b
y
q
u
e
s
t
i
o
n
n
a
i
r
e
:
A
t
e
c
h
n
i
q
u
e
f
o
r
t
h
e
i
d
e
n
t
i
f
i
c
a
t
i
o
n
a
n
d
a
ssessm
e
n
t
o
f
n
o
n
-
p
sy
c
h
o
t
i
c
p
syc
h
i
a
t
r
i
c
i
l
l
n
e
ss.
O
x
f
o
r
d
,
1
9
7
2
.
[
3
]
R
.
B
e
n
o
n
i
e
t
a
l
.
,
“
T
h
e
u
se
o
f
1
2
-
i
t
e
m
g
e
n
e
r
a
l
h
e
a
l
t
h
q
u
e
st
i
o
n
n
a
i
r
e
(GHQ
-
1
2
)
i
n
U
k
r
a
i
n
i
a
n
r
e
f
u
g
e
e
s
:
t
r
a
n
s
l
a
t
i
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4
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[
4
4
]
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.
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[
4
5
]
D
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[
4
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.
[
4
7
]
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.
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.
[
4
8
]
A
.
J.
M
a
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,
“
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.
[
4
9
]
A
.
W
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C
.
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.
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Ps
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.
[
5
0
]
J.
H
a
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r
,
“
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D
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0
4
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4
.
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O
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.
A
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:
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5
[
5
1
]
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.
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.
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L
a
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k
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.
[
5
2
]
B
.
L.
N
u
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n
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l
l
y
,
“
P
sy
c
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me
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r
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(
3
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.
)
,
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N
Y
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M
c
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1
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4
.
A
c
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d
:
Jan
.
1
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,
[
O
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l
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]
.
A
v
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:
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/
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.
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.
[
5
3
]
L.
S
ü
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c
ü
,
İ
.
Y
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k
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ma
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,
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n
d
A
.
M
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:
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]
.
A
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[
5
4
]
P
.
L.
P
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M
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.
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x
.
[
5
5
]
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.
S
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mi
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,
J
.
K
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n
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.
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,
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q
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(GHQ
-
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[
5
6
]
C
.
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