Psychometric properties and structural validity of traditional Chinese version of the Richards-Campbell Sleep Questionnaire in intensive care unit patients without physical restraint

Pin-Yuan Chen; Tsui-Mien Kuo; Shih-Heng Chen; Hui-Chuan Huang; Ting-Jhen Chen; Tzu-Hao Wang; Hsiang-Ling Wang; Hsiao-Yean Chiu

doi:10.1016/j.aucc.2023.11.004

Psychometric properties and structural validity of traditional Chinese version of the Richards-Campbell Sleep Questionnaire in intensive care unit patients without physical restraint

Aust Crit Care. 2024 Jan 4:S1036-7314(23)00194-7. doi: 10.1016/j.aucc.2023.11.004. Online ahead of print.

Authors

Pin-Yuan Chen¹, Tsui-Mien Kuo², Shih-Heng Chen³, Hui-Chuan Huang⁴, Ting-Jhen Chen⁵, Tzu-Hao Wang⁶, Hsiang-Ling Wang⁷, Hsiao-Yean Chiu⁸

Affiliations

¹ Department of Neurosurgery, Chang Gung Memorial Hospital, Keelung Branch, Keelung, Taiwan; School of Medicine, College of Medicine, Chang-Gung University, Taoyuan, Taiwan.
² School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Department of Nursing, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
³ Department of Plastic Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan.
⁴ School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
⁵ School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Ave, Wollongong, NSW 2522, Australia.
⁶ School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Department of Nursing, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
⁷ Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan.
⁸ School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan; Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Research Center of Sleep Medicine, Taipei Medical University Hospital, Taipei, Taiwan. Electronic address: hychiu0315@tmu.edu.tw.

PMID: 38182530
DOI: 10.1016/j.aucc.2023.11.004

Abstract

Background: Sleep assessment in the intensive care unit (ICU) is difficult and often unreliable. The most commonly used questionnaire for assessing ICU sleep, the Richards-Campbell Sleep Scale (RCSQ), has not been tested for reliability and construct validity in the Mandarin-Taiwanese speaking population.

Objective: The objective of this study was to test the construct validity and criterion validity of the traditional Chinese version of RCSQ (TC-RCSQ) in critically ill patients without physical restraint.

Methods: We adopted a cross-sectional study design. Adults aged 20 years and above were recruited from a plastic surgery ICU of a medical center. The Cronbach's alpha was used to test internal consistency; the validity testing included content validity, criterion validity, and construct validity. Criterion validity was analysed by testing the association of TC-RCSQ with the Chinese version of Verran and Snyder-Halpern Sleep Questionnaire and sleep parameter of actigraphy using the Pearson correlation coefficient; construct validity was analysed using exploratory factor analysis.

Results: A total of 100 patients were included with a mean age of 49.78 years. Internal consistency reliability suggested Cronbach's alpha of 0.93. Moderate to strong correlations of TC-RCSQ with Verran-Snyder-Halpern Sleep Questionnaire were identified (r = 0.36 to 0.80, P < 0.05). We found significant correlations of actigraphic sleep efficiency with difficulty of falling sleep, awakening times, sleep quality, and total score of the TC-RCSQ (r = 0.23, 0.23, 0.20, and 0.23, P < 0.05). One factor (named as overall sleep quality) was extracted by exploratory factor analysis with a total variance explained of 78.40 %, which had good construction validity.

Conclusions: The TC-RCSQ yields satisfactory reliability and validity in critically ill patients. Actigraphic sleep efficiency may be a single index for objectively sleep assessment of sleep quality in patients without physical restraint. Both the TC-RCSQ and actigraphy can aid nurses to evaluate the sleep quality in critically ill patients without physical restraint.

Keywords: Critically ill patients; Reliability; Sleep quality; Sleep questionnaire; Validity.