Abstract
Objective
To generate the Chinese Sleep Health Index (SHI-C) in Mandarin with cross-cultural
adaptations and test its psychometric properties.
Methods
This study used a cross-sectional design. Health science students were included (N = 271)
and a sub-set (n = 74) was invited for the re-test. Cross-cultural adaptation of the
SHI-C was performed prior to formal validation. The SHI-C, Pittsburgh Sleep Quality
Index (PSQI), Insomnia Severity Index (ISI), Bedtime Procrastination Scale, and Sleep
Hygiene Index were used to measure variables of interest. Exploratory factor analysis
was used to evaluate the structure validity. Bivariate analyses were used to evaluate
the construct validity.
Results
Exploratory factor analysis identified 3 factors (ie, sleep quality, sleep duration,
and disordered sleep) accounting for 55.6% of the total variance. The SHI-C total
and sleep quality sub-index scores were significantly associated with both PSQI global
score (r = -0.132, p < .05; r = -0.182, p < .01, respectively) and ISI score (r = -0.655, p < .05; r = -0.820, p < .05, respectively). SHI-C total, sleep quality sub-index, and sleep duration sub-index
scores were significantly associated with Bedtime Procrastination Scale and Sleep
Hygiene Index scores (r = -0.238 to -0.368, p < .05). Students with insomnia (ISI > 9) or poor sleep quality (PSQI > 5) had significantly
lower SHI-C scores than those without (73.5 vs. 89.0, p < .01; 84.1 vs. 86.7, p < .05, respectively). SHI-C showed good internal consistency (Cronbach's alpha = 0.73)
and test-retest reliability (intraclass correlation coefficient = 0.82).
Conclusions
The SHI-C demonstrated good validity and adequate reliability in a Chinese sample
of health science students. It could be used to measure sleep health in future research
and practice. Psychometric properties of the SHI-C among other Chinese populations
remain to be confirmed.
Keywords
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References
- Sleep disturbances increase the risk of dementia: a systematic review and meta-analysis.Sleep Med Rev. 2018; 40: 4-16
- Long sleep duration and health outcomes: a systematic review, meta-analysis and meta-regression.Sleep Med Rev. 2018; 39: 25-36
- Effects of sleep restriction on metabolism-related parameters in healthy adults: a comprehensive review and meta-analysis of randomized controlled trials.Sleep Med Rev. 2019; 45: 18-30
- Sleep disruption in medicine students and its relationship with impaired academic performance: a systematic review and meta-analysis.Sleep Med Rev. 2020; 53101333
- Sleep is essential to health: an American Academy of Sleep Medicine position statement.J Clin Sleep Med. 2021; 17: 2115-2119
- Sleep health: can we define it? Does it matter?.Sleep. 2014; 37: 9-17
- Sleep health: an opportunity for public health to address health equity.Annu Rev Public Health. 2020; 41: 81-99
- Beyond single sleep measures: a composite measure of sleep health and its associations with psychological and physical well-being in adulthood.Soc Sci Med. 2021; 274113800
- A preliminary study of a composite sleep health score: associations with psychological distress, body mass index, and physical functioning in a low-income African American community.Sleep Health. 2019; 5: 514-520
- Multidimensional sleep health domains in older men and women: an actigraphy factor analysis.Sleep. 2021; 44zsaa181
- Toward a multi-lingual diagnostic tool for the worldwide problem of sleep health: the French RU-SATED validation.J Psychiatr Res. 2021; 143: 341-349
- Validation of the satisfaction, alertness, timing, efficiency and duration (SATED) questionnaire for sleep health measurement.Ann Am Thorac Soc. 2020; 17: 338-343
- The validity and reliability of the Japanese version of RU-SATED.Sleep Medicine. 2022; 91: 109-114
- Sleep health assessment: a scale validation.Psychiatry Res. 2018; 259: 51-55
- The National Sleep Foundation's Sleep Health Index.Sleep Health. 2017; 3: 234-240
- The Sleep Health Index: correlations with standardized stress and sleep measures in a predominantly Hispanic college student population.Sleep Health. 2019; 5: 587-591
- Validation de la version française du Sleep Health Index: l'index sur la santé du sommeil.Médecine du Sommeil. 2022; 19: 78-88
- Considering cross-cultural differences in sleep duration between Japanese and Canadian university students.PLoS One. 2021; 16e0250671
- Is the siesta an adaptation to disease?: a cross-cultural examination.Hum Nat. 2000; 11: 233-258
- Help-seeking behaviors for insomnia in Hong Kong Chinese: AA community-based study.Sleep Med. 2016; 21: 106-113
- COSMIN methodology for assessing the content validity of PROMs–user manual.VU University Medical Center, Amsterdam2018
- COSMIN methodology for evaluating the content validity of patient-reported outcome measures: a Delphi study.Qual Life Res. 2018; 27: 1159-1170
- Content validity-establishing and reportingthe evidence in newly developed patient-reported outcomes (PRO) instruments for medical product evaluation: ISPOR PRO Good Research Practices Task Force report: Part 2–assessing respondent understanding.Value Health. 2011; 14: 978-988
- The quality of factor solutions in exploratory factor analysis: the influence of sample size, communality, and overdetermination.Educ Psycholo Measurement. 2005; 65: 202-226
- The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research.Psychiatry Res. 1989; 28: 193-213
- Structural validity of the Pittsburgh Sleep Quality Index in Chinese Undergraduate Students.Front Psychol. 2016; 7: 1126
- Validation of the Insomnia Severity Index as an outcome measure for insomnia research.Sleep Med. 2001; 2: 297-307
- The Insomnia Severity Index: psychometric indicators to detect insomnia cases and evaluate treatment response.Sleep. 2011; 34: 601-608
- Insomnia Severity Index: psychometric properties with Chinese community-dwelling older people.J Adv Nurs. 2010; 66: 2350-2359
- Bedtime procrastination: introducing a new area of procrastination.Front Psychol. 2014; 5: 611
- Mediating effects of rumination and bedtime procrastination on the relationship between Internet addiction and poor sleep quality.J Behav Addict. 2020; 9: 1002-1010
- Assessment of sleep hygiene using the Sleep Hygiene Index.J Behav Med. 2006; 29: 223-227
- Psychometric analysis of a Chinese version of the Sleep Hygiene Index in nursing students in China: a cross-sectional study.Sleep Med. 2021; 81: 253-260
- Discovering Statistics Using IBM SPSS Statistics.Sage, Singapore2013
- Scale Development: Theory and Applications.Sage publications, Thousand Oaks, CA2021
- Quality criteria were proposed for measurement properties of health status questionnaires.J Clin Epidemiol. 2007; 60: 34-42
- Intraclass correlations: uses in assessing rater reliability.Psychol Bull. 1979; 86: 420-428
- A guideline of selecting and reporting intraclass correlation coefficients for reliability research.J Chiropr Med. 2016; 15: 155-163
- A systematic review of studies on the prevalence of insomnia in university students.Public Health. 2015; 129: 1579-1584
- The role of sleep hygiene in promoting public health: a review of empirical evidence.Sleep Med Rev. 2015; 22: 23-36
- Bedtime procrastination: a self-regulation perspective on sleep insufficiency in the general population.J Health Psychol. 2016; 21: 853-862
- Association between sleep hygiene and sleep quality in medical students.Behav Sleep Med. 2010; 8: 113-121
- Bedtime procrastination predicts the prevalence and severity of poor sleep quality of Chinese undergraduate students.J Am Coll Health. 2022; 70: 1104-1111
- Do procrastinators get worse sleep? Cross-sectional study of US adolescents and young adults.SSM Popul Health. 2020; 10100518
- Association of sleep attitudes with sleep hygiene, duration, and quality: a survey exploration of the moderating effect of age, gender, race, and perceived socioeconomic status.Health Psychol Behav Med. 2019; 7: 19-44
- Validation of the Pittsburgh Sleep Quality Index in community-dwelling Ethiopian adults.Health Qual Life Outcomes. 2017; 15: 58
- Questionnaire Design.in: Marsden PV Wright DJ Handbook of Survey Research. 2nd ed. Emerald, Bingley, UK2010: 264-313
Article info
Publication history
Published online: October 25, 2022
Accepted:
September 8,
2022
Received in revised form:
August 17,
2022
Received:
June 27,
2022
Identification
Copyright
© 2022 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.
