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Psychometric performance and responsiveness of the functional outcomes of sleep questionnaire and sleep apnea quality of life instrument in a randomized trial: the HomePAP study.

ABSTRACT: Measures of health-related quality of life (HRQL) specific for sleep disorders have had limited psychometric evaluation in the context of randomized controlled trials (RCTs). We investigated the psychometric properties of the Functional Outcomes of Sleep Questionnaire (FOSQ) and Sleep Apnea Quality of Life Instrument (SAQLI). We evaluated the FOSQ and SAQLI construct and criterion validity, determined a minimally important difference, and assessed for associations of responsiveness to baseline subject characteristics and continuous positive airway pressure (CPAP) adherence in a RCT population.Secondary analysis of data collected in a multisite RCT of home versus laboratory-based diagnosis and treatment of obstructive sleep apnea (HomePAP trial).Individuals enrolled in the HomePAP trial (n = 335).N/A.The FOSQ and SAQLI subscores demonstrated high reliability and criterion validity, correlating with Medical Outcomes Study 36-Item Short Form Survey domains. Correlations were weaker with the Epworth Sleepiness Scale (ESS). Both the FOSQ and SAQLI scores improved after 3 mo with CPAP therapy. Averaging 4 h or more of CPAP use was associated with an increase in the FOSQ beyond the minimally important difference. Baseline depressive symptoms and sleepiness predicted FOSQ and SAQLI responsiveness; demographic, objective obstructive sleep apnea (OSA) severity and sleep habits were not predictive in linear regression.The FOSQ and SAQLI are responsive to CPAP intervention, with the FOSQ being more sensitive to differences in CPAP adherence than the SAQLI. These instruments provide unique information about health outcomes beyond that provided by changes in physiological measures of OSA severity (apnea-hypopnea index).Portable Monitoring for Diagnosis and Management of Sleep Apnea (HomePAP) URL: http://clinicaltrials.gov/show/NCT00642486. NIH clinical trials registry number: NCT00642486.

SUBMITTER: Billings ME

PROVIDER: S-EPMC4548522 | biostudies-literature | 2014 Dec

REPOSITORIES: biostudies-literature

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Psychometric performance and responsiveness of the functional outcomes of sleep questionnaire and sleep apnea quality of life instrument in a randomized trial: the HomePAP study.

Billings Martha E ME Rosen Carol L CL Auckley Dennis D Benca Ruth R Foldvary-Schaefer Nancy N Iber Conrad C Zee Phyllis C PC Redline Susan S Kapur Vishesh K VK

Sleep 20141201 12

<h4>Study objectives</h4>Measures of health-related quality of life (HRQL) specific for sleep disorders have had limited psychometric evaluation in the context of randomized controlled trials (RCTs). We investigated the psychometric properties of the Functional Outcomes of Sleep Questionnaire (FOSQ) and Sleep Apnea Quality of Life Instrument (SAQLI). We evaluated the FOSQ and SAQLI construct and criterion validity, determined a minimally important difference, and assessed for associations of res ...[more]

PMID: 25325491

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Project description:Data from a randomized, controlled study of adenotonsillectomy for obstructive sleep apnea syndrome (OSAS) were used to test the hypothesis that children undergoing surgery had greater quality of life (QoL) and symptom improvement than control subjects. The objectives were to compare changes in validated QoL and symptom measurements among children randomized to undergo adenotonsillectomy or watchful waiting; to determine whether race, weight, or baseline OSAS severity influenced changes in QoL and symptoms; and to evaluate associations between changes in QoL or symptoms and OSAS severity.Children aged 5 to 9.9 years with OSAS (N = 453) were randomly assigned to undergo adenotonsillectomy or watchful waiting with supportive care. Polysomnography, the Pediatric Quality of Life inventory, the Sleep-Related Breathing Scale of the Pediatric Sleep Questionnaire, the 18-item Obstructive Sleep Apnea QoL instrument, and the modified Epworth Sleepiness Scale were completed at baseline and 7 months. Changes in the QoL and symptom surveys were compared between arms. Effect modification according to race and obesity and associations between changes in polysomnographic measures and QoL or symptoms were examined.Greater improvements in most QoL and symptom severity measurements were observed in children randomized to undergo adenotonsillectomy, including the parent-completed Pediatric Quality of Life inventory (effect size [ES]: 0.37), the 18-item Obstructive Sleep Apnea QoL instrument (ES: -0.93), the modified Epworth Sleepiness Scale score (ES: -0.42), and the Sleep-Related Breathing Scale of the Pediatric Sleep Questionnaire (ES: -1.35). Effect modification was not observed by obesity or baseline severity but was noted for race in some symptom measures. Improvements in OSAS severity explained only a small portion of the observed changes.Adenotonsillectomy compared with watchful waiting resulted in significantly more improvements in parent-rated generic and OSAS-specific QoL measures and OSAS symptoms.

Project description:ObjectiveThe sleep of healthcare students is worth discovering. Mental health and self-rated health are thought to be associated with sleep quality. As such, valid instruments to assess sleep quality in healthcare students are crucial and irreplaceable. This study aimed to investigate the measurement properties of the Sleep Quality Questionnaire (SQQ) for Chinese healthcare students.MethodsTwo longitudinal assessments were undertaken among healthcare students, with a total of 595, between December 2020 and January 2021. Measures include the Chinese version of the SQQ, Patient Health Questionnaire-4 (PHQ-4), Self-Rated Health Questionnaire (SRHQ), and sociodemographic questionnaire. Structural validity through confirmatory factor analysis (CFA) was conducted to examine factor structure of the SQQ. T-tests and ANOVAs were used to examine sociodemographic differences in sleep quality scores. Multi Group CFA and longitudinal CFA were respectively used to assess cross-sectional invariance and longitudinal invariance across two-time interval, i.e., cross-cultural validity. Construct validity, internal consistency, and test-retest reliability were correspondingly examined via Spearman correlation, Cronbach's alpha and McDonald's omega, and intraclass correlation coefficient. Multiple linear regression analysis was performed to examine incremental validity of the SQQ based on the PHQ-4 and SRHQ as indicators of the criterion variables.ResultsCFA results suggested that the two-factor model of the SQQ-9 (item 2 excluded) had the best fit. The SQQ-9 scores differed significantly by age, grade, academic stage, hobby, stress coping strategy, anxiety, depression, and self-rated health subgroups. Measurement invariance was supported in terms of aforesaid subgroups and across two time intervals. In correlation and regression analyses, anxiety, depression, and self-rated health were moderately strong predictors of sleep quality. The SQQ-9 had good internal consistency and test-retest reliability.ConclusionGood measurement properties suggest that the SQQ is a promising and practical measurement instrument for assessing sleep quality of Chinese healthcare students.

Project description:BACKGROUND:Assessing quality of life (QOL) in elderly needs specific instruments. The Older People's Quality of Life Questionnaire (OPQOL-35) is one of the common tools that used for measuring quality of life in elderly populations. The questionnaires contains 35 items tapping into eight domains including life overall, health, social relationships and participation, independence, control over life and freedom, home and neighborhood, psychological and emotional well-being, financial circumstances, culture and religion. This study aimed to translate and validate the OPQOL-35 in Iran. METHODS:Forward-backward procedure was applied to translate the original questionnaire from English into Persian. Then following qualitative face and content validity, a sample of elderly people completed the questionnaire. In order to evaluate the construct validity, exploratory and confirmatory factor analyses was performed. Subsequently, convergent and divergent validity of the factors were evaluated. Reliability was evaluated by performing internal consistency analysis and Intraclass Correlation Coefficients (ICC). RESULTS:In all 500 older people completed the questionnaire. The mean age of participant was 68.92 (SD?=?6.97) years, and mostly were males (66.6%). The result of exploratory factor analysis showed 8 factors with Eigen values of greater than one, which explained 67.4% of the variance observed. Confirmatory factor analysis showed acceptable fit indexes for the data [Comparative Fit Index (CFI)?=?0.92, Minimum Discrepancy Function by Degrees of Freedom divided (CMIN/DF)?=?2.832, Root Mean Square Error of Approximation (RMSEA)?=?0.067]. The convergent and divergent validity did not support three latent factors (Life overall, Independence, control over life, freedom and Psychological and emotional well-being). Convergent and divergent validity shown that construct fulfilled for the health, social relationships and participation, home and neighborhood, financial circumstances, culture and religion latent factors, however the results did not support the convergent and divergent validity for three latent factors (Life overall, Independence, control over life, freedom and Psychological and emotional well-being). Cronbach's alpha coefficient for the subscales ranged from 0.65-0.95. Test-retest reliability (ICC) of the questionnaire with two weeks interval were ranged from 0.88-0.95 indicating a good range of reliability. CONCLUSION:The findings suggest that the Iranian version of OPQOL-35 is a valid measure for assessing quality of life in elderly populations in different settings.

Project description:Study Objectives:Obstructive sleep apnea (OSA) is common in children with Down syndrome (DS) and is associated with adverse health and cognitive outcomes. Daytime clinical assessment is poorly predictive of OSA, so regular screening with sleep studies is recommended. However, sleep studies are costly and not available to all children worldwide. We aimed to evaluate the psychometric properties and predictive value of a newly developed screening questionnaire for OSA in this population. Methods:202 children aged 6 months to 6th birthday with DS were recruited, of whom 188 completed cardio-respiratory sleep studies to generate an obstructive apnea hypopnea index (OAHI). Parents completed the 14-item Down syndrome OSA screening questionnaire. Responses were screened, a factor analysis undertaken, internal consistency calculated and receiver operator characteristic (ROC) curves drawn to generate an area under the curve (AUC) to assess criterion related validity. Results:Of 188 children who completed cardiorespiratory sleep studies; parents completed the screening questionnaire for 186. Of this study population 15.4% had moderate to severe OSA defined by an OAHI of ?5/h. Sixty-three (33.9%) participants were excluded due to "unsure" responses or where questions were not answered. Using the remaining 123 questionnaires a four-factor solution was found, with the 1st factor representing breathing related symptoms, explaining a high proportion of the variance. Internal consistency was acceptable with a Cronbach alpha of 0.87. ROC curves for the total score generated an AUC statistic of 0.497 and for the breathing subscale an AUC of 0.603 for moderate to severe OSA. Conclusion:A well designed questionnaire with good psychometric properties had limited predictive value to screen for moderate to severe OSA in young children with DS. The use of a screening questionnaire is not recommended. Screening for OSA in this population requires objective sleep study measures.

Project description:ObjectiveThe Menopause-Specific Quality-of-Life (MENQOL) questionnaire was developed as a specific tool to measure the health-related quality-of-life of postmenopausal women. Thus far, the Chinese version questionnaire has not been subjected to psychometric assessment with a large sample. This study aims to evaluate the validity and reliability of the Chinese version of the MENQOL specific to postmenopausal women in China.MethodsA total of 1,137 menopausal symptomatic and 491 menopausal asymptomatic women from eight cities in China were recruited using a convenience sampling method. Psychometric properties were evaluated by descriptive statistics, validity, and reliability. Reliability was assessed for each subscale of the MENQOL through internal consistency reliability with Cronbach's ? and intersubscale correlations. Item-domain correlations, principal components analysis (PCA), and confirmatory factor analysis were performed to determine construct validity. t tests were used to compare the differences between the menopausal symptomatic and asymptomatic women and to evaluate the discriminate validity. Pearson correlation coefficients were calculated between MENQOL scores and the Kupperman index to assess criterion-related validity.ResultsThe most common symptoms in Chinese menopausal symptomatic women were "experiencing poor memory" (94.4%), "feeling tired or worn out" (93.8%), "aching in muscle and joints" (89.4%), "low backache" (86.9%), "decrease in physical strength" (86.6%), "aches in back of neck or head" (86.2%), "difficulty sleeping" (83.6%), "accomplishing less than I used to" (83.4%), "feeling a lack of energy" (83.3%), "change in your sexual desire" (81%), and "hot flash" (80.7%) among others. The symptoms of "increased facial hair" were rarely seen (9.9%). The vasomotor domain, as well as psychosocial, physical, and sexual domains showed high reliability (Cronbach's ? 0.84, 0.87, 0.89, and 0.86, respectively). Item-domain correlation analysis showed that all items correlated more strongly with their own domains than with other domains. In the PCA, after deleting the "increased facial hair" item, items in the vasomotor, sexual, and psychosocial subscales loaded on their respective domains by and large, and items in the physical subscale divided into two factors. The PCA revealed a latent structure of the Chinese version of MENQOL nearly identical to the original MENQOL domains. The confirmatory factor analysis demonstrated that the questionnaire fits well with a four-domain model. The MENQOL can discriminate between menopausal symptomatic women with asymptomatic women as it showed good discriminate validity. Criterion-related validity was confirmed by a significant correlation between MENQOL scores and the Kupperman index.ConclusionsThis study showed that Chinese version of MENQOL has good psychometric properties and would be suitable to measure the health-related quality-of-life of Chinese menopausal women except for item 21 (increased facial hair).

Dataset Information

Psychometric performance and responsiveness of the functional outcomes of sleep questionnaire and sleep apnea quality of life instrument in a randomized trial: the HomePAP study.

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Psychometric performance and responsiveness of the functional outcomes of sleep questionnaire and sleep apnea quality of life instrument in a randomized trial: the HomePAP study.

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