Construct Validity and Factor Structure of the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale in a Multi-National Study of African, South East Asian and South American College Students

Abstract

BackgroundThe Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) are questionnaires used to assess sleep quality and excessive daytime sleepiness in clinical and population-based studies. The present study aimed to evaluate the construct validity and factor structure of the PSQI and ESS questionnaires among young adults in four countries (Chile, Ethiopia, Peru and Thailand).MethodsA cross-sectional study was conducted among 8,481 undergraduate students. Students were invited to complete a self-administered questionnaire that collected information about lifestyle, demographic, and sleep characteristics. In each country, the construct validity and factorial structures of PSQI and ESS questionnaires were tested through exploratory and confirmatory factor analyses (EFA and CFA).ResultsThe largest component-total correlation coefficient for sleep quality as assessed using PSQI was noted in Chile (r = 0.71) while the smallest component-total correlation coefficient was noted for sleep medication use in Peru (r = 0.28). The largest component-total correlation coefficient for excessive daytime sleepiness as assessed using ESS was found for item 1 (sitting/reading) in Chile (r = 0.65) while the lowest item-total correlation was observed for item 6 (sitting and talking to someone) in Thailand (r = 0.35). Using both EFA and CFA a two-factor model was found for PSQI questionnaire in Chile, Ethiopia and Thailand while a three-factor model was found for Peru. For the ESS questionnaire, we noted two factors for all four countriesConclusionOverall, we documented cross-cultural comparability of sleep quality and excessive daytime sleepiness measures using the PSQI and ESS questionnaires among Asian, South American and African young adults. Although both the PSQI and ESS were originally developed as single-factor questionnaires, the results of our EFA and CFA revealed the multi- dimensionality of the scales suggesting limited usefulness of the global PSQI and ESS scores to assess sleep quality and excessive daytime sleepiness.

Psychometric Properties of the Pittsburgh Sleep Quality Index (PSQI) in a Cohort of Peruvian Pregnant Women

“…Differences in culture, demographics, and linguistics may contribute to observed variations. 18 Future studies are warranted to further explore underlying explanations of these observed differences.…”

“…[8][9][10][11][12][13][14][15][16][17][18] Though increasingly being used among pregnant women, 1,7,19 the psychometric properties of the PSQI has not been adequately assessed in this population. We are aware of only two published studies have evaluated the psychometric properties of the PSQI among pregnant women.…”

“…32 Recently, in our study of male and female Peruvian college students, we found that three factors (i.e., sleep quality, sleep efficiency, and sleep latency) resulted from our best fitting model. 18 Lastly, in studies of community-dwelling older adults in the U.S. 31 and renal transplant recipients in Switzerland, 14 investigators completed confirmatory factor analyses and observed three-factor models as follows: sleep efficiency, sleep quality, and daytime dysfunction. Although several three-factor models have been reported, the specific contents of the three factors varied across previous studies.…”

Psychometric Evaluation of the Ford Insomnia Response to Stress Test (FIRST) in Early Pregnancy

“…This classification system is consistent with prior studies conducted globally including Peru. 31,32 We have demonstrated that the Spanish-language version of the PSQI instrument to have good construct validity among pregnant women in Peru. 33 …”

Kejadian Excessive Daytime Sleepiness (Eds) Dan Kualitas Tidur Pada Mahasiswa Kesehatan

“…Sebuah penelitian mengenai validitas konstruk dan faktor struktur kuesioner PSQI dan ESS pada skala multi-nasional di Afrika, Asia Timur dan Amerika Selatan, menunjukkan perbedaan hasil dari kedua kuesioner tersebut (Gelaye, et al, 2014). Hasil penelitian tersebut menunjukkan bahwa etnis Malaysia dan China lebih rentan mengalami kejadian EDS dibandingkan dengan etnis India (TP & WC, 2005).…”