Psychometric properties of Indonesian version of sleep condition indicator for screening poststroke insomnia

Abstract

Background No study has examined the psychometric properties of the sleep condition indicator (SCI) for screening poststroke insomnia in the Indonesian population. We aimed to develop the Indonesian version of the sleep condition indicator (ISCI) and to examine its psychometric properties for screening adult patients in late sub-acute and chronic periods after stroke. Methods This was a cross-sectional study with two stages. In the first stage, the English version of the SCI was translated into the ISCI using standard procedures. The psychometric properties of the ISCI were tested in the second stage. Internal consistency and test-retest reliability of ISCI were used to evaluate reliability. A confirmatory factor analysis (CFA) was performed to test construct validity. To test concurrent and convergent validity, the Indonesian version of the insomnia severity index (ISI-INA), generalized anxiety disorder questionnaire (IGAD-7), and patient health questionnaire (IPHQ-9) were used. A receiver operating characteristic (ROC) analysis was conducted to calculate the optimal cutoff score of the ISCI on the basis of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnostic criteria for insomnia. Results A total of 160 adults with a diagnosis of stroke for more than 3 months were included (median age of 58.5 years, 31% met the DSM-5 criteria for insomnia). The ISCI had a satisfactory Cronbach's alpha of 0.89 and test-retest reliability of 0.78. The CFA revealed that the ISCI exhibited a satisfactory model fit and was associated with the ISI-INA, IGAD-7, and IPHQ-9 (r = −0.81, −0.32, and −0.52, respectively; all P < .001). The ROC test revealed that the optimal cutoff point of ≤23 yielded the highest sensitivity (94%) and specificity (97%). ConclusionThe study results revealed that the 8-item ISCI is a reliable and valid screening tool for detecting insomnia symptoms according to the DSM-5 criteria in the chronic period after stroke.

Validity and Reliability of the Turkish Version of the Sleep Condition Indicator: A Clinical Screening Instrument Based on the DSM-5 Criteria for Insomnia

“…In a recent study, the Indonesian version of the SCI score of 23 points or less had a 94% sensitivity and 97% specificity discrimination power for insomnia disorder in post-stroke patients. 25 Indonesian version study conducted a clinical interview for insomnia disorder, and 31% of the participants were diagnosed with insomnia according to the DSM-5 criteria. 25 This is a significantly higher rate of insomnia than in the current study population (7.3%).…”

“… 25 Indonesian version study conducted a clinical interview for insomnia disorder, and 31% of the participants were diagnosed with insomnia according to the DSM-5 criteria. 25 This is a significantly higher rate of insomnia than in the current study population (7.3%). However, the median age in this study was 58.5 years, an older age group compared to other studies, and it was the study with the least number of participants among the SCI version studies (n = 160).…”

“…However, the median age in this study was 58.5 years, an older age group compared to other studies, and it was the study with the least number of participants among the SCI version studies (n = 160). 25 Insomnia disorder is more common in female and in the older population. 50 , 51 Different insomnia rates have been found in SCI validation studies due to gender and age differences in the samples.…”

“…Other SCI version studies have shown that the SCI has good internal consistency and test-retest reliability. 15,[20][21][22][23][24][25] We found a strong correlation between the SCI, ISI, and PSQI. This finding demonstrates that the construct validity of the SCI was good.…”

“…10,21 The SCI assesses nighttime and daytime insomnia symptoms and focuses on the frequency and persistence of these symptoms. The SCI has been adapted to many languages, 15,20,[22][23][24][25] and validation studies have confirmed robust psychometric properties of the SCI. In addition, studies show that SCI has a cut-off value for insomnia disorder and can distinguish between patients with insomnia diagnosed according to the DSM-5 criteria and healthy controls.…”