A thorough psychometric comparison between Athens Insomnia Scale and Insomnia Severity Index among patients with advanced cancer

Abstract

For patients with cancer, sleep disturbance is commonplace. Using classical test theory and Rasch analyses, the present study compared two commonly used psychometric instruments for insomnia-Athens Insomnia Scale (AIS) and Insomnia Severity Index (ISI)-among patients with advanced cancer. Through convenience sampling, patients with cancer at stage III or IV (n=573; 326 males; mean age=61.3 years; SD=10.7) from eight oncology units of university hospitals in Iran participated in the study. All the participants completed the AIS, ISI, Edmonton Symptom Assessment Scale (ESAS), Hospital Anxiety and Depression Scale (HADS), General Health Questionnaire-12 (GHQ-12), Epworth Sleepiness Scale (ESS), and Pittsburgh Sleep Quality Index (PSQI). Additionally, 433 participants wore an Actigraph device for two continuous weekdays. Classical test theory and Rasch analysis both supported the construct validity for AIS (factor loadings from confirmatory factor analysis [CFA] = 0.61 to 0.87; test-retest reliability = 0.72 to 0.82; infit mean square [MnSq] = 0.81 to 1.17; outfit MnSq = 0.79 to 1.14) and for ISI (factor loadings from CFA = 0.61 to 0.81; test-retest reliability = 0.72 to 0.82; infit MnSq = 0.72 to 1.14; outfit MnSq = 0.76 to 1.11). Both AIS and ISI had significant associations with ESAS, HADS, GHQ-12, ESS, and PSQI, as well as having good sensitivity and specificity. Significant differences in the actigraphy measure were found between insomniacs and non-insomniacs based on AIS or ISI score. With promising results, healthcare providers can use either AIS or ISI to understand the insomnia of patients with advanced cancer.

Investigating mediated effects of fear of COVID-19 and COVID-19 misunderstanding in the association between problematic social media use, psychological distress, and insomnia

“…The ISI item scores were summed, with a higher score indicating a greater level of insomnia. The psychometric properties (including construct validity, concurrent validity, test-retest reliability, and internal consistency) of the Persian ISI have been found satisfactory in prior research ( Lin et al, 2020 ). The internal consistency of the ISI in the present study was very good (α = 0.86).…”

Temporal associations between morningness/eveningness, problematic social media use, psychological distress and daytime sleepiness: Mediated roles of sleep quality and insomnia among young adults

“…After summing up the seven item scores, the total score ranges between 0 and 28, with a higher score indicating a higher level of insomnia. More specifically, a cut‐off score of 9 is recommended as identifying insomnia (Lin et al., 2019). Good internal consistency of the Persian ISI has been reported (McDonald's ω = 0.79; Lin et al., 2019).…”

“…More specifically, a cut‐off score of 9 is recommended as identifying insomnia (Lin et al., 2019). Good internal consistency of the Persian ISI has been reported (McDonald's ω = 0.79; Lin et al., 2019). The internal consistency of the ISI in the present study was good (α = 0.88).…”

Preliminary validation of the insomnia severity index in Danish outpatients with a medical condition

“…Before conducting the CFA, data suitability was tested by the Kaiser-Meyer-Olkin (KMO) test with a limit of > 0.60 and by Bartlett's test of sphericity with a significance limit of p ≤ 0.05 [26]. The original article on ISI did not present a factor analysis, so the CFA was compared with previously tested models, with one [17,27], two [28], and three [10,13,29] factors. The goodness of fit of each model was assessed by the fit indices; Root Mean Square Error of Approximation (RMSEA) value < 0.08, and Comparative Fit Index (CFI) > 0.90, Tucker-Lewis fit Index (TLI) > 0.95, and Standardized Root Mean Square Residual (SRMR value < 0.08 [30].…”