Investigating the construct and concurrent validity of the Richards-Campbell Sleep Questionnaire with intensive care unit patients and home sleepers

Abstract

Background: Sleep is vital to our wellbeing. Critically ill patients are vulnerable with effects of sleep deprivation including weakened immune function, decreased glucose tolerance, and increased sympathetic activity. Intensive care unit (ICU) patients' sleep evaluation is difficult and often not reliable. The most commonly used instrument for assessing ICU patients' perspective of their sleep, Richards-Campbell Sleep Questionnaire (RCSQ), has not been reported to have undergone known-group construct validity testing or concurrent validity testing with the criterion measure of feeling refreshed. Objectives: The aim of the study was to explore the construct validity of the RCSQ with known-groups technique and concurrent validity with the criterion measure of feeling refreshed on awakening. Methods: A cross-sectional descriptive survey study using the RCSQ was conducted on people sleeping at home (n ¼ 114) over seven nights. The results were compared with the RCSQ sleep scores of nonintubated alert oriented adult ICU patients (n ¼ 114). Home sleepers were also asked to rate how refreshed they felt on awakening. The study was executed and reported in accordance with the STROBE checklist for observational studies. Findings: RCSQ construct validity was supported because home sleepers' and ICU sleepers' sleep evaluations differed significantly. Home sleepers rated their sleep significantly better than ICU patients in all five sleep domains of the RCSQ. Concurrent validity was supported because the item "feeling refreshed on awakening" correlated strongly with all sleep domains. Conclusions: Sleep quality may be accurately measured using the RCSQ in alert people both in the ICU and at home. This study has added to the validity discussion around the RCSQ. The RCSQ can be used for sleep evaluation in ICUs to promote wellbeing and recovery.

Sensitivity and specificity of proposed Richards‐Campbell Sleep Questionnaire cut‐off scores for good quality sleep during an ICU stay

“…The median global RCSQ (54.4 [30.1, 77.1] mm) was somewhat higher than reported previously in some studies for example median 46 mm reported from a two‐centre study in Australia (Aitken et al, 2017), 47 mm from a one‐centre validation study in Germany (Krotsetis et al, 2017) and 44 mm from a one‐centre validation study in China (Chen et al, 2019) but lower than the median values (Ritmala‐Castren et al, 2017; Rood et al, 2019) and mean values for others (Kamdar et al, 2012; Richards et al, 2000). Of note, in our study scores for the RCSQ domain (VAS) ‘sleep depth’ were exceptionally low when compared to the results of other studies (Kamdar et al, 2012) but similar to others (Aitken et al, 2017; Ritmala‐Castren et al, 2021) indicating that self‐perceived sleep depth was low. These scores were particularly low for patients who classified their sleep as ‘poor’ or ‘very poor’ using the 5‐category scale.…”

“…The overall sleep quality (global RCSQ score) was 76 (SD 13.5) mm (Ritmala-Castren et al, 2021). Therefore, the aim of this study was to determine the global RCSQ cut-off score for good to very good sleep during an ICU stay based on patients' verbal self-evaluation but also the utility of a simple 5-category item Likert scale in which patients rated their nocturnal sleep quality as 'very poor', 'poor', 'fair', 'good' and 'very good'. The study comprised a secondary (cohort) analysis of patient data from an interventional study in which the effectiveness of a sleep promotion bundle was tested (unpublished study).…”

“…In our recent study of home sleepers, we assessed sleep quality using the RCSQ. The overall sleep quality (global RCSQ score) was 76 (SD 13.5) mm (Ritmala‐Castren et al, 2021). Therefore, the aim of this study was to determine the global RCSQ cut‐off score for good to very good sleep during an ICU stay based on patients’ verbal self‐evaluation but also the utility of a simple 5‐category item Likert scale in which patients rated their nocturnal sleep quality as ‘very poor’, ‘poor’, ‘fair’, ‘good’ and ‘very good’.…”

RECOVARI – Postoperative massage in colorectal cancer patients: a randomized controlled, three-arm parallel group trial

“…However, this is a well-known phenomenon in sleep research, that a sleep dept can be developed in nights with disturbed sleep and a subsequent night with less disturbance -such as those at the normal ward after nights at the ICU -tend to be rated better than the following nights when no sleep debt is present [41]. Rating of sleep in the second night at the normal ward was comparable to results from intensive care units and rating of the sleep at home in the follow up was comparable to sleeping at home from other populations [42].…”

The effects of opioid-free anesthesia with dexmedetomidine and esketamine on postoperative anesthetic-related complications for hip surgery in the elderly – a randomized controlled trial

“…Adverse events including PONV, hypoxemia (de ned as a SpO 2 level < 95% with a need for oxygen supplementation) [8], postoperative ileus (de ned as an absence of atus or stools), urinary retention (de ned as the inability to void with bladder distention and need of catheterization), delirium (measured twice daily using the Confusion Assessment Method) [9] were recorded. Sleep quality during the rst postoperative night was evaluated using the Richards-Campbell Sleep Questionnaire [10]. Quality of life was assessed using the VAS score of the EuroQol 5 Dimension 5 Level (EQ-5D-5L) [11] 30 days after surgery by a telephone interview.…”