1
|
Becking BE, Verweij JP, Jonkman REG, van Merkesteyn JPR, Van den Akker-Van Marle ME. Cross-cultural validity of the Dutch sleep-related breathing disorder scale of the Pediatric Sleep Questionnaire in a general population. Sleep Med 2024; 119:19-26. [PMID: 38636211 DOI: 10.1016/j.sleep.2024.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 03/18/2024] [Accepted: 04/06/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Pediatric sleep-disordered breathing is associated with multiple health problems. Polysomnography is the reference standard for identifying this disorder, but availability is limited. Therefore, an alternative screening tool is needed. Globally, the Sleep-Related Breathing Disorder scale of the Pediatric Sleep Questionnaire (PSQ) has proven to be a feasible tool. Consequently, this study aimed to translate and culturally adapt the PSQ into Dutch and then to examine the cultural validity, internal consistency, and test-retest reliability of the Dutch version among a general population visiting oral healthcare centers. METHODS The translation, review, adaptation, pretest, and documentation approach was used to ensure cross-cultural adaptation of the PSQ. Then, 220 children (2.4-18 years) were sampled for clinimetric evaluation. We estimated the cross-cultural validity by comparing the factor analyses of the original PSQ and the Dutch version. Reliability was assessed using Cronbach's alpha, Spearman's correlation, the intraclass correlation coefficient, the standard error of measurement, and a Bland-Altman plot. RESULTS The factor loading patterns of the Dutch version matched with the original study around the four predetermined factors: breathing, sleepiness, behavior, and other. The internal consistency, with a Cronbach's α of 0.77, was acceptable. The test-retest reliability with an intraclass correlation coefficient and Spearman's correlation of 0.89 and 0.93, respectively, was good to excellent. CONCLUSIONS Cultural adaptation was ensured and the results support cross-cultural validity, internal consistency, and test-retest reliability of the Dutch Sleep-Related Breathing Disorder scale of the PSQ. This questionnaire could therefore be a valuable tool for screening disordered breathing in Dutch children.
Collapse
Affiliation(s)
- Bibi E Becking
- Department of Oral and Maxillofacial Surgery, Leiden University Medical Center, P.O Box 9600, 2300 RC, Leiden, the Netherlands.
| | - Jop P Verweij
- Department of Oral and Maxillofacial Surgery, Amphia Hospital, Breda, the Netherlands.
| | | | - J P Richard van Merkesteyn
- Department of Oral and Maxillofacial Surgery, Leiden University Medical Center, P.O Box 9600, 2300 RC, Leiden, the Netherlands.
| | | |
Collapse
|
2
|
Rajan A, Chakrabarty B, Gulati S, Jauhari P, Pandey RM, Tripathi M, Kabra SK, Jain V, Sikka K, Zulfiqar L, Upadhyay AD, Gupta S, Chandeliya K. Childhood and Adolescent Sleep Awareness in Caregivers and Health Care Providers: A Community- and Hospital-Based Survey. Pediatr Neurol 2023; 147:14-23. [PMID: 37531700 DOI: 10.1016/j.pediatrneurol.2023.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 05/19/2023] [Accepted: 06/20/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND Sleep disorders are common in childhood and adolescence with mental and physical consequences needing appropriate intervention by caregivers and health care providers (HCPs). The objective of the study, conducted at a tertiary teaching hospital and public school in north India, was to develop validated questionnaires to evaluate childhood and adolescent sleep awareness in caregivers and HCPs. METHODS The study participants (caregivers represented by parents of 2-18 year olds attending a public school and of those attending outpatient services at the study hospital and HCPs represented by medical interns and nursing graduates within 1 year of graduation) were enrolled after appropriate screening. RESULTS Two separate questionnaires in English for caregivers (also translated in Hindi) and HCPs were applied on 313 caregivers and 175 HCPs (110 medical interns and 65 nursing graduates) and developed and validated with a Cronbach α of 0.73 and 0.74, respectively. The questionnaires covered three domains: sleep hygiene, sleep related health problems, and miscellaneous. Both group of respondents had >50% correct responses in sleep hygiene. The ĸ agreement between knowledge and practice of sleep hygiene in caregivers was 0.2. Poor response (<50% correct responses) was seen in sleep-related health problems in both groups of respondents implying knowledge deficit in various sleep disorders. The HCPs performed poorly on basic theoretical questions in miscellaneous domain. For consultation of sleep problems, most caregivers (48%) chose pediatricians. CONCLUSION There is a need to strengthen undergraduate medical and nursing curriculum in sleep. Caregivers should be made aware of implications of unhealthy sleep.
Collapse
Affiliation(s)
- Aswani Rajan
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Biswaroop Chakrabarty
- Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
| | - Sheffali Gulati
- Coordinator DM Pediatric Neurology Programme, Faculty-in-Charge, Centre of Excellence and Advanced Research on Childhood Neurodevelopmental Disorders, Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Prashant Jauhari
- Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Ravindra Mohan Pandey
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Manjari Tripathi
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Sushil Kumar Kabra
- Division of Pediatric Pumonology and Intensive Care, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Vandana Jain
- Pediatric Endocrinology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Kapil Sikka
- Department of ENT, All India Institute of Medical Sciences, New Delhi, India
| | - Luhar Zulfiqar
- Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Ashish Datt Upadhyay
- Scientist II, Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Sandhya Gupta
- Nursing College, All India Institute of Medical Sciences, New Delhi, India
| | - Kamlesh Chandeliya
- Chief Nursing Officer, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
3
|
Mazi A. The validity and reliability of the Arabic translation of the Pediatric Sleep Questionnaire. Sleep Med 2023; 103:116-122. [PMID: 36780751 DOI: 10.1016/j.sleep.2023.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/18/2023] [Accepted: 01/21/2023] [Indexed: 01/27/2023]
Abstract
OBJECTIVE/BACKGROUND Obstructive sleep apnea (OSA) is a common sleep disorder in childhood. Polysomnography is the gold standard for the diagnosis of OSA. However, it is expensive and time-consuming, and it may be unavailable. The self-administered Pediatric Sleep Questionnaire (PSQ) is a reliable and validated screening test featuring high sensitivity (0.85) and specificity (0.87). It has been translated into multiple languages and is widely used to screen for OSA in children. This study translated the PSQ into Saudi Arabian Arabic and validated it. PATIENTS/METHODS The Arabic-PSQ was translated using forward-backward translation, following established guidelines. A review committee monitored the process and approved the final version. The reliability of the scale was measured using Cronbach's alpha and kappa statistics. The validity of the Arabic-PSQ was evaluated using confirmatory factor analysis (CFA). RESULTS Our study recruited 220 Saudi children with potential adenoid hypertrophy from King Abdulaziz University hospital clinics. The Arabic-PSQ had excellent internal consistency (Cronbach's α 0.946). Additionally, all subscales had excellent reliability, with Cronbach's α of 0.924 for snoring, 0.762 for sleepiness, and 0.820 for behavior. Test-retest reliability showed excellent agreement of >80% in all items (p < 0.0001). CFA for the Arabic-PSQ confirmed a significant correlation between the items of each subscale. CONCLUSIONS The Arabic-PSQ is reliable, validated, and culturally adapted. It can be safely used to screen for OSA in children. However, given this study's limitations, the diagnostic efficacy of the Arabic-PSQ should be assessed in future studies.
Collapse
Affiliation(s)
- Ahlam Mazi
- Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, PO Box 80215, Jeddah, 21589, Kingdom of Saudi Arabia.
| |
Collapse
|
4
|
Niu X, Yung AKC, Strickertsson TIB, Stoustrup P, Cornelis MA, Cattaneo PM. Translation and cross-cultural adaptation of the sleep-related breathing disorder scale of the Pediatric Sleep Questionnaire into Danish language. Acta Odontol Scand 2022; 80:411-418. [PMID: 35044870 DOI: 10.1080/00016357.2021.2023755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE/BACKGROUND Sleep-disordered breathing (SDB) is common but often underestimated in children. The gold standard for assessing SDB is polysomnography, but it is expensive and time-consuming. The Paediatric Sleep Questionnaire (PSQ/SRDB) is a validated screening tool for SDB, which represents an efficient and alternative tool for screening SDB among children. However, a translated and validated Danish version of the PSQ/SRDB is not available yet. Our aim was to cross-culturally translate the PSQ/SRDB into Danish language for use in clinical and research settings. PATIENTS/METHODS The translation was carried out through forward-backward translation techniques performed by a panel of experts, and the cross-cultural adaptation was achieved by pretesting of the pre-final version. Internal consistency of the Danish PSQ/SRDB version was measured by Cronbach's alpha coefficients, while Cohen's kappa was used to evaluate test-retest reliability. Construct validity was assessed by factor analysis of the principal components. RESULTS The Danish PSQ/SRDB was administered to the caregivers of 348 children. An overall Cronbach's alpha of 0.72 was found, confirming the survey's consistency, with the results for the domains ranging 0.52-0.70. The Danish PSQ/SRDB showed moderate to perfect reliability for all items, except for one question (C14). Factor analysis performed on the Danish PSQ/SRDB showed that the predetermined four factors were similar with the original version of the PSQ/SRDB. CONCLUSIONS The Danish version of the PSQ/SRDB has been successfully translated and cross-culturally adapted, suggesting that it can be used as an appropriate paediatric screening tool for SDB in Denmark.
Collapse
Affiliation(s)
- Xiaowen Niu
- Department of Dentistry and Oral Health, Section of Orthodontics, Aarhus University, Aarhus, Denmark
| | - Augustine K. C. Yung
- Department of Dentistry and Oral Health, Section of Orthodontics, Aarhus University, Aarhus, Denmark
| | | | - Peter Stoustrup
- Department of Dentistry and Oral Health, Section of Orthodontics, Aarhus University, Aarhus, Denmark
| | - Marie A. Cornelis
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Paolo M. Cattaneo
- Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| |
Collapse
|
5
|
Zulfiqar L, Chakrabarty B, Gulati S, Jauhari P, Pandey RM, Tripathi M, Kabra SK, Jain V, Sikka K, Rajan A, Kaur P. The Childhood and Adolescent Sleep Evaluation Questionnaire (CASEQ): Development and validation of an ICSD-3-based screening instrument, a community and hospital-based study. J Sleep Res 2021; 31:e13479. [PMID: 34494338 DOI: 10.1111/jsr.13479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 07/29/2021] [Accepted: 08/21/2021] [Indexed: 12/01/2022]
Abstract
Sleep disorders are common in children and adolescents. Polysomnography is the gold-standard diagnostic method; however, it is a tedious procedure. The objective of the study was to develop a screening questionnaire for sleep problems based on International Classification of Sleep Disorders-3 in children and adolescents, and validate it with clinical evaluation and polysomnography. A questionnaire was developed in English and Hindi with content validation by eight multidisciplinary experts. Respondents were parents of children and adolescents, aged 2-18 years, recruited from a public school and a tertiary care teaching hospital in north India. A subset of these children and adolescents underwent overnight polysomnography and detailed clinical evaluation within 4 weeks of applying the questionnaire. The questionnaire, named Childhood and Adolescent Sleep Evaluation Questionnaire, contains primary questions covering all subgroups of disorders under International Classification of Sleep Disorders-3, and secondary questions on sleep hygiene and comorbidities. The questionnaire was filled by 750 respondents, out of which 100 cases underwent polysomnography and clinical evaluation. The internal consistency in the form of Cronbach's α was 0.8 for the questionnaire. The sensitivity, specificity, positive and negative predictive values for the questionnaire in identifying those with sleep problems compared with detailed clinical and polysomnographic evaluations were 85%, 100%, 100% and 62.5%, respectively. For individual subgroups of disorders, the sensitivity, specificity, positive and negative predictive values varied between 72.7% and 100%, 88.9% and 100%, 62.5% and 100% and 81.6% and 100%, respectively. The Childhood and Adolescent Sleep Evaluation Questionnaire has good psychometric properties, moreover, its simplicity and translatability make it ideal for use at the community and hospital settings.
Collapse
Affiliation(s)
- Luhar Zulfiqar
- Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Biswaroop Chakrabarty
- Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Sheffali Gulati
- Centre of Excellence and Advanced Research on Childhood Neurodevelopmental Disorders, Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi
| | - Prashant Jauhari
- Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Ravindra Mohan Pandey
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Manjari Tripathi
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Sushil Kumar Kabra
- Division of Pediatric Pulmonology and Intensive Care, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Vandana Jain
- Pediatric Endocrinology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Kapil Sikka
- Department of ENT, All India Institute of Medical Sciences, New Delhi, India
| | - Aswani Rajan
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Prabhjot Kaur
- Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
6
|
Wadhwa R, Jain A, Kundu K, Nebhinani N, Gupta R. Knowledge about obstructive sleep apnea among medical undergraduate students: A long way to go! Indian J Psychiatry 2020; 62:713-717. [PMID: 33896979 PMCID: PMC8052889 DOI: 10.4103/psychiatry.indianjpsychiatry_587_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 12/29/2019] [Accepted: 06/17/2020] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE The aim is to study the knowledge and attitude of medical undergraduate students regarding obstructive sleep apnea (OSA). MATERIALS AND METHODS This cross-sectional study involved 324 medical undergraduate students in clinical semesters. Knowledge and attitude regarding adult OSA were assessed using the obstructive sleep apnea knowledge and attitude (OSAKA), and to evaluate the same about childhood OSA, OSAKA-KIDS was used. RESULTS Results showed that the study population was not informed about OSA among adults as well as kids. Most of the participants could recognize that snoring was a common symptom of adult OSA but failed to identify the association between childhood OSA and hyperactivity. The participants had a good knowledge about the pathophysiology of OSA. More than 80% of students reported that OSA is an important disorder and that these patients should be identified. CONCLUSION Medical undergraduates are poorly informed about OSA.
Collapse
Affiliation(s)
- Ridhima Wadhwa
- Department of Psychiatry, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
| | - Ashita Jain
- Department of Psychiatry, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
| | - Kaustav Kundu
- Department of Psychiatry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Naresh Nebhinani
- Department of Psychiatry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Ravi Gupta
- Department of Psychiatry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| |
Collapse
|
7
|
Pediatric Sleep Related Problems: The Tip of the Iceberg. Indian J Pediatr 2018; 85:825-826. [PMID: 30099689 DOI: 10.1007/s12098-018-2762-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 07/27/2018] [Indexed: 10/28/2022]
|