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Ozturk GY, Arat NB, Ozdemir AA, Bashan I, Kocyigit BF. The effect of earthquake on fibromyalgia: a comparison of patients on medication and without medication. Rheumatol Int 2024; 44:1345-1351. [PMID: 38722331 PMCID: PMC11178565 DOI: 10.1007/s00296-024-05605-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 04/24/2024] [Indexed: 06/15/2024]
Abstract
INTRODUCTION / OBJECTIVES Stressful events like earthquakes might worsen the symptoms of fibromyalgia, although the influence of medications on these consequences is yet uncertain. The objective of this study was to examine the influence of an earthquake on the symptoms of fibromyalgia and evaluate the impacts of medications used to treat fibromyalgia on the clinical picture. METHOD Ninety-five fibromyalgia patients were enrolled in a comparative study and divided into two groups: medication and non-medication. Three subcategories of medication groups were established: selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and gabapentinoid drugs (GDs). Before and after the earthquake, clinical evaluations were conducted using the Fibromyalgia Impact Questionnaire (FIQ), Hospital Anxiety and Depression Scale (HADS), and Jenkins Sleep Rating Scale (JSS). Statistical analyses were conducted to compare the scores before and after the earthquake and evaluate the differences between the groups. RESULTS Statistically significant increases were observed in FIQ, HADS-anxiety, HADS-depression, and JSS scores in the medication and non-medication groups before and after the earthquake comparisons (p < 0.05). Non-medication group reported significantly higher post-earthquake changes in FIQ, HADS-anxiety, HADS-depression, and JSS compared to the medication group (p < 0.05). While HADS-anxiety, HADS-depression, and JSS changes after the earthquake differed according to the drug subgroups (p < 0.05), no statistically significant difference was observed in FIQ values (p > 0.05). The highest scores were detected in the GD subgroup. CONCLUSIONS This study highlights the substantial impact of earthquakes on fibromyalgia patients. Medication use may assist in reducing the detrimental effects of stresses like earthquakes on fibromyalgia symptomatology. Future research with larger sample sizes and more extended follow-up periods is needed to explain these findings and optimize treatment regimens for fibromyalgia patients experiencing significant stressors.
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Affiliation(s)
- Gulsah Yasa Ozturk
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Adana City Research and Training Hospital, Adana, Türkiye
| | - Neval Bozok Arat
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Adana City Research and Training Hospital, Adana, Türkiye
| | - Asena Ayca Ozdemir
- Department of Medical Education, Faculty of Medicine, Mersin University, Mersin, Türkiye
| | - Ibrahim Bashan
- Department of Medical Education, Faculty of Medicine, Mersin University, Mersin, Türkiye
| | - Burhan Fatih Kocyigit
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Adana City Research and Training Hospital, Adana, Türkiye.
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AlMashouk Y, Abu-Saleh SY, Ghazzawi H, Trabelsi K, Jahrami H. Translating and establishing the psychometric properties of the Jenkins Sleep Scale for Arabic-speaking individuals. BMC Psychiatry 2024; 24:236. [PMID: 38549105 PMCID: PMC10976800 DOI: 10.1186/s12888-024-05714-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 03/25/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND The Jenkins Sleep Scale is a widely used self-report questionnaire that assesses sleep quality and disturbances. This study aimed to translate the scale into Arabic and evaluate its psychometric properties in an Arabic-speaking population. METHODS The Jenkins Sleep Scale was translated into Arabic using forward and backward translation procedures. The Arabic version was administered to a convenience sample of 420 adults along with the Pittsburgh Sleep Quality Index (PSQI) and Athens Insomnia Scale (AIS) for validation purposes. Reliability was examined using Cronbach's alpha and McDonald's omega coefficients. Confirmatory factor analysis (CFA) was also conducted to test the unidimensional factor structure. Convergent validity was assessed using correlations with PSQI and AIS scores. RESULTS The Cronbach's alpha and McDonald's omega values for the Arabic Jenkins Sleep Scale were 0.74 and 0.75, respectively, indicating good internal consistency. The 2-week and 4-week test-retest intraclass correlation coefficients were both 0.94 (p < 0.001), indicating excellent test-retest reliability. The CFA results confirmed the unidimensional factor structure (CFI = 0.99, TLI = 0.96, RMSEA = 0.08). The measurement model had an equivalent factor structure, loadings, intercepts, and residuals across sex, age, and marital status. Significant positive correlations were found between the Arabic Jenkins scale score and the PSQI (r = 0.80, p < 0.001) and AIS (r = 0.74, p < 0.001), supporting convergent validity. CONCLUSION The Arabic version of the Jenkins Sleep Scale demonstrated good psychometric properties. The findings support its use as a valid and reliable measure for evaluating sleep quality and disturbances among Arabic-speaking populations.
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Affiliation(s)
| | - Salma Yasser Abu-Saleh
- Department Nutrition and Food Technology, Jordan University of Science and Technology, Irbid, Jordan
| | - Hadeel Ghazzawi
- Nutrition and Food Science Department, Agriculture School, The University of Jordan, Amman, P. O. Box 11942, Jordan
| | - Khaled Trabelsi
- High Institute of Sport and Physical Education of Sfax, University of Sfax, 3000, Sfax, Tunisia
- Research Laboratory: Education, Motricity, Sport and Health, EM2S, LR19JS01, University of Sfax, 3000, Sfax, Tunisia
| | - Haitham Jahrami
- Government Hospitals, Manama, Bahrain.
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain.
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Juhola J, Arokoski JPA, Ervasti J, Kivimäki M, Vahtera J, Myllyntausta S, Saltychev M. Sex-related differential item functioning of the Jenkins Sleep Scale: a cross-sectional study among 77 967 employees in the Finnish public sector. BMJ Open 2024; 14:e074867. [PMID: 38458793 DOI: 10.1136/bmjopen-2023-074867] [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] [Indexed: 03/10/2024] Open
Abstract
OBJECTIVES To investigate if the Jenkins Sleep Scale (JSS) demonstrates sex-related differential item functioning (DIF). DESIGN Cross-sectional study. SETTING Survey data from the Finnish Public Sector study (2015-2017). PARTICIPANTS 77 967 employees in the Finnish public sector, with a mean age of 51.9 (SD 13.1) years and 82% women. OUTCOME MEASURES Item response theory estimates: difficulty and discrimination parameters of the JSS and differences in these parameters between men and women. RESULTS The mean JSS total score was 6.4 (4.8) points. For all four items of the JSS, the difficulty parameter demonstrated a slight shift towards underestimation of the severity of sleep difficulties. The discrimination ability of all four items was moderate to high. For the JSS composite score, overall discrimination ability was moderate (0.98, 95% CI 0.97 to 0.99). Mild uniform DIF (p<0.001) was seen: two items showed better discrimination ability among men and two others among women. CONCLUSIONS The JSS showed overall good psychometric properties among this healthy population of employees in the Finnish public sector. The JSS was able to discriminate people with different severities of sleep disturbances. However, when using the JSS, the respondents might slightly underestimate the severity of these disturbances. While the JSS may produce slightly different results when answered by men and women, these sex-related differences are probably negligible when applied to clinical situations.
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Affiliation(s)
- Juhani Juhola
- Department of Physical and Rehabilitation Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Jari P A Arokoski
- Department of Physical and Rehabilitation Medicine, Helsingin yliopistollinen Keskussairaala, Helsinki, Finland
- Helsingin yliopisto, Helsinki, Finland
| | - Jenni Ervasti
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Mika Kivimäki
- University of Helsinki Faculty of Medicine, Helsinki, Finland
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Jussi Vahtera
- Department of Public Health, Turun Yliopisto, Turku, Finland
- Finnish Institute of Occupational Health, Turku, Finland
| | | | - Mikhail Saltychev
- Department of Physical and Rehabilitation Medicine, Turku University Hospital and University of Turku, Turku, Finland
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Alptug B, Tüzün EH, Keçeci B, Eker L. Effects of perceptive rehabilitation and mobilization methods on symptoms and disability in patients with fibromyalgia: A preliminary randomized control trial. Ir J Med Sci 2023; 192:2937-2947. [PMID: 36897535 DOI: 10.1007/s11845-023-03333-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 03/02/2023] [Indexed: 03/11/2023]
Abstract
BACKGROUND Currently, there is no definitive cure for fibromyalgia. Instead, treatments focus of reducing symptoms and disability. AIMS This randomized controlled study aimed to evaluate the effectiveness of perceptive rehabilitation and soft tissue and joint mobilization on the severity of symptoms and disability in fibromyalgia compared with a control group. METHODS A total of 55 fibromyalgia patients were randomized into three groups: perceptive rehabilitation, mobilization, and control. The impact of fibromyalgia was evaluated using the Revised Fibromyalgia Impact Questionnaire (FIQR; primary outcome). Pain intensity, fatigue severity, depression, and sleep quality were secondary outcome measures. Data were collected at baseline (T0), the end of treatment (8 weeks; T1), and the end of 3 months (T2). RESULTS Statistically significant differences were found in between-groups comparisons at T1 for primary and secondary outcome measurements (p < .05), except for sleep quality. Both the perceptive rehabilitation and mobilization groups had statistically significant differences at T1 over the control group (p < .05). Between-group pairwise comparisons showed statistically significant differences between the perceptive and control groups for all outcome measures at T1 (p < .05). Similarly, statistically significant differences existed between the mobilization and control groups for all outcome measures at T1 (p < .05), except the FIQR overall impact scores. All other variables except depression were statistically similar between groups at T2. CONCLUSION This study shows that perceptive rehabilitation and mobilization therapy are similarly effective in improving fibromyalgia symptoms and disability, but the effects disappear within 3 months. Further research is needed to understand how the improvements could be maintained longer. TRIAL REGISTRATION Clinical Trial Registration number, ClinicalTrials.gov Identifier: NCT03705910.
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Affiliation(s)
- Beraat Alptug
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, European University of Lefke, Mersin 10, Lefke, Northern Cyprus, Turkey.
| | - Emine Handan Tüzün
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Eastern Mediterranean University, Mersin 10, Famagusta, Northern Cyprus, Turkey
| | - Barış Keçeci
- Sorgun Municipality Sports Club Association, Sorgun Municipality, Sorgun, Yozgat, Turkey
| | - Levent Eker
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Eastern Mediterranean University, Mersin 10, Famagusta, Northern Cyprus, Turkey
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Gouda W, Mokhtar M, Elazab SA, Alreefi R, Alomar T, Kushk F, Alahmadi R, Khalil M, Kamal M. Sleep disorders in patients with rheumatoid arthritis: association with quality of life, fatigue, depression levels, functional disability, disease duration, and activity: a multicentre cross-sectional study. J Int Med Res 2023; 51:3000605231204477. [PMID: 37818729 PMCID: PMC10568993 DOI: 10.1177/03000605231204477] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 09/13/2023] [Indexed: 10/13/2023] Open
Abstract
OBJECTIVE To investigate the correlations between pain, quality of life, fatigue, levels of depression, disability and activity, and sleep quality and common sleep disorders in patients with rheumatoid arthritis (RA). METHODS This multicentre, cross-sectional study enrolled patients with RA and sex- and age-matched control subjects. Clinical, sociodemographic, serological and therapeutic data were collected. Data from the Disease Activity Score (DAS28-CRP), the Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), Berlin questionnaire, a visual analogue scale to evaluate fatigue severity (VAS-F), health assessment questionnaire disability index (HAQ-DI) and the Center for Epidemiological Studies-depression (CES-D) score were analysed. RESULTS The study enrolled 247 patients with RA (190 females and 57 males) and 60 control subjects (50 females and 10 males). The PSQI for patients with RA was significantly associated with the DAS28-CRP, HAQ-DI and VAS-F. There was a significant correlation between the CES-D score, the Berlin questionnaire and the HAQ-DI and the age of control subjects. Multiple linear regression analysis demonstrated that HAQ-DI (coefficient β = 0.103) and VAS-F (coefficient β = 0.028) significantly predicted the risk of sleep apnoea. CONCLUSION Patients with RA may suffer from poor sleep quality, which is attributed to depression, fatiguability, disability and disease activity.
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Affiliation(s)
- Wesam Gouda
- Department of Rheumatology, Faculty of Medicine, Al Azhar University, Assiut, Egypt
| | - Mona Mokhtar
- Department of Rheumatology and Rehabilitation, Faculty of Medicine, Al Azhar University, Cairo, Egypt
| | - Seham A. Elazab
- Department of Rheumatology and Rehabilitation, Faculty of Medicine, Al Azhar University, Cairo, Egypt
| | - Reem Alreefi
- Department of Internal Medicine, Faculty of Medicine, Taibah University, Medina, Saudi Arabia
| | - Taif Alomar
- Department of Internal Medicine, Faculty of Medicine, Taibah University, Medina, Saudi Arabia
| | - Fatimah Kushk
- Department of Internal Medicine, Faculty of Medicine, Taibah University, Medina, Saudi Arabia
| | - Raghad Alahmadi
- Department of Internal Medicine, Faculty of Medicine, Taibah University, Medina, Saudi Arabia
| | - Mayada Khalil
- Department of Rheumatology and Rehabilitation, Faculty of Medicine, Benha University, Benha, Egypt
| | - Mohamed Kamal
- Department of Rheumatology and Rehabilitation, Faculty of Medicine, Al Azhar University, Cairo, Egypt
- Department of Internal Medicine, Faculty of Medicine, Taibah University, Medina, Saudi Arabia
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Song Y, Dong Q, Chang Z, Song C, Cui K, Wu S, Gao G, Fu R, Gao Y, Dou K. The impact of sleep quality and its change on the long-term risk of stroke in middle-aged and elderly people: Findings from the English Longitudinal Study of Ageing. Sleep Med 2023; 107:281-288. [PMID: 37263080 DOI: 10.1016/j.sleep.2023.04.032] [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: 02/16/2023] [Revised: 04/26/2023] [Accepted: 04/30/2023] [Indexed: 06/03/2023]
Abstract
OBJECTIVE This study focused on middle-aged and elderly adults (mean age ≥60 years) in England and aimed to evaluate the impact of sleep quality and change in sleep quality on the long-term risk of stroke. PATIENTS/METHODS The current prospective study enrolled 6214 participants without stroke from wave 4 (2008-2009) of the English Longitudinal Study Aging (ELSA) dataset. From the ELSA questionnaires, sleep quality scores were calculated and used to evaluate the sleep quality of each participant. Cox proportional hazards regression models were used to assess the association between sleep status and stroke risk. Restricted cubic spline (RCS) was employed for the relationship between sleep quality score and the risk of stroke. RESULTS During the 8-year follow-up, 130 (2.1%) cases of stroke were recorded. Participants with poor baseline sleep quality had a significantly higher long-term risk of stroke compared with those with good sleep quality (hazard ratio [HR] 2.37, 95% confidence intervals [CI] 1.44, 3.91). For the influence of change in sleep quality on stroke risk, worsened sleep quality was associated with a significant increase in the risk of stroke in the good (HR 2.08, 95% CI, 1.02, 4.26) and intermediate sleep quality groups (HR 2.15, 95% CI, 1.16, 3.98). Moreover, improved sleep quality decreased stroke risk among subjects with poor sleep quality (HR 0.31, 95% CI, 0.15, 0.61). CONCLUSIONS Poor and worsened sleep quality is associated with an increased risk of stroke. Emphasis should be placed on improving sleep quality in middle-aged and elderly individuals.
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Affiliation(s)
- Yanjun Song
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; State Key Laboratory of Cardiovascular Disease, Beijing, China
| | - Qiuting Dong
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; State Key Laboratory of Cardiovascular Disease, Beijing, China
| | - Zhen'ge Chang
- Department of Respiratory Medicine, Civil Aviation General Hospital, Beijing, China
| | - Chenxi Song
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; State Key Laboratory of Cardiovascular Disease, Beijing, China
| | - Kongyong Cui
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; State Key Laboratory of Cardiovascular Disease, Beijing, China
| | - Shaoyu Wu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; State Key Laboratory of Cardiovascular Disease, Beijing, China
| | - Guofeng Gao
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; State Key Laboratory of Cardiovascular Disease, Beijing, China
| | - Rui Fu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; State Key Laboratory of Cardiovascular Disease, Beijing, China
| | - Ying Gao
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; State Key Laboratory of Cardiovascular Disease, Beijing, China.
| | - Kefei Dou
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; State Key Laboratory of Cardiovascular Disease, Beijing, China.
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AKÇAY İH, DEMİRDEL E. The Investigation of the Results of Clinical Evaluation, Pain, Functional Status and Sleep Quality According to Electrodiagnostic Test Results in Females with Carpal Tunnel Syndrome: A Pilot Study. İSTANBUL GELIŞIM ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2022. [DOI: 10.38079/igusabder.1087891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Amaç: Çalışmamız, elektrodiagnostik test sonuçlarına göre hafif ve orta düzey Karpal Tünel Sendromu (KTS) tanısı almış kadın hastaların klinik semptom şiddetleri, el fonksiyonları ve uyku kalitelerinin karşılaştırılması ve hastaların semptom şiddetleri ile el fonksiyonelliği ve uyku kalitesi arasındaki ilişkinin incelenmesi amacıyla planlandı.Yöntem: Çalışmamız, Erzurum Atatürk Üniversitesi Eğitim ve Araştırma Hastanesi Fizik Tedavi Polikliniğine başvuran, hafif-orta düzey KTS tanısı alan ve 35-65 yaş aralığında olan 32 kadın hasta ile gerçekleştirildi. KTS şiddetinin elektrofizyolojik tanılaması için elektromiyografi (EMG), ağrı ölçümü için Vizüel Analog Skalası (VAS), KTS fonksiyonel durum şiddeti ve semptom şiddeti için Boston KTS Anketi, el fonksiyonelliği için Duruöz El İndeksi, uyku kalitesi için Jenkins Uyku Skalası kullanıldı. Veriler SPSS programı ile değerlendirildi.Bulgular: Çalışmamız sonuçlarına göre hafif ve orta şiddette KTS tanısı almış hastaların ağrı, Boston KTS Anketi, Jenkins Uyku Skalası sonuçlarının benzer olduğu (p>0.05); Duruöz El İndeksi sonuçlarının ise orta şiddette KTS tanısı almış hastalarda hafif şiddette KTS hastalarına göre daha yüksek olduğu belirlendi (p<0.05). Hastaların semptom şiddetleri ile el fonksiyonelliği ve uyku kalitesi arasındaki ilişki incelendiğinde ise; semptom şiddeti yüksek olan hastalarda fonksiyonel durum ve uyku kalitelerinin daha kötü olduğu belirlendi (p<0.01).Sonuç: KTS hastalarında EMG sonuçları ile klinik semptomlar her zaman birbiri ile uyumlu olmayabilmekte, EMG sonuçlarına göre farklı şiddette KTS’si olan hastaların yaşadığı semptomlar hastaya özgü değişiklikler gösterebilmektedir. Buna göre KTS hastalarının klinik durumları ile EMG sonuçlarının birlikte değerlendirilmesi ile hastaya özgü planlanacak tedaviler ile daha etkili sonuçlara ulaşılabileceğini düşünmekteyiz.
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Affiliation(s)
- İbrahim Halil AKÇAY
- ANKARA YILDIRIM BEYAZIT UNIVERSITY, ANKARA STUDIES APPLICATION AND RESEARCH CENTER
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Spanish version of Jenkins Sleep Scale in physicians and nurses: psychometric properties from a Peruvian nationally representative sample. J Psychosom Res 2022; 157:110759. [PMID: 35358746 DOI: 10.1016/j.jpsychores.2022.110759] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 02/02/2022] [Accepted: 02/05/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To evaluate the psychometric properties of the Spanish version of Jenkins Sleep Scale with 4 items (JSS-4) of the Peruvian health system's (PHS) nurses and physicians. METHODS We carried out a psychometric study based on secondary analysis in a sample from a nationally representative survey that used acomplex sampling design. The participants were physicians and nurses aged 18-65 years, working in PHS private and public facilities, who have fulfilled all JSS-4 items. We performed a confirmatory factor analysis. Reliability was evaluated via two estimates - classic alpha (α) and categorical omega (ω) coefficients. Also, we tested the invariance across groups of variables. The convergent validity was evaluated based on the relation between JSS-4 and PHQ-2 using Pearson's correlation coefficient and effect size (Cohen's d). Also, we designed normative values based on percentiles. RESULTS We included 2100 physicians and 2826 nurses in the analysis. We observed that the unidimensional model has adequate goodness-of-fit indices and values of α and ω coefficients. No measurement invariance was found between the groups of professionals and age groups; however, invariance was achieved between sex, monthly income, work-related illness, and chronic illness groups. Regarding the relation with other variables, the JSS-4 has a small correlation with PHQ-2. Also, profession and age-specific normative values were proposed. CONCLUSION JSS-4 Spanish version has adequate psychometric properties in PHS nurses and physicians.
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von Känel R, Meister-Langraf RE, Pazhenkottil AP, Barth J, Schnyder U, Schmid JP, Znoj H, Princip M. Insomnia Symptoms and Acute Coronary Syndrome-Induced Posttraumatic Stress Symptoms: A Comprehensive Analysis of Cross-sectional and Prospective Associations. Ann Behav Med 2021; 55:1019-1030. [PMID: 33580657 DOI: 10.1093/abm/kaaa128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Acute coronary syndrome (ACS) induces clinically significant posttraumatic stress symptoms (PTSS) in 12% of patients. Subjective sleep problems are a risk factor for the development of PTSS, but this is underexplored in patients with ACS. PURPOSE To examine the association of insomnia symptoms with ACS-induced PTSS. METHODS In this longitudinal study with 154 patients (all white, 84.4% male, mean age 58.7 years) with a verified ACS, insomnia symptoms were interviewer assessed at hospital admission and at 3 months, using the Jenkins Sleep Scale (JSS)-4. ACS-induced PTSS were assessed with the Clinician-Administered Posttraumatic Stress Disorder Scale 3 months after hospital admission. In multivariable linear models, insomnia symptoms were regressed on PTSS, adjusting for demographics, clinical variables, health behaviors, and psychological data, including cognitive depressive symptoms. RESULTS Greater insomnia symptoms at admission (β = .165, p = .034), greater increase in insomnia symptoms from admission to 3 months (β = .233, p = .008), and greater insomnia symptoms at 3 months (β = .239, p = .002) were independently associated with more severe total PTSS at 3 months. Concerning the individual PTSS clusters, both insomnia symptoms at admission (β = .214, p = .007) and at 3 months (β = .213, p = .012) were independently associated with reeexperiencing symptoms. Removing sleep items from PTSS scores and excluding patients on antidepressants in two sensitivity analyses did not substantially change the results. CONCLUSIONS Insomnia symptoms could play an important role in the development and severity of ACS-induced PTSS. This relationship seems not simply explained by the fact that sleeping difficulties are inherent to the phenotype of posttraumatic stress disorder. CLINICAL TRIAL INFORMATION NCT01781247.
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Affiliation(s)
- Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Culmannstrasse, Zurich, Switzerland
| | - Rebecca E Meister-Langraf
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Culmannstrasse, Zurich, Switzerland.,Department of Psychiatry, Clienia Schlössli AG, Oetwil am See, Zurich, Switzerland
| | - Aju P Pazhenkottil
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Culmannstrasse, Zurich, Switzerland.,Department of Cardiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.,Cardiac Imaging, Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Jürgen Barth
- Institute for Complementary and Integrative Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | | | - Jean-Paul Schmid
- Department of Cardiology, Clinic Barmelweid, Barmelweid, Switzerland
| | - Hansjörg Znoj
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - Mary Princip
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Culmannstrasse, Zurich, Switzerland
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Karaaslan Y, Mete O, Karadag M, Ozer Kaya D, Toprak Celenay S. An investigation of potential coronaphobia-related factors in adults and sleep quality relations. Sleep Med 2021; 84:356-361. [PMID: 34246043 DOI: 10.1016/j.sleep.2021.06.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 03/01/2021] [Accepted: 06/11/2021] [Indexed: 01/16/2023]
Abstract
BACKGROUND The study aimed to investigate potential coronaphobia-related factors in adults and to assess the relationship between coronaphobia and sleep quality. METHODS This cross-sectional study was conducted in 1262 participants. The Covid-19 Phobia Scale (C19P-S) and Jenkins Sleep Scale (JSS) were used to measure outcomes. Univariate and multivariate logistic regression analyses were constructed to determine risk factors for coronaphobia. Pearson correlation coefficient was used to assess the correlation between C19P-S and JSS. RESULTS The following risk factors were found to be associated with coronaphobia: gender, marital status, presence of chronic disease, staying home, and sleep disturbances. Female gender (OR = 2.23 and OR = 2.12), being married (OR = 1.31 and OR = 1.45), chronic disease status (OR = 1.39 and OR = 1.27), staying home (OR = 1.72 and OR = 1.35) and sleep disturbances (OR = 2.63 and OR = 2.49) were found to be associated with the likelihood of having a higher coronaphobia score (p < 0.05). Weak positive correlations were found between C19P-S and its subscales and JSS scores (p < 0.001). CONCLUSIONS Female gender, being married, having chronic diseases, staying home, and having sleep disturbances were found to be risk factors for having high coronaphobia scores. Moreover, the severity of coronaphobia was associated with sleep disturbances. These results should be considered in the management of coronaphobia.
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Affiliation(s)
- Yasemin Karaaslan
- Beykent University, School of Health Sciences, Department of Physiotherapy and Rehabilitation, Istanbul, Turkey
| | - Oguzhan Mete
- Ankara Yildirim Beyazit University, Health Sciences Faculty, Department of Physiotherapy and Rehabilitation, Ankara, Turkey
| | - Mehmet Karadag
- Hatay Mustafa Kemal University, Medicine Faculty, Department of Biostatistics, Hatay, Turkey
| | - Derya Ozer Kaya
- Izmir Katip Celebi University, Health Sciences Faculty, Department of Physiotherapy and Rehabilitation, Izmir, Turkey
| | - Seyda Toprak Celenay
- Ankara Yildirim Beyazit University, Health Sciences Faculty, Department of Physiotherapy and Rehabilitation, Ankara, Turkey.
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11
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Juhola J, Arokoski JPA, Ervasti J, Kivimäki M, Vahtera J, Myllyntausta S, Saltychev M. Internal consistency and factor structure of Jenkins Sleep Scale: cross-sectional cohort study among 80 000 adults. BMJ Open 2021; 11:e043276. [PMID: 33462100 PMCID: PMC7813292 DOI: 10.1136/bmjopen-2020-043276] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES To assess the internal consistency and construct validity of the Finnish translation of the Jenkins Sleep Scale (JSS) in a large healthy working-age population with diverse work characteristics. DESIGN Survey-based cross-sectional cohort study. SETTING Survey conducted by an institute of occupational health. PARTICIPANTS Employees of 10 towns and 6 hospital districts. PRIMARY AND SECONDARY OUTCOME MEASURES The internal consistency defined by a Cronbach's alpha. Exploratory and confirmatory factor analyses to evaluate the construct structure of the JSS. RESULTS Of 81 136 respondents, 14 890 (18%) were men and 66 246 (82%) were women. Their average age was 52.1 (13.2) years. Of the respondents, 41 823 (52%) were sleeping 7 or less hours per night. The mean JSS total score was 6.4 (4.8) points. The JSS demonstrated high internal consistency with an alpha of 0.80 (lower 95% confidence limit 0.80). Exploratory factor analysis supported a one-factor solution with eigenvalue of 1.94. Confirmatory factor analysis showed that all four items were positively correlated with a single common factor explaining 44%-61% of common factor's variance. CONCLUSIONS The Finnish translation of JSS was found to be a unidimensional scale with good internal consistency. As such, the scale may be recommended as a practicable questionnaire when studying sleep difficulties in a healthy working-age population.
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Affiliation(s)
- Juhani Juhola
- Physical and Rehabilitation Medicine, TYKS Turku University Hospital, Turku, Varsinais-Suomi, Finland
| | - J P A Arokoski
- Department of Physical and Rehabilitation Medicine, Helsinki University Central Hospital, Helsinki, Uusimaa, Finland
- Department of Physical and Rehabilitation Medicine, University of Helsinki, Helsinki, Finland
| | - Jenni Ervasti
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Mika Kivimäki
- Finnish Institute of Occupational Health, Helsinki, Finland
- University of Helsinki Faculty of Medicine, Helsinki, Finland
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Jussi Vahtera
- Department of Public Health, University of Turku, Turku, Finland
| | - Saana Myllyntausta
- Department of Public Health, University of Turku, Turku, Finland
- School of Educational Sciences and Psychology, Psychology, University of Eastern Finland, Joensuu, Finland
| | - M Saltychev
- Department of Physical and Rehabilitation Medicine, Turku University Hospital and University of Turku, Turku, Finland
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12
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Phelps C, Bellon S, Hinkey M, Nash A, Boyd J, Cook CE, Garcia AN. Measurement properties of Patient-Reported Outcome Measures used to assess the sleep quality in adults with high prevalence chronic pain conditions: a systematic review. Sleep Med 2020; 74:315-331. [DOI: 10.1016/j.sleep.2020.06.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 06/15/2020] [Accepted: 06/22/2020] [Indexed: 11/26/2022]
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13
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Toprak Celenay S, Karaaslan Y, Mete O, Ozer Kaya D. Coronaphobia, musculoskeletal pain, and sleep quality in stay-at home and continued-working persons during the 3-month Covid-19 pandemic lockdown in Turkey. Chronobiol Int 2020; 37:1778-1785. [DOI: 10.1080/07420528.2020.1815759] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Seyda Toprak Celenay
- Health Sciences Faculty, Department of Physiotherapy and Rehabilitation, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Yasemin Karaaslan
- Department of Physiotherapy and Rehabilitation, School of Health Sciences, Beykent University, Istanbul, Turkey
| | - Oguzhan Mete
- Health Sciences Faculty, Department of Physiotherapy and Rehabilitation, Ankara Yildirim Beyazit University, Ankara, Turkey
| | - Derya Ozer Kaya
- Health Sciences Faculty, Department of Physiotherapy and Rehabilitation, Izmir Katip Celebi University, Izmir, Turkey
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14
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Unal-Ulutatar C, Duruoz MT. Development and validation of a quality of life scale in Familial Mediterranean Fever (FMFQoL). Mod Rheumatol 2020; 31:710-717. [PMID: 32475195 DOI: 10.1080/14397595.2020.1775946] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To develop a valid and reliable quality-of-life (QoL) scale in familial Mediterranean fever (FMF). METHODS After producing question pool by using psychometric methods, high-performance questions were obtained according to expert panel. The principal component analysis (PCA) was done with varimax rotation for factor analysis. The final version of the scale (FMF-QoL) was examined for reliability and validity. Internal consistency with Cronbach alpha was calculated. The face, content, convergent and discriminant validity were analyzed. PRAS score used to assess the disease activity. Spearman correlation coefficient (rho) was used to assess the convergent and discriminant validity. RESULTS In our study, 123 FMF patients were recruited. According to the factor analysis the FMF-QoL were represented by 4 factor groups (eigenvalues >1) which were physical impact, social and recreational impact, psychological impact, and impact of sleep. All questions' factor loadings after Varimax rotation were bigger than 0.5 and the cumulative variance of the scale was 68.11%. The strongest correlation of the FMF-QoL was found with other QoL scales like EUROHIS (rho: -0.64, p < .0005) and Short Form 36 physical functioning subscale (rho: -0.63, p < .0005). The correlations between the FMF-QoL and functional parameters were found to be moderate [Beck Depression Inventory-Primary Care (rho: 0.46, p < .0005), Jenkins Sleep Scale (rho: 0.44, p < .0005), Health Assessment Questionnaire (rho: 0.44, p < .0005)]. FMF-QoL was also correlated with the disease specific measures [PRAS (rho: 0.42, p < .0005), number of attacks in the previous year (rho: 0.44, p < .0005)]. CONCLUSION A valid, reliable, practical, not time-consuming FMF-specific QoL scale that can be used in the clinical follow-up and treatment of these patients was developed and validated.
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Affiliation(s)
- Cagri Unal-Ulutatar
- Sancaktepe Sehit Prof Dr Ilhan Varank Training and Research Hospital, Physical Medicine and Rehabilitation (PMR) Department, Istanbul, Turkey
| | - Mehmet Tuncay Duruoz
- School of Medicine, Physical Medicine and Rehabilitation (PMR) Department, Rheumatology Division, Marmara University, Istanbul, Turkey
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15
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Kim B, Jung H, Kim J, Lee J, Kim O. Depressive Symptoms and Sleep Disturbance in Female Nurses with Atopic Dermatitis: The Korea Nurses' Health Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082743. [PMID: 32316146 PMCID: PMC7215983 DOI: 10.3390/ijerph17082743] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 04/13/2020] [Accepted: 04/13/2020] [Indexed: 12/12/2022]
Abstract
Although the prevalence of atopic dermatitis is high in nurses, there is a lack of research on the relationship between atopic dermatitis and depressive symptoms and sleep disturbance among female nurses. This study aimed to determine the effects of atopic dermatitis on depressive symptoms and sleep disturbance in female nurses. We analyzed the data of the Korea Nurses’ Health Study, a large-scale prospective cohort study. A total of 20,613 female hospital nurses aged 20–45 years who participated in the Module 1 of Korea Nurses’ Health Study between July 2013 and November 2014 were included. The chi-square test, t-test, and multivariate ordinal logistic regression analysis were conducted for statistical analysis. The prevalence of atopic dermatitis among female nurses was 11.6%. The levels of depressive symptoms and sleep disturbance were higher in nurses with atopic dermatitis than those without atopic dermatitis. Nurses with atopic dermatitis were 1.16 times more likely to have depressive symptoms and 1.35 times more likely to have sleep disturbance than those without atopic dermatitis after adjusting for confounding variables. The results of this study suggest that additional support should be considered for nurses with atopic dermatitis to improve the occupational environment for managing and preventing the exacerbation of symptoms.
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Affiliation(s)
- Bohye Kim
- College of Nursing, Ewha Womans University, Seoul 03760, Korea
| | - Heeja Jung
- College of Nursing, Konyang University, Daejeon 35365, Korea
| | - Jiyoung Kim
- Department of Nursing, Sangmyung University, Cheonan-si 31066, Korea or
| | - Jisun Lee
- College of Nursing, Ewha Womans University, Seoul 03760, Korea
| | - Oksoo Kim
- College of Nursing, Ewha Womans University, Seoul 03760, Korea
- Correspondence: ; Tel.: +82-02-3277-3703
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Unal-Ulutatar C, Ozsoy-Unubol T. Psychometric properties of Turkish version of Jenkins sleep scale in fibromyalgia syndrome. Adv Rheumatol 2020; 60:22. [PMID: 32299495 DOI: 10.1186/s42358-020-0123-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 02/17/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Fibromyalgia syndrome (FMS) has adverse effects on the quality of sleep. The aim of this study was to investigate the validity and reliability of Jenkins Sleep Scale (JSS-TR) in Turkish FMS patients. METHODS FMS patients who met the 2016 fibromyalgia diagnostic criteria were included in the study. Clinical and demographic data of the patients were noted. The relationship between this scale and other functional parameters such as Pittsburgh Sleep Quality Index (PSQI), European Quality of Life Scale-5 Dimensions (EQ-5D), Fatigue Severity Scale (FSS), Beck Depression Inventory (BDI) was examined. Fibromyalgia Impact Questionnaire (FIQ) was used to evaluate the functional status of the patients and the progression of the disease. Test-retest reliability was calculated by re-applying the questionnaire to patients at 2-week intervals. Duloxetine treatment was initiated in newly diagnosed patients and sensitivity to change was tested at the end of the treatment. Spearman correlation coefficient was used. P < 0.05 was accepted as significant. RESULTS Eighty-one FMS patients (71 females, 10 males) were included in the study. The mean age was 44.2 ± 10.7 years. The strongest correlation of JSS-TR was with another sleep questionnaire, PSQI (rho = 0.79, p < 0.0005). The correlation with other functional parameters and FIQ was moderate. In test-retest validity, intraclass correlation coefficient was found to be 0.98 (p < 0.0005). Chronbach α value calculated for internal consistency was found to be 0.741. CONCLUSIONS JSS-TR is a valid, simple and feasible sleep instrument that can be easily applied to FMS patients both in researches and clinical settings.
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Affiliation(s)
- Cagri Unal-Ulutatar
- Physical Medicine and Rehabilitation Department, Sancaktepe Sehit Prof Dr Ilhan Varank Training and Research Hospital, Emek Mahallesi, Namık Kemal Cad. No: 54, 34785 Sancaktepe, Istanbul, Turkey.
| | - Tugba Ozsoy-Unubol
- PMR Department, Istanbul Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
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Toprak Celenay S, Mete O, Akan S, Un Yildirim N, Erten S. Comparison of the effects of stabilization exercise plus kinesio taping and stabilization exercise alone on pain and well-being in fibromyalgia. Complement Ther Clin Pract 2020; 38:101076. [PMID: 32056812 DOI: 10.1016/j.ctcp.2019.101076] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 11/10/2019] [Accepted: 12/03/2019] [Indexed: 11/28/2022]
Abstract
PURPOSE To compare the effects of spinal stabilization exercise (SSE) plus kinesio taping (KT) and SSE alone on pain and well-being in women with fibromyalgia (FM). MATERIAL AND METHODS Patients with FM were randomly allocated into SSE (n:19) and SSE + KT (n:17) groups. Pain and fatigue with Visual Analog Scale, health status with Fibromyalgia Impact Questionnaire, quality of life (QoL) with Nottingham Health Profile, depression with Beck Depression Inventory, sleep quality with Jenkins Sleep Scale were assessed. SSE and KT with fascial correction technique were carried out 2 days a week for 6 weeks. RESULTS SSE + KT was more effective in decreasing pain and fatigue, and improving some parameters related to health status and the QoL compared to SSE alone (p < 0.05). After treatment, pain, depression, health status, QoL, and sleep quality improved in both groups (p < 0.05). CONCLUSIONS SSE with KT was superior for improving pain and general well-being compared to SSE alone.
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Affiliation(s)
- Seyda Toprak Celenay
- Department of Physiotherapy and Rehabilitation, Health Sciences Faculty, Ankara Yildirim Beyazit University Ankara, Turkey.
| | - Oguzhan Mete
- Department of Physiotherapy and Rehabilitation, Health Sciences Faculty, Ankara Yildirim Beyazit University Ankara, Turkey.
| | - Selcuk Akan
- Department of Internal Medicine, Ankara City Hospital, Ankara, Turkey.
| | - Necmiye Un Yildirim
- Department of Physiotherapy and Rehabilitation, Gulhane Health Sciences Faculty, Health Science University, Ankara, Turkey.
| | - Sukran Erten
- Department of Rheumatology, Ankara City Hospital, Ankara Yildirim Beyazit University, Ankara, Turkey.
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Duruoz MT, Ulutatar F, Ozturk EC, Unal-Ulutatar C, Sanal Toprak C, Kayhan O. Assessment of the validity and reliability of the Jenkins Sleep Scale in ankylosing spondylitis. Int J Rheum Dis 2018; 22:275-279. [PMID: 30565868 DOI: 10.1111/1756-185x.13447] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 10/09/2018] [Accepted: 10/23/2018] [Indexed: 12/14/2022]
Abstract
AIM Ankylosing spondylitis (AS) affects sleep quality. Jenkins Sleep Scale (JSS) Evaluation Questionnaire is a simple and easy to understand scale. The aim of this study is to constitute validity and reliability of JSS-TR in AS patients. METHODS Jenkins Sleep Scale was translated and culturally adapted by using guidelines. Clinical and demographic data of AS patients were noted. Correlations with other functional parameters such as Multidimensional Assessment of Fatigue (MAF) scale, Ankylosing Spondylitis Quality of Life (ASQoL), Pittsburgh Sleep Quality Index (PSQI) were used to assess convergent validity of JSS-TR (Turkish version). Discriminant validity was also assessed. Shapiro-Wilk test was used as a test of normality. Spearman's rank correlation coefficient (rho) was used to assess the relation. RESULTS Sixty patients (24 female and 36 male) with mean age of 39.6 ± 10.8 years were recruited. The JSS-TR took an average of 1.5 minutes (±30 seconds) to complete. JSS-TR had the strongest correlation with PSQI scores (ρ = 0.75) and moderate-strong correlations with MAF, ASQoL, and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores. There was insignificant correlation with non-clinical parameters. CONCLUSIONS JSS-TR is a valid, simple and feasible sleep instrument that can be easily applied to AS patients both in research and clinical settings.
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Affiliation(s)
- Mehmet Tuncay Duruoz
- Rheumatology Division, PMR Department, School of Medicine, Marmara University, Istanbul, Turkey
| | - Firat Ulutatar
- Pain Medicine Division, PMR Department, School of Medicine, Cukurova University, Adana, Turkey
| | - Ekim Can Ozturk
- PMR Department, Darende Hulusi Efendi Devlet Hospital, Malatya, Turkey
| | - Cagri Unal-Ulutatar
- Sancaktepe Sehit Prof Dr Ilhan Varank Training and Research Hospital, Istanbul, Turkey
| | - Canan Sanal Toprak
- PMR Department, School of Medicine, Marmara University, Istanbul, Turkey
| | - Onder Kayhan
- PMR Department, School of Medicine, Marmara University, Istanbul, Turkey
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