Examining the reliability and validity of the arabic version of the Glasgow Sleep Effort Scale (GSES)

BACKGROUND

Sleep effort refers to the cognitive and behavioral exertion involved in initiating and maintaining sleep. High sleep effort is increasingly recognized as perpetuating insomnia and poor sleep quality. Validated sleep effort scales enable the quantification of this construct in clinical and research settings. However, no Arabic version has been available. This study translated and validated the Glasgow Sleep Effort Scale (GSES) into Arabic to assess sleep effort in Arabic-speaking populations.

METHOD

The GSES was translated into Arabic using the forward-backward translation approach. This involved an initial Arabic translation from the source followed by a back translation into English to ensure accuracy. A total of 369 participants were recruited to assess the psychometric properties of the Arabic version of the GSES, specifically its reliability and validity. The reliability analysis included Cronbach's α, McDonald's ω, and test-retest reliability. Validity was examined using confirmatory factor analysis (CFA) to evaluate the unidimensionality of the scale and assess model fit. Convergent validity was also assessed through correlation analysis with the Athens Insomnia Scale (AIS) and the Generalized Anxiety Disorder-7 Scale (GAD-7).

RESULTS

The Cronbach's α reliability coefficient and McDonald's ω for the scale were found to be 0.87 (95% CI: 0.85-0.89). The test-retest reliability was 0.95 (95% CI: 0.93 - 0.97) after two weeks. The one-factor model showed an acceptable fit, with a CFI of 0.96, a TLI of 0.94, and an SRMR of 0.04. Invariance analysis revealed that male and female participants conceptualized and responded to the GSES items similarly, without differences in factor loadings or scale characteristics between the sexes. The Arabic version of the GSES has good convergent validity, as shown by the significant correlation between the AIS and the GSES (r = 0.72, p < 0.001). Similarly, the GAD-7 score was significantly correlated with the GSES score (r = 0.77, p < 0.001).

CONCLUSION

This is the first study in which the GSES was validated in Arabic. This allows the scale to reliably gauge sleep effort among Arabic speakers, providing new clinical and research opportunities to understand how maladaptive sleep effort may contribute to insomnia and suboptimal sleep in this demographic population.

The psychometric properties of the Arabic version of the dieting beliefs scale (DBS)

Background

There are relatively few data about the association between locus of control and weight loss in Arabic populations. A tool does exist, the Dieting Belief Scale (DBS), that was designed to measure individuals' beliefs regarding their ability to control their body weight. The aim of this study was to translate this tool into Arabic and to evaluate its psychometric properties.

Methods

The forward translation of the DBS from English to Arabic was completed by two professional bilingual translators, while the back translation from Arabic to English was independently performed by another two different professional bilingual translators. An online survey using the tool was then completed by 245 participants, fully aware of the study's purpose. Psychometric analyses were subsequently conducted to assess the reliability and validity of the Arabic DBS.Internal consistency was examined using Cronbach's α and McDonald's ω coefficients. Test-retest reliability was also assessed. Confirmatory factor analysis was employed to evaluate the fit of a three-factor model, with indices including Comparative Fit Index (CFI), Tucker Lewis Index (TLI), Root Mean Square Error of Approximation (RMSEA), and Standardized Root Mean Square Residual (SRMR). Convergent validity was assessed by examining the correlation between the Arabic DBS and the Eating Attitude Test (EAT-26) previously translated into Arabic, the latter identifying attitudes, feelings and behaviors related to eating.

Results

The Arabic translated DBS scale demonstrated high translation accuracy and content validity estimates. Cronbach's α and McDonald's ω reliability coefficients for the translated scale were approximately 0.91. Test-retest reliability was 0.96. The three-factor model showed an acceptable fit (CFI = 0.93, TLI = 0.92, RMSE = 0.08, SRMR = 0.06). The Arabic version of the DBS was found to have good convergent validity, as evidenced by the significant correlation between the EAT-26 and DBS questionnaires (r = 0.53, p < 0.01).

Conclusion

The Arabic version of the DBS is highly reliable and has sufficient content validity to measure belief about personal ability to control one's weight.

Translating and establishing the psychometric properties of the Jenkins Sleep Scale for Arabic-speaking individuals

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.

Development and Validation of a Food Frequency Questionnaire for Evaluating the Nutritional Status of Patients with Serious Mental Illnesses (DIETQ-SMI) in Bahrain

General food frequency questionnaires (FFQs) have not been tailored for or validated in individuals with psychiatric disorders. Given the unique eating behaviors of patients with serious mental illnesses (SMIs), custom-made tools are needed. Therefore, we developed and validated an FFQ customized to individuals with SMIs. A total of 150 adults with SMIs (schizophrenia, bipolar disorder, or major depression) were recruited from Bahrain. The participants completed the 50-item Dietary Intake Evaluation Questionnaire for Serious Mental Illness (DIETQ-SMI) FFQ and a 3-day food record (FR). The validity of the FFQ was assessed by comparing nutrient intake to FR intake using correlation and reliability statistics. The DIETQ-SMI demonstrated a good ranking validity compared to the FR based on correlation coefficients (rho 0.33 to 0.92) for energy and macro- and micronutrients. The FFQ had high internal consistency (McDonald's omega = 0.84; Cronbach's alpha = 0.91) and test-retest reliability (ICC > 0.90). The FFQ tended to estimate higher absolute intakes than the FR but adequately ranked the intakes. The FFQ value was correlated with the FR for all the items (p < 0.001). The DIETQ-SMI is a valid and reliable FFQ for ranking dietary intake in individuals with an SMI. It can help assess nutritional status and, subsequently, guide interventions in high-risk psychiatric populations.

Reliability generalization meta-analysis of orthorexia nervosa using the ORTO-11/12/15/R scale in all populations and language versions

BACKGROUND

The ORTO scale was developed in 2004 as a self-report questionnaire to assess symptoms of orthorexia nervosa (ON). ON is an unhealthy preoccupation with eating healthy food. The scale aims to measure obsessive attitudes and behaviors related to the selection, purchase, preparation, and consumption of pure, healthy food. Since its development, the ORTO-15 has been adapted into several shorter versions. The objective was to conduct a reliability generalization meta-analysis of the ORTO scale and its variant versions in all populations and languages.

METHODS

A systematic literature search was conducted to identify studies reporting the internal consistency of ORTO. Random-effect models were used to evaluate summary statistics of reliability coefficients, weighting the coefficients by the inverse variance using the restricted maximum likelihood method. The heterogeneity among the reliability coefficients was evaluated and assessed using numerous statistical metrics. The tau (τ), tau2 (τ2), I2, H2, R2, df, and the Q-statistic are among those obtained. Meta-regression analyses were used to examine moderators such as age and sex.

RESULTS

Twenty-one studies (k = 21) involving 11,167 participants (n = 11,167) were analyzed. The overall effect estimate on internal consistency was 0.59 (95% CI 0.49-0.68), with a minimum reliability coefficient of 0.23 and a maximum reliability coefficient of 0.83. The heterogeneity statistics were found to have an I2 of 99.31%, which suggested high heterogeneity owing to a decrease in the confidence interval (95% CI) and an increase in variability. Sensitivity analysis revealed that a few studies strongly influenced the overall estimate. Egger's test suggested possible publication bias. Neither age nor sex significantly moderated reliability via meta-regression.

CONCLUSIONS

The ORTO scale has a relatively low pooled reliability coefficient. Alternative ON assessment tools with enhanced psychometric properties are needed. Clinicians should not base diagnoses or treatment decisions on ORTO alone. Comprehensive psychiatric assessment is essential for accurate ON evaluation.

The Psychometric Properties of the Arabic Version of the Anxiety and Preoccupation About Sleep Questionnaire (APSQ)

Background

Insomnia disorder is a common health condition; it has a role in increasing the possibility of developing other psychological disorders, including anxiety and depression. Anxiety and preoccupation with sleep are two examples of common cognitive factors that contribute to the development of chronic insomnia; thus, it is important to have a tool that assesses worry in insomnia. There is no comprehensive psychiatric measure to assess anxiety and preoccupation with sleep in Arabic. We conducted this study to translate, adapt, and validate the Arabic version of the Anxiety and Preoccupation about Sleep Questionnaire (APSQ), providing a reliable psychometric tool to assess concerns regarding sleep within Arabic-speaking communities.

Methods

The translation process of the scale involved several steps, including forward and backward translation. A cross-sectional study was conducted using an online survey completed by 523 participants from various Arabic-speaking countries. Psychometric analysis was performed utilizing the R software, including internal consistency, test-retest reliability, and confirmatory factor analysis. In addition, convergent and divergent against the Athens insomnia scale (AIS) and general anxiety disorder (GAD) were conducted.

Results

The Arabic-translated form of the APSQ expresses excellent internal consistency with a value of 0.91 for both Cronbach's α and McDonald's ω. The test-retest reliability of a subsample showed an excellent coefficient of 0.93 (p<0.01). A good fit of the APSQ was observed by CFI = 0.93, TLI = 0.91, SRMR = 0.05, and RMSEA = 0.1. Convergent and divergent against AIS and GAD showed statistically significant correlations of 0.85 (p<0.01) and 0.69 (p<0.01), respectively. Our sample showed a mean APSQ score of 31.28 ± 8.31, and the mean age was 23.62 ± 7.5.

Conclusion

The Arabic APSQ is reliable and valid for measuring anxiety and preoccupation with sleep in Arabic countries. Using translated APSQ for clinical diagnosis and research is currently trustworthy.

Athletes' nutritional demands: a narrative review of nutritional requirements

Nutrition serves as the cornerstone of an athlete's life, exerting a profound impact on their performance and overall well-being. To unlock their full potential, athletes must adhere to a well-balanced diet tailored to their specific nutritional needs. This approach not only enables them to achieve optimal performance levels but also facilitates efficient recovery and reduces the risk of injuries. In addition to maintaining a balanced diet, many athletes also embrace the use of nutritional supplements to complement their dietary intake and support their training goals. These supplements cover a wide range of options, addressing nutrient deficiencies, enhancing recovery, promoting muscle synthesis, boosting energy levels, and optimizing performance in their respective sports or activities. The primary objective of this narrative review is to comprehensively explore the diverse nutritional requirements that athletes face to optimize their performance, recovery, and overall well-being. Through a thorough literature search across databases such as PubMed, Google Scholar, and Scopus, we aim to provide evidence-based recommendations and shed light on the optimal daily intakes of carbohydrates, protein, fats, micronutrients, hydration strategies, ergogenic aids, nutritional supplements, and nutrient timing. Furthermore, our aim is to dispel common misconceptions regarding sports nutrition, providing athletes with accurate information and empowering them in their nutritional choices.

Development and validation of a questionnaire (GHOST) to assess sudden, unexplained communication exclusion or "ghosting"

The topic of "ghosting" as a method of terminating a relationship has been discussed in both popular media and academic circles. Although research on this issue is scarce, the concept has acquired popularity and gained scholarly attention. A reliable and valid measure of this phenomenon does not, however, exist. GHOST (The Ghosting Questionnaire) was designed and psychometrically tested to explore ghostee experiences. A total of 811 adults participated in an online survey to test this instrument. It was developed based on a thorough analysis of research on the topic of ghosting using a phenomenological qualitative method to identify ghosting domains and generate questionnaire items. In terms of content validity and construct validity, the final version of the measure was found to be satisfactory. GHOST was found to have adequate internal consistency - scores of 0.74, 0.74, and 0.80, indicating acceptable Cronbach's alpha, McDonald's omega, and ordinal's alpha coefficients, respectively. Factor analyses found the GHOST questionnaire to be a valid and reliable instrument that can be used for screening ghosting experiences and for designing community-based distress prevention and intervention programs. A dynamic fit index (DFI) cutoffs approach was also used and showed robust fitting.

The prevalence and risk factors of screen-based disordered eating among university students: a global systematic review, meta-analysis, and meta-regression

PURPOSE

The purpose of this review was to estimate the prevalence of screen-based disordered eating (SBDE) and several potential risk factors in university undergraduate students around the world.

METHODS

An electronic search of nine data bases was conducted from the inception of the databases until 1st October 2021. Disordered eating was defined as the percentage of students scoring at or above established cut-offs on validated screening measures. Global data were also analyzed by country, research measure, and culture. Other confounders in this review were age, BMI, and sex.

RESULTS

Using random-effects meta-analysis, the mean estimate of the distribution of effects for the prevalence of SBDE among university students (K = 105, N = 145,629) was [95% CI] = 19.7% [17.9%; 21.6%], I2 = 98.2%, Cochran's Q p value = 0.001. Bayesian meta-analysis produced an estimate of 0.24, 95% credible intervals [0.20, 0.30], τ = 92%. Whether the country in which the students were studying was Western or non-Western did not moderate these effects, but as either the mean BMI of the sample or the percentage of the sample that was female increased, the prevalence of SBDE increased.

CONCLUSIONS

These findings support previous studies indicating that many undergraduate students are struggling with disordered eating or a diagnosable eating disorder, but are neither receiver effective prevention nor accessing accurate diagnosis and available treatment. It is particularly important to develop ever more valid ways of identifying students with high levels of disordered eating and offering them original or culturally appropriate and effective prevention or early treatment.

LEVEL OF EVIDENCE

I, systematic review and meta-analysis.

Association between Grain and Legume Consumption and the Risk of Coronary Artery Obstruction among Jordanians Based on Angiography Results

Accumulating evidence suggests that consumption of whole grains and legumes is associated with reduced risk of cardiovascular disease (CVD), whereas the risk is increased by consuming refined grains and cereals. This study aimed to investigate the association between grain and legume consumption and the risk of CVD. The study was conducted using a convenient sampling method with a total of 399 participants who underwent coronary angiography. Cases and controls were matched by age with a 1:1 ratio. Standardized and validated questionnaires were used to collect socio- demographic, health, lifestyle, and dietary data. Intake of more than 1 serving/d of white bread increased the risk of CVD significantly with an adjusted odds ratio (AOR) of 3.06 [95% confidence interval (CI): 1.37∼6.84], while consuming more than 1 serving/d of wholegrain bread reduced the risk significantly to approximately 53% (AOR: 0.47, 95% CI: 0.24∼0.93). Similar trends between consuming white bread on daily basis and increased risk of CVD, and consuming wholegrain bread and reduced risk of CVD were also observed. In addition, consuming unsweetened cornflakes on a weekly basis had a protective effect against CVD (AOR: 0.15, 95% CI: 0.03∼0.96). Intake of legumes reduced the risk of CVD, although only insignificantly for all the tested legumes. The present study calls for consideration of consuming wholegrain bread prevent CVD in the Jordanian population.