Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
J Sleep Res. 2020 Feb;29(1):e12891. doi: 10.1111/jsr.12891. Epub 2019 Jul 21.
For patients with cancer, sleep disturbance is commonplace. Using classical test theory and Rasch analyses, the present study compared two commonly used psychometric instruments for insomnia - Athens Insomnia Scale and Insomnia Severity Index - among patients with advanced cancer. Through convenience sampling, patients with cancer at stage III or IV (n = 573; 326 males; mean age = 61.3 years; SD = 10.7) from eight oncology units of university hospitals in Iran participated in the study. All the participants completed the Athens Insomnia Scale, Insomnia Severity Index, Edmonton Symptom Assessment Scale, Hospital Anxiety and Depression Scale, General Health Questionnaire-12, Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index. Additionally, 433 participants wore an Actigraph device for two continuous weekdays. Classical test theory and Rasch analysis both supported the construct validity for Athens Insomnia Scale (factor loadings from confirmatory factor analysis = 0.61-0.87; test-retest reliability = 0.72-0.82; infit mean square = 0.81-1.17; outfit MnSq = 0.79-1.14) and for Insomnia Severity Index (factor loadings from confirmatory factor analysis = 0.61-0.81; test-retest reliability = 0.72-0.82; infit mean square = 0.72-1.14; outfit mean square = 0.76-1.11). Both Athens Insomnia Scale and Insomnia Severity Index had significant associations with Edmonton Symptom Assessment Scale, Hospital Anxiety and Depression Scale, General Health Questionnaire-12, Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index, as well as having good sensitivity and specificity. Significant differences in the actigraphy measure were found between insomniacs and non-insomniacs based on Athens Insomnia Scale or Insomnia Severity Index score. With promising results, healthcare providers can use either Athens Insomnia Scale or Insomnia Severity Index to understand the insomnia of patients with advanced cancer.
对于癌症患者来说，睡眠障碍是很常见的。本研究采用经典测试理论和 Rasch 分析方法，比较了两种常用于失眠的常用心理计量学工具——雅典失眠量表和失眠严重程度指数，在晚期癌症患者中进行比较。通过便利抽样，来自伊朗 8 所大学医院的 8 个肿瘤病房的 III 或 IV 期癌症患者（n=573；326 名男性；平均年龄 61.3 岁；SD=10.7）参与了这项研究。所有参与者都完成了雅典失眠量表、失眠严重程度指数、埃德蒙顿症状评估量表、医院焦虑和抑郁量表、一般健康问卷-12、Epworth 嗜睡量表和匹兹堡睡眠质量指数。此外，433 名参与者连续两天佩戴了 Actigraph 设备。经典测试理论和 Rasch 分析均支持雅典失眠量表的结构效度（验证性因子分析的因子负荷=0.61-0.87；重测信度=0.72-0.82；infit 均值平方=0.81-1.17；outfit MnSq=0.79-1.14）和失眠严重程度指数（验证性因子分析的因子负荷=0.61-0.81；重测信度=0.72-0.82；infit 均值平方=0.72-1.14；outfit 均值平方=0.76-1.11）。雅典失眠量表和失眠严重程度指数均与埃德蒙顿症状评估量表、医院焦虑和抑郁量表、一般健康问卷-12、Epworth 嗜睡量表和匹兹堡睡眠质量指数有显著关联，且具有良好的敏感性和特异性。根据雅典失眠量表或失眠严重程度指数评分，在活动记录仪测量中发现失眠者和非失眠者之间存在显著差异。基于有希望的结果，医疗保健提供者可以使用雅典失眠量表或失眠严重程度指数来了解晚期癌症患者的失眠情况。
