Original Article Published on 14 Mar, 2024

The Richards Campbell Sleep Questionnaire for Assessment of Sleep in Critically Ill Patients: Translation, Reliability, and Validation of the Malay Language Version

Malay Translation of the RCSQ
Vol. 19 No. 1 : 2024 (114-125)

Yeoh KS Yeoh KS
Raha AR Raha AR
Yeoh CN Yeoh CN
Ahmad FAS Ahmad FAS
cheah sk cheah sk
Aliza MY Aliza MY

Abstract
Poor sleep quality is commonly observed among critically ill patients; however, the assessment of sleep perception in critically ill patients remains challenging. The Richards Campbell Sleep Questionnaire (RCSQ) is a simple, validated tool for sleep quality assessment that has been successfully translated into various languages. This study aimed to translate and assess the validity and reliability of the Malay language version of the RCSQ. The process of translation involved forward and reverse translation methods. The face validity of the translated RCSQ was tested during the pre-test on five non-participating subjects. The reliability of the translated questionnaire was tested with Cronbach’s alpha coefficient. A total of 150 critically ill patients were included in the analysis using the translated RCSQ. The average total score of the Malay language version of the RCSQ was 78.59 + 19.43. The Kaiser-Meyer-Olkin measure of sampling adequacy and Cronbach’s alpha coefficient showed a score of 0.839 and 0.930 respectively, indicating that the sampling of the study was meritorious and good internal consistency of the Malay RCSQ. In conclusion, the Malay language version of the RCSQ demonstrated excellent reliability and may aid in the assessment of sleep quality in critically ill patients in a local setting. 
Keywords : Critical illness, language, sleep quality, surveys and questionnaires, translations,
Abstrak
Kualiti tidur yang kurang baik lazimnya diperhatikan di kalangan pesakit kritikal; namun, penilaian persepsi tidur di dalam pesakit kritikal adalah masih mencabar. ‘Richards Campbell Sleep Questionnaire’ (RCSQ) adalah alat kaji selidik yang telah disahkan dan mudah untuk digunakan bagi menilai kualiti tidur, serta telah berjaya diterjemahkan kepada pelbagai jenis bahasa. Kajian ini adalah bertujuan untuk menterjemah dan menilai kesahihan serta ketepatan RCSQ versi Bahasa Melayu. Proses penterjemahan ini melibatkan terjemahan hadapan dan songsang. Setelah itu, soal selidik RCSQ tersebut diuji ke atas lima subjek yang tidak mengambil bahagian di dalam ujian ini untuk memastikan bahawa soalan yang diterjemahkan adalah relevan. Ketepatan soal selidik yang diterjemahkan seterusnya diuji dengan menggunakan alfa-Cronbach. Sebanyak 150 pesakit kritikal dewasa telah diuji menggunakan terjemahan RCSQ Bahasa Melayu. Purata jumlah skor bagi versi bahasa Melayu RCSQ adalah 78.59 + 19.43. Ukuran Kaiser-Meyer-Olkin adalah 0.839, yang menunjukkan bahawa persampelan kajian adalah kukuh. Alfa-Cronbach adalah 0.930, yang memaparkan soalan yang diterjemahkan mempunyai ketepatan yang baik. Kesimpulannya, versi RCSQ Bahasa Melayu adalah sahih dan tepat untuk digunakan bagi menilai kualiti tidur pesakit kritikal. 
Kata Kunci : Bahasa, kualiti tidur, penyakit kritikal, terjemahan, tinjauan dan soal selidik,

Correspondance Address
Associate Professor Dr Aliza Mohamad Yusof. Department of Anesthesiology & Intensive Care, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Kuala Lumpur, Malaysia. Tel: +6019 2142260 Email: alizamyusof@gmail.com 

References
Biazim, S.K., Souza, D.A., Carraro, H. Jr., Richards, K., Valderramas, S. 2020. The Richards-Campbell Sleep Questionnaire and sleep in the intensive care unit questionnaire: Translation to Portuguese and cross-cultural adaptation for use in Brazil. J Bras Pneumol 46(4): e20180237

Carskadon, M.A., Dement, W.C. 2011. Monitoring and staging human sleep. In Principles and Practice of Sleep Medicine. 5th edition. St. Louis: Elsevier Saunders; 16-26.

Chen, L.X, Ji, D.H., Zhang, F., Li, J.H., Cui, L., Bai, C.J., Liu, H., Liang, Y. 2019. Richards-Campbell sleep questionnaire: Psychometric properties of Chinese critically ill patients. Nurs Crit Care 24(6): 362-8.

Cooper, A.B., Thornley, K.S., Young, G.B., Slutsky, A.S., Stewart, T.E., Hanly P.J. 2000. Sleep in critically ill patients requiring mechanical ventilation. Chest 117: 809-81.

Darbyshire, J.L., Borthwick, M., Edmonds, P., Vollam, S., Hinton, L., Young, J.D. 2020. Measuring sleep in the intensive care unit: Electroencephalogram, actigraphy, or questionnaire? J Intensive Care Soc 21(1): 22-7.

Delaney, L.J., Van Haren, F., Lopez, V. 2015. Sleeping on a problem: The impact of sleep disturbance on intensive care patients – A clinical review. Ann Intensive Care 5:3.

Elliott, R., McKinley, S., Cistulli, P., Fien, M. 2013. Characterisation of sleep in intensive care using 24 hour polysomnography: An observational study. Crit Care 17: R46.

Ferketich, S. 1991. Focus on psychometrics. Aspects of item analysis. Res Nurs Health 14(2): 165-8.

Freedman, N.S., Gazendam, J., Levan, L., Pack, A.I., Schwab, R.J. 2001. Abnormal sleep/wake cycles and the effect of environmental noise on sleep disruption in the intensive care unit. Am J Respir Crit Care Med 163: 451-7.

Guadagnoli, E., Velicer, W.F. 1988. Relation to sample size to the stability of component patterns. Psychol Bull 103(2):265

Kamdar, B., Needham, D.M., Collop, N.A. 2012. Sleep deprivation in critical illness: Its role in physical and psychological recovery. J Intensive Care Med 27(2): 97-111

Kim, J.K., Park, J.H, Cho, J., Lee, S.M., Lee, J.W. 2020. Reliability of the Korean version of the Richards-Campbell Sleep Questionnaire. Acute Crit Care 35(3): 164-8

Knauert, M.P., Yaggi, H.K., Redeker, N.S., Murphy, T.E., Araujo, K.L., Pisani, M.A. 2014. Feasibility study of unattended polysomnography in medical intensive care unit patients. Heart Lung 43: 445 52.

Krotsetis, S., Richards, K.C., Behncke, A., Kopke, S. 2017. The reliability of the German version of the Richards Campbell Sleep Questionnaire. Nurs Crit Care 22(4): 247-52.

Murata, H., Oono, Y., Sanui, M., Saito, K., Yamaguchi, Y., Takinami, M., Richards, K.C., Henker, R. 2019. The Japanese version of the Richards-Campbell Sleep Questionnaire: Reliability and validity assessment. Nurs Open 6(3): 808-14.

Naik, R.D., Gupta, K., Soneja, M., Elavarasi A., Sreenivas, V., Sinha, S. 2018. Sleep quality and quantity in intensive care unit patients: A cross-sectional study. Indian J Crit Care Med 22(6): 408-14.

Pisani, M.A., Friese, R.S., Gehlbach, B.K., Schwab, R.J., Weinhouse, G.L., Jones, S.F. 2015. Sleep in the intensive care unit. Am J Respir Crit Care Med 191(7): 731-8.

Portney, L.G., Watkins, M.P. 2009. Foundations of clinical research: Applications to practice. Upper Saddle River, NJ: Pearson/Prentice Hall; 11-5

Richards, K.C., O’Sullivan, P.S., Phillips, R.L. 2000. Measurement of sleep in critically ill patients. J Nurs Meas 8(2): 131-44.

Sadeh, A., Sharkey, K.M., Carskadon, M.A. 1994. Activity-based sleep-wake identification: An empirical test of methodological issues. Sleep 17(3): 201-7

Salas, R.E., Gamaldo, C.E. 2008. Adverse effects of sleep deprivation in the ICU. Critical Care Clin 24(3): 461-76

Simons, K.S., Verweij, E., Lemmens, P.M.C., Jelfs, S., Park, M., Spronk, P.E., Sonneveld, J.P.C., Feijen, H-M., van der Steen, M., Kohlrausch, A.G., van der Boogaard, B., de Jafer, C.P.C. 2018. Noise in the intensive care unit and its influence on sleep quality: A multicenter observational study in Dutch intensive care units. Crit Care 22(1): 250.

Varella, N.C., Almeida, R.S., Nogueira, L.A.C., Ferreira, A.S. 2021. Cross-cultural adaptation of the Richards-Campbell Sleep Questionnaire for intensive care unit inpatients in Brazil: Internal consistency, test-retest reliability, and measurement error. Sleep Med 85: 38-44.

Weinhouse, G.L., Schwab, R.J., Watson, P.L., Patil, N., Vaccaro, B., Pandharipande, P., Ely, E.W. 2009. Bench-to-bedside review: Delirium in ICU patients – Importance of sleep deprivation. Crit Care 13(6): 234.

Wild, D., Grove, A., Martin, M., Eremenco, S., McElroy, S., Verjee-Lorenz, A., Erikson, P. 2005. Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes (PRO) measures: report of the ISPOR task force for translation and cultural adaptation. Value in Health 8(2): 94-104.

Zhong, X., Hilton, H.J., Gates, G.J., Jelic, S., Stern, Y., Bartels, M.N., DeMeersman, R.E., Basner, R.C. 2005. Increased sympathetic and decreased parasympathetic cardiovascular modulation in normal humans with acute sleep deprivation. J Appl Physiol 98(6): 2024-32
Correspondance Address

Biazim, S.K., Souza, D.A., Carraro, H. Jr., Richards, K., Valderramas, S. 2020. The Richards-Campbell Sleep Questionnaire and sleep in the intensive care unit questionnaire: Translation to Portuguese and cross-cultural adaptation for use in Brazil. J Bras Pneumol 46(4): e20180237

Carskadon, M.A., Dement, W.C. 2011. Monitoring and staging human sleep. In Principles and Practice of Sleep Medicine. 5th edition. St. Louis: Elsevier Saunders; 16-26.

Chen, L.X, Ji, D.H., Zhang, F., Li, J.H., Cui, L., Bai, C.J., Liu, H., Liang, Y. 2019. Richards-Campbell sleep questionnaire: Psychometric properties of Chinese critically ill patients. Nurs Crit Care 24(6): 362-8.

Cooper, A.B., Thornley, K.S., Young, G.B., Slutsky, A.S., Stewart, T.E., Hanly P.J. 2000. Sleep in critically ill patients requiring mechanical ventilation. Chest 117: 809-81.

Darbyshire, J.L., Borthwick, M., Edmonds, P., Vollam, S., Hinton, L., Young, J.D. 2020. Measuring sleep in the intensive care unit: Electroencephalogram, actigraphy, or questionnaire? J Intensive Care Soc 21(1): 22-7.

Delaney, L.J., Van Haren, F., Lopez, V. 2015. Sleeping on a problem: The impact of sleep disturbance on intensive care patients – A clinical review. Ann Intensive Care 5:3.

Elliott, R., McKinley, S., Cistulli, P., Fien, M. 2013. Characterisation of sleep in intensive care using 24 hour polysomnography: An observational study. Crit Care 17: R46.

Ferketich, S. 1991. Focus on psychometrics. Aspects of item analysis. Res Nurs Health 14(2): 165-8.

Freedman, N.S., Gazendam, J., Levan, L., Pack, A.I., Schwab, R.J. 2001. Abnormal sleep/wake cycles and the effect of environmental noise on sleep disruption in the intensive care unit. Am J Respir Crit Care Med 163: 451-7.

Guadagnoli, E., Velicer, W.F. 1988. Relation to sample size to the stability of component patterns. Psychol Bull 103(2):265

Kamdar, B., Needham, D.M., Collop, N.A. 2012. Sleep deprivation in critical illness: Its role in physical and psychological recovery. J Intensive Care Med 27(2): 97-111

Kim, J.K., Park, J.H, Cho, J., Lee, S.M., Lee, J.W. 2020. Reliability of the Korean version of the Richards-Campbell Sleep Questionnaire. Acute Crit Care 35(3): 164-8

Knauert, M.P., Yaggi, H.K., Redeker, N.S., Murphy, T.E., Araujo, K.L., Pisani, M.A. 2014. Feasibility study of unattended polysomnography in medical intensive care unit patients. Heart Lung 43: 445 52.

Krotsetis, S., Richards, K.C., Behncke, A., Kopke, S. 2017. The reliability of the German version of the Richards Campbell Sleep Questionnaire. Nurs Crit Care 22(4): 247-52.

Murata, H., Oono, Y., Sanui, M., Saito, K., Yamaguchi, Y., Takinami, M., Richards, K.C., Henker, R. 2019. The Japanese version of the Richards-Campbell Sleep Questionnaire: Reliability and validity assessment. Nurs Open 6(3): 808-14.

Naik, R.D., Gupta, K., Soneja, M., Elavarasi A., Sreenivas, V., Sinha, S. 2018. Sleep quality and quantity in intensive care unit patients: A cross-sectional study. Indian J Crit Care Med 22(6): 408-14.

Pisani, M.A., Friese, R.S., Gehlbach, B.K., Schwab, R.J., Weinhouse, G.L., Jones, S.F. 2015. Sleep in the intensive care unit. Am J Respir Crit Care Med 191(7): 731-8.

Portney, L.G., Watkins, M.P. 2009. Foundations of clinical research: Applications to practice. Upper Saddle River, NJ: Pearson/Prentice Hall; 11-5

Richards, K.C., O’Sullivan, P.S., Phillips, R.L. 2000. Measurement of sleep in critically ill patients. J Nurs Meas 8(2): 131-44.

Sadeh, A., Sharkey, K.M., Carskadon, M.A. 1994. Activity-based sleep-wake identification: An empirical test of methodological issues. Sleep 17(3): 201-7

Salas, R.E., Gamaldo, C.E. 2008. Adverse effects of sleep deprivation in the ICU. Critical Care Clin 24(3): 461-76

Simons, K.S., Verweij, E., Lemmens, P.M.C., Jelfs, S., Park, M., Spronk, P.E., Sonneveld, J.P.C., Feijen, H-M., van der Steen, M., Kohlrausch, A.G., van der Boogaard, B., de Jafer, C.P.C. 2018. Noise in the intensive care unit and its influence on sleep quality: A multicenter observational study in Dutch intensive care units. Crit Care 22(1): 250.

Varella, N.C., Almeida, R.S., Nogueira, L.A.C., Ferreira, A.S. 2021. Cross-cultural adaptation of the Richards-Campbell Sleep Questionnaire for intensive care unit inpatients in Brazil: Internal consistency, test-retest reliability, and measurement error. Sleep Med 85: 38-44.

Weinhouse, G.L., Schwab, R.J., Watson, P.L., Patil, N., Vaccaro, B., Pandharipande, P., Ely, E.W. 2009. Bench-to-bedside review: Delirium in ICU patients – Importance of sleep deprivation. Crit Care 13(6): 234.

Wild, D., Grove, A., Martin, M., Eremenco, S., McElroy, S., Verjee-Lorenz, A., Erikson, P. 2005. Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes (PRO) measures: report of the ISPOR task force for translation and cultural adaptation. Value in Health 8(2): 94-104.

Zhong, X., Hilton, H.J., Gates, G.J., Jelic, S., Stern, Y., Bartels, M.N., DeMeersman, R.E., Basner, R.C. 2005. Increased sympathetic and decreased parasympathetic cardiovascular modulation in normal humans with acute sleep deprivation. J Appl Physiol 98(6): 2024-32



Biazim, S.K., Souza, D.A., Carraro, H. Jr., Richards, K., Valderramas, S. 2020. The Richards-Campbell Sleep Questionnaire and sleep in the intensive care unit questionnaire: Translation to Portuguese and cross-cultural adaptation for use in Brazil. J Bras Pneumol 46(4): e20180237

Carskadon, M.A., Dement, W.C. 2011. Monitoring and staging human sleep. In Principles and Practice of Sleep Medicine. 5th edition. St. Louis: Elsevier Saunders; 16-26.

Chen, L.X, Ji, D.H., Zhang, F., Li, J.H., Cui, L., Bai, C.J., Liu, H., Liang, Y. 2019. Richards-Campbell sleep questionnaire: Psychometric properties of Chinese critically ill patients. Nurs Crit Care 24(6): 362-8.

Cooper, A.B., Thornley, K.S., Young, G.B., Slutsky, A.S., Stewart, T.E., Hanly P.J. 2000. Sleep in critically ill patients requiring mechanical ventilation. Chest 117: 809-81.

Darbyshire, J.L., Borthwick, M., Edmonds, P., Vollam, S., Hinton, L., Young, J.D. 2020. Measuring sleep in the intensive care unit: Electroencephalogram, actigraphy, or questionnaire? J Intensive Care Soc 21(1): 22-7.

Delaney, L.J., Van Haren, F., Lopez, V. 2015. Sleeping on a problem: The impact of sleep disturbance on intensive care patients – A clinical review. Ann Intensive Care 5:3.

Elliott, R., McKinley, S., Cistulli, P., Fien, M. 2013. Characterisation of sleep in intensive care using 24 hour polysomnography: An observational study. Crit Care 17: R46.

Ferketich, S. 1991. Focus on psychometrics. Aspects of item analysis. Res Nurs Health 14(2): 165-8.

Freedman, N.S., Gazendam, J., Levan, L., Pack, A.I., Schwab, R.J. 2001. Abnormal sleep/wake cycles and the effect of environmental noise on sleep disruption in the intensive care unit. Am J Respir Crit Care Med 163: 451-7.

Guadagnoli, E., Velicer, W.F. 1988. Relation to sample size to the stability of component patterns. Psychol Bull 103(2):265

Kamdar, B., Needham, D.M., Collop, N.A. 2012. Sleep deprivation in critical illness: Its role in physical and psychological recovery. J Intensive Care Med 27(2): 97-111

Kim, J.K., Park, J.H, Cho, J., Lee, S.M., Lee, J.W. 2020. Reliability of the Korean version of the Richards-Campbell Sleep Questionnaire. Acute Crit Care 35(3): 164-8

Knauert, M.P., Yaggi, H.K., Redeker, N.S., Murphy, T.E., Araujo, K.L., Pisani, M.A. 2014. Feasibility study of unattended polysomnography in medical intensive care unit patients. Heart Lung 43: 445 52.

Krotsetis, S., Richards, K.C., Behncke, A., Kopke, S. 2017. The reliability of the German version of the Richards Campbell Sleep Questionnaire. Nurs Crit Care 22(4): 247-52.

Murata, H., Oono, Y., Sanui, M., Saito, K., Yamaguchi, Y., Takinami, M., Richards, K.C., Henker, R. 2019. The Japanese version of the Richards-Campbell Sleep Questionnaire: Reliability and validity assessment. Nurs Open 6(3): 808-14.

Naik, R.D., Gupta, K., Soneja, M., Elavarasi A., Sreenivas, V., Sinha, S. 2018. Sleep quality and quantity in intensive care unit patients: A cross-sectional study. Indian J Crit Care Med 22(6): 408-14.

Pisani, M.A., Friese, R.S., Gehlbach, B.K., Schwab, R.J., Weinhouse, G.L., Jones, S.F. 2015. Sleep in the intensive care unit. Am J Respir Crit Care Med 191(7): 731-8.

Portney, L.G., Watkins, M.P. 2009. Foundations of clinical research: Applications to practice. Upper Saddle River, NJ: Pearson/Prentice Hall; 11-5

Richards, K.C., O’Sullivan, P.S., Phillips, R.L. 2000. Measurement of sleep in critically ill patients. J Nurs Meas 8(2): 131-44.

Sadeh, A., Sharkey, K.M., Carskadon, M.A. 1994. Activity-based sleep-wake identification: An empirical test of methodological issues. Sleep 17(3): 201-7

Salas, R.E., Gamaldo, C.E. 2008. Adverse effects of sleep deprivation in the ICU. Critical Care Clin 24(3): 461-76

Simons, K.S., Verweij, E., Lemmens, P.M.C., Jelfs, S., Park, M., Spronk, P.E., Sonneveld, J.P.C., Feijen, H-M., van der Steen, M., Kohlrausch, A.G., van der Boogaard, B., de Jafer, C.P.C. 2018. Noise in the intensive care unit and its influence on sleep quality: A multicenter observational study in Dutch intensive care units. Crit Care 22(1): 250.

Varella, N.C., Almeida, R.S., Nogueira, L.A.C., Ferreira, A.S. 2021. Cross-cultural adaptation of the Richards-Campbell Sleep Questionnaire for intensive care unit inpatients in Brazil: Internal consistency, test-retest reliability, and measurement error. Sleep Med 85: 38-44.

Weinhouse, G.L., Schwab, R.J., Watson, P.L., Patil, N., Vaccaro, B., Pandharipande, P., Ely, E.W. 2009. Bench-to-bedside review: Delirium in ICU patients – Importance of sleep deprivation. Crit Care 13(6): 234.

Wild, D., Grove, A., Martin, M., Eremenco, S., McElroy, S., Verjee-Lorenz, A., Erikson, P. 2005. Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes (PRO) measures: report of the ISPOR task force for translation and cultural adaptation. Value in Health 8(2): 94-104.

Zhong, X., Hilton, H.J., Gates, G.J., Jelic, S., Stern, Y., Bartels, M.N., DeMeersman, R.E., Basner, R.C. 2005. Increased sympathetic and decreased parasympathetic cardiovascular modulation in normal humans with acute sleep deprivation. J Appl Physiol 98(6): 2024-32