Psychometric and Structural Validity of the Pittsburgh Sleep Quality Index among Filipino Domestic Workers
Abstract
:1. Background
2. Methods
2.1. Participants
2.2. Measures
- Objective Sleep:
- Daily Sleep Diary
- Depressive Symptoms
- Anxiety
- Epworth Sleepiness Scale:
- Rumination
- Perceived social support
3. Data Analysis
3.1. Study 1
3.1.1. Reliability Testing
3.1.2. Validity Testing
3.2. Study 2
4. Results
4.1. Study 1
4.1.1. Reliability
4.1.2. Validity
4.2. Study 2
4.2.1. Participants Characteristics
4.2.2. EFA Results
4.2.3. CFA Results
Study (Year) [Reference] | Population | Sample Size | Type of Structure Model | Results | Added Paths (Modifications) |
---|---|---|---|---|---|
Magee et al. (2008) [30] | Australian adults aged 18 to 59 years old | 364 | two-factor | Perceived sleep quality (C1, C2, C5, C6, C7); Sleep efficiency (C3, C4). | |
Kotronoulas et al. (2011) [28] | Patients with cancer receiving chemotherapy | 209 | two-factor | Quality of nocturnal sleep: C1, C2, C3, C4, C5; Daily disturbances and management of sleep problems: C6, C7. | |
Guo et al. (2016) [51] | Chinese undergraduate students | 631 | two-factor | Same as Magee et al. (2008). | |
Qiu et al. (2016) [62] | US pregnant women | 1488 | two-factor | Factor1: C1, C2, C3, C4; Factor2: C5, C7. | C2 and C4, C3 and C4 |
Becker et al. (2017) [63] | Portuguese community-dwelling older adults | 204 | two-factor | Perceived sleep quality: C1, C2; Sleep efficiency: C3, C4; Daytime function: C5, C7. | |
Fontes et al. (2017) [60] | Portuguese breast cancer patients | 474 | two-factor | Factor1: C1, C2, C3, C4; Factor2: C5, C6, C7. | |
Passos et al. (2017) [64] | Brazilian adolescents | 309 | two-factor | Same as Magee et al. (2008) omitting the sleep medication component | |
Otte et al. (2013) [65] | Non-depressed breast cancer survivors | 1174 | two-factor | Same as Magee et al. (2008). | C1 and C3, C2 and C4, C2 and C6, C2 and C7, C3 and C7. |
Gelaye et al. (2014) [61] | Undergraduate students in Chile, Ethiopia, and Thailand | 5900 | two-factor | Same as Magee et al. (2008). | |
Cole et al. (2006) [27] | Community-dwelling adults | 417 | three-factor | Perceived sleep quality: C1, C2, C6, Sleep efficiency (C3, C4); Daily disturbances (C5, C7). | |
Mariman et al. (2012) [66] | Chronic fatigue syndrome patients | 413 | three-factor | Same as Cole et al. (2006). | |
Gelaye et al. (2014) [61] | Undergraduate students in Peru | 2581 | three-factor | Sleep quality: C1, C5, C7; Sleep efficiency: C3, C4; Other: C2, C6. | |
Koh et al. (2015) [29] | Multi-ethnicities population in Singapore | 489 | three-factor | Perceived sleep quality: C1, C2; Sleep efficiency: C3, C4; Daytime function: C5, C6, C7. | |
Otte et al. (2015) [67] | Women with hot flashes | 890 | three-factor | Same as Cole et al. (2006). | |
Zhong et al. (2015) [68] | Peruvian Pregnant Women | 642 | three-factor | Perceived sleep quality: C1, C2, C5, C7; Sleep efficiency: C3, C4; Sleep medication: C1, C2, C6. |
Sleep Patterns | Description | Actigraphy | Daily Sleep Diary |
---|---|---|---|
Total sleep time (TST) | The total amount of sleep obtained from falling asleep to final awakening (reported in hours and minutes). | √ | |
The time in bed (TIB) | It was calculated by the interval period between the time to wake up and the reported bedtime the night before. | √ | |
Sleep onset latency (SL) | The time between bedtime and sleep onset (reported in minutes). | √ | √ |
Sleep efficiency (SE) | The result of TST divided by the total time in bed x 100%. | √ | √ |
Wake after sleep onset (WASO) | The number of minutes scored as awake during the sleep period after initial sleep onset. | √ | |
Number of wake bouts (WB) | The number of contiguous epochs categorized as wake. | √ | |
Fragmentation index (FI) | The sum of the ‘mobile time (%)’ and the ‘immobile bouts <= 1 min (%)’. | √ | |
Sleep quality (SQ) | Item from PSQI, ‘During the past month, how would you rate your sleep quality overall?’ | √ |
Items | Mean | Standard Deviation | Item-To-Total Correlation b | Alpha if Item Deleted | ICC | 95% CI of ICC |
---|---|---|---|---|---|---|
Component 1: Subjective sleep quality | 1.13 | 0.63 | 0.66 ** | 0.55 | 0.44 ** | (−0.07, 0.91) |
Component 2: Sleep latency | 1.46 | 0.86 | 0.66 ** | 0.56 | 0.58 ** | (0.05, 1.13) |
Component 3: Sleep duration | 1.37 | 0.90 | 0.63 **,a | 0.58 | 0.58 ** | (0.09, 1.08) |
Component 4: Habitual sleep efficiency | 0.45 | 0.74 | 0.43 **,a | 0.64 | 0.35 ** | (−0.27, 0.99) |
Component 5: Sleep disturbances | 1.51 | 0.61 | 0.52 ** | 0.59 | 0.43 ** | (−0.25, 1.10) |
Component 6: Use of sleeping medicine | 0.27 | 0.62 | 0.37 **,a | 0.64 | 0.30 ** | (−0.18, 0.73) |
Component 7: Daytime dysfunction | 0.88 | 0.70 | 0.59 ** | 0.57 | 0.42 ** | (−0.21, 1.03) |
PSQI-Global (0-21) | 7.09 | 2.86 | 0.63 ** | (0.01, 1.24) |
PSQI Items | PHQ-9 a | GAD-7 a | ESS a | RRS a | MSPSS | Height a | |||
---|---|---|---|---|---|---|---|---|---|
Total a | Family a | Friends a | Other a | ||||||
Component 1 | 0.27 ** | 0.26 ** | −0.06 | 0.21 * | −0.23 ** | −0.25 ** | −0.17 | −0.16 | 0.09 |
Component 2 | 0.13 | 0.06 | 0.07 | 0.20 * | −0.21 * | −0.27 ** | −0.13 | −0.12 | 0.09 |
Component 3 | 0.13 | 0.10 | 0.05 | 0.10 | −0.17 | −0.18 * | −0.17 | −0.07 | 0.003 |
Component 4 | −0.06 | −0.03 | 0.07 | 0.12 | −0.04 | −0.13 | 0.03 | 0.07 | 0.22 * |
Component 5 | 0.38 ** | 0.3 1** | 0.11 | 0.38 ** | .06 | 0.10 | 0.03 | 0.05 | 0.03 |
Component 6 | 0.23 ** | 0.23 ** | 0.24 ** | 0.19 * | −0.05 | −0.03 | −0.01 | −0.09 | 0.10 |
Component 7 | 0.47 ** | 0.29 ** | 0.19 * | 0.38 ** | −0.11 | −0.11 | −0.19 | −0.10 | 0.12 |
PSQI-Global | 0.36 ** | 0.28 ** | 0.17 | 0.39 ** | −0.18 * | −0.21 * | −0.15 | −0.07 | 0.18 * |
Follow-Up PSQI Items | Sleep Diary (n = 58) | Actigraphic Variables (n = 61) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
TIB b | SL a | TST b | SQ a | SE a | TST a | SL a | SE a | WASO a | WB b | FI b | |
Component 1 | −0.27 * | 0.31 * | −0.27 * | 0.61 ** | 0.19 | −0.11 | 0.14 | −0.07 | 0.04 | −0.10 | 0.15 |
Component 2 | −0.19 | 0.62 ** | −0.23 | 0.44 ** | 0.34** | −0.09 | 0.16 | −0.16 | 0.17 | −0.07 | 0.15 |
Component 3 | −0.80 ** | 0.25 | −0.79 ** | 0.36 ** | 0.16 | −0.65 ** | −0.09 | 0.13 | −0.24 | −0.43 ** | −0.06 |
Component 4 | −0.29 *,a | 0.15 | −0.31 **,a | 0.30 * | 0.19 | 0.02 | −0.01 | 0.02 | −0.05 | −0.09 a | 0.09 a |
Component 5 | −0.10 | 0.28 * | −0.06 | 0.46 ** | 0.12 | −0.04 | −0.09 | 0.07 | 0.04 | −0.09 | 0.03 |
Component 6 | / | / | / | / | / | 0.15 | 0.12 | −0.18 | 0.22 | 0.09 a | 0.18 a |
Component 7 | −0.13 | 0.30 * | −0.09 ** | 0.44 ** | −0.10 | −0.11 | 0.14 | −0.07 | 0.01 | −0.02 | 0.02 |
PSQI-Global | −0.48 ** | 0.48 ** | −0.48 ** | 0.65 ** | 0.25 | −0.23 | 0.03 | 0.02 | −0.03 | −0.21 | 0.14 |
Selected Variables | Total Sample (n = 1363) | Sample for EFA (n = 681) | Sample for CFA (n = 682) |
---|---|---|---|
Age (years, mean SD) | 40.99 8.92 | 40.79 8.87 | 41.19 8.97 |
Age group | |||
18–30 | 188 (13.79) | 92 (13.51) | 96 (14.08) |
31–40 | 491 (36.02) | 256 (37.59) | 235 (34.46) |
41–50 | 482 (35.36) | 233 (34.21) | 249 (36.51) |
51 | 202 (14.82) | 100 (14.68) | 102 (14.96) |
Time working as a domestic worker in Macao (years) | 6.07 8.60 | 6.16 8.86 | 5.97 8.34 |
Marital status | |||
Single, never married | 347 (25.46) | 175 (25.70) | 172 (25.22) |
Married | 603 (44.24) | 302 (44.35) | 301 (44.13) |
Partnered but not married | 97 (7.12) | 46 (6.75) | 51 (7.48) |
Separated | 214 (15.70) | 100 (14.68) | 114 (16.72) |
Legally separated | 9 (0.66) | 6 (.88) | 3 (0.44) |
Widowed | 93 (6.82) | 52 (7.64) | 41 (6.01) |
Education level | |||
Elementary | 24 (1.76) | 11 (1.62) | 13 (1.91) |
High school | 489 (35.88) | 244 (35.83) | 245 (35.92) |
Technical/vocational | 147 (10.79) | 72 (10.57) | 75 (11.00) |
2-year associate degree | 209 (15.33) | 107 (15.71) | 102 (14.96) |
Some college | 225 (16.51) | 116 (17.03) | 109 (15.98) |
Bachelor’s degree | 265 (19.44) | 130 (19.09) | 135 (19.79) |
Master’s degree or higher | 4 (0.29) | 1 (0.15) | 3 (0.44) |
Type of Visa | |||
Working Visa | 1358 (99.63) | 678 (99.56) | 680 (99.71) |
Temporary permanent resident | 3 (0.22) | 2 (0.29) | 1 (0.15) |
Permanent resident | 2 (0.15) | 1 (0.15) | 1 (0.15) |
Language speaking level (Cantonese) | 1.64 1.76 | 1.63 1.76 | 1.64 1.75 |
Language understanding level (Cantonese) | 1.72 1.88 | 1.72 1.91 | 1.71 1.85 |
Live-in / live-out | |||
Live-in | 672 (49.30) | 333 (48.90) | 339 (49.71) |
Live-out | 691 (50.70) | 348 (51.50) | 343 (50.29) |
Monthly salary (USD) | 436.93 101.31 | 436.72 108.46 | 437.14 93.70 |
Working hours per week | 65.60 21.99 | 66.55 22.51 | 64.66 21.44 |
Numbers of days off per month | 3.71 1.77 | 3.71 1.13 | 3.71 1.23 |
PSQI Items | Factor 1 | Factor 2 |
---|---|---|
Component 1: Subjective sleep quality | 0.62 | 0.16 |
Component 2: Sleep latency | 0.48 | 0.11 |
Component 3: Sleep duration | 0.13 | 0.77 |
Component 4: Habitual sleep efficiency | 0.00 | 0.77 |
Component 5: Sleep disturbances | 0.58 | 0.03 |
Component 6: Use of sleeping medicine | 0.38 | 0.08 |
Component 7: Daytime dysfunction | 0.60 | 0.05 |
% Variance explained | 33.99% | 22.25% |
Models | df | CFI | TLI | RMSEA | SRMR | ||
---|---|---|---|---|---|---|---|
The second random sample | One-factor | 466.20 ** | 14 | 0.55 | 0.33 | 0.22 | 0.12 |
Two-factor a | 50.75 ** | 13 | 0.96 | 0.94 | 0.065 | 0.039 | |
Two-factor b | 457.24 ** | 13 | 0.56 | 0.29 | 0.22 | 0.11 | |
Two-factor c | 464.13 ** | 13 | 0.55 | 0.28 | 0.23 | 0.11 | |
Three-factor a | 83.29 ** | 12 | 0.93 | 0.88 | 0.050 | 0.093 | |
Three-factor b | 72.42 ** | 12 | 0.94 | 0.90 | 0.048 | 0.086 | |
Three-factor c | 83.78 ** | 12 | 0.93 | 0.88 | 0.084 | 0.05 |
PSQI Items | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 |
---|---|---|---|---|---|---|---|---|---|
1.Component 1: Subjective sleep quality | 1 | ||||||||
2. Component 2: Sleep latency | 0.41 ** | 1 | |||||||
3. Component 3: Sleep duration | 0.23 ** | 0.14 ** | 1 | ||||||
4. Component 4: Habitual sleep efficiency | 0.08 ** | 0.04 | 0.60 ** | 1 | |||||
5. Component 5: Sleep disturbances | 0.39 ** | 0.38 ** | 0.13 ** | 0.01 | 1 | ||||
6. Component 6: Use of sleeping medicine | 0.16 ** | 0.04 | 0.09 ** | 0.09 ** | 0.24 ** | 1 | |||
7. Component 7: Daytime dysfunction | 0.39 ** | 0.28 ** | 0.16 ** | 0.06 * | 0.38 ** | 0.26 ** | 1 | ||
8. PSQI factor 1 | 0.73 ** | 0.75 ** | NA | NA | 0.71 ** | 0.24 ** | 0.68 ** | 1 | |
9. PSQI factor 2 | NA | NA | 0.91 ** | 0.85 ** | NA | NA | NA | NA | 1 |
Mean | 0.79 | 1.29 | 1.29 | 0.83 | 1.28 | 0.27 | 0.54 | 3.89 | 2.12 |
Standard deviation | 0.63 | 0.83 | 1.00 | 1.13 | 0.67 | 0.65 | 0.67 | 2.04 | 1.96 |
Median | 1 | 1 | 1 | 0 | 1 | 0 | 0 | 4 | 1 |
IQR | 0–1 | 1–2 | 1–2 | 0–1 | 1–2 | 0–0 | 0–1 | 2–5 | 1–3 |
4.2.4. Basic Psychometric Properties of PSQI
5. Discussion
6. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Declarations
Abbreviations
References
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Xiong, P.; Spira, A.P.; Hall, B.J. Psychometric and Structural Validity of the Pittsburgh Sleep Quality Index among Filipino Domestic Workers. Int. J. Environ. Res. Public Health 2020, 17, 5219. https://doi.org/10.3390/ijerph17145219
Xiong P, Spira AP, Hall BJ. Psychometric and Structural Validity of the Pittsburgh Sleep Quality Index among Filipino Domestic Workers. International Journal of Environmental Research and Public Health. 2020; 17(14):5219. https://doi.org/10.3390/ijerph17145219
Chicago/Turabian StyleXiong, Peng, Adam P. Spira, and Brian J. Hall. 2020. "Psychometric and Structural Validity of the Pittsburgh Sleep Quality Index among Filipino Domestic Workers" International Journal of Environmental Research and Public Health 17, no. 14: 5219. https://doi.org/10.3390/ijerph17145219