Nature and Science of Sleep (Apr 2022)
Psychometric Validation of the Athens Insomnia Scale Among Nurses: A Robust Approach Using Both Classical Theory and Rating Scale Model Parameters
Abstract
Md Dilshad Manzar,1 Abdulrhman Albougami,1 Hamid Yimam Hassen,2 Mohamed Yacin Sikkandar,3 Seithikurippu R Pandi-Perumal,4,5 Ahmed S Bahammam6,7 1Department of Nursing, College of Applied Medical Sciences, Majmaah University, Al Majmaah, 11952, Saudi Arabia; 2Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, 2610, Belgium; 3Department of Medical Equipment Technology, College of Applied Medical Sciences, Majmaah University, Al Majmaah, 11952, Saudi Arabia; 4Somnogen Canada Inc, Toronto, ON, Canada; 5Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India; 6The University Sleep Disorders Center, College of Medicine, King Saud University, Riyadh, 11324, Saudi Arabia; 7National Plan for Science and Technology, College of Medicine, King Saud University, Riyadh, Saudi ArabiaCorrespondence: Md Dilshad Manzar, Department of Nursing College of Applied Medical Sciences, Majmaah University, Al Majmaah, 11952, Saudi Arabia, Email [email protected]: Few studies have investigated the validity of the Athens insomnia scale (AIS) using a robust approach of both classical theory and the rating scale model. Therefore, in this study, we investigated psychometric validation of the AIS using both of these approaches in nurses.Methods: Nurses (n= 563, age= 33.2± 7.1 years) working in health facilities in Saudi Arabia participated in a cross-sectional study. Participants completed the AIS, socio-demographics tool, and sleep health-related questions.Results: Confirmatory factor analysis (CFA) favored a 2-factor structure with both comparative fit index (CFI), and incremental fit index (IFI) having values above 0.95. The 2-factor model had the lowest values of Akaike information criterion (AIC), root mean square error of approximation (RMSEA), χ2, and χ2/df. This 2-factor structure showed configural invariance (CFI more than 0.95, RMSEA less than 0.08, and &KHgr;2/df less than 3), and metric, scalar, and strict invariance (based on Δ CFI ≤-0.01, and Δ RMSEA ≥ 0.015 criteria). No ceiling/floor effects were seen for the AIS total scores. Infit and outfit mean square values for all the items were within the acceptable range ( 0.6). The threshold estimates for each item were ordered as expected. Cronbach’s α for the AIS tool, factor-1 score, factor-2 score was 0.86, 0.82, and 0.72, respectively. AIS factor scores-1/2 were significantly associated with a habitual feeling of tiredness after usual night sleep (p< 0.001), Impairment of daytime socio-occupational functioning (p< 0.05), and with a feeling of daytime fatigue, irritability, and restlessness (p< 0.05).Conclusion: The findings favor the validity of a 2-factor structure of the AIS with adequate item properties, convergent validity, and reliability in nurses.Keywords: insomnia, reliability, factor analysis, sleep, validity
