中国幼儿睡眠状况评估量表的编制与评价研究

Development and evaluation of the Chinese Toddler Sleep Assessment Scale

目的编制适用于我国12~35月龄幼儿的睡眠状况评估量表,评价其信度、效度和可行性,为评估中国幼儿睡眠情况提供适宜的评估工具。方法建立条目池,通过头脑风暴法、德尔菲法和预调查对条目进行初筛和修改。采用抽样调查方法,2019年7-11月从全国6个社区、6个乡镇和两家睡眠门诊选择12~35月龄幼儿看护人进行现场调查,共收回有效问卷551份。采用项目分析、效度分析、信度分析、可行性和验证性因子分析对量表进行评价。结果幼儿睡眠状况评估量表(12~35个月)包含睡眠节律、夜醒情况、入睡行为、日间嗜睡,睡眠呼吸和异态睡眠6个因子20个条目,累积解释变异量为55.55%。所有条目的内容效度指数介于0.83~1.00。量表入睡潜伏期、夜醒次数、睡眠时间3个条目与简明婴儿睡眠问卷呈正相关(r=0.41、0.69、0.42,P<0.001)。除日间嗜睡外,社区幼儿量表总分以及其他5个因子得分均低于门诊幼儿(P<0.05)。量表总Cronbach′s α系数为0.72,两周重测信度为0.84,完成率为92.6%。验证性因子分析结果显示,量表的因子结构模型较为合理、稳定。结论量表具有较好的信度效度,可以区分不同幼儿的睡眠状况,有助于及早发现幼儿的睡眠问题。

Objective To develop Chinese Toddler Sleep Assessment Scale(TSAS) suitable for Chinese toddles aged 13-35 months, and to evaluate the reliability, validity and feasibility of the scale, so as to provide an appropriate tool for assessing the sleep of Chinese children. Methods An item pool was established.The items were preliminary selected and modified through brainstorming, Delphi and pre-test.A total of 551 children aged 12-35 months in six communities, six towns and two sleep clinics were investigated from July to November 2019 using random sampling.Item analysis, validity analysis, reliability analysis, feasibility and confirmatory factor analysis were used to evaluate the scale. Results The TSAS had 20 items, including 6 factors of sleep rhythm, bedtime arrangement, night wakings, daytime sleepiness, parasomnias breathing and sleep disordered with total variance explained of 55.55%.The item-level content validity of all items ranged from 0.83 to 1.00.The scale was positively correlated with the Brief Infant Sleep Questionnaires in terms of sleep latency, number of night wakings and sleep duration(r=0.41, 0.69, 0.42, P<0.001).Except for daytime sleepiness, community sample scored lower than clinical sample in terms of the total score and other 5 factors(P<0.05).The total Cronbach′s α coefficient was 0.72.The total retest reliability was 0.84.The completion rate of the scale was 92.6%.The results of confirmatory factor analysis showed that the factor structure model of TSAS was reasonable and stable. Conclusions TSAS have good reliability and validity, which could distinguish the sleep of toddlers in the community and clinics, and could be used for early screening of toddlers′ sleep problems.