家庭睡眠习惯调查在孤独症患儿睡眠评估中的信效度研究

Reliability and validity of the family sleep habits inventory in the sleep assessment among children with autism spectrum disorder

目的检验家庭睡眠习惯调查(FISH)在评估孤独症谱系障碍(ASD)患儿睡眠评估中的信度和效度。方法随机抽取在清远市妇幼保健院儿童语言行为科干预的199例2~6岁ASD共患睡眠障碍患儿,其照顾者同时完成FISH和儿童睡眠习惯问卷(CSHQ),2周后再次同时完成上述两个问卷,以检验FISH的信度和效度。结果验证性因素分析的结果表明,五因素模型拟合良好(χ^(2)=79.05,df=44,χ^(2)/df=1.80,P<0.001,SRMR=0.06,GFI=0.94,IFI=0.89,RMSEA=0.06),总量表及各分量表有较高的内部一致性信度(0.71~0.77)和重测信度(0.79~0.88)。FISH的白天习惯分别与CSHQ的入睡延迟、夜醒呈负相关,入睡前习惯分别与CSHQ的睡眠抵触、睡眠焦虑、白天睡眠呈负相关,睡眠常规分别与CSHQ的睡眠抵触、入睡延迟、睡眠焦虑呈负相关,睡前父母行为分别与CSHQ的睡眠抵触、睡眠焦虑呈负相关,总分与CSHQ总分呈负相关,差异均有统计学意义(P<0.05)。结论FISH具有较好的信度和效度,可作为ASD患儿睡眠习惯的评估工具。

Objective To test the reliability and validity of the famity inveritory of sleep habits(FISH) in the sleep assessment among children with autism spectrum disorder(ASD). Methods A random sample of 199 children with ASD and sleep disorders intervened in the Children’s Language and Behavior Department of Maternal and Child Health Hospital of Qingyuan City were selected, their caregivers completed the FISH and the children’s sleep habit questionnaire(CSHQ) at the same time, and completed the above two questionnaires again 2 weeks later to test the reliability and validity of the FISH. Results The results of confirmatory factor analysis showed that the five-factor model fits well(χ~2=79.05, df=44, χ~2/df=1.80, P<0.001, SRMR=0.06, GFI=0.94, IFI =0.89, RMSEA=0.06), the total scale and each subscale had high internal consistent reliability(0.71~0.77) and test-retest reliability(0.79~0.88). The daytime habits of FISH were negatively correlated with sleep delay and waking up at night of CSHQ respectively, the habits before sleep of FISH were negatively correlated with sleep conflict, sleep anxiety and daytime sleep of CSHQ respectively, the sleep routine of FISH was negatively correlated with sleep conflict, sleep delay and sleep anxiety of CSHQ respectively, the parents’ behavior before sleep of FISH was negatively correlated with sleep conflict and sleep anxiety of CSHQ respectively, and the total score of FISH was negatively correlated with CSHQ, with statistically significant differences(P<0.05). Conclusions The FISH had good reliability and validity, and can be used as an assessment tool for children with ASD.