Validity and reliability of the sleep health index among community-dwelling older adults.

IF 3.4 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Frontiers in Public Health Pub Date : 2026-04-22 eCollection Date: 2026-01-01 DOI:10.3389/fpubh.2026.1651175
Miao Miao, Nan Zhang, Bingqian Zhu, Jingyao Yu, Ying Chen, Subiyinuer Maimaiti, Ping Yan
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Abstract

Background: Sleep health represents a positive and multidimensional framework that extends beyond the absence of sleep disturbances or insufficient sleep duration. Despite its clinical relevance, empirical research on sleep health in older adults remains limited. The Sleep Health Index (SHI) was developed to comprehensively evaluate sleep health. This study aimed to validate the Chinese version of the SHI among community-dwelling older adults.

Methods: This is a cross-sectional design. Older adults aged 60 years and above were recruited (n = 274), and a subset (n = 60) was invited to complete the test-retest survey after a two-month interval. The SHI-C, Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), 15-Item Geriatric Depression Scale (GDS-15), comorbidity burden (aCCI), and handgrip strength (HGS) were administered to assess sleep health and related health indicators. The SHI-C was evaluated for structural, convergent, concurrent, known-group validity, internal consistency, and test-retest reliability.

Results: Exploratory factor analysis supported a three-factor structure, which was subsequently confirmed by confirmatory factor analysis (i.e., sleep quality, sleep duration, and disordered sleep), consistent with the original validation study. Parallel analysis further confirmed the three-factor solution. Measurement invariance testing across gender supported full metric and scalar invariance. The SHI-C demonstrated concurrent validity through strong negative correlations with both the PSQI (r = -0.624) and ISI (r = -0.696). It also showed weak but significant associations with the ESS (r = -0.328) and the GDS-15 (r = -0.329). Known-group validity was supported as participants with chronic diseases, insomnia, or depression had significantly lower SHI-C scores (p < 0.001). Furthermore, the total score of SHI-C exhibited a significant negative correlation with the aCCI (r = -0.302) and a significant positive correlation with HGS (r = 0.171), supporting its association with key objective health indicators. The SHI-C showed acceptable internal consistency (Cronbach's α = 0.775) and test-retest reliability (intraclass correlation coefficient = 0.784).

Conclusion: The SHI-C is a reliable and valid measurement for assessing sleep health in community-dwelling older adults. These findings suggest its potential utility for the sleep health assessment among this population, thereby contributing to the geriatric care enhancement.

社区居住老年人睡眠健康指数的效度和信度。
背景:睡眠健康是一个积极的、多维的框架,它超越了没有睡眠障碍或睡眠时间不足。尽管具有临床意义,但对老年人睡眠健康的实证研究仍然有限。睡眠健康指数(SHI)是一种综合评价睡眠健康的指标。本研究的目的是在社区居住的老年人中验证中文版本的SHI。方法:采用横断面设计。招募年龄在60 岁及以上的老年人(n = 274),并邀请一个子集(n = 60)在两个月间隔后完成测试-再测试调查。采用shic量表、匹兹堡睡眠质量指数(PSQI)、失眠严重程度指数(ISI)、Epworth嗜睡量表(ESS)、15项老年抑郁量表(GDS-15)、共病负担(aCCI)和握力(HGS)评估睡眠健康及相关健康指标。评估SHI-C的结构效度、收敛效度、并发效度、已知组效度、内部一致性和重测信度。结果:探索性因子分析支持三因素结构,随后通过验证性因子分析(即睡眠质量、睡眠持续时间和睡眠障碍)证实了这一结构,与原始验证性研究一致。并行分析进一步证实了三因素解。跨性别的测量不变性测试支持全度量和标量不变性。SHI-C与PSQI (r = -0.624)和ISI (r = -0.696)呈显著负相关,显示出并发效度。与ESS (r = -0.328)和GDS-15 (r = -0.329)也有微弱但显著的相关性。已知组效度得到支持,因为患有慢性疾病、失眠或抑郁的参与者的SHI-C评分显著降低(p r = -0.302),与HGS显著正相关(r = 0.171),支持其与关键客观健康指标的关联。SHI-C具有可接受的内部一致性(Cronbach's α = 0.775)和重测信度(类内相关系数 = 0.784)。结论:SHI-C是一种可靠、有效的评估社区老年人睡眠健康状况的方法。这些研究结果表明,该方法对这一人群的睡眠健康评估具有潜在的效用,从而有助于提高老年护理水平。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Frontiers in Public Health
Frontiers in Public Health Medicine-Public Health, Environmental and Occupational Health
CiteScore
4.80
自引率
7.70%
发文量
4469
审稿时长
14 weeks
期刊介绍: Frontiers in Public Health is a multidisciplinary open-access journal which publishes rigorously peer-reviewed research and is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians, policy makers and the public worldwide. The journal aims at overcoming current fragmentation in research and publication, promoting consistency in pursuing relevant scientific themes, and supporting finding dissemination and translation into practice. Frontiers in Public Health is organized into Specialty Sections that cover different areas of research in the field. Please refer to the author guidelines for details on article types and the submission process.
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