Validation and the psychometric properties of the Persian version of the sleep quality scale for coronary care patients: a methodological survey

Abstract

Sleep quality is crucial for recovery in coronary care patients, yet sleep disturbances are prevalent in intensive care settings. This study aimed to validate the Persian version of the Sleep Quality Scale for Coronary Care Patients (SQ-CC-P) in the Iranian population and ensure its psychometric robustness for clinical and research applications. A methodological study was conducted in the Coronary Care Unit (CCU) and heart unit of Imam Khomeini Hospital in Ardabil Province, Iran, from May to September 2024, involving 220 participants diagnosed with acute coronary conditions. The SQ-CC-P, which includes self-assessment and environmental factors, was assessed for content validity, construct validity, and reliability in accordance with COSMIN guidelines. The SQ-CC-P demonstrated strong content validity, with CVI (0.80-0.92), CVR (0.70-1.00), S-CVI/UA (0.85), S-CVI/Ave (0.91), and Adjusted Kappa (0.697) confirming item relevance and necessity. Construct validity was supported by exploratory factor analysis (EFA), which revealed a two-factor structure explaining 62.4% of the variance, and confirmatory factor analysis (CFA), which showed strong factor loadings (0.72-0.82) and excellent model fit. The scale exhibited high internal consistency (Cronbach's alpha = 0.862, McDonald's omega = 0.864) and test-retest reliability (ICC = 0.785, 95% CI [0.718, 0.841]). The SQ-CC-P is a valid and reliable tool for assessing sleep quality among coronary care patients, addressing a critical gap in sleep assessment in intensive care settings.

Keywords: Cardiovascular diseases; Intensive care unit; Psychometrics; Questionnaires; Sleep.

Fig. 1

Flowchart of translation procedure and psychometric evaluation of the SQ-CC-P.

Fig. 2

First-order CFA model and the standardized parameter estimates of the modified model of the SQ-CC-P.