Portuguese Children's Sleep Habits Questionnaire -validation
          and cross-cultural comparison

Silva, Filipe Glória; Silva, Cláudia Rocha; Braga, Lígia Barbosa; Serrão Neto, Ana

doi:10.1016/j.jped.2013.06.009

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Original articles • J. Pediatr. (Rio J.) 90 (01) • jan-feb 2014 • https://doi.org/10.1016/j.jped.2013.06.009 copy

Portuguese Children's Sleep Habits Questionnaire -validation and cross-cultural comparison

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE:

To validate the Portuguese version of the Children's Sleep Habits Questionnaire (CSHQ-PT) and compare it to the versions from other countries.

METHODS:

The questionnaire was previously adapted to the Portuguese language according to international guidelines. 500 questionnaires were delivered to the parents of a Portuguese community sample of children aged 2 to 10 years old. 370 (74%) valid questionnaires were obtained, 55 children met exclusion criteria and 315 entered in the validation study.

RESULTS:

The CSHQ-PT internal consistency (Cronbach's α) was 0.78 for the total scale and ranged from 0.44 to 0.74 for subscales. The test-retest reliability for subscales (Pearson's cor-relations, n=58) ranged from 0.59 to 0.85. Our data did not adjust to the original 8 domains structure in Confirmatory Factor Analysis but the Exploratory Factor Analysis extracted 5 factors that have correspondence to CSHQ subscales.

CONCLUSION:

The CSHQ-PT evidenced psychometric properties that are comparable to the versions from other countries and adequate for the screening of sleep disturbances in children from 2 to 10 years old.

Sleep; Questionnaire; Portuguese; Child; Validity; Reliability; Cross-Cultural Comparison

Variable	n	%
Child gender
Male	149	47.3%
Female	166	52.7%
Child age
2 years old	37	11.7%
3 y.o.	31	9.8%
4 y.o.	43	13.7%
5 y.o.	33	10.5%
6 y.o.	34	10.8%
7 y.o.	45	14.3%
8 y.o.	49	15.6%
9 y.o.	34	10.8%
10 y.o.	9	2.9%
Parent education
I. Less than 9 years	24	7.6%
II. 9 years	65	20.6%
III. 12 years	96	30.5%
IV. Bachelor’s degree or higher	118	37.5%
Missing	12	3.8%
Population density zone
Medium-High (urban =100/Km² )	225	72.6%
Low (rural, <100/Km² )	85	27.4%
Country of residence
Portugal	315	100%

	Portugal	_US12	China¹⁵	Israel¹⁶	Netherlands¹⁷	Germany¹⁸
Full scale	0.78^a	0.68	0.80	0.81	NP	0.68
Subscales:			0.49-0.72
Bedtime resistance	0.74^a	0.70		0.78	0.68	0.70
Sleep duration	0.68^a	0.69		0.68	0.63	0.70
Sleep anxiety	0.44^a	0.63		0.65	0.54	0.55
Night wakings	0.58^a	0.54		0.49	0.62	0.49
Parasomnias	0.57^a	0.36		0.28	0.54	0.36
Sleep-disordered breathing	0.67^a	0.51		0.46	0.47	0.23
Daytime sleepiness	0.71^a	0.65		0.67	0.67	0.63
Study sample size	315	469	517	98	1145	298

Subscales	Test-retest reliability
	Portugal (Pearson’s r)^a	United States¹² (Pearson’s r)	Netherlands¹⁷ (ICC)	Germany¹⁸ (ICC)
Bedtime resistance	0.85^b	0.68	0.83	0.74
Sleep onset delay	0.59^b	0.62	0.65	0.72
Sleep duration	0.67^b	0.40	0.47	0.46
Sleep anxiety	0.82^b	0.79	0.93	0.73
Night wakings	0.80^b	0.63	0.79	0.68
Parasomnias	0.79^b	0.62	0.73	0.67
SDB	0.82^b	0.69	0.72	0.63
Daytime sleepiness	0.69^b	0.65	0.79	0.81

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E-mail: jped@jped.com.br

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[1] * Corresponding author. E-mail: fs.sono@gmail.com (F.G. Silva).