Abstract
The COVID-19 outbreak is associated with sleep problems and mental health issues among individuals. Therefore, there is a need to assess sleep efficiency during this tough period. Unfortunately, the commonly used instrument on insomnia severity—the Insomnia Severity Index (ISI)—has never been translated and validated among Bangladeshis. Additionally, the ISI has never been validated during a major protracted disaster (such as the COVID-19 outbreak) when individuals encounter mental health problems. The present study aimed to translate the ISI into Bangla language (ISI-Bangla) and validate its psychometric properties. First, the linguistic validity of the ISI-Bangla was established. Then, 9790 Bangladeshis (mean age = 26.7 years; SD = 8.5; 5489 [56.1%] males) completed the Bangla versions of the following questionnaires: ISI, Fear of COVID-19 Scale (FCV-19S), and Patient Health Questionnaire-9 (PHQ-9). All the participants also answered an item on suicidal ideation. Classical test theory and Rasch analyses were conducted to evaluate the psychometric properties of the ISI-Bangla. Both classical test theory and Rasch analyses support a one-factor structure for the ISI-Bangla. Moreover, no substantial differential item functioning was observed across different subgroups (gender, depression status (determined using PHQ-9), and suicidal ideation). Additionally, concurrent validity of the ISI-Bangla was supported by significant and moderate correlations with FCV-19S and PHQ-9; known-group validity was established by the significant difference of the ISI-Bangla scores between participants who experienced suicidal ideation and those without. The present psychometric validation conducted during the COVID-19 outbreak suggests that the ISI-Bangla is a promising and operationally adequate instrument to assess insomnia in Bangladeshis.
Highlights
Insomnia as well as other sleep problems, are intrinsically linked to people’s wellness, health, and development [1–6]
In light of the adverse consequences associated with the presence of insomnia, and the opportunities afforded by simple and valid instruments, such as the Insomnia Severity Index (ISI) to diagnose and manage this condition, it seemed of great importance and urgency to enable this tool for Bangladesh
The ISI has the advantage of using standard and diagnostic criteria to define insomnia severity, which is outlined in the International Classification of Sleep Disorders (ICSD) and the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) [39,40]
Summary
Insomnia as well as other sleep problems, are intrinsically linked to people’s wellness, health, and development [1–6]. Studies have shown fear of COVID-19, a pandemic caused by the novel coronavirus (SARS-CoV-2) as a potential threat to good sleep and possibly linked to psychological distress and suicidality [7–9]. COVID-19 has been associated with dramatic increases in the prevalence of psychosocial health problems in light of its ability to rapidly spread, induce severe multi-organ symptoms, and with elevated mortality rates. Mental health problems are frequent and are either induced by COVID-19 among those infected or among the general population by virtue of the lockdown measures and associated economic hardship imposed by the various social and work-related restrictions [10]. Insomnia has emerged as a latent—yet frequent—issue worldwide [12]
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