A longitudinal examination of the measurement properties and invariance of the Sleep Condition Indicator in Chinese healthcare students.

BACKGROUND: The Sleep Condition Indicator (SCI), an insomnia measurement tool based on the updated Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria with sound psychometric properties when applied in various populations, was evaluated here among healthcare students longitudinally, to demonstrate its measurement properties and invariance in this particularly high-risk population. METHODS: Healthcare students of a Chinese university were recruited into this two-wave longitudinal study, completing the simplified Chinese version of the SCI (SCI-SC), Chinese Regularity, Satisfaction, Alertness, Timing, Efficiency, Duration (RU_SATED-C) scale, Chinese Patient Health Questionnaire-4 (PHQ-4-C), and sociodemographic variables questionnaire (Q-SV) between September and November 2022. Structural validity, measurement invariance (MI), convergent and discriminant validity, internal consistency, and test-retest reliability of the SCI-SC were examined. Subgroups of gender, age, home location, part-time job, physical exercise, and stress-coping strategy were surveyed twice to test cross-sectional and longitudinal MI. RESULTS: We identified 343 valid responses (62.9% female, mean age = 19.650 ± 1.414 years) with a time interval of seven days. The two-factor structure was considered satisfactory (comparative fit index = 0.953-0.989, Tucker-Lewis index = 0.931-0.984, root means square error of approximation = 0.040-0.092, standardized root mean square residual = 0.039-0.054), which mostly endorsed strict invariance except for part-time job subgroups, hence establishing longitudinal invariance. The SCI-SC presented acceptable convergent validity with the RU_SATED-C scale (r ≥ 0.500), discriminant validity with the PHQ-4-C (0.300 ≤ r < 0.500), internal consistency (Cronbach's alpha = 0.811-0.835, McDonald's omega = 0.805-0.832), and test-retest reliability (intraclass correlation coefficient = 0.829). CONCLUSION: The SCI-SC is an appropriate screening instrument available for assessing insomnia symptoms among healthcare students, and the promising measurement properties provide additional evidence about validity and reliability for detecting insomnia in healthcare students.

[Gender characteristics and HIV/AIDS related knowledge awareness and behaviors of transgender women].

OBJECTIVE: To understand the gender characteristics, HIV/AIDS related knowledge awareness and behaviors of transgender women. METHODS: A questionnaire survey was conducted among the transgender women recruited through snowball sampling in Jinan in 2014, and descriptive epidemiologic analysis was conducted on the survey results. RESULTS: A total of 55 transgender women were surveyed, all of them were male physically and female psychologically. Serious gender conflict occurred in 27 subjects (49.1%), and very serious gender conflict occurred in 8 subjects (14.5%). Thirty subjects dressed up as a man in social life, accounting for 54.5%; 25 subjects dressed up as a women in social life, accounting for 45.5%. The average awareness rate of HIV/AIDS related knowledge was 57.9%(22/38). The awareness of knowledge about AIDS associated behaviors, such as multi sex partner and anal sex, was poor. For the lovers or sexual partners, 58.2% of the subjects (32/55) would choose males and 50.9% of the subjects (28/55) had chosen males, and for the sex partner at latest sex, 63.6%(35/55) of the subjects had chosen males. Up to 56.3% of the subjects had sex with casual sexual partners (net friends and partners of one-night stand) at latest sex behavior. Among the subjects surveyed, 18(32.7%) never used condoms; 29(52.7%) used condoms occasionally; 4(7.3%) used condoms frequently and 4(7.3%) used condoms at each sex. CONCLUSIONS: AIDS associated high risk behaviors were common among the transgender women, such as unprotected anal sex, multiple sexual partners, frequent sex and poor condom use. It is necessary to conduct the study of the HIV infection prevention in transgender women.