Nonrestorative sleep scale: a reliable and valid short form of the traditional Chinese version.

PURPOSE: Previous research has suggested the essential unidimensionality of the 12-item traditional Chinese version of the Nonrestorative Sleep Scale (NRSS). This study aimed to develop a short form of the traditional Chinese version of the NRSS without compromising its reliability and validity. METHODS: Data were collected from 2 cross-sectional studies with identical target groups of adults residing in Hong Kong. An iterative Wald test was used to assess differential item functioning by gender. Based on the generalized partial credit model, we first obtained a shortened version such that further shortening would result in substantial sacrifice of test information and standard error of measurement. Another shortened version was obtained by the optimal test assembly (OTA). The two shortened versions were compared for test information, Cronbach's alpha, and convergent validity. RESULTS: Data from a total of 404 Chinese adults (60.0% female) who had completed the Chinese NRSS were gathered. All items were invariant by gender. A 6-item version was obtained beyond which the test performance substantially deteriorated, and a 9-item version was obtained by OTA. The 9-item version performed better than the 6-item version in test information and convergent validity. It had discrimination and difficulty indices ranging from 0.44 to 2.23 and - 7.58 to 2.13, respectively, and retained 92% of the test information of the original 12-item version. CONCLUSION: The 9-item Chinese NRSS is a reliable and valid tool to measure nonrestorative sleep for epidemiological studies.

Nonrestorative sleep scale: reliable and valid for the Chinese population.

PURPOSE: To conduct a linguistic and psychometric evaluation of a Chinese version of the Nonrestorative Sleep Scale (NRSS). METHODS: The Chinese NRSS was created from a standard forward-backward translation and trialed on 10 Chinese adults. Telephone interviews were then conducted with 100 adults, who completed the Chinese NRSS, the Pittsburgh Sleep Quality Index (PSQI), the Athens Insomnia Scale (AIS), the Center for Epidemiological Studies Depression Scale (CES-D), and the Toronto Hospital Alertness Test (THAT). A household survey was conducted with 20 subjects, followed by a confirmatory factor analysis (CFA), and a bifactor model was developed to evaluate the reliability and validity of the NRSS. RESULTS: The bifactor model had the root mean square error of approximation (RMSEA), standardized root mean square residual (SRMR), and comparative fit index (CFI) of 0.06, 0.06, and 0.97, respectively. Convergent validity was shown from the moderate associations with PSQI (r = - 0.66, P < 0.01), AIS (r = - 0.65, P < 0.01), CES-D (r = - 0.54, P < 0.01), and THAT (r = 0.68, P < 0.01). The coefficient omega (0.92), omega hierarchical (0.81), factor determinacy (0.93), H value (0.91), explained common variance (0.63), and percentage of uncontaminated correlations (0.80) derived from the bifactor CFA supported the essential unidimensionality of NRSS. CONCLUSIONS: The Chinese NRSS is a valid and reliable essential unidimensional tool for the assessment of nonrestorative sleep in the Chinese population.

The use of social networking applications of smartphone and associated sexual risks in lesbian, gay, bisexual, and transgender populations: a systematic review.

The use of social networking applications (apps) on smartphones has the potential to impact sexual health and behaviour. This was the first systematic review to critically appraise and summarize the existing literature on the use of social networking apps on smartphones and their associated sexual health and sexual behaviour effects in lesbian, gay, bisexual and transgender populations. A systematic search was conducted in five databases (CINAHL Plus, PsycINFO, PubMed, SCOPUS and Sociological Abstracts), using controlled terms and keywords. Thirteen articles from 11 studies were included in this review. Studied outcomes included rates of unprotected sexual intercourse, the number of sexual partners, drug/alcohol use prior to/during sexual intercourse, sexually transmitted infections (STIs) testing and the prevalence of STIs. Among app users, the prevalence of unprotected sex ranged from 17.0% to 66.7%. The mean number of sexual partners ranged from 1.4 to 2.9 (last 1-month period), and from 46.2 to 79.6 (lifetime). Two studies found that the prevalence of HIV infection was 1.9% and 11.4%, respectively. The self-reported prevalence of prior diagnosis of STIs other than HIV ranged from 9.1% to 51.0%. It should be noted that the heterogeneity of the study design and outcome measures across different studies hindered the comparison of findings across different studies. Furthermore, the findings in some studies are not reliable due to methodological problems. Our results highlight the need for more research with rigorous methodology to understand the negative impacts of using these apps on sexual health and sexual behaviour. For future studies, the operational definition of outcomes, including social networking app use and unprotected anal intercourse (UAI), should be clearly outlined. The use of validated tools to measure sexual behaviour and biological measures of HIV and other STDs is preferable so that outcomes can be standardized to facilitate comparisons between studies and the pooling of data.