The Pittsburgh Sleep Quality Index (PSQI).

WHY: For all people, sleep is part of the rhythm of life. Without a " good " sleep, the body loses the ability to revitalize, the mind is less adept and one's mood is altered. Circadian rhythms have a major impact on older adults' health and well-being. Normal aging changes conspire to interfere with the quality of sleep, while health and medication use can affect the sleep patterns in a negative manner. A nursing assessment of sleep begins with a comprehensive assessment of sleep quality and sleep patterns. The nurse may be able to improve the sleep problem immediately with interventions or work with the health care team to assess the sleep problem in greater depth. BEST TOOL: The Pittsburgh Sleep Quality Index (PSQI) is an effective instrument used to measure the quality and patterns of sleep in the older adult. It differentiates " poor " from " good " sleep by measuring seven areas: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction over the last month. The client self-rates each of these seven areas of sleep. Scoring of answers is based on a 0 to 3 scale, whereby 3 reflects the negative extreme on the Likert Scale. A global sum of " 5 " or greater indicates a " poor " sleeper. Although there are several questions that request the evaluation of the client's bedmate or roommate, these are not scored (not reflected in the attached instrument; refer to " More on the Topic " , Buysse, et al., 1989, for these questions). TARGET POPULATION: The PSQI can be used for both an initial assessment and ongoing comparative measurements with older adults across all health care settings. VALIDITY AND RELIABILITY: The PSQI has internal consistency and a reliability coefficient (Cronbach's alpha) of 0.83 for its seven components. Numerous studies using the PSQI in a variety of older adult populations throughout the world have supported high validity and reliability. STRENGTHS AND LIMITATIONS: The PSQI is a subjective measure of sleep. Self-reporting can empower the client, but can reflect inaccurate information if the client has difficulty understanding what is written, or cannot see or physically write out responses. Moreover, the scale is presented in English and has been used mostly in English speaking countries, with recent studies validating Chinese and Japanese versions. The scale can be adapted to enable the …