The Richards-Campbell Sleep Questionnaire is a validated instrument used in surveys for taking measurements of sleep quality in patients who are in intensive care. While it can be completed by both nurses and patients, the Richard-Campbell Sleep Questionnaire’s agreement and inter-reliability between the two have not yet been validated…
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In the development of the instrument, studies describing critically ill patients’ patterns of sleep were used as a theoretical basis for various items incorporated into the instrument. The instrument was validated against the polysomnograph and found to be an improvement in measuring sleep quality for patients in intensive care (Richards et al, 2000).
As currently used, the Richard-Campbell Sleep Questionnaire reflects five items that are used for measuring sleep quality in ICU patients. These are the depth of sleep, ability to fall asleep, number of times the patients wake up, percentage of the time the patients are awake, and the overall sleep quality of the patients (Richards et al, 2000). The Richard-Campbell Sleep Questionnaire, on top of these five items, also includes a rating for noise during the nighttime, which are scored using a visual analogue scale. The five scores for the Richard-Campbell Sleep Questionnaire is averaged, and the mean score used in determining sleep quality. Night shift nurses are required to complete the Richard-Campbell Sleep Questionnaire with regards to the sleep quality of their patients overnight, while the patients also fill in the Richard-Campbell Sleep Questionnaire after they wake up. The instrument was modified to measure how many awakenings the patient had during their sleep in order to differentiate between patients who woke up frequently and those who did not wake up during their sleep. Further advances in the instrument involved the requirement that the items and directions on the questionnaire be read out to the patients in intensive care (Richards et al, 2000). This was because, while patients have been found to have little trouble in completing it if nurses read the items and directions out to them, majority of the critically ill patients had problems when completing the questionnaire without provision of assistance. However, for obvious reasons, this survey is only useful if the patients are awake and non-delirious. The visual analog nature of the Richard-Campbell Sleep Questionnaire scales means that, as a measure of the latency of sleep, it is not very sensitive in comparison to other modalities of scaling (Richards et al, 2000). For this reason, there is a need to revise the instrument. This could be done in order to improve the Richard-Campbell Sleep Questionnaire’s ability to predict the efficiency of sleep in intensive care patients. For example, the instrument could be revised by adding more items in an attempt to predict sleep efficiency with an improved percentage of variance. However, this will be done at the risk of decreasing the practicality of outcome measurements for patients who are critically ill (Richards et al, 2000), especially as increasing the number of items may be too much for nurses who are overworked and patients who are critically ill and may be too weak to answer them. The Richard-Campbell Sleep Questionnaire’s predictive ability could also be potentially improved by adding another section with more items for nurses. This additional section would consist of additional observations that the nurses make for the critically ill patients’ quality of sleep (Richards et al, 2000). The Richard-Campbell Sleep Questionnaire could also be revised to account for sleep characteristic
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