A Theory-Based Nursing Scale for Measuring the Impact of Sleep Disturbance on Quality of Life

Abstract

Aims Sleep disturbance and quality of life have been widely studied; however, there is a lack of theory-based, nursing-specific tools that directly assess their relationship. This study aimed to develop a valid and reliable measurement tool based on Kolcaba's Comfort Theory.Design Methodological study.Methods The study included 781 patients and followed standard procedures for scale development. The scale was rated on a 5-point Likert scale, and item scores were averaged to obtain overall scores. Data were collected using the Personal Information Form, the Pittsburgh Sleep Quality Index, the Visual Analog Scale (impact of sleep disturbance), the World Health Organization Quality of Life Scale, and the newly developed scale. Content validity, exploratory factor analysis, and confirmatory factor analysis were used to assess validity. Reliability was evaluated using Cronbach's alpha, McDonald's omega, and split-half reliability.Results The final scale consists of 23 items and two sub-dimensions: Physical-Psycho-Spiritual and Environmental-Sociocultural. Mean scores range from 1 to 5, with higher scores indicating a greater negative impact of sleep disturbance on quality of life. These findings suggest that the scale may capture the multidimensional impact of sleep disturbance on quality of life. Reliability coefficients were 0.96 for both sub-dimensions and 0.98 for the overall scale. However, the confirmatory factor analysis results indicated an acceptable yet borderline model fit, particularly with respect to the RMSEA value, and therefore should be interpreted with caution.Patient or Public Contributions The Effect of Sleep Disturbance on Quality of Life Scale may offer a theory-based approach to assessing how sleep disturbances relate to patients' quality of life. It may assist healthcare professionals in clinical assessment by helping to identify the multidimensional impact of sleep-related problems and could potentially contribute to clinical decision-making and care planning. The findings suggest that the scale demonstrates adequate psychometric properties and may be a useful tool for research, education, and clinical practice. In addition, criterion-related validity showed correlations ranging from weak to moderate levels, indicating partial support rather than strong evidence. These findings should therefore be interpreted with caution, as the observed correlations provide limited rather than conclusive evidence of criterion validity.Conclusions The scale appears to be a valid and reliable tool for assessing the impact of sleep disturbance on quality of life. The scale may provide a theory-based framework for assessing patient needs, which may support holistic assessment and individualized care.