A cross-sectional validation study of the verran and snyder-halpern sleep scale and the factors influencing sleep questionnaire in Dutch hospitals

Christel T A J Derks, Jessica J J Cramer-Kruit, Paul Lodder, RENurse Consortium, Annemarie J B M de Vos and Catharina J van Oostveen

PLOS ONE, 2026, vol. 21, issue 9, 1-16

Abstract: Background: Adequate sleep is important for hospitalised patients, yet often disrupted by poor sleep hygiene. Limited research exists on sleep quality and contributing factors in general hospital wards, and reliable assessment tools are lacking. This study aimed to cross-culturally validate the Verran and Snyder-Halpern Sleep Scale (VSH) and the Factors Influencing Sleep Questionnaire (FISQ), assessing their psychometric properties among Dutch hospital patients, and evaluate patients sleep quality in general wards. Methods: A cross-sectional validation study included patients from internal medicine and surgical wards in six Dutch teaching hospitals. The VSH and the FISQ underwent a forward-backward translation process and were validated following COSMIN guidelines, including Confirmatory Factor Analysis (CFA). Sleep quality and hygiene were measured with the VSH (visual analogue scale) and FISQ (5-point Likert scale). Associations between patient characteristics and sleep hygiene factors were analysed using regression analyses. Results: A total of 693 respondents completed the questionnaire. Over half were aged 50−74 years and stayed in multi-occupancy rooms for more than four nights. Most (51%; n = 354) reported poorer sleep than at home. Reported disturbances included uncomfortable beds, pain, noisy ventilation, patient noise and equipment alarms. CFA revealed a three-factor model for the VSH and a one-factor model for the FISQ. Regression analysis showed daytime sleep was linked to more disturbance (β = 0,13[0,03, 0,23]) and lower sleep effectiveness (β = −0,11[−0,19, −0,03]). Fewer sleep hours were associated with lower sleep effectiveness (β = 0,57[0,48, 0,66]) and increased disturbance (β = −0,59[−0,67, −0,5]). More frequent sleep interruptions were associated with higher sleep disturbance (β = −0,22[−0,3, −0,15]) and increased need for sleep supplementation (β = −0,11[−0,21, 0]). Conclusions: The Dutch VSH and FISQ are valid, reliable tools for assessing sleep quality and hygiene. Despite measured suboptimall sleep conditions, these tools offer valuable insights for targeted improvements in hospital sleep hygiene.

Date: 2026
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0354633

DOI: 10.1371/journal.pone.0354633

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