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Peer-reviewedCC BY 4.0PLOS One

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. Derks1
  • Jessica J. J. Cramer-Kruit2
  • Paul Lodder3
  • RENurse Consortium4
  • Annemarie J. B. M. de Vos5
  • Catharina J. van Oostveen6
6 affiliations
  1. 1Elisabeth-TweeSteden Hospital, Hilvarenbeekse Weg 60, Tilburg, The Netherlands
  2. 2Martini Hospital, Van Swietenplein 1, Groningen, The Netherlands
  3. 3Department of Methodology & Statistics, Tilburg University, Tilburg, The Netherlands
  4. 4Fontys University of Applied Sciences, Professor Goossenslaan 1-01, Tilburg, The Netherlands
  5. 5Avans University of Applied Sciences, Hogeschoollaan 1, Breda, The Netherlands
  6. 6Spaarne Gasthuis Hospital, Spaarne Gasthuis Academy, Haarlem, The Netherlands
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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.

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Cite

BibTeXRIS
BibTeX
@article{derks2026crosssectional,
  title = {{A cross-sectional validation study of the verran and snyder-halpern sleep scale and the factors influencing sleep questionnaire in Dutch hospitals}},
  author = {Christel T. A. J. Derks and Jessica J. J. Cramer-Kruit and Paul Lodder and RENurse Consortium and Annemarie J. B. M. de Vos and Catharina J. van Oostveen},
  journal = {PLOS One},
  year = {2026},
  month = sep,
  doi = {10.1371/journal.pone.0354633},
  url = {https://doi.org/10.1371/journal.pone.0354633},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - A cross-sectional validation study of the verran and snyder-halpern sleep scale and the factors influencing sleep questionnaire in Dutch hospitals
AU  - Christel T. A. J. Derks
AU  - Jessica J. J. Cramer-Kruit
AU  - Paul Lodder
AU  - RENurse Consortium
AU  - Annemarie J. B. M. de Vos
AU  - Catharina J. van Oostveen
PY  - 2026
DA  - 2026/09/01
JO  - PLOS One
DO  - 10.1371/journal.pone.0354633
UR  - https://doi.org/10.1371/journal.pone.0354633
AB  - 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.
SN  - 1932-6203
ER  -