title: Patient-nurse interrater reliability and agreement of the Richards-Campbell sleep questionnaire.
abstract: BACKGROUND
  The Richards-Campbell Sleep Questionnaire (RCSQ) is a simple, validated survey instrument for measuring sleep quality in intensive care patients. Although both patients and nurses can complete the RCSQ, interrater reliability and agreement have not been fully evaluated.
  
  
  OBJECTIVE
  To evaluate patient-nurse interrater reliability and agreement of the RCSQ in a medical intensive care unit.
  
  
  METHODS
  The instrument included 5 RCSQ items plus a rating of nighttime noise, each scored by using a 100-mm visual analogue scale. The mean of the 5 RCSQ items comprised a total score. For 24 days, the night-shift nurses in the medical intensive care unit completed the RCSQ regarding their patients' overnight sleep quality. Upon awakening, all conscious, nondelirious patients completed the RCSQ. Neither nurses nor patients knew the others' ratings. Patient-nurse agreement was evaluated by using mean differences and Bland-Altman plots. Reliability was evaluated by using intraclass correlation coefficients.
  
  
  RESULTS
  Thirty-three patients had a total of 92 paired patient-nurse assessments. For all RCSQ items, nurses' scores were higher (indicating "better" sleep) than patients' scores, with significantly higher ratings for sleep depth (mean [SD], 67 [21] vs 48 [35], P = .001), awakenings (68 [21] vs 60 [33], P = .03), and total score (68 [19] vs 57 [28], P = .01). The Bland-Altman plots also showed that nurses' ratings were generally higher than patients' ratings. Intraclass correlation coefficients of patient-nurse pairs ranged from 0.13 to 0.49 across the survey questions.
  
  
  CONCLUSIONS
  Patient-nurse interrater reliability on the RCSQ was "slight" to "moderate," with nurses tending to overestimate patients' perceived sleep quality.
authors: Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD 21205, USA.
authors: Biren B
authors: BB
authors: Kamdar
authors: Pooja A
authors: PA
authors: Shah
authors: Lauren M
authors: LM
authors: King
authors: Michelle E
authors: ME
authors: Kho
authors: Xiaowei
authors: X
authors: Zhou
authors: Elizabeth
authors: E
authors: Colantuoni
authors: Nancy A
authors: NA
authors: Collop
authors: Dale M
authors: DM
authors: Needham
mesh_terms: D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D009622:Noise; D009730:Nursing Assessment; D017286:Polysomnography; D015203:Reproducibility of Results; D012647:Self-Assessment; D012890:Sleep / Q000502:physiology; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis* / Q000517:prevention & control; D011795:Surveys and Questionnaires