Measuring hospitalised patients' experiences of sleep and rest: development and validation of a nursing-informed patient-reported instrument.

BACKGROUND

Sleep and rest are fundamental to recovery during hospitalisation and are highly sensitive to nursing care. However, they are rarely assessed systematically in a way that captures patients' experiences and care-sensitive dimensions within routine nursing practice.

AIM: To develop and psychometrically evaluate a patient-reported, nursing-informed instrument of hospitalised patients' experiences of sleep and rest, derived from selected Nursing Outcomes Classification (NOC) indicators.

METHODS

A multicentre, cross-sectional psychometric study was conducted in two phases. First, a panel of experts reached consensus on relevant NOC outcomes and indicators related to sleep and rest. Second, the resulting instrument was administered to 1060 adult patients hospitalised in Internal Medicine units across eight hospitals. Psychometric evaluation included factor analyses, internal consistency assessment, hierarchical latent structure analysis and convergent validity testing.

RESULTS

Analyses supported a three-dimensional structure encompassing physiological, contextual and emotional domains, explaining 70.6% of the total variance. The confirmatory model showed good overall fit, and reliability estimates indicated high internal consistency for both the total instrument and individual dimensions. Hierarchical modelling revealed a strong general latent factor underlying the three domains, supporting the primary interpretation of an overall score, with dimension-specific information considered supplementary.

CONCLUSIONS

The findings support the validity and reliability of a multidimensional, nursing-informed instrument to assess patients' experiences of sleep and rest during hospitalisation. The instrument provides a clinically meaningful framework informed by nursing theory and operationalised using selected NOC indicators, facilitating systematic nursing assessment of sleep and rest during hospitalisation.