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Validation of the Malay version of Epworth sleepiness scale for children and adolescents (MESS-CHAD)

Lee WY 1 , Lau MN 2 , Soh EX 3 , Yuen SW 3 , Ashari A 4 , Radzi Z 3

Affiliations 

  • 1 Lanang Dental Clinic, Ministry of Health Malaysia, Sibu, Sarawak, Malaysia
  • 2 Department of Paediatric Dentistry & Orthodontics, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia. minalau@um.edu.my
  • 3 Department of Paediatric Dentistry & Orthodontics, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
  • 4 Centre for Family Oral Health, Faculty of Dentistry, The National University of Malaysia, Kuala Lumpur, Malaysia. asmaashari@ukm.edu.my
BMC Oral Health, 2023 Dec 19;23(1):1015.
PMID: 38115099 DOI: 10.1186/s12903-023-03762-w

Abstract

BACKGROUND: Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD) is a valid and reliable eight-item self-administered questionnaire for the assessment of excessive daytime sleepiness and is commonly used to screen sleep-disordered breathing for children and adolescents. The cross-sectional study aimed to translate and cross-culturally adapt ESS-CHAD into a Malay version of Epworth Sleepiness Scale for Children and Adolescents (MESS-CHAD) for the Malaysian population, and to assess the validity and reliability of MESS-CHAD.

METHODS: Forward-backward translation method was used to translate and cross-culturally adapt ESS-CHAD. Three linguistic experts and two paediatricians content validated the translated version. Face validity was conducted through audio-recorded semi-structured in-depth interviews with 14 native Malay-speaking children and adolescents followed by thematic analysis. The revised questionnaire was then proofread by a linguistic expert. A total of 40 subjects answered the MESS-CHAD twice, 2 weeks apart, for test-retest reliability and internal consistency. For criterion validity, 148 eligible subjects and their parents answered MESS-CHAD and the Malay version of Sleep-Related Breathing Disorder scale extracted from the Paediatric Sleep Questionnaire (M-PSQ:SRBD) concurrently. Variance Inflation Factor (VIF) and P values of the model's outer weight and outer loading were analysed using SmartPLS software to assess the indicator's multicollinearity and significance for formative construct validity.

RESULTS: Intraclass Correlation Coefficient (ICC) ranging from 0.798 to 0.932 and Cronbach's alpha ranging from 0.813 to 0.932 confirmed good to excellent test-retest reliability and internal consistency, respectively. Spearman Correlation Coefficient value of 0.789 suggested a very strong positive correlation between MESS-CHAD and M-PSQ:SRBD. VIF ranging from 1.109 to 1.455 indicated no collinearity problem. All questionnaire items in MESS-CHAD were retained as the P value of either outer model weight or outer model loading was significant (P 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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