Patient-nurse interrater reliability and agreement of the Richards-Campbell sleep questionnaire

Biren B. Kamdar, Pooja A. Shah, Lauren M. King, Michelle E. Kho, Xiaowei Zhou, Elizabeth Colantuoni, Nancy A. Collop, Dale M. Needham

Research output: Contribution to journalArticlepeer-review


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. Objectives 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 patientnurse 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.

Original languageEnglish (US)
Pages (from-to)261-269
Number of pages9
JournalAmerican Journal of Critical Care
Issue number4
StatePublished - Jul 1 2012

ASJC Scopus subject areas

  • Critical Care


Dive into the research topics of 'Patient-nurse interrater reliability and agreement of the Richards-Campbell sleep questionnaire'. Together they form a unique fingerprint.

Cite this