Development of Questionnaires for Assessing Anxiety, Sleep Quality, and Quality of Life in the Elderly for Nursing Practice

Agus Dodi Praptomo; Mulya Virgonita I Winta; Margaretha Maria Shinta Pratiwi

doi:10.58418/ijni.v3i2.111

Authors

Agus Dodi Praptomo University Semarang, Indonesia
Mulya Virgonita I Winta University Semarang, Indonesia
Margaretha Maria Shinta Pratiwi University Semarang, Indonesia

DOI:

https://doi.org/10.58418/ijni.v3i2.111

Keywords:

Elderly, Anxiety, Sleep Quality, Quality of Life, Questionnaires, Nursing Practice

Abstract

The elderly face complex and interrelated health challenges, including anxiety, sleep disturbances, and decreased quality of life, which can affect their physical and psychological well-being. In nursing, screening using valid and reliable questionnaires can help nurses identify mental health problems early, prevent complications, and provide appropriate interventions. Therefore, assessment scales such as the Elderly Anxiety Questionnaire (EAQ), Elderly Sleep Quality Questionnaire (ESQQ), and Elderly Quality of Life Questionnaire (EQLQ) were developed to assess anxiety, sleep quality, and quality of life in the elderly according to current conditions and needs. This study aims to develop and validate the EAQ, ESQQ, and EQLQ as initial screening tools for clinical and community practice nurses. The method used a qualitative approach; questionnaires were distributed to 60 elderly participants selected based on inclusion and exclusion criteria, followed by statistical validity and reliability tests. The results showed that the r-count value for the three questionnaires was more significant than the r-table (0.254), indicating good item validity. The reliability test using Cronbach's alpha also showed that the three questionnaires had high reliability. In conclusion, EAQ, ESQQ, and EQLQ are practical tools for detecting the mental condition of the elderly and supporting the role of nurses in providing comprehensive care. This study contributes significantly to nursing practice by providing tools for initial screening, data collection, and analysis to improve the quality of care for the elderly. Further research with a larger sample size is recommended to strengthen these findings.

References

Aithal, A., & Aithal, P. S. (2020). Development and Validation of Survey Questionnaire & Experimental Data – A Systematical Review-based Statistical Approach. International Journal of Management, Technology, and Social Sciences (IJMTS), 5(2), 233–251. https://doi.org/10.2139/ssrn.3724105

Allen, M. S., Iliescu, D., & Greiff, S. (2022). Single Item Measures in Psychological Science. European Journal of Psychological Assessment, 38(1), 1–5. https://doi.org/10.1027/1015-5759/a000699

Andreescu, C., & Lee, S. (2020). Anxiety Disorders in the Elderly. In Y.-K. Kim (Ed.), Anxiety Disorders: Rethinking and Understanding Recent Discoveries (pp. 561–576). Springer Singapore. https://doi.org/10.1007/978-981-32-9705-0_28

Atchison, K., Wu, P., Samii, L., Walsh, M., Ismail, Z., Iaboni, A., & Goodarzi, Z. (2024). Detection of anxiety symptoms and disorders in older adults: a diagnostic accuracy systematic review. Age and Ageing, 53(7). https://doi.org/10.1093/ageing/afae122

Banerjee, D. (2020). ‘Age and ageism in COVID-19’: Elderly mental health-care vulnerabilities and needs. Asian Journal of Psychiatry, 51, 102154. https://doi.org/10.1016/j.ajp.2020.102154

Berkley, A. S., Carter, P. A., Yoder, L. H., Acton, G., & Holahan, C. K. (2020). The effects of insomnia on older adults’ quality of life and daily functioning: A mixed-methods study. Geriatric Nursing, 41(6), 832–838. https://doi.org/10.1016/j.gerinurse.2020.05.008

Brouwers, M. C., Spithoff, K., Kerkvliet, K., Alonso-Coello, P., Burgers, J., Cluzeau, F., Férvers, B., Graham, I., Grimshaw, J., Hanna, S., Kastner, M., Kho, M., Qaseem, A., Straus, S., & Florez, I. D. (2020). Development and Validation of a Tool to Assess the Quality of Clinical Practice Guideline Recommendations. JAMA Network Open, 3(5), e205535. https://doi.org/10.1001/jamanetworkopen.2020.5535

Casagrande, M., Forte, G., Favieri, F., & Corbo, I. (2022). Sleep Quality and Aging: A Systematic Review on Healthy Older People, Mild Cognitive Impairment and Alzheimer’s Disease. International Journal of Environmental Research and Public Health, 19(14), 8457. https://doi.org/10.3390/ijerph19148457

Cho, S. M., Saw, Y. M., Saw, T. N., Than, T. M., Khaing, M., Khine, A. T., Kariya, T., Soe, P. P., Oo, S., & Hamajima, N. (2021). Prevalence and risk factors of anxiety and depression among the community-dwelling elderly in Nay Pyi Taw Union Territory, Myanmar. Scientific Reports, 11(1), 9763. https://doi.org/10.1038/s41598-021-88621-w

Costa, D. S. J., Mercieca-Bebber, R., Rutherford, C., Tait, M.-A., & King, M. T. (2021). How is quality of life defined and assessed in published research? Quality of Life Research, 30(8), 2109–2121. https://doi.org/10.1007/s11136-021-02826-0

El Sayed, S., Gomaa, S., Shokry, D., Kabil, A., & Eissa, A. (2021). Sleep in post-COVID-19 recovery period and its impact on different domains of quality of life. The Egyptian Journal of Neurology, Psychiatry and Neurosurgery, 57(1), 172. https://doi.org/10.1186/s41983-021-00429-7

Extermann, M., Brain, E., Canin, B., Cherian, M. N., Cheung, K.-L., de Glas, N., Devi, B., Hamaker, M., Kanesvaran, R., Karnakis, T., Kenis, C., Musolino, N., O’Donovan, A., Soto-Perez-de-Celis, E., Steer, C., & Wildiers, H. (2021). Priorities for the global advancement of care for older adults with cancer: an update of the International Society of Geriatric Oncology Priorities Initiative. The Lancet Oncology, 22(1), e29–e36. https://doi.org/10.1016/S1470-2045(20)30473-3

Fabbri, M., Beracci, A., Martoni, M., Meneo, D., Tonetti, L., & Natale, V. (2021). Measuring Subjective Sleep Quality: A Review. International Journal of Environmental Research and Public Health, 18(3), 1082. https://doi.org/10.3390/ijerph18031082

Ferreira, L. N., Pereira, L. N., da Fé Brás, M., & Ilchuk, K. (2021). Quality of life under the COVID-19 quarantine. Quality of Life Research, 30(5), 1389–1405. https://doi.org/10.1007/s11136-020-02724-x

Hamilton, N., Freche, R., Zhang, Y., Zeller, G., & Carroll, I. (2021). Test Anxiety and Poor Sleep: A Vicious Cycle. International Journal of Behavioral Medicine, 28(2), 250–258. https://doi.org/10.1007/s12529-021-09973-1

Hayes, A. F., & Coutts, J. J. (2020). Use Omega Rather than Cronbach’s Alpha for Estimating Reliability. But…. Communication Methods and Measures, 14(1), 1–24. https://doi.org/10.1080/19312458.2020.1718629

Javaid, S. F., Hashim, I. J., Hashim, M. J., Stip, E., Samad, M. A., & Ahbabi, A. Al. (2023). Epidemiology of anxiety disorders: global burden and sociodemographic associations. Middle East Current Psychiatry, 30(1), 44. https://doi.org/10.1186/s43045-023-00315-3

Kvalbein-Olsen, L. C., Aakhus, E., Haavet, O. R., & Werner, E. L. (2023). Unrecognised depression among older people: a cross-sectional study from Norwegian general practice. BJGP Open, 7(1), BJGPO.2022.0135. https://doi.org/10.3399/BJGPO.2022.0135

Lee, S., Kim, J. H., & Chung, J. H. (2021). The association between sleep quality and quality of life: a population-based study. Sleep Medicine, 84, 121–126. https://doi.org/10.1016/j.sleep.2021.05.022

Leng, M., Yin, H., Zhang, P., Jia, Y., Hu, M., Li, G., Wang, C., & Chen, L. (2020). Sleep Quality and Health-Related Quality of Life in Older People With Subjective Cognitive Decline, Mild Cognitive Impairment, and Alzheimer Disease. Journal of Nervous & Mental Disease, 208(5), 387–396. https://doi.org/10.1097/NMD.0000000000001137

Li, C., Liu, Y., Xue, D., & Chan, C. W. H. (2020). Effects of nurse-led interventions on early detection of cancer: A systematic review and meta-analysis. International Journal of Nursing Studies, 110, 103684. https://doi.org/10.1016/j.ijnurstu.2020.103684

Oldland, E., Botti, M., Hutchinson, A. M., & Redley, B. (2020). A framework of nurses’ responsibilities for quality healthcare — Exploration of content validity. Collegian, 27(2), 150–163. https://doi.org/10.1016/j.colegn.2019.07.007

Olsen, J. A., & Misajon, R. (2020). A conceptual map of health-related quality of life dimensions: key lessons for a new instrument. Quality of Life Research, 29(3), 733–743. https://doi.org/10.1007/s11136-019-02341-3

Perez-Pozuelo, I., Zhai, B., Palotti, J., Mall, R., Aupetit, M., Garcia-Gomez, J. M., Taheri, S., Guan, Y., & Fernandez-Luque, L. (2020). The future of sleep health: a data-driven revolution in sleep science and medicine. Npj Digital Medicine, 3(1), 42. https://doi.org/10.1038/s41746-020-0244-4

Purwati, Y., & Kustiningsih, K. (2023). Development of comfort instrument in breast cancer patients: mixed methods study. International Journal of Public Health Science (IJPHS), 12(4), 1483. https://doi.org/10.11591/ijphs.v12i4.23050

Ranganathan, P., Caduff, C., & Frampton, C. M. A. (2024). Designing and validating a research questionnaire - Part 2. Perspectives in Clinical Research, 15(1), 42–45. https://doi.org/10.4103/picr.picr_318_23

Ribeiro, O., Teixeira, L., Araújo, L., Rodríguez-Blázquez, C., Calderón-Larrañaga, A., & Forjaz, M. J. (2020). Anxiety, Depression and Quality of Life in Older Adults: Trajectories of Influence across Age. International Journal of Environmental Research and Public Health, 17(23), 9039. https://doi.org/10.3390/ijerph17239039

Rodrigues, J., Chicau Borrego, C., Ruivo, P., Sobreiro, P., Catela, D., Amendoeira, J., & Matos, R. (2020). Conceptual Framework for the Research on Quality of Life. Sustainability, 12(12), 4911. https://doi.org/10.3390/su12124911

Søvold, L. E., Naslund, J. A., Kousoulis, A. A., Saxena, S., Qoronfleh, M. W., Grobler, C., & Münter, L. (2021). Prioritizing the Mental Health and Well-Being of Healthcare Workers: An Urgent Global Public Health Priority. Frontiers in Public Health, 9. https://doi.org/10.3389/fpubh.2021.679397

Streiner, D. L., Norman, G. R., & Cairney, J. (2024). Health measurement scales: a practical guide to their development and use (6th ed.). Oxford university press.

Sun, Y., Fu, Z., Bo, Q., Mao, Z., Ma, X., & Wang, C. (2020). The reliability and validity of PHQ-9 in patients with major depressive disorder in psychiatric hospital. BMC Psychiatry, 20(1), 474. https://doi.org/10.1186/s12888-020-02885-6

Szuhany, K. L., & Simon, N. M. (2022). Anxiety Disorders. JAMA, 328(24), 2431. https://doi.org/10.1001/jama.2022.22744

Tavakol, M., & Wetzel, A. (2020). Factor Analysis: a means for theory and instrument development in support of construct validity. International Journal of Medical Education, 11, 245–247. https://doi.org/10.5116/ijme.5f96.0f4a

Voros, V., Fekete, S., Tenyi, T., Rihmer, Z., Szili, I., & Osvath, P. (2020). Untreated depressive symptoms significantly worsen quality of life in old age and may lead to the misdiagnosis of dementia: a cross-sectional study. Annals of General Psychiatry, 19(1), 52. https://doi.org/10.1186/s12991-020-00302-6

Wilmer, M. T., Anderson, K., & Reynolds, M. (2021). Correlates of Quality of Life in Anxiety Disorders: Review of Recent Research. Current Psychiatry Reports, 23(11), 77. https://doi.org/10.1007/s11920-021-01290-4

Wuthrich, V. M., Meuldijk, D., Jagiello, T., Robles, A. G., Jones, M. P., & Cuijpers, P. (2021). Efficacy and effectiveness of psychological interventions on co‐occurring mood and anxiety disorders in older adults: A systematic review and meta‐analysis. International Journal of Geriatric Psychiatry, 36(6), 858–872. https://doi.org/10.1002/gps.5486

Xi, J.-Y., Lin, X., & Hao, Y.-T. (2022). Measurement and projection of the burden of disease attributable to population aging in 188 countries, 1990-2050: A population-based study. Journal of Global Health, 12, 04093. https://doi.org/10.7189/jogh.12.04093

Zhao, N., Yang, Y., Zhang, L., Zhang, Q., Balbuena, L., Ungvari, G. S., Zang, Y., & Xiang, Y. (2021). Quality of life in Parkinson’s disease: A systematic review and meta‐analysis of comparative studies. CNS Neuroscience & Therapeutics, 27(3), 270–279. https://doi.org/10.1111/cns.13549