Preliminary validity and reliability of a Thai Berlin questionnaire in stroke patientsReportar como inadecuado

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BMC Research Notes

, 7:348

First Online: 09 June 2014Received: 03 November 2013Accepted: 02 June 2014DOI: 10.1186-1756-0500-7-348

Cite this article as: Saengsuwan, J., Ungtrakul, N., Saengsuwan, J. et al. BMC Res Notes 2014 7: 348. doi:10.1186-1756-0500-7-348


BackgroundObstructive sleep apnea OSA is a major risk factor for stroke. The Berlin Questionnaire BQ has been shown to be a valid tool to screen for OSA. The literature has limited data on using the BQ in stroke patients; particularly in Thailand and other developing countries. Here, we aimed to develop a Thai-language Berlin Questionnaire Thai BQ and to preliminarily assess construct validity, test-retest reliability and the agreement of the Thai BQ with the Thai Epworth Sleepiness Scale Thai ESS, another screening tool for OSA.

MethodsA hospital-based cross-sectional study was performed from January to July, 2011. One hundred first-ever stroke patients, including acute and chronic cases, and their caregivers were enrolled. The Thai BQ was developed using the forward-backward translation method. Evaluation of construct validity was done by factor analysis. Internal consistency of the Thai BQ and the Thai ESS were evaluated using Cronbach’s alpha coefficient. Test-retest reliability and the agreement of the Thai BQ and the Thai ESS were evaluated using Cohen’s kappa coefficient.

ResultsFactor analysis identified 4 main factors: Factor 1–Snoring behaviour; Factor 2–Sleepiness during driving; Factor 3–Daytime fatigue; and Factor 4–Hypertension or obesity. Cronbach’s alpha coefficient was 0.77 95% confidence interval CI = 0.69-0.83 and Cohen’s kappa coefficient was 0.86 95% CI = 0.74-0.98 in the Thai BQ. Cronbach’s alpha coefficient was 0.59 95% CI = 0.45-0.70 and the Cohen’s kappa coefficient was 0.81 95% CI = 0.60-1.00 in the Thai ESS. The agreement between the Thai ESS and the Thai BQ was fair.

ConclusionsThe Thai BQ is a valid and reliable tool to screen for OSA in stroke patients. As factor analysis revealed 4 factors in contrast to the 3 factors in the original BQ, further modification of the Thai BQ is required.

KeywordsStroke Obstructive sleep apnea Berlin questionnaire Epworth sleepiness scale Validity Electronic supplementary materialThe online version of this article doi:10.1186-1756-0500-7-348 contains supplementary material, which is available to authorized users.

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Autor: Jittima Saengsuwan - Niramon Ungtrakul - Jiamjit Saengsuwan - Kittisak Sawanyawisuth


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