Sick and Tired: Understanding and Managing Sleep Difficulties in ...
Sick and Tired: Understanding and Managing Sleep Difficulties in ...
Sick and Tired: Understanding and Managing Sleep Difficulties in ...
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heart disease (Epste<strong>in</strong> et al., 1999; Salaffi, Sarzi-Putt<strong>in</strong>i, Girolimetti et al., 2009).<br />
Evidence has supported the unidimensionality of the eight subscales, with each scale<br />
reveal<strong>in</strong>g a Cronbach‟s alpha score above 0.7 (Kos<strong>in</strong>ski, Keller, Hatoum, Kong, &<br />
Ware, 1999; Moorer, Suurmeije, Foets, & Molenaar, 2001) <strong>and</strong> <strong>in</strong>ter item correlations<br />
above 0.4 (Leung et al., 2010). Some ceil<strong>in</strong>g <strong>and</strong> floor effects have been found <strong>in</strong> the<br />
utilisation of the SF36 <strong>in</strong> cl<strong>in</strong>ical populations (McHorney, Ware, Lu, & Sherbourne,<br />
1994) <strong>and</strong> the measurement characteristics of the role limitations due to emotional <strong>and</strong><br />
physical function<strong>in</strong>g scales have come under question <strong>in</strong> patients with arthritis (Ruta,<br />
Hurst, K<strong>in</strong>d, Hunter, & Stubb<strong>in</strong>gs, 1998). Despite these limitations the SF-36 has been<br />
recommended for use as an assessment measure <strong>in</strong> studies with people with FMS<br />
(Salaffi, Sarzi-Putt<strong>in</strong>i, Ciapetti et al., 2009). In addition, the SF-36 was also chosen for<br />
use <strong>in</strong> this study as it <strong>in</strong>cludes scales focus<strong>in</strong>g specifically on levels of pa<strong>in</strong> <strong>and</strong> fatigue<br />
(the two ma<strong>in</strong> symptoms <strong>in</strong> FMS), <strong>in</strong> addition to factors explor<strong>in</strong>g general health quality<br />
of life.<br />
Age, length of illness, negative affect, cop<strong>in</strong>g <strong>and</strong> sleep quality sub-scales were<br />
considered to be <strong>in</strong>dependent variables <strong>and</strong> constructs (subscales) of health related<br />
quality of life, the dependent variables.<br />
Data Analysis<br />
Data was entered <strong>in</strong>to SPSS Version 16.0 (SPSS for W<strong>in</strong>dows, 2006) <strong>and</strong> the<br />
questionnaire measures were scored accord<strong>in</strong>g to their <strong>in</strong>structions. The median <strong>and</strong><br />
<strong>in</strong>ter-quartile range were calculated to describe the distribution of the ord<strong>in</strong>al data for<br />
the questionnaire variables (Howitt & Cramer, 2005). Underly<strong>in</strong>g the analysis of the<br />
data, presented <strong>in</strong> this thesis, is the pr<strong>in</strong>ciple that data from the questionnaire scales used<br />
<strong>in</strong> this thesis was ord<strong>in</strong>al, there be<strong>in</strong>g no evidence that there are equal <strong>in</strong>tervals between<br />
the po<strong>in</strong>ts on the given scales. Rasch analysis can be a useful tool to explore the<br />
<strong>in</strong>tervals between po<strong>in</strong>ts on a scale to determ<strong>in</strong>e if they are equal <strong>and</strong> provid<strong>in</strong>g<br />
evidence for treat<strong>in</strong>g the data as ratio level data. However, due to its complexity, Rasch<br />
analysis has not always been conducted on every st<strong>and</strong>ardized measure, <strong>and</strong> with<strong>in</strong><br />
every population under <strong>in</strong>vestigation (particularly this has not been applied to the<br />
measures used with<strong>in</strong> this thesis <strong>in</strong> the FMS population).<br />
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