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Association Between Sleep Quality and Cognitive Symptoms in Patients with Major Depressive Disorder
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Developing a pictorial Epworth Sleepiness Scale.

Ramesh Ghiassi1, Kevin Murphy, Andrew R Cummin

  • 1Imperial College London, 5 North Charing Cross Hospital, Hammersmith, London W68RF, UK. r.ghiassi@imperial.ac.uk

Thorax
|October 28, 2010
PubMed
Summary
This summary is machine-generated.

A pictorial version of the Epworth Sleepiness Scale (ESS) improves understanding for patients with literacy challenges. This visual ESS shows comparable results to the traditional scale and is preferred by most patients.

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Area of Science:

  • Sleep Medicine
  • Medical Education
  • Health Literacy

Background:

  • The Epworth Sleepiness Scale (ESS) is a self-administered questionnaire to assess daytime sleepiness.
  • Literacy issues can hinder accurate self-completion of the traditional written ESS.
  • A pictorial version may improve accessibility for diverse patient populations.

Purpose of the Study:

  • To evaluate the accuracy and patient preference of a pictorial ESS compared to the traditional written version.
  • To assess the impact of literacy on ESS completion.
  • To determine if a pictorial ESS is a suitable alternative for patients with normal or diminished literacy skills.

Main Methods:

  • Patients completed both traditional and pictorial ESS versions in sleep and respiratory clinics.
  • Errors and difficulties during self-completion were recorded.
  • Agreement between scales was assessed using kappa statistics, and patient preferences were surveyed.

Main Results:

  • 33.8% of patients made errors and 22.5% needed help with the traditional ESS.
  • The pictorial ESS demonstrated good agreement with the traditional scale (median kappa 0.63).
  • 55% of patients preferred the pictorial ESS, with 75.6% finding it 'very easy' to complete compared to 64.6% for the written version.

Conclusions:

  • The traditional written ESS is prone to errors during self-completion, particularly for patients with literacy challenges.
  • A pictorial ESS offers comparable results to the traditional version.
  • The pictorial ESS is a potentially valuable tool to enhance understanding and accessibility for patients with varying literacy levels.