Validation of the Postpartum Sleep Quality Scale and assessment of postpartum sleep quality in Vietnam during the COVID-19 pandemic
Ha Thu Thi Nguyen, Hien Thu Nguyen, Thuong Huyen Thi Phan, Giang Tra Thi Duong, Linh Anh Do, Ha Ngoc Vu, Tham Thi Nguyen, Sara Fernandes, Laurent Boyer, Pascal Auquier, Cuong Tat Nguyen, Duc Anh Ha, Huyen Do, Giang Thu Vu, Roger C M Ho, Cyrus S H HoObjective
This study aimed to evaluate the validity and reliability of the Postpartum Sleep Quality Scale (PSQS) for assessing sleep quality among postpartum women in Vietnam during the COVID-19 pandemic. The major hypothesis is that the PSQS will provide a reliable and valid measure of postpartum sleep disturbances and their correlation with mental health outcomes, particularly postpartum depression (PPD).
Design
A cross-sectional, observational study was conducted from May to December 2023.
Setting
The study was carried out at a leading maternal healthcare centre in Vietnam, located in Hanoi, Vietnam.
Participants
A total of 223 postpartum women participated in the study, with inclusion criteria specifying women aged 18–45 years, who had delivered within the past 3 months, and were capable of completing the survey. Participants with severe psychiatric or neurological disorders or those experiencing postpartum complications affecting sleep were excluded.
Primary and secondary outcome measures
The primary outcome was the psychometric evaluation of the PSQS, including internal consistency (Cronbach’s α), construct validity (through exploratory factor analysis) and concurrent validity (via correlation with the Edinburgh Postnatal Depression Scale and the Perinatal Infant Care Social Support Scale). Secondary outcomes included the relationship between sleep quality and PPD as well as the role of social support in moderating sleep disturbances.
Results
Exploratory factor analysis identified a three-factor structure for the PSQS: (1) sleep efficiency and satisfaction, (2) sleep disruptions and infant-related disturbances and (3) postpartum sleep impairment and daytime fatigue. The PSQS demonstrated strong internal consistency (Cronbach’s α=0.839–0.875). Poor sleep quality was significantly correlated with higher PPD scores (r=0.6890, p<0.05), and greater social support was associated with better sleep quality, particularly in the factors of sleep efficiency and satisfaction (r=−0.5357, p<0.05).
Conclusions
The PSQS is a reliable and valid tool for assessing postpartum sleep quality in Vietnamese women. Its multidimensional structure provides valuable insights into postpartum sleep disturbances. Enhancing social support may improve maternal sleep and mental health. Further research is needed to explore the long-term impact of sleep quality on postpartum recovery and mental well-being.