Educational Intervention for Sleep Hygiene Nursing in Adolescents

The ASHS is a 32-item self-report measure used to assess adolescent sleep hygiene (LeBourgeois et al., 2005). The ASHS includes four qualitative items to ascertain usual bedtime and wake time on weekdays and weekends and 28 quantitative items that are used to calculate nine subscale scores: physiological (5 items), cognitive (6 items), emotional (3 items), sleep environment (4 items), daytime sleep (1 item), substances (2 items), sleep stability (4 items), bedtime routine (1 item) and bed sharing (2 items). Response choices are on a 6-point ordinal scale: 1 = Never (0%); 2 = Once in a while (20%); 3 = sometimes (40%); 4 = quite often (60%); 5 = frequently, if not always (80%); 6 = always (100%). Scoring: Each subscale score is calculated by taking the average of the items comprising that subscale.

The questionnaire consists of a combination of Likert-type and open-ended questions. Respondents are asked to indicate how frequently they have experienced certain sleep difficulties over the past month and to rate their overall sleep quality. Scores for each question range from 0 to 3, with higher scores indicating more acute sleep disturbances.

Sleep diary includes entries for bedtimes, wake-up times, the number and duration of awakenings during the night, overall sleep duration, perceived quality of sleep, and daily activities that might affect sleep, such as caffeine or alcohol intake, exercise, and naps.

Knowledge, attitude, subjective norm, perceived behavioural control and intention. The Sleep Knowledge Questionnaire (SKQ) scores from 0 to 20, where higher points reflect sleep knowledge. The Sleep Attitudes Questionnaire uses a 5-point Likert scale (10 to 50 points), with higher scores indicating favourable attitudes toward sleep. The Subjective Norm Scale typically has a 7-point scale (7 to 49 points) reflecting perceived social pressure. The Self-Efficacy for Sleep Scale is scored on a 10-point scale (10 to 100 points), where higher scores show more confidence in sleep management. Finally, the Sleep Intention Scale employs a 5-point scale (5 to 25 points), with higher scores signifying greater intentions to adopt positive sleep behaviours.

The research team will create a questionnaire to capture relevant variables. Participants will report sociodemographic factors like age (age ranges), sex (male, female, other), and perceived social class (lower, middle, upper). Family variables will include cohabitation status (living alone, with family, with friends) and the number of family members (1, 2-3, 4 or more). Lifestyle questions will cover physical activity levels (sedentary, moderate, active), eating habits (balanced, unhealthy, irregular), hygiene practices (daily, weekly), and substance use (none, occasional, regular tobacco, alcohol, or other drugs).