Construction of a biological rhythm assessment scale for children

Biological rhythm is associated with the level of alertness, cognitive performance and mood of the individuals. Its regularity is essential to preserve good health and quality of life.

Objective

To present the steps for the construction of the scale entitled Biological Rhythm Interview of Assessment in Neuropsychiatry – Kids (BRIAN-K), designed to measure biological rhythm disruptions in Brazilian children and adolescents.

Methods

Items were developed following the adult version of the scale. Analysis of the psychometric characteristics of the scale was based on the responses of 373 parents/caregivers of school age children (7 and 8 years old).

Results

A theoretical model of 17 items with the purpose of evaluating four domains (sleep, activities, social rhythm and eating pattern) was determined using exploratory factor analysis (EFA) and via identification of a general factor. The psychometric properties of the BRIAN-K showed favorable properties.

Conclusion

Only two items needed to be rewritten. Further studies are needed to investigate the instrument's adequacy to different age groups and additional evidence of validity and reliability.

Keywords
BRIAN; biological rhythm; circadian rhythm; construction of scale; kids

Items	Factors
Items	F1 Activities	F2 Eating pattern	F3 Sleep	F4 Social rhythm
7. Difficulties completing habitual tasks	0.752	0.066	-0.103	-0.013
9. Difficulties completing tasks at usual time	0.622	0.087	0.073	-0.063
6. Difficulties completing school tasks	0.571	0.032	0.049	-0.002
8. Difficulties keeping rhythm and persistence in physical activities	0.433	-0.033	0.085	-0.040
17. Difficulties consuming moderate amounts of stimulants	0.292	0.246	0.066	-0.077
15. Difficulties eating daily meals	-0.086	0.748	0.054	-0.062
16. Difficulties eating the same amount of food	0.143	0.540	-0.034	0.044
14. Difficulties sticking with the meal schedule	0.051	0.429	0.137	-0.172
2. Difficulties getting out of bed after wakening up	-0.100	0.106	0.784	0.065
1. Difficulties waking up at the same time most of the days	0.188	-0.015	0.635	0.071
5. Difficulties going to sleep at the same time with the others in the house	0.027	0.046	0.487	-0.252
3. Difficulties feeling rested with the number of hours of sleep	0.122	-0.019	0.403	-0.208
10. Difficulties relating to other people in the house at appropriate times	-0.054	0.058	-0.053	-0.742
12. Difficulties syncing own daily routine with other people in the house	0.053	0.124	0.090	-0.593
13. Difficulties giving time and paying attention to other people in the house	0.151	0.065	-0.031	-0.416
4. Difficulties of the child “disconnecting” while at rest	0.132	-0.101	0.292	-0.341
11. Difficulties using electronics in a balanced way	0.230	-0.071	0.091	-0.323
Eigenvalues	5.710	1.390	1.213	1.040
Total variance (%)	33.588	8.179	7.133	6.115
Cronbach's alpha	0.735	0.664	0.767	0.695

Items	Factors
Items	F1 Activities	F2 Sleep	F3 Eating patterns	F4 Social rhythm
1. Difficulties waking up at the same time most of the days		-0.639
2. Difficulties getting out of bed after wakening up		-0.815
3. Difficulties feeling rested with the amount of hours of sleep		-0.388
5. Difficulties going to sleep at the same time with the others in the house		-0.473
6. Difficulties completing school tasks	0.571
7. Difficulties completing habitual tasks	0.74
8. Difficulties keeping rhythm and persistence in physical activities	0.407
9. Difficulties completing tasks at the usual time	0.626
10. Difficulties relating to other people in the house at appropriate times				-0.761
11. Difficulties using electronics in a balanced way				-0.306
12. Difficulties syncing own daily routine with other people in the house				-0.628
13. Difficulties giving time and paying attention to other people in the house				-0.436
14. Difficulties sticking with the meal schedule			0.413
15. Difficulties eating daily meals			0.819
16. Difficulties eating the same amount of food			0.501

Items	F1 BRIAN-K
9. Difficulties completing tasks at the usual time	0.689
12. Difficulties syncing own daily routine with other people in the house	0.676
5. Difficulties going to sleep at the same time with the others in the house	0.622
7. Difficulties completing habitual tasks	0.602
3. Difficulties feeling rested with the number of hours of sleep	0.568
1. Difficulties waking up at the same time most of the days	0.555
4. Difficulties of the child “disconnecting” while at rest	0.554
10. Difficulties relating to other people in the house at appropriate times	0.548
6. Difficulties completing school tasks	0.546
14. Difficulties sticking with the meal schedule	0.543
17. Difficulties consuming moderate amounts of stimulants	0.514
11. Difficulties using electronics in a balanced way	0.494
13. Difficulties giving time and paying attention to other people in the house	0.492
2. Difficulties getting out of bed after wakening up	0.486
8. Difficulties keeping rhythm and persistence in physical activities	0.450
15. Difficulties eating daily meals	0.437
16. Difficulties eating the same amount of food	0.373

Items of the experimental version	Reason for alteration	Improved items with suggestions from experts (in italics)
3. What degree of difficulty does the child have in feeling rested with the number of hours of sleep (subjective feeling and normal performance in daily tasks such as playing games and school activities)?	Clarity	How difficult it is for the child to feel rested with the number of hours of sleep (having normal performance in everyday tasks such as playing and performing tasks at school)?
4. What degree of difficulty does the child have in “disconnecting” while at rest (when there are no tasks)?	Ambiguity	How difficult it is for the child to calm down while at rest?
5. What degree of difficulty does the child have in sleeping at the same time as the others in the house?	Clarity	How difficult it is for the child to sleep at the same time as the people in the house?
6. What degree of difficulty does the child have in completing the school tasks?	Clarity	How difficult it is for the child to complete the school tasks?
7. What degree of difficulty does the child have in completing the habitual tasks (finishing play, cleaning up toys and bedroom)?	Clarity	How difficult it is for the child to complete the habitual tasks (doing school tasks, cleaning up toys after play, etc.)?
9. What degree of difficulty does the child have in completing tasks at the usual time?	Clarity	How difficult it is for the child to complete the tasks (school tasks, cleaning up the bedroom, etc.) at the usual time?
10. What degree of difficulty does the child have in relating and communicating with the social activities of people in the house at appropriate times?	Clarity	How difficult it is for the child to communicate with friends and family members at appropriate times?
12. What degree of difficulty does the child have in syncing own daily routine with other people (family members, neighbors, and friends)?	Clarity	How difficult it is for the child to maintain the routine adopted by other people in the house (family members, neighbors, and friends)?
17. What degree of difficulty does the child have in consuming moderate amounts of stimulants (cocoa and non-alcoholic beverages) or candies?	Clarity; close to the original domain	How difficult it is for the child to consume moderate amounts of stimulants (cocoa, coffee, non-alcoholic beverages) or sweets, regardless of the period of the day?

Associação de Psiquiatria do Rio Grande do Sul Av. Ipiranga, 5311/202, 90610-001 Porto Alegre RS/ Brasil, Tel./Fax: (55 51) 3024 4846 - Porto Alegre - RS - Brazil
E-mail: trends@aprs.org.br

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[1] Correspondence: Karen Jansen, Rua Gonçalves Chaves, 373/224, Centro 96015-560 - Pelotas, RS - Brazil, Tel./Fax: +55 (53) 21288404, +55 (53) 991489066 E-mail: karen.jansen@ucpel.edu.br