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. 2018 Dec 3;179(1):38–45. doi: 10.1001/jamainternmed.2018.5100

Table 1. In-Hospital Disturbance Survey.

Domain Source Question Response Choice Disturbance Categorizationa
Sleep Questions adapted from PROMIS Short Form v1.0–Sleep Disturbance 4a In hospital, my sleep quality has been… Very poor (5), poor (4), fair (3), good (2), very good (1) Considered disturbance if score ≥13; cutoff reflects an overall score of less than average
In hospital, my sleep has been refreshing Not at all (5), a little bit (4), somewhat (3), quite a bit (2), very much (1)
In hospital, I have had a problem with my sleep Not at all (1), a little bit (2), somewhat (3), quite a bit (4), very much (5)
In hospital, I have had difficulty falling asleep Not at all (1), a little bit (2), somewhat (3), quite a bit (4), very much (5)
Mobility 1 Item adapted from the Eastern Cooperative Oncology Group Scale of Performance Status and similar to the Saltin-Grimby Physical Activity Level Scale During my hospitalization, I was…
  • Fully active

  • Not fully active but up and about for >50% of waking hours

  • Confined to bed or chair for >50% of waking hours

  • Totally confined to bed or chair

Considered disturbance if confined to bed or chair for >50% of waking hours or totally confined to bed or chair
Nutrition Patient Mealtime and Nutrition Care Survey When I was eating, I was disturbed Yes (1), no (2) Considered disturbance if total score <8, suggesting that meals were disturbed or missed in the hospital
My meal times were interrupted by staff Yes (1), no (2)
I missed meals because I was not available when they were served Yes (1), no (2)
I missed meals because I had to avoid food for tests Yes (1), no (2)
Mood (anxiety or depression) 1 item from Euro-Qol Five Dimensions Questionnaire Now, I am…
  • Not anxious or depressed

  • Slightly anxious or depressed

  • Moderately anxious or depressed

  • Severely anxious or depressed

  • Extremely anxious or depressed

Considered disturbance if moderately to extremely anxious or depressed
a

These were prespecified cutoffs for disturbance according to clinical judgment.