I
nte
rna
t
io
na
l J
o
urna
l o
f
P
u
bli
c
H
ea
lt
h Science
(
I
J
P
H
S)
Vo
l.
1
3
,
No
.
4
,
Dec
em
b
er
20
24
,
p
p
.
1
6
7
2
~
1
678
I
SS
N:
2
2
5
2
-
8
8
0
6
,
DOI
: 1
0
.
1
1
5
9
1
/ijp
h
s
.
v
1
3
i
4
.
2
3
4
3
9
1672
J
o
ur
na
l ho
m
ep
a
g
e
:
h
ttp
:
//
ijp
h
s
.
ia
esco
r
e.
co
m
Cro
ss
-
cultur
e ada
ptatio
n and
va
lid
a
tion o
f
Indo
nesia
n lang
ua
g
e
v
ersio
n of
Pit
tsbu
rg
h Sleep
Q
ua
lity
Index
Achm
a
d F
a
uzi
1,
2
,
F
a
t
i
m
a
h A
hm
edy
1
,
Ro
s
ida
h
3
1
S
a
b
a
h
R
e
h
a
b
i
l
i
t
a
t
i
o
n
R
e
s
e
a
r
c
h
&
S
e
r
v
i
c
e
G
r
o
u
p
,
F
a
c
u
l
t
y
o
f
M
e
d
i
c
i
n
e
a
n
d
H
e
a
l
t
h
S
c
i
e
n
c
e
s
,
U
n
i
v
e
r
si
t
i
M
a
l
a
y
s
i
a
S
a
b
a
h
,
K
o
t
a
K
i
n
a
b
a
l
u
,
M
a
l
a
y
si
a
2
D
e
p
a
r
t
me
n
t
o
f
N
u
r
si
n
g
,
S
TI
K
ES A
b
d
i
N
u
sa
n
t
a
r
a
,
B
e
k
a
si
,
I
n
d
o
n
e
si
a
3
R
u
m
a
h
S
a
k
i
t
H
a
j
i
Ja
k
a
r
t
a
,
Ja
k
a
r
t
a
,
I
n
d
o
n
e
s
i
a
Art
icle
I
nfo
AB
S
T
RAC
T
A
r
ticle
his
to
r
y:
R
ec
eiv
ed
Ma
y
2
0
,
2
0
2
3
R
ev
is
ed
Mar
10
,
2
0
2
4
Acc
ep
ted
Ap
r
24
,
2
0
2
4
He
m
o
d
ialy
sis
(HD
)
p
a
ti
e
n
ts
h
a
v
e
a
h
ig
h
ra
te
o
f
p
o
o
r
sle
e
p
.
T
h
e
P
it
tsb
u
rg
h
S
lee
p
Qu
a
li
ty
In
d
e
x
(P
S
QI)
is
th
e
m
o
st
p
o
p
u
lar
se
lf
-
re
p
o
r
ted
in
st
ru
m
e
n
t
t
o
m
e
a
su
re
sle
e
p
q
u
a
li
ty
.
No
st
u
d
y
h
a
s tes
ted
th
e
p
sy
c
h
o
m
e
tri
c
e
fficie
n
c
y
o
f
th
e
Ba
h
a
sa
(In
d
o
n
e
sia
n
lan
g
u
a
g
e
)
P
S
QI
in
h
e
m
o
d
ialy
sis
(HD
)
p
a
ti
e
n
ts,
a
n
d
n
o
c
ro
ss
-
c
u
lt
u
ra
l
a
d
a
p
tatio
n
h
a
s
b
e
e
n
d
o
n
e
.
T
h
e
p
u
rp
o
se
o
f
t
h
is
re
se
a
rc
h
wa
s
to
tran
sla
te
th
e
P
S
QI
in
t
o
Ba
h
a
sa
a
n
d
imp
ro
v
e
it
s
p
s
y
c
h
o
m
e
tri
c
p
ro
p
e
rti
e
s
fo
r
u
se
in
e
v
a
lu
a
ti
n
g
HD
p
a
ti
e
n
ts
in
In
d
o
n
e
sia
.
Th
is
stu
d
y
u
se
d
i
n
stru
m
e
n
t
tran
sla
ti
o
n
,
c
u
lt
u
ra
l
a
d
a
p
tatio
n
,
c
o
n
ten
t
v
a
li
d
a
ti
o
n
,
a
n
d
e
q
u
iv
a
len
c
e
to
c
ro
ss
-
c
u
lt
u
ra
ll
y
v
a
li
d
a
te
a
n
d
a
d
a
p
t
a
n
in
stru
m
e
n
t
.
T
h
e
h
e
m
o
d
ialy
sis
c
e
n
ter
a
t
a
Wes
t
Ja
v
a
m
e
d
ica
l
fa
c
il
it
y
se
rv
e
d
a
s
a
so
u
rc
e
o
f
p
o
ten
t
ial
H
D
p
a
ti
e
n
ts
th
ro
u
g
h
o
u
t
t
h
e
p
e
rio
d
o
f
Oc
to
b
e
r
2
0
2
2
t
o
F
e
b
ru
a
ry
2
0
2
3
.
A
c
o
n
ten
t
v
a
li
d
it
y
in
d
e
x
(CVI)
wa
s
c
a
lcu
late
d
fo
r
e
a
c
h
it
e
m
a
n
d
th
e
e
n
ti
re
sc
a
le.
Th
e
fa
c
to
r
stru
c
tu
re
o
f
t
h
e
Ba
h
a
sa
P
S
QI
h
a
s
b
e
e
n
e
v
a
lu
a
ted
b
y
c
o
n
firma
t
o
ry
fa
c
to
r
a
n
a
ly
sis a
n
d
in
tern
a
l
c
o
n
siste
n
c
y
wa
s c
a
lcu
late
d
u
sin
g
Cro
n
b
a
c
h
'
s a
lp
h
a
.
Th
e
o
n
li
n
e
su
r
v
e
y
re
c
e
iv
e
d
a
re
sp
o
n
s
e
ra
te
o
f
6
2
.
8
%
fro
m
a
to
tal
o
f
2
2
0
p
a
ti
e
n
t
with
HD
(a
b
o
u
t
ten
re
sp
o
n
d
e
rs
e
a
c
h
it
e
m
)
.
Th
e
lev
e
l
o
f
lan
g
u
a
g
e
c
l
a
rit
y
wa
s
8
7
.
8
%
,
a
n
d
t
h
e
lev
e
l
o
f
c
u
lt
u
ra
l
r
e
lev
a
n
c
e
wa
s
8
4
.
5
%
.
Th
e
CVI
v
a
ried
fro
m
0
.
9
2
to
1
.
0
0
.
Eac
h
fa
c
to
r
h
a
d
fa
c
to
r
l
o
a
d
i
n
g
ra
n
g
in
g
fr
o
m
0
.
5
1
to
0
.
6
2
.
th
a
t
Cro
n
b
a
c
h
a
l
p
h
a
fo
r
t
o
tal
sc
o
re
wa
s
0
.
8
0
3
,
a
n
d
t
h
e
su
b
sc
a
le
ra
n
g
e
d
fr
o
m
0
.
7
7
1
to
0
.
8
6
3
.
O
u
r
re
se
a
rc
h
p
ro
v
id
e
s
p
re
li
m
i
n
a
ry
e
v
id
e
n
c
e
o
f
th
e
v
a
li
d
it
y
a
n
d
re
li
a
b
il
it
y
o
f
t
h
e
tran
sla
ted
a
n
d
a
d
a
p
ted
to
o
l
u
sin
g
d
a
ta
fr
o
m
HD
p
a
ti
e
n
ts
in
In
d
o
n
e
sia
n
h
o
sp
it
a
ls.
K
ey
w
o
r
d
s
:
C
r
o
s
s
-
cu
ltu
r
e
ad
ap
tatio
n
Hem
o
d
ialy
s
is
Pit
ts
b
u
r
g
h
Sleep
Qu
ality
I
n
d
e
x
Ps
y
ch
o
m
etr
ic
Valid
atio
n
T
h
is i
s
a
n
o
p
e
n
a
c
c
e
ss
a
rticle
u
n
d
e
r th
e
CC B
Y
-
SA
li
c
e
n
se
.
C
o
r
r
e
s
p
o
nd
ing
A
uth
o
r
:
Ach
m
ad
Fau
zi
Dep
ar
tm
en
t K
ep
er
awa
tan
,
STI
KE
S Ab
d
i N
u
s
an
tar
a
B
ek
asi,
W
e
s
t Jav
a,
I
n
d
o
n
esia
E
m
ail:
f
au
zi.
u
m
ay
@
g
m
ail.
co
m
1.
I
NT
RO
D
UCT
I
O
N
E
n
d
-
s
tag
e
r
e
n
al
d
is
ea
s
e
(
E
S
R
D)
ca
u
s
es
s
er
io
u
s
h
ea
lth
is
s
u
es
an
d
is
tr
ea
ted
m
o
s
tly
th
r
o
u
g
h
h
em
o
d
ialy
s
is
(
HD)
[
1
]
.
HD
p
atien
ts
h
av
e
a
h
ig
h
r
ate
o
f
p
o
o
r
s
leep
(
4
1
-
8
5
%;
[
2
]
)
.
E
l
-
B
ar
o
u
d
y
[
2
]
f
o
u
n
d
th
a
t
p
o
o
r
s
leep
q
u
ality
is
a
s
tr
o
n
g
p
r
ed
icto
r
o
f
HD
p
atien
ts
'
q
u
ality
o
f
life
.
I
n
ad
d
itio
n
,
th
e
lead
in
g
ca
u
s
es
o
f
d
ea
th
in
HD
p
atien
ts
ar
e
ca
r
d
io
v
as
cu
lar
d
is
ea
s
e
an
d
in
f
ec
tio
u
s
c
o
m
p
licatio
n
s
,
b
o
th
o
f
wh
ich
ar
e
co
r
r
elate
d
with
s
leep
d
is
r
u
p
tio
n
s
[
3
]
.
T
h
e
ter
m
"sleep
q
u
ality
"
is
c
o
m
m
o
n
ly
u
s
ed
to
r
ef
e
r
to
a
v
ar
iet
y
o
f
d
i
f
f
er
en
t
s
leep
m
ea
s
u
r
em
en
ts
[
4
]
,
[
5
]
,
in
cl
u
d
in
g
to
tal
s
leep
d
u
r
atio
n
,
s
leep
o
n
s
et
laten
cy
,
s
leep
e
f
f
icien
cy
,
aler
tn
ess
f
o
llo
win
g
s
leep
o
n
s
et,
an
d
d
a
y
tim
e
d
r
o
wsi
n
ess
.
Su
b
jectiv
e
s
leep
q
u
ality
is
r
ated
d
if
f
er
e
n
tly
f
r
o
m
o
b
jectiv
e
s
leep
r
atin
g
s
.
I
n
d
icato
r
s
o
f
im
p
r
o
v
e
d
s
u
b
jectiv
e
s
leep
q
u
ality
in
clu
d
e
s
h
o
r
ter
s
leep
laten
cies,
s
u
f
f
icien
t
to
tal
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
C
r
o
s
s
-
cu
ltu
r
e
a
d
a
p
ta
tio
n
a
n
d
va
lid
a
tio
n
o
f I
n
d
o
n
esia
n
l
a
n
g
u
a
g
e
ve
r
s
io
n
o
f …
(
A
ch
ma
d
F
a
u
z
i)
1673
s
leep
tim
e,
r
ed
u
ce
d
wa
k
in
g
af
ter
s
leep
in
itiatio
n
,
an
d
d
aily
aler
tn
ess
[
6
]
.
Go
o
d
s
leep
q
u
ality
ca
n
b
e
o
b
jectiv
ely
d
eter
m
in
ed
v
ia
p
o
l
y
s
o
m
n
o
g
r
ap
h
y
[
5
]
.
Po
ly
s
o
m
n
o
g
r
a
p
h
y
(
PS
G)
is
th
e
'
g
o
ld
s
tan
d
ar
d
'
f
o
r
o
b
jectiv
e
ly
m
ea
s
u
r
in
g
s
leep
d
u
r
atio
n
,
d
ep
th
,
a
n
d
p
atter
n
[
5
]
.
T
h
is
p
ar
ad
ig
m
is
co
n
s
tr
ain
ed
wh
en
a
p
p
lied
to
p
u
b
lic
s
tu
d
ies,
esp
ec
ially
in
ar
ea
s
with
lim
ited
PS
G
ac
ce
s
s
.
Du
e
to
its
lo
w
co
s
t
an
d
ac
ce
s
s
ib
ilit
y
o
f
u
s
e,
s
u
b
jectiv
e
s
leep
ev
alu
atio
n
m
ay
b
e
b
etter
f
o
r
ass
ess
in
g
s
leep
q
u
ality
in
lar
g
e
r
g
r
o
u
p
s
.
Sev
er
al
s
leep
-
r
atin
g
q
u
esti
o
n
n
air
es
h
elp
clin
ician
s
an
d
r
esear
ch
er
s
ass
ess
s
u
b
jectiv
e
esti
m
ates
o
f
to
tal
s
leep
tim
e,
s
leep
m
ain
ten
a
n
c
e,
wak
in
g
d
u
r
in
g
t
h
e
n
i
g
h
t,
m
o
o
d
an
d
p
h
y
s
ical
f
ee
lin
g
s
u
p
o
n
wak
i
n
g
,
an
d
o
th
er
f
ac
to
r
s
th
at
m
ay
af
f
ec
t
s
leep
q
u
ality
,
s
u
ch
as
co
m
o
r
b
id
co
n
d
itio
n
s
an
d
m
ed
icatio
n
s
[
7
]
.
T
h
e
Pit
ts
b
u
r
g
h
Sleep
Qu
ality
I
n
d
ex
(
PS
Q
I
)
is
th
e
m
o
s
t
p
o
p
u
lar
s
elf
-
r
e
p
o
r
ted
in
s
tr
u
m
e
n
t
to
m
ea
s
u
r
e
s
leep
q
u
ality
[
8
]
.
T
h
e
PS
QI
is
a
s
elf
-
r
ep
o
r
t
q
u
esti
o
n
n
air
e
co
n
s
is
tin
g
o
f
1
9
i
tem
s
u
s
ed
to
ev
alu
ate
in
d
iv
i
d
u
al
s
leep
q
u
ality
o
v
er
th
e
c
o
u
r
s
e
o
f
th
e
p
r
ev
io
u
s
m
o
n
th
[
9
]
,
[
1
0
]
.
I
n
o
r
d
er
to
d
if
f
er
en
tiate
b
etwe
en
"g
o
o
d
"
an
d
"p
o
o
r
"
s
leep
er
s
,
th
e
PS
QI
's
1
9
q
u
esti
o
n
s
ar
e
ag
g
r
eg
ated
in
t
o
s
ev
e
n
co
m
p
o
n
en
ts
th
at
ass
ess
d
if
f
er
en
t
elem
en
ts
o
f
s
leep
,
an
d
th
e
s
u
m
o
f
t
h
ese
s
ev
en
co
m
p
o
n
e
n
ts
p
r
o
d
u
ce
s
a
g
l
o
b
al
s
co
r
e
[
8
]
.
Acc
o
r
d
in
g
to
B
u
y
s
s
e
et
a
l.
[
8
]
th
e
o
r
ig
in
al
PS
QI
h
as
s
u
f
f
icien
t
i
n
ter
n
al
co
n
s
is
ten
cy
an
d
g
o
o
d
test
-
r
etest
r
eliab
ilit
y
.
T
h
e
in
d
i
ce
s
o
f
s
leep
q
u
ality
ar
e
co
n
s
is
ten
t
an
d
s
im
p
le
t
o
u
n
d
er
s
tan
d
f
o
r
b
o
th
p
atien
ts
an
d
h
ea
lth
ca
r
e
p
r
ac
titi
o
n
er
s
[
4
]
,
[
8
]
.
T
h
er
e
h
as
n
ev
er
b
ee
n
a
s
tu
d
y
d
o
n
e
to
test
th
e
p
s
y
ch
o
m
etr
ic
e
f
f
icien
cy
o
f
t
h
e
B
ah
asa
(
I
n
d
o
n
esian
lan
g
u
ag
e)
v
er
s
io
n
o
f
th
e
PS
QI
in
HD
p
atien
ts
,
an
d
th
e
r
e
h
as
b
ee
n
n
o
cr
o
s
s
-
cu
ltu
r
al
a
d
ap
tatio
n
o
f
t
h
e
PS
QI
in
to
B
ah
asa
[
1
1
]
,
[
1
2
]
.
T
h
e
p
u
r
p
o
s
e
o
f
th
is
r
esear
ch
was
t
o
tr
an
s
late
th
e
PS
QI
in
to
B
ah
asa
an
d
im
p
r
o
v
e
its
p
s
y
ch
o
m
e
tr
ic
p
r
o
p
er
ties
(
i.e
.
,
tr
an
s
latio
n
,
cu
ltu
r
al
ad
a
p
tatio
n
,
v
alid
ity
,
an
d
r
eliab
ilit
y
)
f
o
r
u
s
e
in
ev
alu
atin
g
HD
p
atien
ts
in
I
n
d
o
n
esia.
B
y
h
av
in
g
a
v
alid
ate
to
o
l
o
f
PS
QI
f
o
r
u
s
e
in
p
atien
t
with
h
em
o
d
ialy
s
is
,
it
wo
u
ld
p
r
o
v
id
e
a
b
asic
s
cr
ee
n
in
g
in
f
o
r
m
atio
n
ab
o
u
t sleep
q
u
alit
y
th
u
s
h
elp
h
ea
lth
ca
r
e
p
r
o
v
i
d
e
r
to
d
esig
n
e
f
f
ec
tiv
e
in
ter
v
en
ti
o
n
.
2.
M
E
T
H
O
D
2
.
1
.
Study
des
ig
n
T
h
is
s
tu
d
y
u
s
ed
in
s
tr
u
m
e
n
t
tr
an
s
latio
n
,
cu
ltu
r
al
ad
ap
tatio
n
,
co
n
ten
t
v
alid
atio
n
,
an
d
e
q
u
i
v
alen
ce
to
cr
o
s
s
-
cu
ltu
r
ally
v
alid
ate
an
d
a
d
ap
t
an
in
s
tr
u
m
en
t
[
1
3
]
,
[
1
4
]
.
T
h
e
f
ir
s
t
s
tep
in
v
o
lv
ed
tr
an
s
latin
g
th
e
in
s
tr
u
m
en
t
in
to
I
n
d
o
n
esian
an
d
th
en
b
ac
k
in
to
E
n
g
lis
h
.
T
h
e
item
s
f
r
o
m
Ph
ase
I
I
,
"c
u
ltu
r
al
ad
a
p
tatio
n
,
"
wer
e
ass
ess
ed
f
o
r
th
eir
r
ea
d
ab
ilit
y
,
c
u
ltu
r
al
ap
p
licab
ilit
y
,
an
d
o
v
er
all
ap
p
r
o
p
r
ia
ten
ess
.
I
n
ter
n
al
co
n
s
is
ten
cy
an
d
co
n
ce
p
t
v
alid
ity
wer
e
ev
alu
ated
in
t
h
e
f
in
al
p
h
ase.
2
.
2
.
P
a
rt
icipa
nts
T
h
e
h
e
m
o
d
ialy
s
is
ce
n
ter
at
a
W
est
J
av
a
m
ed
ical
f
ac
ilit
y
s
er
v
ed
as
a
s
o
u
r
ce
o
f
p
o
ten
tial
H
D
p
atien
ts
th
r
o
u
g
h
o
u
t
th
e
p
er
io
d
o
f
Oct
o
b
er
2
0
2
2
to
Feb
r
u
ar
y
2
0
2
3
.
Ab
o
u
t
6
5
0
p
atien
ts
wer
e
in
itially
en
r
o
lled
,
all
o
f
wh
o
m
wer
e
r
ec
eiv
in
g
u
s
u
al
h
em
o
d
ialy
s
is
.
All
willin
g
p
ar
ticip
an
ts
h
ad
th
eir
elig
ib
ilit
y
d
eter
m
in
ed
b
y
a
n
ep
h
r
o
lo
g
is
t.
All
p
atien
ts
m
u
s
t
b
e
ab
le
t
o
s
p
ea
k
a
n
d
u
n
d
e
r
s
tan
d
B
ah
asa,
b
e
o
n
m
ain
ten
an
c
e
h
em
o
d
ialy
s
is
,
(
3
)
b
e
b
etwe
en
th
e
a
g
es
o
f
2
0
an
d
6
5
,
an
d
(
4
)
h
a
v
e
b
ee
n
r
ec
eiv
i
n
g
r
eg
u
lar
h
em
o
d
ialy
s
is
th
er
a
p
y
(
th
r
ee
tim
es
p
er
wee
k
)
f
o
r
at
least
s
ix
m
o
n
th
s
.
R
ec
en
t
h
is
to
r
y
o
f
ac
u
te
m
y
o
ca
r
d
ial
in
f
a
r
ctio
n
,
u
n
s
tab
le
a
n
g
in
a,
u
n
co
n
tr
o
lle
d
ar
r
h
y
th
m
ias,
ac
u
te
s
tr
o
k
e,
ca
n
ce
r
,
a
d
iag
n
o
s
is
o
f
m
alig
n
a
n
cy
,
a
n
d
a
d
ia
g
n
o
s
is
o
f
m
en
t
al
d
is
o
r
d
er
wer
e
al
l
r
ea
s
o
n
s
to
ex
clu
d
e
a
p
atien
t f
r
o
m
th
e
s
tu
d
y
.
2
.
3
.
I
ns
t
rum
ent
T
h
e
PS
QI
was
d
ev
elo
p
e
d
b
y
B
u
y
s
s
e
et
a
l.
[
8
]
.
T
h
e
PS
QI
e
v
alu
ates
h
o
w
well
an
d
h
o
w
o
f
ten
a
p
er
s
o
n
s
lep
t
th
r
o
u
g
h
o
u
t
th
e
p
r
e
v
io
u
s
m
o
n
th
b
ased
o
n
th
eir
o
wn
r
ep
o
r
ts
.
T
h
er
e
ar
e
a
t
o
tal
o
f
1
9
q
u
esti
o
n
s
o
n
th
e
test
,
an
d
d
iv
id
e
in
to
s
ev
en
ca
teg
o
r
i
es:
i
)
s
leep
q
u
ality
(
with
o
n
e
q
u
esti
o
n
)
,
ii
)
s
leep
laten
cy
(
w
ith
two
q
u
esti
o
n
s
)
,
iii
)
s
leep
d
u
r
atio
n
(
with
o
n
e
q
u
esti
o
n
)
,
iv
)
s
leep
ef
f
icie
n
cy
(
with
th
r
ee
q
u
esti
o
n
s
)
,
v
)
s
leep
d
is
r
u
p
tio
n
(
with
n
in
e
q
u
esti
o
n
s
)
,
vi
)
s
leep
m
ed
icatio
n
(
with
o
n
e
q
u
esti
o
n
)
,
a
n
d
v
ii
)
d
aily
d
y
s
f
u
n
ctio
n
(
with
two
q
u
esti
o
n
s
)
.
A
lo
wer
to
tal
s
co
r
e
(
5
)
in
d
icate
s
b
etter
s
leep
q
u
ality
,
with
s
co
r
es
o
n
th
e
lo
wer
en
d
o
f
th
e
s
ca
le
(
1
)
in
d
icatin
g
p
o
o
r
s
leep
.
T
h
e
in
ter
n
al
co
n
s
is
ten
cy
o
f
t
h
e
PS
QI
is
s
atis
f
ac
to
r
y
(
C
r
o
n
b
ac
h
alp
h
a=
0
.
7
3
;
[
8
]
).
2
.
4
.
E
t
hica
l c
o
ns
idera
t
io
ns
T
h
is
r
esear
ch
was
g
iv
en
f
in
al
p
er
m
is
s
io
n
b
y
th
e
eth
ics
co
m
m
ittee
at
STI
Kes
Ab
d
i
Nu
s
an
t
ar
a,
wh
ich
is
lo
ca
ted
in
I
n
d
o
n
esia
(
ap
p
r
o
v
al
n
u
m
b
er
:
0
5
6
/ET
I
K/XI
I
/2
0
2
2
)
.
I
n
ex
ch
a
n
g
e
f
o
r
th
eir
tim
e,
th
e
p
ar
ticip
an
ts
wer
e
g
iv
en
a
g
if
t
ca
r
d
in
th
e
a
m
o
u
n
t
o
f
$
5
,
as
well
as
in
f
o
r
m
atio
n
d
escr
ib
i
n
g
th
e
o
b
jectiv
es
an
d
m
et
h
o
d
o
lo
g
y
o
f
th
e
s
tu
d
y
,
th
e
f
ac
t t
h
at
th
eir
p
ar
ticip
atio
n
was v
o
lu
n
tar
y
,
a
n
d
th
e
a
n
o
n
y
m
ity
o
f
th
eir
r
esp
o
n
s
es.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
1
3
,
No
.
4
,
Dec
em
b
er
20
24
:
1
6
7
2
-
1
6
7
8
1674
2
.
5
.
Cro
s
s
cult
ure
-
v
a
lid
a
t
io
n a
nd
a
da
pta
t
io
n pro
ce
s
s
-
Ph
ase
1
.
T
r
an
s
latio
n
T
h
r
ee
I
n
d
o
n
esian
n
u
r
s
in
g
s
ch
o
lar
s
wh
o
ar
e
also
b
ilin
g
u
al,
as
well
as
a
h
o
s
p
ital
n
u
r
s
e
w
h
o
is
also
b
ilin
g
u
al,
wo
r
k
e
d
to
g
eth
e
r
to
tr
an
s
late
th
is
to
o
l.
All f
o
u
r
o
f
th
em
h
ad
ex
p
er
ien
ce
s
tu
d
y
i
n
g
ab
r
o
ad
as we
ll a
s
in
I
n
d
o
n
esia,
s
o
th
e
y
wer
e
co
m
f
o
r
tab
le
n
av
ig
atin
g
b
etwe
en
t
h
e
two
c
u
ltu
r
es.
T
o
b
eg
in
,
w
e
h
ad
ea
ch
ex
p
e
r
t
tr
an
s
late
PS
QI
o
n
th
ei
r
o
w
n
.
T
h
e
g
r
o
u
p
o
f
ex
p
e
r
ts
ev
alu
ated
th
e
f
o
u
r
tr
a
n
s
lated
v
er
s
i
o
n
s
th
at
d
ea
lt
with
am
b
ig
u
ities
an
d
in
co
n
s
is
ten
cies
b
ef
o
r
e
s
ettlin
g
o
n
th
e
f
in
al
B
ah
asa
v
er
s
io
n
o
f
th
e
PS
Q
I
,
wh
ich
f
o
llo
we
d
in
d
ep
en
d
en
t
tr
an
s
latio
n
.
C
o
n
c
ep
tu
al
m
ea
n
in
g
,
as
o
p
p
o
s
ed
t
o
a
liter
al
"wo
r
d
-
f
o
r
-
wo
r
d
"
tr
an
s
latio
n
,
was
th
e
g
o
al
o
f
th
e
r
e
v
er
s
e
-
tr
an
s
latio
n
p
r
o
ce
s
s
[
1
5
]
.
T
h
e
I
n
d
o
n
esian
to
Am
er
ican
E
n
g
lis
h
tr
an
s
latio
n
o
f
th
e
s
y
n
th
etic
in
s
tr
u
m
en
t
was
p
er
f
o
r
m
ed
f
i
r
s
t
b
y
a
th
ir
d
p
ar
ty
w
h
o
is
f
lu
e
n
t
in
b
o
th
lan
g
u
a
g
es.
T
h
e
lea
d
in
v
esti
g
ato
r
an
d
a
p
an
el
o
f
h
ea
lth
e
x
p
er
ts
th
en
co
m
p
ar
ed
t
h
e
two
v
er
s
io
n
s
o
f
th
e
in
s
tr
u
m
en
t.
T
h
er
e
w
as
a
co
n
s
id
er
ab
le
d
is
cr
ep
an
cy
in
th
e
in
v
e
r
s
e
tr
an
s
latio
n
,
b
u
t
it
tu
r
n
ed
o
u
t
to
b
e
d
u
e
to
v
er
b
c
h
o
ices
th
at
wer
e
v
ir
tu
ally
id
en
tical
to
th
e
o
r
ig
in
al.
T
h
er
e
ar
e
t
h
r
ee
p
lace
s
in
th
e
s
en
ten
ce
s
wh
er
e
ex
tr
a
ca
r
e
is
n
ee
d
ed
to
p
r
o
v
id
e
t
h
e
s
am
e
m
ea
n
in
g
as in
E
n
g
lis
h
wh
en
r
ea
d
in
I
n
d
o
n
esia.
-
Ph
ase
I
I
.
C
u
ltu
r
e
-
Ad
ap
tatio
n
T
en
HD
p
atien
ts
wer
e
in
ter
v
i
ewe
d
co
g
n
itiv
el
y
to
e
v
alu
ate
cu
ltu
r
al
ad
a
p
tatio
n
b
y
e
v
alu
atin
g
h
o
w
well
th
e
tr
an
s
lated
item
s
,
r
es
p
o
n
s
e
ca
teg
o
r
ies,
an
d
q
u
esti
o
n
n
air
e
d
i
r
ec
tio
n
s
m
ad
e
s
en
s
e
to
th
em
[
1
6
]
.
All
p
ar
ticip
an
ts
wer
e
ask
ed
t
o
o
f
f
er
im
p
r
o
v
em
e
n
ts
to
an
y
s
e
ctio
n
s
th
ey
f
o
u
n
d
co
n
f
u
s
in
g
.
I
n
a
d
d
itio
n
,
f
iv
e
p
r
o
f
ess
io
n
als
f
r
o
m
ac
a
d
em
ic
an
d
clin
ical
s
ettin
g
s
ass
ess
ed
th
e
q
u
esti
o
n
n
air
e
to
en
s
u
r
e
its
ac
cu
r
ac
y
.
E
ac
h
item
's
cu
ltu
r
al
ac
ce
p
tab
ilit
y
a
n
d
r
elev
an
ce
was
ev
alu
ated
b
y
a
s
ep
ar
ate
p
an
el
o
f
ex
p
er
ts
u
s
in
g
a
4
-
p
o
in
t
s
ca
le
r
an
g
in
g
f
r
o
m
1
(
n
o
t
r
elev
an
t
at
all)
to
4
(
v
er
y
r
elev
an
t)
.
E
x
p
er
t
p
an
el
ev
alu
atio
n
s
wer
e
u
s
ed
to
d
r
aw
ju
d
g
m
en
ts
o
n
t
h
e
co
n
ten
t
v
alid
ity
o
f
th
e
PS
QI
in
B
ah
asa.
A
co
n
ten
t
v
alid
ity
in
d
e
x
(
C
VI
)
was
ca
lcu
lated
f
o
r
ea
ch
item
an
d
th
e
e
n
tire
s
ca
le.
T
h
e
s
ca
le
-
C
VI
(
S
-
C
VI
)
was
c
alcu
lated
b
y
av
e
r
ag
in
g
th
e
I
-
C
VI
s
co
r
es,
an
d
th
e
C
VI
v
alu
es
f
o
r
in
d
iv
id
u
al
item
s
wer
e
d
er
iv
ed
f
r
o
m
th
e
p
r
o
p
o
r
tio
n
o
f
ex
p
er
ts
wh
o
r
a
n
k
ed
th
o
s
e
item
s
as
3
s
o
r
4
s
.
Acc
ep
tab
le
I
-
C
VI
v
alu
es
ar
e
o
v
e
r
0
.
8
0
,
wh
ile
S
-
C
VI
v
alu
es
ab
o
v
e
0
.
9
0
b
ein
g
c
o
n
s
id
er
ed
o
u
ts
tan
d
in
g
[
1
7
]
.
-
Ph
ase
I
I
I
.
C
o
n
s
tr
u
ct
v
alid
ity
a
n
d
r
eliab
ilit
y
test
in
g
Dete
r
m
in
in
g
th
e
s
am
p
le
s
ize
f
o
r
a
co
n
f
ir
m
ato
r
y
f
ac
t
o
r
an
aly
s
is
(
C
FA)
is
ch
allen
g
in
g
d
u
e
to
th
e
in
f
lu
en
ce
o
f
t
h
e
to
tal
n
u
m
b
er
o
f
f
ac
to
r
s
an
d
in
d
icato
r
s
as
we
ll
as
th
e
m
ag
n
itu
d
e
o
f
f
ac
to
r
l
o
ad
in
g
s
[
1
8
]
.
W
h
ile
Fu
r
r
[
1
9
]
s
u
g
g
ests
5
0
p
ar
tic
ip
an
ts
f
o
r
s
im
p
le
C
FA
m
o
d
els,
o
th
er
s
tu
d
ies
h
av
e
s
u
g
g
ested
s
am
p
le
s
izes,
b
etwe
en
5
an
d
2
0
p
ar
ticip
an
ts
p
er
item
.
2
.
6
.
Da
t
a
a
na
ly
s
is
Descr
ip
tiv
e
s
tatis
tic
s
wer
e
u
s
ed
to
s
u
m
m
ar
ize
t
h
e
d
ata
an
d
p
r
o
v
id
e
a
s
u
m
m
a
r
y
o
f
t
h
e
s
tu
d
y
'
s
p
ar
ticip
an
ts
.
Fo
r
th
e
p
u
r
p
o
s
es
o
f
th
e
s
tatis
tics
,
all
item
s
wi
th
n
eg
ativ
e
wo
r
d
in
g
wer
e
s
witch
ed
ar
o
u
n
d
.
T
h
e
f
ac
to
r
s
tr
u
ctu
r
e
o
f
th
e
B
ah
asa
PS
QI
h
as
b
ee
n
ev
al
u
ated
b
y
C
FA,
an
d
th
e
b
est
p
o
s
s
ib
le
e
s
tim
atio
n
h
as
b
ee
n
m
ad
e.
Acc
o
r
d
in
g
to
Klin
e
s
u
g
g
esti
o
n
s
,
th
e
f
o
llo
win
g
f
it
in
d
ices
f
o
r
m
ea
s
u
r
em
en
ts
h
av
e
b
ee
n
an
aly
ze
d
[
2
0
]
:
Stan
d
ar
d
ized
r
o
o
t
-
m
ea
n
-
s
q
u
ar
e
r
esid
u
al
(
SR
MR),
r
o
o
t
-
m
ea
n
-
s
q
u
ar
e
ap
p
r
o
x
im
atio
n
er
r
o
r
(
R
MSE
A)
,
an
d
f
it
co
m
p
ar
is
o
n
(
C
FI)
[
2
1
]
.
Valu
es
o
f
R
MSE
A
an
d
SR
MR
b
elo
w
0
.
0
6
an
d
0
.
0
8
,
r
esp
ec
tiv
ely
,
in
d
icate
a
s
atis
f
ac
to
r
y
m
o
d
el
o
f
f
it.
Fit
s
with
C
FI
s
co
r
es
ab
o
v
e
0
.
9
ar
e
co
n
s
id
er
ed
ex
ce
llen
t,
wh
ile
t
h
o
s
e
b
elo
w
0
.
8
a
r
e
co
n
s
id
er
ed
ad
eq
u
ate
[
2
2
]
.
R
e
latio
n
s
h
ip
s
am
o
n
g
th
e
s
ev
en
s
leep
q
u
ality
d
im
en
s
io
n
s
wer
e
ex
am
in
e
d
u
s
in
g
Pear
s
o
n
co
r
r
elatio
n
an
aly
s
es.
I
f
th
e
co
r
r
elatio
n
co
e
f
f
icien
ts
b
etwe
en
th
e
two
s
ets
o
f
m
ea
s
u
r
em
en
ts
wer
e
ab
o
v
e
0
.
7
,
it
wo
u
ld
in
d
icate
th
at
th
e
two
s
ets
o
f
m
ea
s
u
r
e
m
en
ts
wer
e
m
ea
s
u
r
in
g
th
e
s
am
e
c
o
n
ce
p
t,
an
d
th
e
two
s
ets
o
f
m
ea
s
u
r
em
e
n
ts
co
u
l
d
b
e
co
m
b
i
n
ed
with
s
o
m
e
item
s
r
em
o
v
ed
[
2
2
]
.
I
n
ter
n
al
c
o
n
s
is
ten
cy
was
ca
lc
u
lated
u
s
in
g
C
r
o
n
b
ac
h
'
s
alp
h
as,
wit
h
a
v
alu
e
o
f
0
.
7
b
ei
n
g
co
n
s
id
er
ed
m
in
im
ally
ac
ce
p
tab
le
f
o
r
r
eliab
ilit
y
[
2
3
]
.
Statis
t
ical
tes
ts
wer
e
r
u
n
in
S
PS
S
v
er
s
io
n
2
3
an
d
L
I
SR
E
L
8
.
8
0
(
s
tu
d
e
n
t)
,
an
d
a
p
-
v
alu
e
o
f
0
.
0
5
was
u
s
ed
to
in
d
icate
s
tatis
tical
s
ig
n
if
ican
ce
.
3.
RE
SU
L
T
S
3
.
1
.
Cha
ra
ct
er
is
t
ics o
f
re
s
po
nd
en
t
T
h
e
o
n
lin
e
s
u
r
v
e
y
r
ec
eiv
e
d
a
r
esp
o
n
s
e
r
ate
o
f
6
2
.
8
%
f
r
o
m
a
to
tal
o
f
2
2
0
p
atien
t
with
HD
(
ab
o
u
t
ten
r
esp
o
n
d
er
s
ea
c
h
item
)
.
T
h
er
e
f
o
r
e,
we
b
eliev
e
th
at
o
u
r
s
am
p
le
s
ize
is
s
u
f
f
icien
t
to
p
r
o
v
i
d
e
a
r
eliab
le
f
ac
to
r
an
aly
s
is
o
f
th
e
PS
QI
tr
an
s
lat
ed
in
to
B
ah
asa.
T
h
e
m
ea
n
ag
e
was
5
5
.
7
6
(
SD=1
0
.
4
5
)
,
m
o
s
t
o
f
th
em
(
6
5
.
9
%)
wer
e
m
ale,
7
0
%
m
a
r
r
ied
,
an
d
5
2
.
7
%
h
a
d
e
d
u
ca
tio
n
b
elo
w
s
en
io
r
h
ig
h
s
ch
o
o
l.
T
h
e
av
er
a
g
e
d
u
r
atio
n
o
f
HD
am
o
n
g
p
ar
ticip
an
ts
was 8
.
8
7
y
ea
r
s
(
SD=1
.
3
4
)
as sh
wo
n
in
T
ab
le
1
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
C
r
o
s
s
-
cu
ltu
r
e
a
d
a
p
ta
tio
n
a
n
d
va
lid
a
tio
n
o
f I
n
d
o
n
esia
n
l
a
n
g
u
a
g
e
ve
r
s
io
n
o
f …
(
A
ch
ma
d
F
a
u
z
i)
1675
T
ab
le
1
.
Dem
o
g
r
ap
h
ic
ch
ar
ac
t
er
is
tics
(
n
=2
2
0
)
C
h
a
r
a
c
t
e
r
i
s
t
i
c
n
(
%)
A
g
e
,
M
e
a
n
±
S
D
5
5
.
7
6
±
1
0
.
4
5
G
e
n
d
e
r
M
a
l
e
1
4
5
(
6
5
.
9
)
F
e
mal
e
7
5
(
3
4
.
1
)
Ed
u
c
a
t
i
o
n
l
e
v
e
l
B
e
l
o
w
s
e
n
i
o
r
h
i
g
h
sc
h
o
o
l
1
1
6
(
5
2
.
7
)
A
b
o
v
e
se
n
i
o
r
h
i
g
h
sc
h
o
o
l
1
0
4
(
4
7
.
3
)
M
a
r
i
t
a
l
s
t
a
t
u
s
M
a
r
r
i
e
d
1
5
4
(
7
0
.
0
)
S
i
n
g
l
e
6
6
(
3
0
.
0
)
D
u
r
a
t
i
o
n
o
f
h
e
m
o
d
i
a
l
y
si
s
(
y
e
a
r
)
,
M
e
a
n
±
S
D
8
.
8
7
±
1
.
3
4
3
.
2
.
Cro
s
s
-
cult
ure
a
da
pta
t
io
n
Acc
o
r
d
in
g
to
th
e
f
in
d
in
g
s
o
f
t
h
e
co
g
n
itiv
e
test
,
th
e
lev
el
o
f
l
an
g
u
ag
e
cla
r
ity
was 8
7
.
8
%,
an
d
th
e
lev
el
o
f
cu
ltu
r
al
r
elev
a
n
ce
was
8
4
.
5
%.
E
ac
h
item
p
ass
ed
th
e
test
f
o
r
cu
ltu
r
al
ap
p
r
o
p
r
iaten
es
s
,
r
ea
d
ab
ilit
y
,
an
d
co
m
p
r
eh
e
n
s
io
n
ac
c
o
r
d
in
g
to
th
e
p
an
el
o
f
ex
p
er
ts
.
Feed
b
a
ck
f
r
o
m
th
e
in
ter
v
iews
r
esu
lt
ed
in
s
o
m
e
m
in
o
r
ad
ju
s
tm
en
ts
.
Sp
ec
if
ically
,
th
e
co
n
ce
r
n
s
with
cu
ltu
r
al
d
ef
in
i
tio
n
s
wer
e
th
e
m
o
s
t
p
r
o
b
lem
a
tic.
Fo
r
in
s
tan
ce
,
a
b
ad
d
r
ea
m
is
eq
u
iv
alen
t t
o
a
n
i
g
h
tm
ar
e
in
B
ah
asa.
3
.
3
.
Co
nte
nt
v
a
lid
it
y
Ou
t
o
f
th
e
s
ix
e
x
p
er
ts
th
at
we
r
e
in
v
ited
to
tak
e
p
a
r
t
in
th
e
e
v
alu
atio
n
o
f
th
e
item
'
s
co
n
ten
t
,
o
n
ly
f
iv
e
ex
p
er
ts
wer
e
ab
le
to
c
o
m
p
lete
th
e
p
r
o
ce
s
s
in
its
en
tire
ty
.
T
h
e
C
VI
r
an
g
ed
f
r
o
m
0
.
9
2
to
1
.
0
0
f
o
r
a
to
tal
item
s
.
T
h
en
,
S
-
C
VI
o
f
0
.
9
2
f
o
r
clar
i
ty
an
d
an
S
-
C
VI
o
f
1
.
0
0
f
o
r
r
elev
an
ce
d
ep
en
d
in
g
o
n
t
h
e
c
o
n
tex
t.
T
h
e
r
esu
lts
in
d
icate
d
th
at
th
e
c
o
n
ten
t o
f
th
e
PS
QI
is
v
alid
b
ased
o
n
th
e
e
x
p
er
t r
e
v
iew.
3
.
4
.
Co
nfir
m
a
t
o
r
y
f
a
c
t
o
r
a
na
ly
s
is
E
ac
h
f
ac
to
r
h
a
d
f
ac
t
o
r
lo
a
d
in
g
r
an
g
in
g
f
r
o
m
0
.
5
1
to
0
.
6
2
,
as
s
h
o
wn
in
Fig
u
r
e
1
.
T
h
e
f
it
in
d
ices
in
d
icate
d
th
at
th
e
7
-
f
ac
t
o
r
m
o
d
el
p
r
o
v
i
d
ed
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ato
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N
o
t
e
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R
M
S
EA
(
r
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t
me
a
n
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u
a
r
e
e
r
r
o
r
o
f
a
p
p
r
o
x
i
m
a
t
i
o
n
)
,
S
M
R
R
(
st
a
n
d
a
r
d
i
z
e
d
r
o
o
t
m
e
a
n
s
q
u
a
r
e
r
e
si
d
u
a
l
)
,
C
F
I
(
c
o
m
p
a
r
a
t
i
v
e
f
i
t
i
n
d
e
x
)
,
N
N
F
I
(
n
o
n
-
n
o
r
mal
i
z
e
d
f
i
t
i
n
d
e
x
)
,
a
n
d
G
F
I
(
g
o
o
d
n
e
ss
o
f
f
i
t
i
n
d
e
x
)
.
T
ab
le
3
.
I
tem
c
o
r
r
elatio
n
o
f
ea
ch
s
u
b
s
ca
le
o
f
th
e
B
ah
asa
v
e
r
s
io
n
o
f
PS
QI
C
h
ar
ac
ter
is
tic
1
2
3
4
5
6
7
Su
b
jectiv
e
s
leep
q
u
ality
0
.
4
2
1
*
*
Sleep
laten
cy
0
.
4
3
4
*
*
0
.
4
3
1
*
*
Sleep
d
u
r
atio
n
0
.
4
2
8
*
0
.
4
5
2
*
*
0
.
5
3
3
*
*
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ef
f
icien
cy
0
.
5
1
1
*
*
0
.
4
3
5
*
0
.
4
3
2
*
0
.
4
3
1
*
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d
is
tu
r
b
an
ce
0
.
4
2
3
*
*
0
.
4
4
1
*
*
0
.
4
1
5
*
0
.
4
3
5
*
*
0
.
4
2
5
*
*
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in
g
m
ed
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s
e
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4
1
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*
0
.
5
1
2
*
*
0
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4
3
3
*
0
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4
5
4
*
*
0
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4
5
4
*
0
.
4
1
4
*
*
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tim
e
d
y
s
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n
ctio
n
0
.
3
9
6
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0
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4
5
2
*
0
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4
3
5
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4
3
5
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*
0
.
4
2
5
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*
0
.
4
0
3
*
0
.
4
0
1
*
*
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o
t
e
:
*
p
<
0
.
0
5
;
*
*
p
<
0
.
0
0
1
3.5.
Relia
bil
it
y
t
es
t
i
ng r
es
u
l
t
s
T
ab
le
4
s
h
o
ws
th
at
C
r
o
n
b
ac
h
alp
h
a
f
o
r
to
tal
s
co
r
e
was
0
.
8
0
3
,
in
d
icatin
g
th
at
th
e
q
u
esti
o
n
n
air
e
was
r
eliab
le.
T
h
e
C
r
o
n
b
ac
h
alp
h
a
f
o
r
ea
ch
d
o
m
a
n
s
r
an
g
ed
f
r
o
m
0
.
7
7
1
to
0
.
8
6
3
.
T
h
e
lo
wes
t
s
co
r
e
was
f
o
r
th
e
d
ay
tim
e
d
y
s
f
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n
ctio
n
d
o
m
ain
a
n
d
th
e
h
ig
h
er
s
co
r
e
f
o
r
th
e
d
o
m
ain
o
f
s
u
b
jectiv
e
s
leep
q
u
alit
y
.
T
ab
le
4
.
I
n
ter
n
al
co
n
s
is
ten
cy
u
s
in
g
alp
h
a
C
r
o
n
b
ac
h
f
o
r
t
h
e
t
o
tal
s
ca
le
an
d
s
u
b
-
s
ca
le
C
h
a
r
a
c
t
e
r
i
s
t
i
c
To
t
a
l
i
t
e
m
C
r
o
n
b
a
c
h
A
l
p
h
a
To
t
a
l
sc
o
r
e
19
0
.
8
0
3
S
u
b
j
e
c
t
i
v
e
sl
e
e
p
q
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a
l
i
t
y
1
0
.
8
6
3
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l
e
e
p
l
a
t
e
n
c
y
2
0
.
7
3
6
S
l
e
e
p
d
u
r
a
t
i
o
n
1
0
.
8
6
0
S
l
e
e
p
e
f
f
i
c
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e
n
c
y
3
0
.
8
8
2
S
l
e
e
p
d
i
s
t
u
r
b
a
n
c
e
9
0
.
7
6
7
S
l
e
e
p
i
n
g
m
e
d
i
c
a
t
i
o
n
u
se
1
0
.
7
7
3
D
a
y
t
i
me
d
y
sf
u
n
c
t
i
o
n
2
0
.
7
7
1
4.
DIS
CU
SS
I
O
N
I
n
th
is
s
tu
d
y
,
th
e
p
s
y
ch
o
m
et
r
ic
p
r
o
p
er
ties
o
f
th
e
PS
QI
wer
e
ev
alu
ated
af
ter
its
tr
an
s
latio
n
an
d
ad
ap
tatio
n
to
th
e
I
n
d
o
n
esian
co
n
tex
t.
T
h
e
s
tu
d
y
co
n
clu
d
ed
th
at
th
e
PS
QI
h
ad
s
tr
o
n
g
in
ter
n
al
co
n
s
is
ten
cy
,
co
n
ten
t
v
alid
ity
,
an
d
co
n
s
tr
u
c
t
v
alid
ity
f
o
r
ass
ess
in
g
s
leep
q
u
ality
in
I
n
d
o
n
esian
HD
p
at
ien
ts
.
T
h
e
PS
QI
in
B
ah
asa
v
er
s
io
n
h
as
s
ev
en
-
f
ac
t
o
r
s
tr
u
ctu
r
e,
as
s
u
p
p
o
r
ted
b
y
t
h
e
co
n
f
ir
m
ato
r
y
f
ac
to
r
an
al
y
s
is
r
esu
lts
f
o
r
th
e
1
9
item
s
o
f
th
e
tr
an
s
lated
to
o
l
[
2
4
]
–
[
2
6
]
.
T
h
e
co
n
s
tr
u
ct
v
alid
ity
o
f
th
e
to
tal
s
ca
les
was
s
h
o
wn
b
y
th
e
f
ac
t
th
at
all
item
s
co
n
tr
ib
u
ted
to
th
e
p
r
ed
i
cted
s
u
b
s
ca
le.
I
n
ad
d
itio
n
,
as
p
r
ed
icted
,
co
r
r
elatio
n
s
b
etwe
en
s
u
b
s
ca
le
s
co
r
es
an
d
s
leep
q
u
ality
lev
el
wer
e
f
o
u
n
d
,
p
r
o
v
id
in
g
a
d
d
itio
n
al
ev
i
d
en
ce
f
o
r
t
h
e
co
n
s
tr
u
ct
v
alid
it
y
o
f
th
e
PS
QI
in
its
B
ah
asa
v
er
s
io
n
.
T
h
e
q
u
esti
o
n
n
air
e
h
as
b
ee
n
tr
a
n
s
lated
in
to
an
d
v
alid
ate
d
f
o
r
a
n
u
m
b
er
o
f
lan
g
u
ag
es,
in
clu
d
in
g
Fre
n
ch
,
J
ap
an
ese,
Ger
m
an
,
Sp
a
n
is
h
,
Heb
r
ew,
Nig
er
ian
,
C
h
in
ese,
an
d
Ar
ab
i
c
[
4
]
,
a
n
d
h
as
s
ee
n
ex
ten
s
iv
e
u
s
e
in
a
v
ar
iety
o
f
a
g
e
g
r
o
u
p
s
an
d
clin
ical
an
d
n
o
n
-
clin
ical
s
am
p
les
(
i.e
.
,
co
n
tr
o
l
p
ar
ticip
an
ts
with
n
o
m
ed
ical
co
n
d
itio
n
s
)
.
Mo
r
e
o
v
er
,
a
n
u
m
b
er
o
f
v
ar
ia
b
les
ap
p
ea
r
to
b
e
c
o
n
s
is
ten
t
ac
r
o
s
s
co
u
n
tr
ies
in
o
p
tim
al
f
ac
to
r
m
o
d
els.
T
wo
d
is
tin
ct
ca
teg
o
r
ies
o
f
tr
a
n
s
latio
n
al
is
s
u
es
h
av
e
b
ee
n
i
d
en
tifie
d
b
y
th
e
item
a
n
aly
s
is
[
1
3
]
.
T
h
is
in
clu
d
es
wo
r
d
s
th
at
d
o
n
o
t
r
e
tain
th
eir
m
ea
n
in
g
wh
en
tr
an
s
lated
f
r
o
m
E
n
g
lis
h
in
to
I
n
d
o
n
esian
,
as
well
as
p
h
r
ases
o
r
id
io
m
atic
e
x
p
r
ess
io
n
s
th
at
wer
e
u
n
f
a
m
iliar
to
r
es
p
o
n
d
e
n
ts
af
ter
b
ein
g
tr
an
s
lated
f
r
o
m
E
n
g
lis
h
in
to
I
n
d
o
n
esian
d
u
e
to
d
if
f
er
e
n
ce
s
in
cu
ltu
r
al
co
n
tex
t
o
r
n
atio
n
al
b
o
u
n
d
ar
ies.
C
o
g
n
itiv
e
in
ter
v
iews,
h
o
wev
er
,
h
elp
ed
p
ar
ticip
an
ts
ca
teg
o
r
i
ze
th
ese
is
s
u
es
in
to
th
e
f
o
u
r
s
u
b
d
o
m
ai
n
s
o
f
r
ea
d
i
n
g
in
co
r
r
ec
tly
,
n
o
t
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
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d
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a
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(
A
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1677
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T
h
e
f
o
u
r
th
item
d
r
aws
atten
tio
n
to
p
r
o
b
lem
s
with
th
e
t
o
o
l'
s
s
tr
u
ctu
r
e
an
d
f
lo
w,
alth
o
u
g
h
it
is
n
o
t
r
ef
lect
ed
in
t
h
e
liter
atu
r
e.
At
last
,
r
es
p
o
n
d
e
n
ts
r
ea
lized
th
at
a
s
u
r
v
e
y
q
u
esti
o
n
o
n
s
leep
d
is
tu
r
b
an
ce
was in
ten
d
e
d
f
o
r
t
h
em
to
f
ill o
u
t
[
2
7
]
,
[
2
8
]
.
Fin
ally
,
th
is
in
v
esti
g
atio
n
h
as th
r
ee
lim
itatio
n
s
.
Hea
lth
p
r
o
f
e
s
s
io
n
als
with
an
ex
ce
llen
t u
n
d
er
s
tan
d
in
g
o
f
th
e
E
n
g
lis
h
lan
g
u
ag
e
wer
e
r
eq
u
ir
ed
f
o
r
th
e
c
o
g
n
itiv
e
i
n
ter
v
iews
[
2
9
]
,
[
3
0
]
.
As
a
r
esu
lt,
it's
p
o
s
s
ib
le
th
at
th
ese
ex
p
er
ts
k
n
o
w
m
o
r
e
ab
o
u
t
th
e
im
p
o
r
tan
ce
o
f
q
u
alit
y
s
leep
th
an
th
e
g
en
e
r
al
p
u
b
lic.
T
h
e
co
g
n
itiv
e
in
ter
v
iews
co
u
ld
o
n
l
y
ac
ce
p
t
a
s
u
b
s
et
o
f
p
o
ten
tial
p
ar
ticip
an
ts
b
ec
au
s
e
o
f
t
h
e
cr
iter
ia
f
o
r
n
ativ
e
E
n
g
lis
h
s
p
ea
k
er
s
.
Seco
n
d
,
t
h
is
r
esear
ch
ap
p
r
o
ac
h
es
cr
o
s
s
-
cu
ltu
r
a
l
in
q
u
ir
y
with
a
n
ad
h
er
en
ce
to
eth
ics.
I
t
was
h
y
p
o
th
esized
th
at
I
n
d
o
n
esia
m
ay
tr
a
n
s
late
g
en
er
al
p
r
in
cip
l
es
an
d
th
e
s
tr
o
n
g
ass
o
ciatio
n
s
with
s
leep
q
u
ality
.
T
h
e
s
tu
d
y
ap
p
r
o
ac
h
,
o
n
th
e
o
t
h
er
h
an
d
,
was
a
s
tr
o
n
g
p
o
in
t
t
h
at
p
r
o
v
ed
th
e
tr
an
s
f
er
a
b
ilit
y
o
f
r
ec
o
g
n
izin
g
a
n
d
u
n
d
er
s
tan
d
i
n
g
th
e
u
n
d
er
ly
in
g
ass
u
m
p
tio
n
s
an
d
f
r
am
ewo
r
k
.
Fin
ally
,
at
th
e
ex
p
er
t
m
ee
tin
g
s
,
th
e
tr
an
s
lato
r
s
wh
o
wo
r
k
e
d
o
n
b
o
th
t
h
e
f
o
r
war
d
an
d
b
ac
k
war
d
t
r
an
s
latio
n
s
wer
e
co
n
s
u
lted
as
lan
g
u
a
g
e
ex
p
er
ts
.
Fo
r
th
is
r
ea
s
o
n
,
th
e
"p
u
r
en
ess
"
o
f
th
e
f
o
r
war
d
an
d
b
ac
k
war
d
tr
an
s
latio
n
ca
n
n
o
t
b
e
co
n
s
id
er
ed
to
h
a
v
e
b
ee
n
p
r
eser
v
ed
.
Fo
u
r
th
,
th
is
s
tu
d
y
was
lim
ited
b
y
its
s
in
g
le
-
s
ite
d
esig
n
,
th
u
s
its
f
in
d
in
g
s
m
ay
n
o
t
ap
p
ly
to
all
HD
p
atien
ts
in
I
n
d
o
n
esia.
5.
CO
NCLU
SI
O
N
T
h
is
is
th
e
f
ir
s
t
in
v
esti
g
atio
n
o
f
th
e
PS
QI
p
s
y
c
h
o
m
etr
ic
p
r
o
p
er
ties
am
o
n
g
I
n
d
o
n
esian
HD
p
atien
ts
.
Ou
r
r
esear
ch
p
r
o
v
id
es
p
r
elim
in
ar
y
ev
id
e
n
ce
o
f
th
e
v
alid
ity
an
d
r
eliab
ilit
y
o
f
th
e
tr
an
s
lated
an
d
ad
ap
ted
to
o
l
u
s
in
g
d
ata
f
r
o
m
HD
p
atien
ts
i
n
I
n
d
o
n
esian
h
o
s
p
itals
.
I
n
a
d
d
itio
n
,
o
u
r
C
FA
r
esu
lts
v
alid
at
e
th
e
u
s
e
o
f
th
e
1
9
-
item
,
7
-
f
ac
to
r
B
ah
asa
PS
QI
v
er
s
io
n
.
Ho
wev
er
,
m
o
r
e
r
e
s
ea
r
ch
is
n
ee
d
ed
to
ex
am
in
e
its
p
s
y
ch
o
m
etr
ic
p
r
o
p
er
ties
with
in
th
e
co
n
tex
t
o
f
m
o
r
e
c
o
m
p
r
e
h
en
s
iv
e
v
alid
atio
n
an
d
in
m
u
lti
-
s
ite
s
ce
n
ar
io
o
f
v
a
r
io
u
s
lo
ca
tio
n
s
/h
o
s
p
itals
in
I
n
d
o
n
esia in
o
r
d
e
r
to
s
tr
en
g
th
en
g
en
er
a
lizab
ilit
y
.
ACK
NO
WL
E
DG
M
E
N
T
W
e
th
an
k
s
to
all
p
ar
ticip
a
n
t
to
j
o
in
in
th
is
s
tu
d
y
a
n
d
th
a
n
k
s
to
STI
Kes
Ab
d
i
Nu
s
an
tar
a
(
I
I
I
/0
1
2
3
/2
0
2
3
)
to
p
r
o
v
id
e
f
u
n
d
in
g
f
o
r
th
is
r
esear
ch
a
n
d
Un
i
v
er
s
iti Ma
lay
s
ia
Sab
ah
f
o
r
p
u
b
licatio
n
f
u
n
d
i
n
g
.
RE
F
E
R
E
NC
E
S
[
1
]
M
.
M
i
r
g
h
a
e
d
,
R
.
S
e
p
e
h
r
i
a
n
,
A
.
R
a
k
h
s
h
a
n
,
a
n
d
H
.
G
o
r
j
i
,
“
S
l
e
e
p
q
u
a
l
i
t
y
i
n
I
r
a
n
i
a
n
h
e
m
o
d
i
a
l
y
s
i
s
p
a
t
i
e
n
t
s
:
A
s
y
s
t
e
m
a
t
i
c
r
e
v
i
e
w
a
n
d
m
e
t
a
-
a
n
a
l
y
s
i
s
,
”
I
r
a
n
i
a
n
J
o
u
r
n
a
l
o
f
N
u
r
s
i
n
g
a
n
d
M
i
d
w
i
f
e
r
y
R
e
s
e
a
r
c
h
,
v
o
l
.
2
4
,
n
o
.
6
,
p
.
4
0
3
,
2
0
1
9
,
d
o
i
:
1
0
.
4
1
0
3
/
i
j
n
m
r
.
I
JN
M
R
_
1
8
4
_
1
8
.
[
2
]
N
.
El
-
b
a
r
o
u
d
y
e
t
a
l
.
,
“
S
l
e
e
p
d
i
so
r
d
e
r
s
i
n
c
h
i
l
d
r
e
n
a
n
d
a
d
o
l
e
s
c
e
n
t
s
o
n
r
e
g
u
l
a
r
h
e
m
o
d
i
a
l
y
s
i
s,
”
E
u
ro
p
e
a
n
J
o
u
rn
a
l
o
f
Pe
d
i
a
t
r
i
c
s
,
v
o
l
.
1
7
9
,
n
o
.
7
,
p
p
.
1
1
3
9
–
1
1
4
6
,
Ju
l
.
2
0
2
0
,
d
o
i
:
1
0
.
1
0
0
7
/
s
0
0
4
3
1
-
020
-
0
3
6
1
1
-
w.
[
3
]
C
.
R
.
P
r
e
t
t
o
,
M
.
B
.
C
.
d
a
R
o
s
a
,
C
.
M
.
D
e
z
o
r
d
i
,
S
.
A
.
W
.
B
e
n
e
t
t
i
,
C
.
d
e
F
.
C
o
l
e
t
,
a
n
d
E
.
M
.
F
.
S
t
u
m
m
,
“
D
e
p
r
e
s
s
i
o
n
a
n
d
c
h
r
o
n
i
c
r
e
n
a
l
p
a
t
i
e
n
t
s
o
n
h
e
m
o
d
i
a
l
y
s
i
s
:
a
s
s
o
c
i
a
t
e
d
f
a
c
t
o
r
s
,
”
R
e
v
i
s
t
a
B
r
a
s
i
l
e
i
r
a
d
e
E
n
f
e
r
m
a
g
e
m
,
v
o
l
.
7
3
,
n
o
.
s
u
p
p
l
1
,
2
0
2
0
,
d
o
i
:
1
0
.
1
5
9
0
/
0
0
3
4
-
7
1
6
7
-
2
0
1
9
-
0
1
6
7
.
[
4
]
T.
M
o
l
l
a
y
e
v
a
,
P
.
Th
u
r
a
i
r
a
j
a
h
,
K
.
B
u
r
t
o
n
,
S
.
M
o
l
l
a
y
e
v
a
,
C
.
M
.
S
h
a
p
i
r
o
,
a
n
d
A
.
C
o
l
a
n
t
o
n
i
o
,
“
T
h
e
P
i
t
t
s
b
u
r
g
h
sl
e
e
p
q
u
a
l
i
t
y
i
n
d
e
x
a
s
a
scre
e
n
i
n
g
t
o
o
l
f
o
r
s
l
e
e
p
d
y
sf
u
n
c
t
i
o
n
i
n
c
l
i
n
i
c
a
l
a
n
d
n
o
n
-
c
l
i
n
i
c
a
l
sam
p
l
e
s:
A
sy
st
e
mat
i
c
r
e
v
i
e
w
a
n
d
me
t
a
-
a
n
a
l
y
s
i
s,
”
S
l
e
e
p
Me
d
i
c
i
n
e
Re
v
i
e
w
s
,
v
o
l
.
2
5
,
p
p
.
5
2
–
7
3
,
F
e
b
.
2
0
1
6
,
d
o
i
:
1
0
.
1
0
1
6
/
j
.
smr
v
.
2
0
1
5
.
0
1
.
0
0
9
.
[
5
]
A
.
D
.
K
r
y
st
a
l
a
n
d
J.
D
.
E
d
i
n
g
e
r
,
“
M
e
a
su
r
i
n
g
sl
e
e
p
q
u
a
l
i
t
y
,
”
S
l
e
e
p
Me
d
i
c
i
n
e
,
v
o
l
.
9
,
p
p
.
S
1
0
–
S
1
7
,
S
e
p
.
2
0
0
8
,
d
o
i
:
1
0
.
1
0
1
6
/
S
1
3
8
9
-
9
4
5
7
(
0
8
)
7
0
0
1
1
-
X.
[
6
]
M
.
O
h
a
y
o
n
e
t
a
l
.
,
“
N
a
t
i
o
n
a
l
S
l
e
e
p
F
o
u
n
d
a
t
i
o
n
’
s
sl
e
e
p
q
u
a
l
i
t
y
r
e
c
o
m
me
n
d
a
t
i
o
n
s
:
f
i
r
s
t
r
e
p
o
r
t
,
”
S
l
e
e
p
H
e
a
l
t
h
,
v
o
l
.
3
,
n
o
.
1
,
p
p
.
6
–
1
9
,
F
e
b
.
2
0
1
7
,
d
o
i
:
1
0
.
1
0
1
6
/
j
.
sl
e
h
.
2
0
1
6
.
1
1
.
0
0
6
.
[
7
]
E.
S
n
y
d
e
r
,
B
.
C
a
i
,
C
.
D
e
M
u
r
o
,
M
.
F
.
M
o
r
r
i
s
o
n
,
a
n
d
W
.
B
a
l
l
,
“
A
n
e
w
s
i
n
g
l
e
-
i
t
e
m
s
l
e
e
p
q
u
a
l
i
t
y
s
c
a
l
e
:
r
e
su
l
t
s
o
f
p
s
y
c
h
o
me
t
r
i
c
e
v
a
l
u
a
t
i
o
n
i
n
p
a
t
i
e
n
t
s
w
i
t
h
c
h
r
o
n
i
c
p
r
i
mar
y
i
n
s
o
m
n
i
a
a
n
d
d
e
p
r
e
ss
i
o
n
,
”
J
o
u
rn
a
l
o
f
C
l
i
n
i
c
a
l
S
l
e
e
p
Me
d
i
c
i
n
e
,
v
o
l
.
1
4
,
n
o
.
1
1
,
p
p
.
1
8
4
9
–
1
8
5
7
,
N
o
v
.
2
0
1
8
,
d
o
i
:
1
0
.
5
6
6
4
/
j
c
sm.
7
4
7
8
.
[
8
]
D
.
J
.
B
u
y
s
s
e
,
C
.
F
.
R
e
y
n
o
l
d
s
,
T
.
H
.
M
o
n
k
,
S
.
R
.
B
e
r
m
a
n
,
a
n
d
D
.
J
.
K
u
p
f
e
r
,
“
T
h
e
P
i
t
t
s
b
u
r
g
h
s
l
e
e
p
q
u
a
l
i
t
y
i
n
d
e
x
:
A
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9
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9
8
5
2
7
6
3
.
[
2
3
]
E.
M
.
I
k
a
r
t
,
“
S
u
r
v
e
y
q
u
e
st
i
o
n
n
a
i
r
e
su
r
v
e
y
p
r
e
t
e
st
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n
g
met
h
o
d
:
A
n
e
v
a
l
u
a
t
i
o
n
o
f
s
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r
v
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y
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n
a
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r
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e
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p
e
r
t
r
e
v
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e
w
s
t
e
c
h
n
i
q
u
e
,
”
As
i
a
n
J
o
u
r
n
a
l
o
f
S
o
c
i
a
l
S
c
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n
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t
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o
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p
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,
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0
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9
.
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O
I
:
1
0
.
2
0
8
4
9
/
a
j
sss.
v
4
i
2
.
5
6
5
[
2
4
]
M
.
B
.
R
a
n
i
t
i
,
J.
M
.
W
a
l
o
sz
e
k
,
O
.
S
c
h
w
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r
t
z
,
N
.
B
.
A
l
l
e
n
,
a
n
d
J.
Tr
i
n
d
e
r
,
“
F
a
c
t
o
r
s
t
r
u
c
t
u
r
e
a
n
d
p
s
y
c
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o
met
r
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c
p
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o
f
t
h
e
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i
t
t
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h
S
l
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p
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u
a
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n
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e
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n
c
o
mm
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n
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t
y
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b
a
s
e
d
a
d
o
l
e
s
c
e
n
t
s
,
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S
l
e
e
p
,
v
o
l
.
4
1
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o
.
6
,
J
u
n
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3
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e
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s
y
0
6
6
.
[
2
5
]
B
.
G
e
l
a
y
e
e
t
a
l
.
,
“
C
o
n
st
r
u
c
t
V
a
l
i
d
i
t
y
a
n
d
f
a
c
t
o
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s
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c
t
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r
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t
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s
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e
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d
e
p
w
o
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s
l
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p
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e
ss
sc
a
l
e
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n
a
mu
l
t
i
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n
a
t
i
o
n
a
l
st
u
d
y
o
f
A
f
r
i
c
a
n
,
S
o
u
t
h
E
a
st
A
si
a
n
a
n
d
S
o
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t
h
A
meri
c
a
n
C
o
l
l
e
g
e
S
t
u
d
e
n
t
s
,
”
PLo
S
O
N
E
,
v
o
l
.
9
,
n
o
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1
2
,
p
.
e
1
1
6
3
8
3
,
D
e
c
.
2
0
1
4
,
d
o
i
:
1
0
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1
3
7
1
/
j
o
u
r
n
a
l
.
p
o
n
e
.
0
1
1
6
3
8
3
.
[
2
6
]
R
.
d
e
l
a
V
e
g
a
e
t
a
l
.
,
“
T
h
e
P
i
t
t
sb
u
r
g
h
sl
e
e
p
q
u
a
l
i
t
y
i
n
d
e
x
:
V
a
l
i
d
i
t
y
a
n
d
f
a
c
t
o
r
s
t
r
u
c
t
u
r
e
i
n
y
o
u
n
g
p
e
o
p
l
e
,
”
Psy
c
h
o
l
o
g
i
c
a
l
Assessm
e
n
t
,
v
o
l
.
2
7
,
n
o
.
4
,
p
p
.
e
2
2
–
e
2
7
,
2
0
1
5
,
d
o
i
:
1
0
.
1
0
3
7
/
p
a
s
0
0
0
0
1
2
8
.
[
2
7
]
K
.
M
e
a
d
o
w
s,
“
C
o
g
n
i
t
i
v
e
I
n
t
e
r
v
i
e
w
i
n
g
M
e
t
h
o
d
o
l
o
g
i
e
s
,
”
C
l
i
n
i
c
a
l
N
u
rsi
n
g
Re
se
a
rc
h
,
v
o
l
.
3
0
,
n
o
.
4
,
p
p
.
3
7
5
–
3
7
9
,
M
a
y
2
0
2
1
,
d
o
i
:
1
0
.
1
1
7
7
/
1
0
5
4
7
7
3
8
2
1
1
0
1
4
0
9
9
.
[
2
8
]
T.
N
a
n
d
a
,
H
.
G
u
p
t
a
,
M
.
K
h
a
r
u
b
,
a
n
d
N
.
S
i
n
g
h
,
“
D
i
a
g
n
o
st
i
c
s
f
o
r
p
r
e
t
e
s
t
i
n
g
q
u
e
st
i
o
n
n
a
i
r
e
s:
a
c
o
mp
a
r
a
t
i
v
e
a
n
a
l
y
si
s,”
I
n
t
e
r
n
a
t
i
o
n
a
l
J
o
u
rn
a
l
o
f
T
e
c
h
n
o
l
o
g
y
,
P
o
l
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c
y
a
n
d
M
a
n
a
g
e
m
e
n
t
,
v
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l
.
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3
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o
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7
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2
0
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1
5
0
4
/
I
JTP
M
.
2
0
1
3
.
0
5
1
0
0
8
.
[
2
9
]
E.
K
.
S
c
h
i
l
d
ma
n
n
e
t
a
l
.
,
“
D
i
sc
o
v
e
r
i
n
g
t
h
e
h
i
d
d
e
n
b
e
n
e
f
i
t
s
o
f
c
o
g
n
i
t
i
v
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i
n
t
e
r
v
i
e
w
i
n
g
i
n
t
w
o
l
a
n
g
u
a
g
e
s:
T
h
e
f
i
r
st
p
h
a
se
o
f
a
v
a
l
i
d
a
t
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t
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t
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r
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t
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d
P
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l
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t
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v
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c
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r
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O
u
t
c
o
m
e
S
c
a
l
e
,
”
Pa
l
l
i
a
t
i
v
e
M
e
d
i
c
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n
e
,
v
o
l
.
3
0
,
n
o
.
6
,
p
p
.
5
9
9
–
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1
0
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J
u
n
.
2
0
1
6
,
d
o
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:
1
0
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1
1
7
7
/
0
2
6
9
2
1
6
3
1
5
6
0
8
3
4
8
.
[
3
0
]
I
.
B
e
c
k
e
t
a
l
.
,
“
Tr
a
n
s
l
a
t
i
o
n
a
n
d
c
u
l
t
u
r
a
l
a
d
a
p
t
a
t
i
o
n
o
f
t
h
e
i
n
t
e
g
r
a
t
e
d
p
a
l
l
i
a
t
i
v
e
c
a
r
e
o
u
t
c
o
me
s
c
a
l
e
i
n
c
l
u
d
i
n
g
c
o
g
n
i
t
i
v
e
i
n
t
e
r
v
i
e
w
i
n
g
w
i
t
h
p
a
t
i
e
n
t
s
a
n
d
st
a
f
f
,
”
BM
C
P
a
l
l
i
a
t
i
v
e
C
a
r
e
,
v
o
l
.
1
6
,
n
o
.
1
,
p
.
4
9
,
D
e
c
.
2
0
1
7
,
d
o
i
:
1
0
.
1
1
8
6
/
s
1
2
9
0
4
-
017
-
0
2
3
2
-
x.
B
I
O
G
RAP
H
I
E
S O
F
AUTH
O
RS
Ac
h
m
a
d
F
a
u
z
i
is
a
m
e
d
ica
l
su
r
g
e
ry
sp
e
c
ialist
(KMB)
wit
h
a
sp
e
c
ializa
ti
o
n
in
u
ro
l
o
g
y
.
Cu
rre
n
tl
y
,
h
e
is
t
h
e
He
a
d
o
f
t
h
e
Re
se
a
rc
h
a
n
d
In
n
o
v
a
t
io
n
Ce
n
ter
a
t
S
TIKe
s
Ab
d
i
Nu
sa
n
tara
wh
ich
is
re
sp
o
n
si
b
le
fo
r
d
e
v
e
lo
p
in
g
re
se
a
rc
h
,
c
o
m
m
u
n
it
y
se
rv
ice
a
n
d
i
n
n
o
v
a
ti
o
n
.
Th
e
f
o
c
u
s
a
n
d
sc
o
p
e
o
f
Ac
h
m
a
d
F
a
u
z
i'
s
re
se
a
rc
h
o
n
C
h
ro
n
ic
Dise
a
se
s
sta
rted
in
2
0
1
3
with
a
n
u
n
d
e
r
g
ra
d
u
a
te
t
h
e
sis
a
ss
ig
n
m
e
n
t.
Ac
h
m
a
d
F
a
u
z
i
h
a
s
c
o
n
d
u
c
ted
re
s
e
a
rc
h
in
th
e
f
ield
o
f
c
h
ro
n
ic
d
ise
a
se
,
e
sp
e
c
ially
in
u
ro
l
o
g
y
.
He
c
a
n
b
e
c
o
n
tac
ted
a
t
e
m
a
il
:
F
a
u
z
i.
u
m
a
y
@g
m
a
il
.
c
o
m
.
Fa
tim
a
h
Ahm
e
d
y
is
a
re
h
a
b
il
it
a
ti
o
n
m
e
d
icin
e
sp
e
c
ialist
a
n
d
a
se
n
i
o
r
m
e
d
ica
l
lec
tu
re
r
a
t
th
e
F
a
c
u
lt
y
o
f
M
e
d
icin
e
&
He
a
lt
h
S
c
ien
c
e
s
(F
M
HS).
Cu
rre
n
tl
y
,
sh
e
is
th
e
He
a
d
o
f
De
p
a
rtme
n
t
o
f
M
e
d
ica
l
E
d
u
c
a
ti
o
n
,
F
M
HS
a
n
d
t
h
e
sp
e
c
ialist
in
-
c
h
a
rg
e
d
fo
r
d
e
v
e
l
o
p
i
n
g
t
h
e
Re
h
a
b
il
it
a
ti
o
n
M
e
d
ici
n
e
De
p
a
rt
m
e
n
t
in
th
e
u
p
c
o
m
i
n
g
Ho
sp
it
a
l
UMS
(HU
M
S
).
Dr
F
a
ti
m
a
h
sta
rted
d
e
v
o
ti
n
g
h
e
r
p
a
ss
io
n
i
n
t
h
is
field
a
s
a
m
e
d
ica
l
o
ffice
r
b
a
c
k
in
2
0
1
3
a
n
d
c
o
m
p
lete
d
h
e
r
sp
e
c
ialisa
ti
o
n
in
2
0
1
8
.
He
r
sp
e
c
ial
in
tere
st
is
in
n
e
u
ro
re
h
a
b
il
it
a
ti
o
n
fo
c
u
sin
g
o
n
stro
k
e
,
sp
in
a
l
c
o
rd
in
j
u
ry
a
n
d
trau
m
a
ti
c
b
ra
i
n
in
j
u
ry
.
T
h
e
u
se
o
f
EE
G
sig
n
a
ls
fo
r
re
c
o
v
e
ry
in
str
o
k
e
re
h
a
b
il
it
a
ti
o
n
a
n
d
o
u
tc
o
m
e
m
e
a
su
re
to
o
l
fo
r
d
e
term
in
i
n
g
th
e
wa
lk
in
g
fu
n
c
ti
o
n
in
sp
i
n
a
l
tu
b
e
rc
u
l
o
sis
a
re
fe
w
e
x
a
m
p
les
o
f
h
e
r
re
se
a
rc
h
f
o
c
u
s
.
S
h
e
c
a
n
b
e
c
o
n
tac
ted
a
t
e
m
a
il
:
fa
ti
m
a
h
m
e
d
y
@u
m
s.e
d
u
.
m
y
.
Ro
sid
a
h
is
a
n
e
x
p
e
rien
c
e
d
h
e
m
o
d
ialy
sis
n
u
rse
wh
o
h
a
s
sta
rted
h
e
r
c
a
re
e
r
in
t
h
e
h
e
m
o
d
ialy
sis
ro
o
m
f
o
r
a
lmo
st
2
5
y
e
a
rs
sta
rti
n
g
fr
o
m
1
9
9
8
.
S
h
e
is
c
u
rre
n
tl
y
st
u
d
y
in
g
a
t
S
T
IKES
Ab
d
i
Nu
sa
n
tara
m
a
jo
rin
g
in
N
u
rsin
g
a
n
d
Nu
rsin
g
P
r
o
fe
ss
io
n
.
He
r
sp
e
c
ial
in
tere
st
is
in
th
e
field
o
f
c
h
r
o
n
ic
k
i
d
n
e
y
d
ise
a
se
(CKG
),
b
y
d
isc
u
ss
in
g
Ae
ro
b
ic
a
n
d
S
tr
e
c
h
in
g
Ex
e
rc
ise
in
Re
stles
s
Leg
s
S
y
n
d
ro
m
e
p
a
ti
e
n
ts
is
th
e
ti
t
le
o
f
h
e
r
fin
a
l
u
n
d
e
r
g
ra
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