Page 77 - IJPS-9-1

International Journal of
Population Studies COVID-19, economic crisis, insomnia, and stress

size was 0.0526, expecting a squared multiple correlation 2.3.2. The Lebanese insomnia scale (LIS-18)
of 0.05 (R deviation from 0) related to the Omnibus test of This self-reported 18-item tool, recently validated
2
multiple regression. The minimum necessary sample was in Lebanon (Hallit et al., 2019), is used to screen for
n = 454, considering an alpha error of 5%, a power of 80%, insomnia. Answers are graded on a five-point Likert scale
and allowing 25 predictors to be included in the model. from 1 (never) to 5 (always), with higher scores indicating

2.3. Questionnaire higher insomnia (α Cronbach = 0.847). The LIS-18 was later
dichotomized according to its median (45) into insomnia
The online questionnaire was available in Arabic versus no insomnia.
(Part A in Supplementary File), the native language in
Lebanon. It consisted of three parts. The first part assessed 2.3.3. The fear of COVID-19 (FOC) scale
the sociodemographic features of the participants, such as This 7-item tool is used to measure the extent of fear of
age, gender (female vs. male), marital status (single, married, COVID-19 (FOC) in adult people (Ahorsu et al., 2020).
and widowed/divorced), educational level categories, It is scored on a five-point Likert scale from 1 (strongly
employment status (works vs. others), region (Lebanese disagree) to 5 (strongly agree). The total score (range 1 – 35)
governorates), household size, number of dependent is calculated by summing the answers to all questions.
children, number of rooms, violence at home (verbal, Higher scores indicate a greater FOC (α Cronbach=0.893).
physical, sexual, or no violence), and current monthly
household income. This part also included questions 2.3.4. The family Adaptation, Partnership, Growth,
about medical coverage (yes vs. no), smoking (cigarette Affection, and Resolve (APGAR) index
and waterpipe) and alcohol consumption (previous,
none, occasional, regular), self-perception of the financial This short self-reported instrument evaluates the
situation, having been infected or in contact with people satisfaction with global family function (Good et al.,
infected with coronavirus (yes vs. no), and physical activity 1979). It consists of five questions, each corresponding to
before and during the COVID-19 pandemic (yes vs. no). a component of family function, that is, APGAR. All five
items are scored on a three-point Likert scale: 0 (hardly
The second part of the questionnaire assessed the ever), 1 (some of the time), and 2 (almost always). The
impact of the economic crisis and the COVID-19 total score ranging from 0 to 10 is obtained by summing
pandemic on the status of current employment using 20 the answers to all items. The higher the scores, the higher
work-related questions addressed to working people and the satisfaction with family function (α Cronbach = 0.927).
those seeking employment. More details can be found in
Part B in Supplementary File. 2.3.5. The InCharge financial distress/financial well-
being scale (IFDFW)
The last part of the questionnaire included the following
validated scales: This tool includes eight items assessing the perceived
financial distress/financial well-being on a 1 – 10 linear scale
2.3.1. The post-traumatic stress disorder checklist for (Prawitz et al., 2006). Lower scores reflect higher financial
DSM-5 (PCL-5) distress and lower well-being (α Cronbach = 0.925). Since this
This 20-item self-report tool evaluates the 20 DSM-5 tool is copyrighted, written permission was obtained from
symptoms of PTSD in the past month. It is available the authors to use it and validate it in Lebanon.
in Arabic and validated in Syria (Ibrahim et al., 2018). 2.4. Translation procedure and piloting
Responses are rated on a five-point Likert scale from 0 (not
at all) to 4 (extremely). The total symptom severity score All the scales used were translated into Arabic, except
(range 0 – 80) is obtained by summing the responses to for PCL-5 and LIS-18 already validated and available
all items. Higher scores reflect higher symptoms resulting in this language. Three authors performed the forward
from a stressful experience. Several PCL-5 cutoff scores translation, and the other three did the backward
have been suggested for an optimal diagnosis of probable translation. Discrepancies between the original English
PTSD (between 31 and 33); the 33-cutoff point was adopted versions and translated ones were resolved by consensus.
as previously described for the COVID-19-induced The final questionnaire was pilot-tested on ten people
PTSS (Liu et al., 2020) (α Cronbach = 0.971). Since online unfamiliar with the study; answers were not included in
questionnaires do not allow an accurate PTSD diagnosis the final dataset.
but rather the PTS symptoms, in this manuscript, “PTSS”
is used to refer to this evaluation. The PCL-5 was later 2.5. Statistical analysis
dichotomized into PTSS versus no PTSS, according to Data were collected using Google Forms, a tool that
33-cutoff point. automatically generates an Excel database, then transferred

Volume 9 Issue 1 (2023) 71 https://doi.org/10.36922/ijps.440