Abstract
PurposeFatigue is a common symptom in children and adolescents. Its negative impact on health outcomes is even more pronounced in those with chronic pain. There is currently no fatigue measurement tool in German that is validated for both children and adolescents with and without chronic pain. Therefore, this study aimed to gather quantitative validity evidence to support the use of the German version of the PROMIS® Pediatric Short Form v2.0 - Fatigue 10a (PROMIS® F-SF) in the German pediatric general population as well as in German pediatric chronic pain patients.MethodsThe 10-item self-assessment questionnaire was validated in a sample of N = 1348 school children (9–18 years; 52.4% female) and N = 114 pediatric chronic pain patients (8–17 years; 63.3% female). Construct and convergent validity, reliability, and item and scale characteristics were examined.ResultsConfirmatory factor analyses showed sufficient model fit for the 1-factor model of the questionnaire (school sample: CFI = 0.94, RMSEA = 0.10, SRMR = 0.04; patient sample: CFI = 0.90, RMSEA = 0.14, SRMR = 0.05). Convergent validity was supported by weak-to-large significant correlations with sleep quality, health-related quality of life (HRQoL), and pain characteristics. The questionnaire had excellent internal consistency in both samples (α = 0.92 and α = 0.93). Sex differences and age distributions of the PROMIS® F-SF showed that girls reported significantly higher fatigue than boys and that fatigue increased with age.ConclusionThe PROMIS® F-SF is a reliable instrument with good psychometric properties. Preliminary evidence is provided that the questionnaire validly measures fatigue in children and adolescents with and without chronic pain.
Highlights
Fatigue exhibits itself in symptoms like intense tiredness, lack of energy, and a feeling of profound weakness and exhaustion that can manifest mentally or physically [1,2,3]
The aim of this study was to validate the German version of the PROMIS® F-SF for both school children and pediatric chronic pain patients
Internal consistency of the questionnaire is excellent. Due to these additional psychometric characteristics and considering international comparability of questionnaire results, the model was maintained in its original form despite the limited model fit
Summary
Fatigue exhibits itself in symptoms like intense tiredness, lack of energy, and a feeling of profound weakness and exhaustion that can manifest mentally or physically [1,2,3]. Research shows that 20% of adolescent girls suffer from severe fatigue compared to only 6% of adolescent boys [5]. 11% of children aged 11–14 years and 17% of those aged 13–16 years suffer from severe fatigue [4]. Fatigue has a negative impact on health outcomes in children and adolescents including sleep disturbances, impaired social relationships, school absence, anxiety, depression, and poorer quality of life [3, 5]. Previous research shows that fatigue negatively impacts pain characteristics such as pain intensity [12, 16], functional disability [16], and pain-related school absenteeism [11, 16, 17]
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