Abstract
BackgroundThe Multidimensional Fatigue Inventory (MFI-20) was developed in 1995. Since then, it has been widely used in cancer research and cancer-related illnesses but has never been validated in fatiguing illnesses or in a large US population-selected sample. In this study, we sought to examine the reliability and validity of the MFI-20 in the population of the state of Georgia, USA. Further, we assessed whether the MFI-20 could serve as a complementary diagnostic tool in chronically fatigued and unwell populations.MethodsThe data derive from a cross-sectional population-based study investigating the prevalence of chronic fatigue syndrome (CFS) in Georgia. The study sample was comprised of three diagnostic groups: CFS-like (292), chronically unwell (269), and well (222). Participants completed the MFI-20 along with several other measures of psychosocial functioning, including the Medical Outcomes Survey Short Form-36 (SF-36), the Zung Self-Rating Depression Scale (SDS), and the Spielberger State-Trait Anxiety Inventory (STAI). We assessed the five MFI-20 subscales using several criteria: inter-item correlations, corrected item-total correlations, internal consistency reliability (Cronbach's alpha coefficients), construct validity, discriminant (known-group) validity, floor/ceiling effects, and convergent validity through correlations with the SF-36, SDS, and STAI instruments.ResultsAveraged inter-item correlations ranged from 0.38 to 0.61, indicating no item redundancy. Corrected item-total correlations for all MFI-20 subscales were greater than 0.30, and Cronbach's alpha coefficients achieved an acceptable level of 0.70. No significant floor/ceiling effect was observed. Factor analysis demonstrated factorial complexity. The MFI-20 also distinguished clearly between three diagnostic groups on all subscales. Furthermore, correlations with depression (SDS), anxiety (STAI), and functional impairment (SF-36) demonstrated strong convergent validity.ConclusionsThis study provides support for the MFI-20 as a valuable tool when used in chronically unwell and well populations. It also suggests that the MFI-20 could serve as a complementary diagnostic tool in fatiguing illnesses, such as CFS.
Highlights
The Multidimensional Fatigue Inventory (MFI-20) was developed in 1995
The national Canadian Community Health Survey reported that 36% of individuals with chronic fatigue syndrome (CFS) were depressed [12], whereas a population-based study of CFS reported that 22% of individuals with CFS in Georgia had major depressive disorder, and 46% had anxiety disorders [13]
37% had been classified as CFSlike based on the detailed telephone interview, 34% were chronically unwell, and 28% were considered well
Summary
The Multidimensional Fatigue Inventory (MFI-20) was developed in 1995. Since it has been widely used in cancer research and cancer-related illnesses but has never been validated in fatiguing illnesses or in a large US population-selected sample. We sought to examine the reliability and validity of the MFI-20 in the population of the state of Georgia, USA. We assessed whether the MFI-20 could serve as a complementary diagnostic tool in chronically fatigued and unwell populations. Fatigue is a common symptom associated with numerous acute and chronic illnesses. High levels of fatigue negatively affect quality of life for patients with cancer, Parkinson's disease, multiple sclerosis, and persons with less well-understood illnesses such as chronic fatigue syndrome (CFS) and fibromyalgia [36]. Several standardized instruments have been designed to evaluate fatigue, they have not been validated across illnesses in adults
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