Abstract
ObjectivePrevious validation studies of the Chalder Fatigue Scale (CFS) suffer methodological shortcomings. The present study aimed to re-evaluate its psychometric properties using exploratory structural equation modeling (ESEM).MethodsA Chinese sample of 1259 community-dwelling residents completed the 11-item Chinese CFS and a variety of health measures (anxiety, depression, exhaustion, sleep disturbance, and quality of life). In addition to traditional confirmatory factor analysis, ESEM was performed to assess the fit of two- and three-factor models using robust maximum likelihood estimation and oblique geomin rotation. Convergent validity of the CFS was examined via associations with five covariates (gender, age, exercise, perceived health, and life event) and the health measures in the ESEM model.ResultsThe ESEM models displayed a superior fit to confirmatory factor models. The three-factor ESEM model showed a satisfactory model fit to the data but not for the two-factor model. The three factors were physical fatigue (three items, α = .800), low energy (four items, α = .821), and mental fatigue (four items, α = .861). The factors exhibited convergent validity with the model covariates and health measures.ConclusionThe results demonstrate the satisfactory reliability and convergent validity for the three-factor structure of the CFS as a valid measure of fatigue symptoms in the general population. Future psychometric studies could adopt the ESEM approach as a practical alternative to traditional confirmatory factor analysis.
Highlights
Chronic fatigue is a symptom commonly reported by patients in primary care practice and by the general population, with prevalence of 11.3 % among British primary care patients [1] and of 10.7 % among the general population of Hong Kong [2]
In addition to traditional confirmatory factor analysis, exploratory structural equation modeling (ESEM) was performed to assess the fit of two- and three-factor models using robust maximum likelihood estimation and oblique geomin rotation
Convergent validity of the Chalder Fatigue Scale (CFS) was examined via associations with five covariates and the health measures in the ESEM model
Summary
Chronic fatigue is a symptom commonly reported by patients in primary care practice and by the general population, with prevalence of 11.3 % among British primary care patients [1] and of 10.7 % among the general population of Hong Kong [2]. Patients with relapsing and unexplained fatigue that persists for at least 6 months are said to suffer from chronic fatigue syndrome. This debilitating syndrome is associated with significant disability in the functioning capacity of the cognitive and psychosocial domains [3]. Despite some empirical support for the two-factor structure [8, 10], previous validation studies of the CFS suffer methodological shortcomings. Most of these studies adopted the outdated principal component analysis and varimax
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