Abstract
BackgroundThe original Pittsburgh Fatigability Scale (PFS) was developed to assess perceived fatigability in older adults. The objective of this study was to translate the PFS into Dutch and investigate its validity and reliability among hospitalized older adults aged ≥70 years.MethodsThe PFS was translated into Dutch and pretested for comprehensibility by the Three-Step Test Interview method. The factor structure underlying the final version was evaluated by confirmatory factor analysis (CFA) and exploratory factor analyses (EFA). Internal consistency of the identified subscales was evaluated by Cronbach’s alpha. Construct validity was evaluated by hypothesis testing. Test-retest reliability was evaluated using intraclass correlation coefficients (ICC) and Bland Altman plots.ResultsThe validation sample included 233 patients. CFA of the original factor structure resulted in poor model fit in our Dutch sample. EFA of PFS physical and mental subscales resulted in a two-factor solution underlying the data with good internal consistency of the identified subscales (Cronbach’s alpha: 0.80–0.92). Five out of six hypotheses were confirmed, indicating good construct validity. Retest assessments were performed among 50 patients and showed good reliability for both the physical (ICC: 0.80, 95%CI: 0.68; 0.88) and mental subscale (ICC: 0.81, 95%CI: 0.68; 0.89).ConclusionThe Dutch PFS is a valid and reliable instrument to assess fatigability in older hospitalized patients.
Highlights
The original Pittsburgh Fatigability Scale (PFS) was developed to assess perceived fatigability in older adults
We identified two types of patients: 1. Patients who distinguished physical from mental fatigue using different definitions for both constructs; 2
To clarify the construct of mental fatigue to patients that requested, we stated that mental fatigability refers to fatigue of the mind, not fatigue of the body or muscles
Summary
The original Pittsburgh Fatigability Scale (PFS) was developed to assess perceived fatigability in older adults. Older adults often perceive fatigue without a clear physiological cause, which is suggested to be a consequence of aging in general [2, 3]. Prevalence rates of fatigue vary from 28 to 55% in adults aged 65 years and older and from 68 to 87% among the 85year olds depending on the measurement tool [2, 4]. Sedentary people may perceive lower fatigue levels than their more active counterparts, making their outcomes hard to compare and interpret. Fatigability, defined as the measurement of fatigue in relation to an activity of fixed intensity and duration, accounts for this so called self-pacing bias [7, 10]. Fatigability is a Feenstra et al BMC Geriatrics (2020) 20:234 more sensitive measure of someone’s susceptibility to fatigue, making this construct more suitable as a research outcome [7, 11, 12]
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