Validated Measures Of Fatigue Research Articles

Development of a phone application for assessing fatigue levels in rare disorders: a feasibility and validity study

PurposeBarth syndrome (BTHS) is a rare genetic disorder characterized by skeletal myopathy, cardiomyopathy, and exercise intolerance due to early fatigue. The purpose of this study was to test the feasibility and validity of a new phone application designed to capture multi-dimensional aspects of fatigue across the lifespan. The specific study aims were to (1) assess the feasibility of using the app to record perceived fatigue levels in real-time, (2) evaluate discriminant validity by assessing if the app can differentiate between those with and without BTHS, and (3) content validity by assessing the relationship between perceived energy levels and actual energy expenditure.MethodsEighteen participants with BTHS and 18 age-matched control participants completed the study. The participants wore an activity tracker for 14 days and were prompted to respond to an Android app to report their fatigue levels 6 × /day. Statistical analysis was completed to examine perceived fatigue and the relationship between reported fatigue and actual energy expenditure.ResultsFeasibility was supported by the majority of participants responding to at least 50% of the application prompts and scores indicative of good internal consistency between responses (92–95%) and reliability of the battery scale (p < .001). Discriminant validity of the app was only partially supported, with the number of “crashes” being significantly different between those with and without BTHS (p = 0.042). Other measures of perceived fatigue were not found to be significantly different between groups, even though individuals with BTHS showed significantly lower energy expenditure than control participants during the day as measured by actigraphy (p < 0.001). Content validity of the app was supported, with perceived energy levels significantly correlating with actual energy expenditure collected with the activity tracker (p < 0.001).ConclusionsIn summary, the phone app developed by our team allowed researchers to capture the lived experience of individuals with BTHS while also capturing objective data. We verified that the app was able to consistently and accurately capture participant-reported fatigue. The battery scale tested as part of our feasibility aim was successful in capturing perceived levels of energy and can be used as a valid measure of fatigue in future studies. It was interesting to note that “crashes” appear to be the main differentiating factor in fatigue between the BTHS and control participants, where other measures of perceived fatigue were not found to be significantly different. These results highlight the complex nature of measuring fatigue as a subjective construct. This study provides foundational information on methods for quantifying fatigue in adults, adolescents, and children with BTHS and can provide possible targets for future therapeutic trials.

The Silhouettes Fatigue Scale: a validity study with individuals with physical disabilities and chronic pain

Purpose Fatigue is known to interfere with function in individuals with physical disabilities. In order to monitor changes in fatigue over time and evaluate the efficacy of treatments, psychometrically sound measures of fatigue are needed. The aim of this work was to evaluate the validity of the Silhouettes Fatigue Scale with English instructions (SFS-EN) in a sample of adults with physical disabilities living in the USA. Methods Individuals with medical conditions associated with physical disabilities responded to an online survey that included the SFS-EN as well as another validated measure of fatigue (PROMIS short form-4a Fatigue Scale), and measures of pain intensity and pain catastrophizing. Results 523 individuals participated (mean age = 59.1 years; SD = 11.4). Most participants were Caucasian (89%), women (59%) and unemployed (71%). Results showed strong positive correlations between both measures of fatigue, supporting the convergent validity of the SFS-EN. In addition, the magnitude of this association was significantly greater than the association between the scores of the SFS-EN and the measures of pain intensity and pain catastrophizing, supporting the former’s discriminant validity. Conclusions The findings extend previous results supporting the SFS as a brief, easy to administer and understand, and valid measure of fatigue. IMPLICATIONS FOR REHABILITATION Fatigue is common in adults with physical disabilities and chronic pain. The Silhouettes Fatigue Scale (SFS) is a new single-item measure of general fatigue. Findings show that the SFS with English instructions (SFS-EN) is an easy to understand measure. Results support the convergent and discriminant validity of the SFS-EN score in adults with physical disabilities and chronic pain.

The Silhouettes Fatigue Scale: comprehensibility and validity in older individuals

Purpose: Fatigue has been shown to be one of the key factors that interfere in the quality of life of elderly individuals. In order to understand its impact and evaluate the efficacy of treatments that target fatigue, researchers and clinicians need psychometrically sound and easy to use assessment instruments. The aim of this work was to address this need by evaluating the comprehensibility and validity of the Silhouettes Fatigue Scale (SFS) in a sample of older individuals.Methods: A total of 70 older individuals participated in the study. Participants were interviewed individually and asked to rate their level of fatigue during the week before the interview using the SFS and the FACIT-Fatigue Scale (to help evaluate convergent validity), and respond to the Pain Catastrophizing Scale (to help evaluate discriminant validity).Results: The results indicate that the SFS is understandable and that the scores have an adequate convergent validity and discriminant validity when used with older adults.Conclusions: The SFS is a valid measure of fatigue that can be used with older adults. It fills the need for a brief and easy to administer and score measure, which can be used in situations where assessment burden is a significant issue.Implications for rehabilitationFatigue is a significant problem among the elderly resulting in significant disability, and psychometrically sound and easy to use questionnaires are needed.The Silhouettes Fatigue Scale (SFS) is a new single-item self-report fatigue rating scale.Results show that the SFS is understandable, and that the scores have discriminant and convergent validity when used with older adults.As it does not use written items, it may be more easily understood by people who have basic or even no literacy level, thus making it easier to use for a wider audience.

Evaluation of the psychometric properties of the PROMIS Cancer Fatigue Short Form with cancer patients

ObjectiveFatigue is common among cancer patients and adversely impacts quality of life. As such, it is important to measure fatigue accurately in a way that is not burdensome to patients. The 7-item Patient Reported Outcome Measurement Information System (PROMIS) Cancer Fatigue Short Form scale was recently developed using item response theory (IRT). The current study evaluated the psychometric properties of this scale in two samples of cancer patients using classical test theory (CTT). MethodsTwo samples were used: 121 men with prostate cancer and 136 patients scheduled to undergo hematopoietic cell transplantation (HCT) for hematologic cancer. All participants completed the PROMIS Cancer Fatigue Short Form as well as validated measures of fatigue, vitality, and depression. HCT patients also completed measures of anxiety, perceived stress, and a clinical interview designed to identify cases of cancer-related fatigue. ResultsPROMIS Cancer Fatigue Short Form items loaded on a single factor (CFI=0.948) and the scale demonstrated good internal consistency reliability in both samples (Cronbach's alphas>0.86). Correlations with psychosocial measures were significant (p values<.0001) and in the expected direction, offering evidence for convergent and concurrent validity. PROMIS Fatigue scores were significantly higher in patients who met case definition criteria for cancer-related fatigue (p<.0001), demonstrating criterion validity. ConclusionThe current study provides evidence that the PROMIS Cancer Fatigue Short Form is a reliable and valid measure of fatigue in cancer patients.

Translation and adaptation of the Fatigue Severity Scale for use in Portugal

The Fatigue Severity Scale (FSS) is a widely used instrument to measure the impact of fatigue on specific types of functioning. This study aims to translate and test the reliability and validity of the Portuguese version of the FSS. The questionnaire was administered to a worker sample of 424 nurses. Reliability analysis showed satisfactory results (Cronbach's alpha coefficient = .87). The test–retest reliability was .85. The principal component analysis showed that the FSS was a measure with a one-factor structure. The construct validity of the total FSS score was assessed by correlation with Maslach Burnout Inventory (MBI) score, Depression Anxiety Stress Scale (DASS) score, and Visual Analogue Scale (VAS) score. Each of the corresponding correlation coefficients among the total FSS score and MBI score, DASS score, and perceived fatigue score (VAS) were .55 (p < .01), .62 (p < .01), and .68 (p < .01), respectively, which shows sufficient construct validity. To measure the discriminant validity of FSS, we examined the differences in scores between groups in terms of the number of hours of sleep and overtime. The less nurses slept and the longer they worked, the higher their total FSS score became. This preliminary validation study of the Portuguese version of FSS proved that it is an acceptable, reliable, and valid measure of fatigue in the working population.

COPD and Asthma Fatigue Scale (CAFS): Development and Psychometric Assessment

Objectives Patients with respiratory diseases report significant fatigue, but few measures have been developed to assess respiratory disease-related fatigue in patients with either asthma or chronic obstructive pulmonary disease (COPD). This study developed and evaluated the psychometric characteristics of the COPD and Asthma Fatigue Scale (CAFS), a respiratory disease-targeted scale. Study Design Patient qualitative data (focus groups and individual interviews) with COPD and asthma patients were used to generate the CAFS. An observational study involving patients with asthma or COPD from the US and UK was then conducted to assess the psychometric qualities of the CAFS. COPD patients completed the St. George’s Respiratory Questionnaire, asthma patients completed the Asthma Quality of Life Questionnaire, and selected clinical severity measures were collected for all patients. Results Qualitative data were obtained from 78 patients with COPD and 84 with asthma. The observational study included 311 patients with COPD and 324 with asthma. The final 12-item CAFS was confirmed based on factor and item analyses. Internal consistency was 0.95 (both groups) and test-retest reliability was 0.82 and 0.84 (COPD and asthma, respectively). In COPD patients, CAFS scores were significantly correlated with St. George’s Respiratory Questionnaire scores ( P <.0001); mean CAFS scores varied significantly by disease severity, exacerbations, and health status ( P ≤.0014). In asthma patients, CAFS scores were significantly correlated with Asthma Quality of Life Questionnaire scores ( P <.0001); mean CAFS scores varied significantly by disease severity, exacerbations, and health status (all P ≤.0024). Conclusions The CAFS was developed using systematic qualitative and psychometric methods and is a reliable and valid measure of fatigue in asthma or COPD patients.

Evaluation of validity for novel biomedical instrument measuring fatigue, sleep deprivation and performance capacity

The PMI FIT 2000–3 is an instrument that purports to measure fatigue, sleep deprivation and performance capacity by assessing pupil diameter, constriction amplitude, constriction latency and saccadic velocity and labeling the subject “High Risk” or “Low Risk”. The purpose of this study was to determine the validity of the instrument to detect fatigue in people. Twelve subjects were sleep deprived for 48 hours. The subjects were continuously monitored by the researchers to ensure wakefulness and were also assessed by the instrument every 4 hours. The results of the study showed that none of the subjects were labeled “High Risk” for fatigue at the end of the 48 hours. The distribution of “Low Risk” and “High Risk” assessments throughout the study period appeared random. In no case was a test subject labeled “High Risk” without being labeled “Low Risk” during the same test period. Overall, no test subject was consistently labeled “High Risk” for fatigue, poor performance or sleep deprivation at any time. Conclusions In this study, the PMI FIT 2000–3 failed to find any of the subjects fatigued or sleep deprived at the end of the 48-hour period by labeling them “High Risk”. The instrument failed to indicate a trend that the subjects were becoming more fatigued or sleep deprived as the 48-hour test period progressed. Of the four measurements listed above, only saccadic velocity showed any potential to indicate a trend towards fatigue, reduced performance or sleep deprivation. Therefore, from this study, we concluded that the PMI FIT 2000–3 is not a valid measure of fatigue, sleep deprivation or performance capacity. This study was funded by a grant from Aircraft Certification Branch of Transport Canada Civil Aviation.

P.1.062 Patient-rated improvements for sertraline non-responders treated with fluoxetine

This paper reports the development and validation of a questionnaire assessing fatigue and anemia-related concerns in people with cancer. Using the 28-item Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire as a base, 20 additional questions related to the symptoms and concerns of patients with anemia were developed. Thirteen of these 20 questions dealt with fatigue, while the remaining 7 covered other concerns related to anemia. Using semi-structured interviews with 14 anemic oncology patients and 5 oncology experts, two instruments were produced: The FACT-Fatigue (FACT-F), consisting of the FACT-G plus 13 fatigue items, and the FACT-Anemia (FACT-An), consisting of the FACT-F plus 7 nonfatigue items. These measures were, in turn, tested on a second sample of 50 cancer patients with hemoglobin levels ranging from 7 to 15.9 g/dl. The 41-item FACT-F and the 48 item FACT-An scores were found to be stable (test-retest r = 0.87 for both) and internally consistent (coefficient alpha range = 0.95–0.96). The symptom-specific subscales also showed good stability (test-retest r range = 0.84–0.90), and the Fatigue subscale showed strong internal consistency (coefficient alpha range = 0.93–0.95). Internal consistency of the miscellaneous nonfatigue items was lower but acceptable (alpha range = 0.59–0.70), particularly in light of their strong relationship to patient-rated performance status and hemoglobin level. Convergent and discriminant validity testing revealed a significant positive relationship with other known measures of fatigue, a significant negative relationship with vigor, and a predicted lack of relationship with social desirability. The total scores of both scales differentiated patients by hemoglobin level (p < 0.05) and patient-rated performance status (p < 0.0001). The 13-item Fatigue subscale of the FACT-F and the 7 nonfatigue items of the FACT-An also differentiated patients by hemoglobin level (p < 0.05) and patient-rated performance status (p ⩽ 0.001). The FACT-F and FACT-An are useful measures of quality of life in cancer treatment, adding more focus to the problems of fatigue and anemia. The Fatigue Subscale may also stand alone as a very brief, but reliable and valid measure of fatigue.

Measuring fatigue and other anemia-related symptoms with the Functional Assessment of Cancer Therapy (FACT) measurement system

This paper reports the development and validation of a questionnaire assessing fatigue and anemia-related concerns in people with cancer. Using the 28-item Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire as a base, 20 additional questions related to the symptoms and concerns of patients with anemia were developed. Thirteen of these 20 questions dealt with fatigue, while the remaining 7 covered other concerns related to anemia. Using semi-structured interviews with 14 anemic oncology patients and 5 oncology experts, two instruments were produced: The FACT-Fatigue (FACT-F), consisting of the FACT-G plus 13 fatigue items, and the FACT-Anemia (FACT-An), consisting of the FACT-F plus 7 nonfatigue items. These measures were, in turn, tested on a second sample of 50 cancer patients with hemoglobin levels ranging from 7 to 15.9 g/dl. The 41-item FACT-F and the 48 item FACT-An scores were found to be stable (test-retest r = 0.87 for both) and internally consistent (coefficient alpha range = 0.95–0.96). The symptom-specific subscales also showed good stability (test-retest r range = 0.84–0.90), and the Fatigue subscale showed strong internal consistency (coefficient alpha range = 0.93–0.95). Internal consistency of the miscellaneous nonfatigue items was lower but acceptable (alpha range = 0.59–0.70), particularly in light of their strong relationship to patient-rated performance status and hemoglobin level. Convergent and discriminant validity testing revealed a significant positive relationship with other known measures of fatigue, a significant negative relationship with vigor, and a predicted lack of relationship with social desirability. The total scores of both scales differentiated patients by hemoglobin level ( p < 0.05) and patient-rated performance status ( p < 0.0001). The 13-item Fatigue subscale of the FACT-F and the 7 nonfatigue items of the FACT-An also differentiated patients by hemoglobin level ( p < 0.05) and patient-rated performance status ( p ⩽ 0.001). The FACT-F and FACT-An are useful measures of quality of life in cancer treatment, adding more focus to the problems of fatigue and anemia. The Fatigue Subscale may also stand alone as a very brief, but reliable and valid measure of fatigue.