Mead Gillian, Lynch Joanna, Greig Carolyn, Young Archie, Lewis Susan, Sharpe Michael
Geriatric Medicine, School of Clinical Sciences and Community Health, University of Edinburgh, New Royal Infirmary of Edinburgh, Edinburgh, UK.
Stroke. 2007 Jul;38(7):2090-5. doi: 10.1161/STROKEAHA.106.478941. Epub 2007 May 24.
There is little information on how to best measure poststroke fatigue. Our aim was to identify which currently available fatigue scale is most valid, feasible, and reliable in stroke patients.
Fatigue scales were identified by systematic search, and the 5 with the best face validity were identified by expert consensus. Feasibility (ie, did patients provide answers?) and internal consistency (an aspect of reliability) of these scales were evaluated by interviewing 55 stroke patients. Test-retest reliability was assessed by reinterviewing 51 patients, interrater reliability was assessed by rerating audio recordings, and convergent validity was assessed by measuring the correlation between scale scores.
Of the 52 scales identified, the SF-36v2 (vitality component), the fatigue subscale of the Profile of Mood States, the Fatigue Assessment Scale, the general subscale of the Multidimensional Fatigue Symptom Inventory, and the Brief Fatigue Inventory had the best face validity. The Brief Fatigue Inventory was unfeasible to administer and was omitted. Of the remaining 4 scales, the Fatigue Assessment Scale had the poorest internal consistency. Test-retest reliability for individual scale questions ranged from fair to good; the Fatigue Assessment Scale had the narrowest limits of agreement for the total score, indicating the best test-retest reliability. Interrater reliability for individual questions ranged from good to very good, and there was no significant mean difference in total scores for any scale. Convergent validity was moderate to high for the total scores of the 4 scales.
All four scales were valid and feasible to administer to stroke patients. The Fatigue Assessment Scale had the best test-retest reliability but the poorest internal consistency.
关于如何最佳地测量中风后疲劳的信息较少。我们的目的是确定目前哪种疲劳量表在中风患者中最有效、可行且可靠。
通过系统检索确定疲劳量表，并经专家共识确定5个表面效度最佳的量表。通过对55名中风患者进行访谈，评估这些量表的可行性（即患者是否提供了答案？）和内部一致性（可靠性的一个方面）。通过对51名患者进行再次访谈评估重测信度，通过对录音重新评分评估评分者间信度，并通过测量量表得分之间的相关性评估收敛效度。
在确定的52个量表中，SF - 36v2（活力分量表）、情绪状态剖面图疲劳分量表、疲劳评估量表、多维疲劳症状量表总体分量表和简明疲劳量表具有最佳的表面效度。简明疲劳量表实施不可行，被排除。在其余4个量表中，疲劳评估量表的内部一致性最差。各个量表问题的重测信度从一般到良好不等；疲劳评估量表总分的一致性界限最窄，表明重测信度最佳。各个问题的评分者间信度从良好到非常好，任何量表的总分均无显著平均差异。4个量表总分的收敛效度为中等至高度。
所有这四个量表对中风患者进行测量都是有效且可行的。疲劳评估量表的重测信度最佳，但内部一致性最差。
