Mattsson M, Möller B, Lundberg Ie, Gard G, Boström C
Department of Physiotherapy, Sunderby Hospital, Luleå, Sweden.
Scand J Rheumatol. 2008 Jul-Aug;37(4):269-77. doi: 10.1080/03009740801914868.
The aim was to translate, test, and describe aspects of reliability and validity of the Fatigue Severity Scale (FSS) in Swedish (FSS-Swe) in patients with systemic lupus erythematosus (SLE).
Patients with stable SLE, low or moderate disease activity, and low organ damage were included. Forward and back translations of the FSS were performed. Construct validity was tested with 32 women using a first Swedish translation. Feasibility, ceiling and floor effects, internal consistency, test-retest reliability, and content validity were tested on a slightly modified final version of the FSS-Swe in a non-selected group of patients (n = 23).
There were correlations (p< or =0.05) between the FSS-Swe and overall disease activity according to the Systemic Lupus Activity Measure (SLAM) (r(s) = 0.48) and the SLAM Visual Analogue Scale (SLAM-VAS) (r(s) = 0.46); between the FSS-Swe and eight subscales of the Swedish 36-Item Medical Outcomes Study Short-Form Health Survey (SF-36) (r(s) = -0.41 to -0.65) and between the FSS-Swe and age (r(s) = -0.35). All patients answered all FSS-Swe questions at both test and retest. There was one ceiling effect in one question on one occasion. The Kolmogorov-Smirnov test indicated normal distribution. Cronbach's alpha was 0.94 and corrected item-to-total correlation exceeded 0.3. There were no significant systematic test-retest differences, and the median-weighted kappa coefficient was 0.75. Twenty patients understood the questions in FSS-Swe, 18 considered they were relevant, reflected their fatigue, and that none should be excluded. Five items were suggested to be included.
The FSS-Swe supports construct validity, is feasible, has no important ceiling or floor effects, has satisfactory internal consistency, substantial test-retest reliability, and satisfactory content validity in the SLE patients studied. However, its sensitivity to change needs to be tested.
旨在翻译、测试并描述系统性红斑狼疮（SLE）患者中瑞典语版疲劳严重程度量表（FSS - Swe）的可靠性和有效性方面。
纳入病情稳定、疾病活动度低或中度且器官损害程度低的SLE患者。对FSS进行了正向和反向翻译。使用首个瑞典语翻译版本对32名女性进行了结构效度测试。在一组未经过筛选的患者（n = 23）中，对经过轻微修改的FSS - Swe最终版本进行了可行性、天花板效应和地板效应、内部一致性、重测信度以及内容效度测试。
根据系统性红斑狼疮活动度量表（SLAM）（r(s) = 0.48）和SLAM视觉模拟量表（SLAM - VAS）（r(s) = 0.46），FSS - Swe与总体疾病活动度之间存在相关性（p≤0.05）；FSS - Swe与瑞典36项医学结局研究简表健康调查（SF - 36）的8个分量表之间存在相关性（r(s) = -0.41至 -0.65），且FSS - Swe与年龄之间存在相关性（r(s) = -0.35）。所有患者在测试和重测时都回答了所有FSS - Swe问题。在一次测试中，有一个问题出现了一次天花板效应。Kolmogorov - Smirnov检验表明呈正态分布。Cronbach's alpha为0.94，校正后的项目与总分相关性超过0.3。重测时没有显著的系统差异，中位数加权kappa系数为0.75。20名患者理解FSS - Swe中的问题，18名患者认为这些问题相关，反映了他们的疲劳，且不应排除任何一项。建议纳入5个项目。
FSS - Swe支持结构效度，可行，无重要的天花板或地板效应，具有令人满意的内部一致性、较高的重测信度以及在所研究的SLE患者中具有令人满意的内容效度。然而，其对变化的敏感性需要进行测试。
