School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, and Healthy Ageing Research Center, Chang Gung University, Taoyuan, Taiwan.
Healthy Ageing Research Center, Chang Gung University, Taoyuan, Taiwan.
PLoS One. 2018 May 10;13(5):e0189850. doi: 10.1371/journal.pone.0189850. eCollection 2018.
Fatigue is a common symptom in the general population and has a substantial effect on individuals' quality of life. The Multidimensional Fatigue Inventory (MFI) has been widely used to quantify the impact of fatigue, but no Traditional Chinese translation has yet been validated. The goal of this study was to translate the MFI from English into Traditional Chinese ('the MFI-TC') and subsequently to examine its validity and reliability.
The study recruited a convenience sample of 123 people from various age groups in Taiwan. The MFI was examined using a two-step process: (1) translation and back-translation of the instrument; and (2) examination of construct validity, convergent validity, internal consistency, test-retest reliability, and measurement error. The validity and reliability of the MFI-TC were assessed by factor analysis, Spearman rho correlation coefficient, Cronbach's alpha coefficient, intraclass correlation coefficient (ICC), minimal detectable change (MDC), and Bland-Altman analysis. All participants completed the Short-Form-36 Health Survey Taiwan Form (SF-36-T) and the Chinese version of the Pittsburgh Sleep Quality Index (PSQI) concurrently to test the convergent validity of the MFI-TC. Test-retest reliability was assessed by readministration of the MFI-TC after a 1-week interval.
Factor analysis confirmed the four dimensions of fatigue: general/physical fatigue, reduced activity, reduced motivation, and mental fatigue. A four-factor model was extracted, combining general fatigue and physical fatigue as one factor. The results demonstrated moderate convergent validity when correlating fatigue (MFI-TC) with quality of life (SF-36-T) and sleep disturbances (PSQI) (Spearman's rho = 0.68 and 0.47, respectively). Cronbach's alpha for the MFI-TC total scale and subscales ranged from 0.73 (mental fatigue subscale) to 0.92 (MFI-TC total scale). ICCs ranged from 0.85 (reduced motivation) to 0.94 (MFI-TC total scale), and the MDC ranged from 2.33 points (mental fatigue) to 9.5 points (MFI-TC total scale). The Bland-Altman analyses showed no significant systematic bias between the repeated assessments.
The results support the use of the Traditional Chinese version of the MFI as a comprehensive instrument for measuring specific aspects of fatigue. Clinicians and researchers should consider interpreting general fatigue and physical fatigue as one subscale when measuring fatigue in Traditional Chinese-speaking populations.
疲劳是普通人群中常见的症状，对个体的生活质量有重大影响。多维疲劳量表（MFI）已广泛用于量化疲劳的影响，但尚未有经过验证的繁体中文版。本研究旨在将 MFI 从英文翻译成繁体中文（“MFI-TC”），并随后检验其有效性和可靠性。
研究招募了来自台湾不同年龄段的 123 名方便样本。MFI 采用两步法进行检查：（1）仪器的翻译和回译；（2）检验结构有效性、收敛有效性、内部一致性、测试-重测可靠性和测量误差。通过因子分析、斯皮尔曼 rho 相关系数、克朗巴赫 alpha 系数、组内相关系数（ICC）、最小可检测变化（MDC）和 Bland-Altman 分析评估 MFI-TC 的有效性和可靠性。所有参与者同时完成简短健康调查台湾版（SF-36-T）和匹兹堡睡眠质量指数（PSQI）的中文版本，以检验 MFI-TC 的收敛有效性。通过在一周间隔后重新进行 MFI-TC 评估来检验测试-重测可靠性。
因子分析证实疲劳有四个维度：一般/身体疲劳、活动减少、动机减少和精神疲劳。提取出一个四因素模型，将一般疲劳和身体疲劳组合成一个因素。当将疲劳（MFI-TC）与生活质量（SF-36-T）和睡眠障碍（PSQI）相关联时，结果显示出中度的收敛有效性（Spearman 的 rho 值分别为 0.68 和 0.47）。MFI-TC 总量表和分量表的克朗巴赫 alpha 值范围为 0.73（精神疲劳分量表）至 0.92（MFI-TC 总量表）。ICC 范围为 0.85（动机减少）至 0.94（MFI-TC 总量表），MDC 范围为 2.33 点（精神疲劳）至 9.5 点（MFI-TC 总量表）。Bland-Altman 分析表明，两次评估之间没有明显的系统偏差。
结果支持使用繁体中文版 MFI 作为一种全面的工具来衡量繁体中文人群中特定的疲劳方面。临床医生和研究人员在测量繁体中文人群的疲劳时，应考虑将一般疲劳和身体疲劳视为一个分量表。
