Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
Inflamm Bowel Dis. 2024 Jan 5;30(1):53-63. doi: 10.1093/ibd/izad038.
Fatigue is highly prevalent in people with inflammatory bowel disease (IBD). Fatigue scales are important for studies testing fatigue interventions, but information about psychometric properties of many scales is insufficient in IBD. We compared the psychometric properties of multiple generic fatigue scales in participants with IBD.
Individuals with IBD (N = 216) completed the Daily Fatigue Impact Scale (DFIS), the vitality subscale of the RAND-36, and the Patient Health Questionnaire-9 (PHQ-9) fatigue item twice. A subgroup (n = 84) also completed the Fatigue Impact Scale (FIS) once, from which we also scored the 21 items from the Modified Fatigue Impact Scale (MFIS-IBD). We assessed floor/ceiling effects, construct validity, and internal consistency reliability. Using relative efficiency (RE), we compared discriminating ability and comparative responsiveness of the measures regarding disease activity and employment status and changes.
The FIS, MFIS, and RAND-36-vitality scales did not exhibit floor or ceiling effects. The DFIS showed mild floor effects (19.4%), and the PHQ-9 fatigue item showed floor (18.1%) and ceiling (20.8%) effects. Internal consistency reliability exceeded 0.93 for FIS, MFIS-IBD, and DFIS and was 0.81 for the RAND-36-vitality scale. In the subgroup analysis, the FIS, MFIS-IBD, and DFIS were strongly correlated with each other (r ≥ 0.90). The ability to discriminate between disease activity groups was highest for the FIS and MFIS-IBD, followed by the DFIS. The FIS, MFIS-IBD, and DFIS were responsive to changes in work impairment.
The FIS, MFIS-IBDs and DFIS had adequate validity and reliability for assessing fatigue in IBD.
炎症性肠病（IBD）患者普遍存在疲劳。疲劳量表对于测试疲劳干预措施的研究很重要，但关于许多量表的心理测量特性的信息在 IBD 中不足。我们比较了 IBD 患者中多种通用疲劳量表的心理测量特性。
216 名 IBD 患者完成了每日疲劳影响量表（DFIS）、RAND-36 活力分量表和患者健康问卷-9（PHQ-9）疲劳项目两次。一个亚组（n=84）还完成了疲劳影响量表（FIS）一次，我们还从其中评分了修改后的疲劳影响量表（MFIS-IBD）的 21 项。我们评估了地板/天花板效应、结构有效性和内部一致性可靠性。使用相对效率（RE），我们比较了这些措施在疾病活动和就业状态以及变化方面的区分能力和比较反应性。
FIS、MFIS 和 RAND-36 活力量表没有地板或天花板效应。DFIS 表现出轻度地板效应（19.4%），PHQ-9 疲劳项目表现出地板（18.1%）和天花板（20.8%）效应。FIS、MFIS-IBD 和 DFIS 的内部一致性可靠性超过 0.93，RAND-36 活力量表为 0.81。在亚组分析中，FIS、MFIS-IBD 和 DFIS 彼此之间高度相关（r≥0.90）。FIS 和 MFIS-IBD 对疾病活动组的区分能力最高，其次是 DFIS。FIS、MFIS-IBD 和 DFIS 对工作障碍的变化敏感。
FIS、MFIS-IBD 和 DFIS 具有足够的有效性和可靠性，可用于评估 IBD 中的疲劳。
