Dornonville de la Cour Frederik Lehman, Schow Trine, Andersen Tonny Elmose, Petersen Annemarie Hilkjær, Zornhagen Gry, Visser-Keizer Annemarie C, Norup Anne
Cervello, 2800 Kongens Lyngby, Denmark.
Department of Psychology, University of Southern Denmark, 5230 Odense, Denmark.
J Clin Med. 2023 Mar 29;12(7):2587. doi: 10.3390/jcm12072587.
Fatigue is a major issue in neurorehabilitation without a gold standard for assessment. The purpose of this study was to evaluate measurement properties of the five subscales of the self-report questionnaire the Dutch Multifactor Fatigue Scale (DMFS) among Danish adults with acquired brain injury. A multicenter study was conducted ( = 149, 92.6% with stroke), including a stroke unit and three community-based rehabilitation centers. Unidimensionality and measurement invariance across rehabilitation settings were tested using confirmatory factor analysis. External validity with Depression Anxiety Stress Scales (DASS-21) and the EQ-5D-5L was investigated using correlational analysis. Results were mixed. Unidimensionality and partial invariance were supported for the Impact of Fatigue, Mental Fatigue, and Signs and Direct Consequences of Fatigue, range: RMSEA = 0.07-0.08, CFI = 0.94-0.99, ω = 0.78-0.90. Coping with Fatigue provided poor model fit, RMSEA = 0.15, CFI = 0.81, ω = 0.46, and Physical Fatigue exhibited local dependence. Correlations among the DMFS, DASS-21, and EQ-5D-5L were in expected directions but in larger magnitudes compared to previous research. In conclusion, three subscales of the DMFS are recommended for assessing fatigue in early and late rehabilitation, and these may facilitate the targeting of interventions across transitions in neurorehabilitation. Subscales were strongly interrelated, and the factor solution needs evaluation.
疲劳是神经康复中的一个主要问题，目前尚无评估的金标准。本研究的目的是评估荷兰多因素疲劳量表（DMFS）自填问卷的五个子量表在丹麦获得性脑损伤成年人中的测量属性。进行了一项多中心研究（n = 149，92.6%为中风患者），包括一个中风单元和三个社区康复中心。使用验证性因子分析测试了康复环境中的单维性和测量不变性。使用相关分析研究了与抑郁焦虑压力量表（DASS - 21）和EQ - 5D - 5L的外部效度。结果喜忧参半。疲劳影响、精神疲劳以及疲劳的体征和直接后果的单维性和部分不变性得到支持，范围：RMSEA = 0.07 - 0.08，CFI = 0.94 - 0.99，ω = 0.78 - 0.90。应对疲劳的模型拟合较差，RMSEA = 0.15，CFI = 0.81，ω = 0.46，身体疲劳表现出局部依赖性。DMFS、DASS - 21和EQ - 5D - 5L之间的相关性方向符合预期，但与先前研究相比幅度更大。总之，推荐使用DMFS的三个子量表来评估早期和晚期康复中的疲劳，这可能有助于在神经康复的过渡阶段针对性地进行干预。子量表之间高度相关，因子解决方案需要评估。
