Dataset Information

Further validation of the Multidimensional Fatigue Inventory in a US adult population sample.

ABSTRACT:

Background

The Multidimensional Fatigue Inventory (MFI-20) was developed in 1995. Since then, it has been widely used in cancer research and cancer-related illnesses but has never been validated in fatiguing illnesses or in a large US population-selected sample. In this study, we sought to examine the reliability and validity of the MFI-20 in the population of the state of Georgia, USA. Further, we assessed whether the MFI-20 could serve as a complementary diagnostic tool in chronically fatigued and unwell populations.

Methods

The data derive from a cross-sectional population-based study investigating the prevalence of chronic fatigue syndrome (CFS) in Georgia. The study sample was comprised of three diagnostic groups: CFS-like (292), chronically unwell (269), and well (222). Participants completed the MFI-20 along with several other measures of psychosocial functioning, including the Medical Outcomes Survey Short Form-36 (SF-36), the Zung Self-Rating Depression Scale (SDS), and the Spielberger State-Trait Anxiety Inventory (STAI). We assessed the five MFI-20 subscales using several criteria: inter-item correlations, corrected item-total correlations, internal consistency reliability (Cronbach's alpha coefficients), construct validity, discriminant (known-group) validity, floor/ceiling effects, and convergent validity through correlations with the SF-36, SDS, and STAI instruments.

Results

Averaged inter-item correlations ranged from 0.38 to 0.61, indicating no item redundancy. Corrected item-total correlations for all MFI-20 subscales were greater than 0.30, and Cronbach's alpha coefficients achieved an acceptable level of 0.70. No significant floor/ceiling effect was observed. Factor analysis demonstrated factorial complexity. The MFI-20 also distinguished clearly between three diagnostic groups on all subscales. Furthermore, correlations with depression (SDS), anxiety (STAI), and functional impairment (SF-36) demonstrated strong convergent validity.

Conclusions

This study provides support for the MFI-20 as a valuable tool when used in chronically unwell and well populations. It also suggests that the MFI-20 could serve as a complementary diagnostic tool in fatiguing illnesses, such as CFS.

SUBMITTER: Lin JM

PROVIDER: S-EPMC2801470 | biostudies-literature | 2009 Dec

REPOSITORIES: biostudies-literature

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Publications

Further validation of the Multidimensional Fatigue Inventory in a US adult population sample.

Lin Jin-Mann S JM Brimmer Dana J DJ Maloney Elizabeth M EM Nyarko Ernestina E Belue Rhonda R Reeves William C WC

Population health metrics 20091215

<h4>Background</h4>The Multidimensional Fatigue Inventory (MFI-20) was developed in 1995. Since then, it has been widely used in cancer research and cancer-related illnesses but has never been validated in fatiguing illnesses or in a large US population-selected sample. In this study, we sought to examine the reliability and validity of the MFI-20 in the population of the state of Georgia, USA. Further, we assessed whether the MFI-20 could serve as a complementary diagnostic tool in chronically ...[more]

PMID: 20003524

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Project description: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.

Project description:BackgroundBecause of the absence of biological parameters for fatigue, appropriate instruments for assessing the degree of fatigue are important in the diagnosis and management of people complaining of fatigue-like symptoms. This study statistically analyzed the fatigue scores from two typical questionnaire-based instruments: the Korean version of the Multidimensional Fatigue Inventory (MFI-K) and the modified Chalder Fatigue Scale (mKCFQ).MethodsSeventy participants (males n = 40, females n = 30, median age 48 years old, range of 25-67) were grouped into three groups ('mild' = 20, 'moderate' = 42, and 'severe' = 8) according to self-reported fatigue levels using a 7-point Likert scale. The similarities and differences between two instrument-derived scores were analyzed using correlations (r) and multidimensional scaling (MDS).ResultsThe total scores of the two assessments were significantly correlated (r = 75%, p < 0.001), as were the subscores ('Total Physical fatigue': r = 76%, p < 0.001, 'Total Mental fatigue': r = 56%, p < 0.001). Relative overestimation of the MFI-K (45.8 ± 11.3) compared to the mKCFQ (36.1 ± 16.2) was observed, which was especially prominent in the 'mild' group. The scores of the three groups were more easily distinguished by the mKCFQ than by the MFI-K. In terms of the five dimension scores, we found a higher correlation of the two assessments for 'general fatigue' (r = 79%, p < 0.001) and 'physical fatigue' (r = 66%, p < 0.001) than for the reductions in 'motivation' (r = 41%, p < 0.01) and 'activity' (r = 26%, p > 0.05).ConclusionsOur results may indicate the usefulness of the two instruments, especially for the physical symptoms of fatigue ('general' and 'physical' fatigue). Furthermore, the MFI-K may be useful for conditions of moderate-to-severe fatigue, such as chronic fatigue syndrome, but the mKCFQ may be useful for all spectra of fatigue, including in subhealthy people.

Project description:BackgroundFatigue often occurs as long-term complication in chronically critically ill (CCI) patients after prolonged intensive care treatment. The Multidimensional Fatigue Inventory (MFI-20) has been established as valid instrument to measure fatigue in a wide range of medical illnesses. Regarding the measurement of fatigue in CCI patients, the psychometric properties of the MFI-20 have not been investigated so far. Thus, the present study examines reliability and validity of the MFI-20 in CCI patients.MethodsA convenience sample of n?=?195 patients with Critical Illness Polyneuropathy (CIP) or Myopathy (CIM) were recruited via personal contact within four weeks (t1) following the transfer from acute care ICU to post-acute ICU at a large rehabilitation hospital. N?=?113 (median age 61.1 yrs., 72.6% men) patients were again contacted via telephone three (t2) and six (t3) months following the transfer to post-acute ICU. The MFI-20, the Euro-Quality of Life (EQ-5D-3 L) and the Structured Clinical Interview for the Diagnostic and Statistical Manual of mental disorders DSM-IV (SCID-I) were applied within this prospective cohort study.ResultsThe internal consistency Cronbach's ? was adequate for the MFI-total and all but the subscale Reduced Motivation (RM) (range: .50-.91). Item-to-total correlations (range: .22-.80) indicated item redundancy for the subscale RM. Confirmatory Factor analyses (CFAs) revealed poor model fit for the original 5-factor model of the MFI-20 (t2/t3, Confirmatory Fit Index, CFI?=?.783/ .834; Tucker-Lewis Index, TLI?=?.751/ .809; Root Mean Square Error of Approximation, RMSEA?=?.112/ .103). Among the alternative models (1-, 2-, 3-factor models), the data best fit to a 3-factor solution summarizing the highly correlated factors General -/ Physical Fatigue/ Reduced Activity (GF/ PF/ RA) (t2/ t3, CFI?=?.878/ .896, TLI?=?.846/ .869, RMSEA?=?.089/ .085, 90% Confidence Interval .073-.104/ .066-.104). The MFI-total score significantly correlated with the health-related quality of life (range: -.65-(-).66) and the diagnosis of major depression (range: .27-.37).ConclusionsIn the present sample of CCI patients, a reliable and valid factor structure of the MFI-20 could not be ascertained. Especially the subscale RM should be revised. Since the factors GF, PF and RA cannot be separated from each other and the unclear factorial structure in the present sample of CCI patients, the MFI-20 is not recommended for use in this context.Trial registrationGerman Clinical Trials Registration DRKS00003386 . Registered 13 December 2011, retrospectively registered.

Project description:ObjectiveMultidimensional computerized adaptive testing enables precise measurements of patient-reported outcomes at an individual level across different dimensions. This study examined the construct validity of a multidimensional computerized adaptive test (CAT) for fatigue in rheumatoid arthritis (RA).MethodsThe 'CAT Fatigue RA' was constructed based on a previously calibrated item bank. It contains 196 items and three dimensions: 'severity', 'impact' and 'variability' of fatigue. The CAT was administered to 166 patients with RA. They also completed a traditional, multidimensional fatigue questionnaire (BRAF-MDQ) and the SF-36 in order to examine the CAT's construct validity. A priori criterion for construct validity was that 75% of the correlations between the CAT dimensions and the subscales of the other questionnaires were as expected. Furthermore, comprehensive use of the item bank, measurement precision and score distribution were investigated.ResultsThe a priori criterion for construct validity was supported for two of the three CAT dimensions (severity and impact but not for variability). For severity and impact, 87% of the correlations with the subscales of the well-established questionnaires were as expected but for variability, 53% of the hypothesised relations were found. Eighty-nine percent of the items were selected between one and 137 times for CAT administrations. Measurement precision was excellent for the severity and impact dimensions, with more than 90% of the CAT administrations reaching a standard error below 0.32. The variability dimension showed good measurement precision with 90% of the CAT administrations reaching a standard error below 0.44. No floor- or ceiling-effects were found for the three dimensions.ConclusionThe CAT Fatigue RA showed good construct validity and excellent measurement precision on the dimensions severity and impact. The dimension variability had less ideal measurement characteristics, pointing to the need to recalibrate the CAT item bank with a two-dimensional model, solely consisting of severity and impact.

Project description:Driving style is an important factor in driving psychology, which is useful for effectively evaluating driving behaviors. Exploring driving style in a Chinese sample could help understand the overall situation of Chinese drivers. This study aims to develop a measurement of driving style fit for the Chinese situation and to validate the validity and reliability of this scale. In this study, 296 drivers from China completed the Chinese version of the multidimensional driving style inventory (MDSI), the Big Five Inventory (BFI), and the Driver Behavior Questionnaire (DBQ) as well as several questions about socio-demographic information. After testing the assumed structure by a confirmatory factor analysis, and adjusting the structure, a brief version of Chinese version of MDSI with twelve items categorized into four driving styles, namely, risky style, angry- high-velocity style, careful style and anxious style was revised. The validity and reliability of the scales were acceptable. The results showed that driving styles were closely correlated with self-reported driving behaviors. Specifically, risky style, angry- high-velocity style, and anxious style are all positively associated with dangerous driving behaviors. Meanwhile, careful style was positively associated with positive driving behaviors and negatively correlated with dangerous driving behaviors. Anxious was also found to be negatively associated with fines. For personality, we found a positive relationship between risky, angry- high-velocity, careful and anxious styles and the personality traits that often have negative effects on driving, such as extraversion and neuroticism. Meanwhile, these three styles were negatively correlated with conscientiousness and agreeableness in general. In addition, careful style was positively correlated with conscientiousness and agreeableness. The current study shows convincing evidence for the validity and reliability of the brief MDSI-C and develops a useful tool for identify the driving style of Chinese drivers for future research and relevant departments of road safety.

Dataset Information

Further validation of the Multidimensional Fatigue Inventory in a US adult population sample.

Background

Methods

Results

Conclusions

Publications

Further validation of the Multidimensional Fatigue Inventory in a US adult population sample.

Similar Datasets

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