Qualitative Research on Fatigue Associated with Depression: Content Validity of the Fatigue Associated with Depression Questionnaire (FAsD-V2)

Abstract

BackgroundFatigue is one of the most common symptoms of major depressive disorder (MDD). The Fatigue Associated with Depression Questionnaire (FAsD) was developed to assess fatigue and its impact in patients with MDD. The current article presents the qualitative research conducted to develop and examine the content validity of the FAsD and FASD–Version 2 (FAsD–V2).MethodsThree phases of qualitative research were conducted with patients recruited from a geographically diverse range of clinics in the US. Phase I included concept elicitation focus groups, followed by cognitive interviews. Phase II employed similar techniques in a more targeted sample. Phase III included cognitive interviews to examine whether minor edits made after Phase II altered comprehensibility of the instrument. Concept elicitation focused on patients’ perceptions of fatigue and its impact. Cognitive interviews focused on comprehension, clarity, relevance, and comprehensiveness of the instrument. Data were collected using semi-structured discussion guides. Thematic analyses were conducted and saturation was examined.ResultsA total of 98 patients with MDD were included. Patients’ statements during concept elicitation in phases I and II supported item development and content. Cognitive interviews supported the relevance of the instrument in the target population, and patients consistently demonstrated a good understanding of the instructions, items, response options, and recall period. Minor changes to instructions for the FAsD–V2 did not affect interpretation of the instrument.ConclusionsThis qualitative research supports the content validity of the FAsD and FAsD–V2. These results add to previous quantitative psychometric analysis suggesting the FAsD–V2 is a useful tool for assessing fatigue and its impact in patients with MDD.

Fatigue and Depression in Iranian Amyotrophic Lateral Sclerosis Patients in Tehran in 2012

“…It was revealed that some changes in FAsD could be imposed and the way respondents defined the changes might be effective in interpretation of changes in treatment. Therefore, it can be concluded that FAsD can be used as an effective instrument for measuring the symptoms of fatigue among patients with depression ( 15 ).…”

Do adolescent risk assessment tools capture self-reported reasons for desistance? An examination of the content validity of protective factors

“…Although content validity analyses have not been conducted with risk assessment tools, studies examining evidence for content validity have been conducted within other fields, such as health psychology (e.g., Cervantes et al, 2012;Lasch et al, 2010;Matza et al, 2015;Olshansky et al, 2012;Tatlock et al, 2017). For instance, during the development of new tools, researchers have coded qualitative interview data about individuals' perceptions of the construct of interest, and used the themes to generate items or to revise existing measures (Cervantes et al, 2012;Olshanky et al, 2012).…”

“…First, this study is limited by the sample size of 8 participants. I initially aimed to recruit 30 participants, as this sample size would have been consistent with research examining content validity in health psychology (e.g., Olshansky et al, 2012;Matza et al, 2015;Tatlock et al, 2017) and research using qualitative data collection methods for assessing protective factors relevant to desistance (Amemiya et al, 2017). Also, within qualitative content analyses, it is recommended that data collection continues until a saturation point is achieved, in which additional data collection is unlikely to provide unique information (Cutliffe, 2000).…”

Symptom Descriptions in Psychopathology: How Well Are They Working for Us?

“…Consider the example of extreme fatigue, which is a common symptom of many medical and psychiatric conditions. People with significantly depressed mood commonly describe their fatigue as a feeling of heaviness, such that embarking on even simple tasks requires an enormous amount of effort (Matza et al, 2015). People reporting fatigue in the context of cancer commonly mention decreased physical performance, feelings of weakness, and an excessive need to rest after physical activity (Glaus, Crow, & Hammond, 1996), using phrases that often reference the body (e.g., “heavy limbs,” “legs like jelly/wobbly legs,” “feeling weak,” or “the body is worn out”; Bootsma, Schellekens, van Woezik, van der Lee, & Slatman, 2019).…”