Rasch analysis of the Fatigue Severity Scale in multiple sclerosis

Mills, Roger; Young, Carolyn A; Nicholas, RS; Pallant, JF; Tennant, Alan

doi:10.1177/1352458508096215

Cited by 95 publications

(91 citation statements)

References 18 publications

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“…The Fatigue Severity Scale (FSS), which has been applied in the present study, is a widely used scale with good psychometric properties [4,5]. The FSS was found to be unidimensional in patients with Parkinson's disease [6], while this was not the case in a more recent analysis of a large group of MS patients [7]. As a consequence, the authors of the latter study suggested using a reduced 5-item version of the FSS for studies with MS patients.…”

Section: Introductionmentioning

confidence: 66%

Fatigue, sleepiness, and physical activity in patients with multiple sclerosis

et al. 2010

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Fatigue is a frequent and disabling symptom in patients with multiple sclerosis (MS). The objective of the study was to compare fatigue and sleepiness in MS, and their relationship to physical activity. Eighty patients with MS rated the extent of experienced fatigue (Fatigue Severity Scale, FSS) and sleepiness (Epworth Sleepiness Scale, ESS). The relationship between the scales was analysed for the scales as a whole and for single items. The clinical status of the patients was measured with the Extended Disability Status Scale (EDSS). In addition, physical activity was recorded continuously for 1 week by wrist actigraphy. The mean scores of fatigue and sleepiness were significantly correlated (FSS vs. ESS r=0.42). Single item analysis suggests that fatigue and sleepiness converge for situations that demand self-paced activation, while they differ for situations in which external cues contribute to the level of activation. While fatigue correlated significantly with age (r=0.40), disease severity (EDSS, r=0.38), and disease duration (r=0.25), this was not the case for sleepiness. Single patient analysis showed a larger scatter of sleepiness scores in fatigued patients (FSS>4) than in non-fatigued patients. Probably, there is a subgroup of MS patients with sleep disturbances that rate high on ESS and FSS. The amount of physical activity, which was measured actigraphically, decreased with disease severity (EDSS) while it did not correlate with fatigue or sleepiness.

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Section: Introductionmentioning

confidence: 66%

Fatigue, sleepiness, and physical activity in patients with multiple sclerosis

et al. 2010

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“…This could be an explanation why the ICCs found in this study were higher than in the other studies. Another limitation is that FSS and MFIS were used as comparator instruments despite their problems regarding reliability and validity 4,6 . These were administered in the present study because there were no other Brazilian specific instrument for assessing MS fatigue.…”

Section: Discussionmentioning

confidence: 99%

“…Considering limitations relating to the most widely used instruments for assessing MS fatigue (FSS and MFIS) 4,6,12 , hypotheses were made to include other instruments, so as to attribute more evidence for checking the construct validity of the NFI-MS/BR. Even though the correlation scores turned out to be very low between the nonsimilar subscales of the instruments that measure the same construct all the hypotheses were confirmed.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, they were not specifically developed for MS patients 4,5,6 . Studies using the Rasch measurement model have identified a need for certain items to be removed from the FSS [4] and MFIS [6] so that their measurements can be considered valid and reliable.In Brazil, FSS 7 and MFIS 8 have been widely used, despite the failings of their design and psychometric properties in Brazilian cross-cultural adaptation studies. These Brazilian versions did not fulfill the criteria for adequate sample size and design.…”

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confidence: 99%

“…The Fatigue Severity Scale (FSS) 2 and Modified Fatigue Impact Scale (MFIS) 3 are the most widely used instruments for measuring MS fatigue, although limitations regarding their development and measurement properties have been reported. Moreover, they were not specifically developed for MS patients 4,5,6 . Studies using the Rasch measurement model have identified a need for certain items to be removed from the FSS [4] and MFIS [6] so that their measurements can be considered valid and reliable.…”

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Validation of the Brazilian version of the neurological fatigue index for multiple sclerosis

Lopes

Lavado

Kaimen-Maciel

2016

Arq. Neuro-Psiquiatr.

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Fatigue is the most frequent and severe of symptoms causing morbidity and disability in multiple sclerosis (MS) patients. However, measuring fatigue is a difficult task. There is no clear definition; it is complex and multidimensional, and is a highly subjective symptom with many uncertainties regarding its pathophysiology. No biological or neuroimaging markers for fatigue are currently known 1 . The lack of standardization for fatigue measurement has resulted in development of several assessment instruments, but none of them is universally accepted. The Fatigue Severity Scale (FSS) 2 and Modified Fatigue Impact Scale (MFIS) 3 are the most widely used instruments for measuring MS fatigue, although limitations regarding their development and measurement properties have been reported. Moreover, they were not specifically developed for MS patients 4,5,6 . Studies using the Rasch measurement model have identified a need for certain items to be removed from the FSS [4] and MFIS [6] so that their measurements can be considered valid and reliable.In Brazil, FSS 7 and MFIS 8 have been widely used, despite the failings of their design and psychometric properties in Brazilian cross-cultural adaptation studies. These Brazilian versions did not fulfill the criteria for adequate sample size and design. Moreover, the psychometric properties of the Brazilian FSS adaptation were not assessed. Therefore, there are no Brazilian MS-specific instrument for assessing fatigue with reported methodological and psychometric properties ABstrACtThe Neurological Fatigue Index for Multiple Sclerosis (NFI-MS) is a new fatigue assessment instrument. The aim of this study was to cross-culturally adapt and assess the psychometric properties of the Brazilian version of the NFI-MS (NFI-MS/BR). Method: Two hundred and forty subjects with MS were recruited for this study. The adaptation of the NFI-MS was performed by translation and back translation methodology. In psychometric analysis was performed the administration of the questionnaires Epworth Sleep Scale, Fatigue Severity Scale, Modified Fatigue Impact Scale, Multiple Sclerosis Impact Scale-29, NFI-MS/BR and Pittsburgh Sleep Quality Index with retest of the NFI-MS/BR after 7 days. Results: Reliability was assessed (intraclass correlation coefficients between 0.77 and 0.86), and validity by testing 41 hypotheses about expected correlations between subscales and confirmed 36. The majority of correlations were demonstrated. Conclusion: The NFI-MS/BR is a cross-culturally adapted, valid, and reliable instrument for assessing MS fatigue among Brazilian subjects.Keywords: multiple sclerosis; fatigue; assessment; validation studies; psychometrics. resumo O índice neurológico de fadiga na esclerose múltipla (EM) (NFI-MS) é um novo instrumento de avaliação da fadiga. O objetivo deste estudo foi adaptar transculturalmente e avaliar as propriedades psicométricas da versão Brasileira do NFI-MS (NFI-MS/BR).Método: Duzentos e quarenta indivíduos com EM participaram deste estudo. A adaptação do NFI-MS/BR f...

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