Measuring fatigue following stroke: the Chinese version of the Fatigue Assessment Scale

Abstract

Purpose: The aim of this study was to translate and adapt the Fatigue Assessment Scale into Chinese, examine its psychometric properties, determine the levels of physical and mental fatigue, and compare the fatigue scores in stroke survivors with and without depressive symptoms.

Methods: The translation was conducted according to established guidelines and psychometric properties were examined in 112 stroke survivors. Physical and mental fatigue scores and between-group difference were compared.

Results: Content validity was good. Internal consistency (Cronbach's α = 0.71-0.82) and test-retest reliability (intraclass correlation coefficient = 0.77-0.95; κ = 0.38-0.83) were satisfactory. Minimal detectable change was good. The scale had two factors without ceiling and floor effects. Significant correlations were found between the Chinese version of the Fatigue Assessment Scale and the Mental Fatigue Scale (r_s = 0.68), Fatigue Severity Scale (r_s = 0.57), Epworth Sleepiness Scale (r_s = 0.36), and Fugl-Meyer Assessment of upper (r_s = 0.24) and lower extremities (r_s = 0.24). Physical fatigue score was higher than mental fatigue score (12.00 vs. 10.00). Participants with depressive symptoms had higher fatigue sum, physical, and mental scores than those without.

Conclusion: The Chinese version of the Fatigue Assessment Scale is reliable and valid for assessing fatigue. The level of physical fatigue was higher than that of mental fatigue. Participants with depressive symptoms had higher fatigue scores than those without.Implications for rehabilitationThe Fatigue Assessment Scale has been translated and culturally adapted into Chinese. It is reliable and valid for evaluating fatigue in stroke survivors in both clinical and research settings.The Chinese version of the Fatigue Assessment Scale significantly correlated with the Mental Fatigue Scale, Fatigue Severity Scale, Epworth Sleepiness Scale, and Fugl-Meyer Assessment of upper and lower extremities.The level of physical fatigue was higher than that of mental fatigue in community-dwelling stroke survivors so interventions could target physical fatigue.More attention should be paid to stroke survivors with depressive symptoms as their level of fatigue was higher than those without.

Keywords: Chinese; fatigue; independent living; reproducibility of results; stroke.