Dimensionality, psychometric properties, and population-based norms of the Turkish version of the Chalder Fatigue Scale among adults

Rıdvan M Adın; Ali Naim Ceren; Yeliz Salcı; Ayla Fil Balkan; Kadriye Armutlu; Çiğdem Ayhan Kuru

doi:10.1186/s12955-022-02074-x

Dimensionality, psychometric properties, and population-based norms of the Turkish version of the Chalder Fatigue Scale among adults

Health Qual Life Outcomes. 2022 Dec 7;20(1):161. doi: 10.1186/s12955-022-02074-x.

Authors

Rıdvan M Adın¹, Ali Naim Ceren², Yeliz Salcı², Ayla Fil Balkan², Kadriye Armutlu², Çiğdem Ayhan Kuru²

Affiliations

¹ Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey. ridvanadin1@gmail.com.
² Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.

Abstract

Background: Fatigue is emerging as a major public health problem that is highly associated with poor health-related quality of life and disability. Among adults, fatigue has become increasingly common because of workload or lifestyle changes. This study aimed to cross-culturally adapt the Chalder Fatigue Scale (CFS) into Turkish, to investigate its psychometric properties, and to establish normative data in healthy adults by age and gender.

Methods: The validity of the CFS was tested with a total sample of 476 healthy adults aged 20-40 years (264 males and 212 females) and test-retest/measurement error analyses were performed with 161 participants (94 males and 67 females). The test-retest reliability was examined using the intraclass correlation coefficient (ICC), and internal consistency was determined using Cronbach's α-coefficient. Predictive validity was assessed using the Receiver Operating Characteristic to validate the cut-off value of the CFS for non-fatigued and fatigued participants. Factor analyses and hypothesis testing were conducted to assess construct validity. Hypothesis testing examined convergent and known-group validity by testing 14 predefined hypotheses.

Results: The mean (SD) and median (25-75%) CFS scores were 10.7 (4.9) and 11 (7-14) for the total sample (n = 476). The cut-off point for CFS was set at ≥ 12 with a sensitivity of 65.8% and a specificity of 85.9%. The CFS provided evidence of excellent fit of the two-factor structure (CFI = 0.963, RMSEA = 0.06, SRMR = 0.02). There was evidence of strong internal consistency demonstrated by Cronbach's α = 0.863 and good test-retest reliability by ICC = 0.76. Thirteen out of 14 hypotheses (92.9%) were confirmed and the scale showed low to moderate correlation with other measurement instruments (r = 0.31-0.51).

Conclusions: The CFS has been shown to be a reliable and valid instrument that can be used in various populations for the assessment of fatigue.

Level of evidence: Level II.

Keywords: Fatigue; Public health; Quality of life; Reliability; Translation; Validity.

MeSH terms

Fatigue*
Humans
Quality of Life*
Reproducibility of Results
Research Design*
Workload