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 rehabilitation

• The 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

Acknowledgements

The authors are grateful to Mr Peiming Chen and Ms Carrie Wong for their assistance in recruiting the participants. The authors also thank Mr Kenny Chin for his support with the statistical analysis. The authors sincerely thank all of the participants for their participation.

Disclosure statement

The authors declare that they had no conflicts of interest.

Additional information

Funding

This work was supported by the Hong Kong Polytechnic University, and the Departmental Research Grant [Ref: 90013897] from the Department of Rehabilitation Sciences, The Hong Kong Polytechnic University.