Psychometric Properties of the HIV-Related Fatigue Scale

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The HIV-Related Fatigue Scale (HRFS) was developed to address the specific aspects of fatigue experienced by people who are HIV-positive and are not measured in any commonly used fatigue scale. The necessity for a new scale was determined after analysis of a qualitative study to explore HIV-related fatigue in which it was found that HIV-related fatigue has components related to intensity, circumstances, and consequences that must be included in the measurement of fatigue for this population. The HRFS has 56 items, most of which are on a 1-to-10 scale, drawn from five existing fatigue scales and the data from this qualitative study. The items were deemed content valid, easy to understand, and not fatiguing to complete by people with HIV-related fatigue. Cronbach's alpha for the entire tool was .94; internal consistency for each of the three preliminary subscales is reported as well. Test-retest reliability was moderate at r = .43. Further testing needs to be done, but the HRFS has the potential to be a valuable addition to the measurement of fatigue in seropositive persons.

Section snippets

Qualitative Study on HIV-Related Fatigue

Barroso (2001) conducted a qualitative study on the experience of HIV-related fatigue. A descriptive design was used to elicit in-depth descriptions of the symptom of fatigue from 31 participants who were recruited from a metropolitan area in the southeastern United States. The participants included 1 White female, 9 African American females, 7 White males, 13 African American males, and 1 African male who had recently emigrated from Uganda. The interview began with a statement asking the

Content Validity

Although the items selected for the HRFS were chosen because they corresponded to data from the qualitative work, it was still necessary to evaluate the content validity of the items as well as the entire tool. Using the procedure described by Lynn (1986), six participants rated each HRFS item on a scale from 1 (not relevant) to 4 (relevant and succinct as stated). Items were retained if 5 (of the 6) participants (83%) rated them as a 3 (relevant but in need of revision) or 4. All but two items

Readability

Four participants evaluated the ease of taking the HRFS—its directions, length, and clarity. All four of these participants found the scale easy to complete. Using the SMOG formula, which is the reading grade that a person must have reached if he or she is to fully understand the text, the reading level was found to be seventh grade.

A total of 54 participants completed the HRFS during the second psychometric testing phase. The typical participant was 41 years old (SD = 6.3), African American

Reliability Estimation

Although reliability would ultimately need to be evaluated for subscales or dimensions of the HRFS if they are found to exist, a preliminary assessment of reliability was conducted. First, the internal consistency (unidimensionality) of the instrument was assessed using Cronbach's (1951) coefficient alpha. The alpha on the entire instrument was σ = .94. The magnitude of this coefficient, although well in excess of the desired minimum of .70 for a newly developed tool (Nunnally, 1978), is due,

Summary

Atlhough the HRFS is in its early phases of development, at this point it has the potential to be a valuable addition to the measurement of this devastating component of the AIDS experience. Both face and content validity of the tool seem solidly determined, and early reliability estimations are good (internal consistency). The next step in the development and testing of the HRFS is to obtain data on the HRFS from several hundred participants so that the possible dimensions of the instrument

Acknowledgements

This research was supported by a University of North Carolina at Chapel Hill School of Nursing Faculty Research Opportunity Grant and a University of North Carolina at Chapel Hill School of Nursing Summer Research Award. The authors would like to acknowledge the assistance of Sue Richard.

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