Psychometric study of Turkish version of Fatigue Impact Scale in multiple sclerosis patients
Introduction
The most common and disabling symptom in multiple sclerosis (MS) is severe fatigue, present in 65 to 97% of MS patients [1], [2], [3], [4], [5], [6]. Fatigue induced by MS is different from those seen in healthy people [7]. It is unique to the disorder and is not just an extreme form of the “tiredness” but rather a “short-circuiting” type of fatigue which is incompatible with the activities performed. 15–40% of MS patients complain fatigue as a disabling problem that causes mainly physical, social, and cognitive incapacity as well as unemployment [8], [9], [10].
In order to evaluate the multidimensional aspect of fatigue, several scales have been developed. Fatigue Impact Scale (FIS) (Fisk et al., 1994) is a commonly used fatigue scale in both clinical and experimental studies [11].
We planned to test the validity, test–retest reliability, and internal consistency of Turkish version of FIS; the variables affecting FIS score.
Section snippets
Fatigue Impact Scale
FIS is a multidimensional scale measuring the physical, cognitive, and social effects of fatigue. It comprises 40 questions, of which 10 related to cognitive, 10 to physical, and 20 to social subscales. Each question scores between 1 and 4, changing from minimal to severe degrees. The maximum total score is 160.
We defined the level of patients’ disability using Expanded Disability Status Scale (EDSS) [12] before the application of FIS. Additionally, Beck Depression Inventory (BDI), was applied
Results
The demographic and clinical characteristics of MS patients and healthy volunteers were given in Table 1. There was no statistically significant difference between two groups regarding age, gender, and education level, but marital status was different between groups.
Total FIS score and physical and social subscale scores were different statistically between MS patients and healthy volunteers in both first and second FIS applications (p < 0.001). Although cognitive subscale scores were similar in
Discussion
FIS is a multidimensional scale for the measurement of the effects of fatigue on the daily life activities and quality of life of MS patients. Although it was shortened from 40 questions for practical reasons, we planned to validate the original version of the scale in this study. German and Swedish versions of FIS were developed before [15], [16].
In our study, MS patients and healthy volunteers were different regarding marital status. Being a divorcee or single may affect the psychological
Conclusion
In this validation study of FIS, the most remarkable differences had been found also in social and physical subscales. The cognitive subscale differed the least. However our results showed that FIS is validated in divergent direction. After the effect of depression was eliminated, FIS total, physical, and social subscale scores were still significantly high in MS patients. There was no valid cognitive subscale, when the effect of depression was eliminated.
High Cronbach's alpha values indicate
Acknowledgments
We are gratefully indebted to all of the participants in this study, who so willingly shared their life experiences of MS-related fatigue with us. We are also grateful to the staff working within the MED-ILAC.
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2023, Multiple Sclerosis and Related DisordersCitation Excerpt :The Modified Fatigue Impact Scale (MFIS), the patient-reported outcome measure, provides an assessment of the effects of fatigue in terms of physical, cognitive, and psychosocial functioning (Fisk et al., 1994). The original version of the MFIS was reliable and valid for Turkish pwMS (Armutlu et al., 2007). The Multiple Sclerosis International Quality of Life (MusiQoL) questionnaire is a multidimensional, self-administered disease-specific quality of life scale.