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CME/MOC

Outcome Measures

Fatigue

Authors: Maarten Van Herck, Yvonne Goërtz

This section on fatigue, defined as " a subjective, unpleasant symptom which incorporates total body feelings ranging from tiredness to exhaustion creating an unrelenting overall condition which interferes with individuals' ability to function to their normal capacity" (Ream & Richardson, 1997), presents questionnaires that have been used as outcomes in pulmonary rehabilitation. To-date, various questionnaires exist to measure the symptom of fatigue: from single- and multi-item primary questionnaires to "surrogate" measures, i. e. instruments that are comprised of fatigue as one of several domains. The instruments described are both primary as well as surrogate measures. In general, the use of fatigue-specific measures are preferred however, one could argue for a surrogate measure in certain circumstances. The information provided should guide the reader in the selection of the most appropriate fatigue measure.

 

Brief Fatigue Inventory (BFI)

  Description
Name of Questionnaire Brief Fatigue Inventory
Abbreviation/Alternate Name BFI
Description Developed to assess the severity and impact of fatigue on daily functioning over past 24 hours. Initially developed to explore fatigue in cancer patients 1
Developer Tito R. Mendoza
E-mail symptomresearch@mdanderson.org
Cost Licensing fees and a $100 processing fee may apply. Fees vary depending on the type and extent of use, the setting, and who is sponsoring the research.
License required Yes
Self-or rater-administered Self-administered or interview
Time to complete 5 minutes
Number of items 9 items
Domains & categories (#) 2
Name of domains/ categories Intensity (3 items) Interference (6 items)
Scaling of items Likert 0-10 Scale (0=no fatigue or does not interfere, 10=bad fatigue or completely interferes with activity/work)
Scoring Global fatigue score obtained by averaging 9 items. Score of ≥7 considered clinically significant 1
Test-retest/reproducibility Test-retest (ICC in COPD over 7 days): Total score= 0.86; Intensity= 0.87; Interference=0.872
Internal consistency (Cronbach's α; COPD): 0.96 2
Validity Construct:  Factor analysis provided evidence that the items in the BFI measured the intended constructs 2
Convergent:  ρ = -0.83 (CRQ-SAS; COPD) 2

Discriminant: BFI score did not show significant difference among people with different levels of severity of COPD 2
Responsiveness to PR Used in PR setting. No pre-post comparisons have been made 3
MID N/A
Languages 45 languages: psychometrical and Linguistical validity established for Arabic 4 , Chinese 5 , Filipino 6 , German 7 , Greek 8 , Indonesian 9 , Italian 10 , Japanese 11 , Korean 12
References
  1. Mendoza TR et al. Cancer. 1999; 85:1186-1196.
  2. Chen YW et al. J Pain Symptom Manage. 2016; 52:298-304.
  3. Chen YW et al. COPD. 2018; 15:65-72.
  4. Suleiman K et al. East Mediterr Health J. 2019; 25:784-790.
  5. Wang XS et al. J Pain Symptom Manage. 2004; 27:322-332.
  6. Mendoza TR et al. Oncology. 2010; 79:112-117.
  7. Radbruch L et al. J Pain Symptom Manage. 2003; 25:449-458.
  8. Mystakidou K et al. J Pain Symptom Manage. 2008; 36:367-373.
  9. Paramita N et al. J Pain Symptom Manage. 2016; 52:744-751.
  10. Catania G et al. Support Care Cancer. 2013; 21:413-419.
  11. Okuyama T et al. J Pain Symptom Manage. 2003; 25:106-117.
  12. Yun YH et al. J Pain Symptom Manage. 2005; 29:165-172.
Date of most recent changes May 2022

 

Checklist Individual Strength – Subscale subjective fatigue (CIS-Fatigue)

  Description
Name of Questionnaire Checklist Individual Strength subscale fatigue severity
Abbreviation/Alternate Name CIS-Fatigue
Description Fatigue is one aspect measured by the CIS. Fatigue subscale consists of 8 items, evaluating how participants fatigue felt during the last 2 wks 1,2
Developer Jan H.M.M. Vercoulen
E-mail jan.vercoulen@radboudumc.nl
Cost Free if following references are used 1,2
License required No
Self-or rater-administered Self-administered
Time to complete <5 minutes
Number of items 8
Domains & categories (#) 1
Name of domains/ categories N/A
Scaling of items Seven-point Likert Scale (1 = yes, that is true, 7 = no, that is not true)
Scoring Score derived by summation of the separate item scores, ranging from 8-56. Reversed scoring is applied to some items. Higher scores reflect more severe fatigue. Score of ≤26 points indicate normal fatigue, 27-35 moderate, and ≥36 points severe 3, 4
Test-retest/ reproducibility Test-retest reliability: N/A Internal consistency: Cronbach's α 0.82 in Asthma 5; 0.83 COPD) 6
Validity Convergent validity: ρ = 0.455 ACQ total score in Asthma 7; ρ = -0.554 AQLQ total score in Asthma 7; r = 0.584 CAT in COPD) 8; ρ = -0.414 (EQ-5D-5L index in sarcoidosis 9; ρ = -0.577 EQ-5D-5L index in IPF convergent 9

Discriminant validity: r = 0.076 GOLD grade in COPD 8
Responsiveness to PR Mean change in PR -10.4±11.7 points, p<0.01 in COPD; 12-week inpatient 10; -5.8±10.2 points 95% CI 8.7 to 3.0, p<0.01 in COPD; 12-week community-based 11
MID 10 points 10,11,12
Languages >10 languages (Dutch, English, Japanese, Turkish, German, Spanish, Swedish, French, Portuguese, Polish, Chinese)
References
  1. Vercoulen JHMM et al. J Psychosom Res. 1994;38:383-392.
  2. Vercoulen JHMM et al. Gedragstherapie. 1999;32:131-6.
  3. Vercoulen J. Informatie voor gebruikers van de Checklist Individuele Spankracht (CIS). Radboud Universiteit Nijmegen Medisch Centrum.
  4. Worm-Smeitink M et al. J Psychosom Res. 2017;98:40-46.
  5. Peters JB et al. Respir Med. 2014; 108:278-86.
  6. Peters JB et al. Qual Life Res. 2009; 18:901-12.
  7. Van Herck M et al. J Clin Med. 2018;7:471.
  8. Goërtz YMJG et al. Ther Adv Respir Dis. 2019; 13:1-13.
  9. Bloem et al. J Clin Med. 2020;9:1178.
  10. Van Herck M et al. J Clin Med. 2019;8:1264.
  11. Rebelo P et al. Chest. 2020;158:550-561.
  12. Peters JB et al. Patient Educ Couns. 2011;85:281-5.
Date of most recent changes May 2022

 

Chronic Respiratory Disease Questionnaire – Fatigue domain (CRQ fatigue)

  Description
Name of Questionnaire  Chronic Respiratory Disease Questionnaire – Fatigue domain
Abbreviation/Alternate Name  CRDQ–Fatigue
Description  20-item disease-specific HRQoL questionnaire developed to measure the impact of COPD on a person's life. Four domains; dyspnea, fatigue, emotional function, and mastery 1.
Developer  Gordon H. Guyatt 
E-mail guyatt@mcmaster.ca
Cost  Yes. Contact McMaster Industry Liaison Office (milo@mcmaster.ca)
License required  Yes. Copyright © 2001 McMaster University, Hamilton, Ontario, CA
Self-or rater-administered  Developed initially as an interviewer administered questionnaire. 1
Self-report (CRQ-SR) subsequently developed. 2
Time to complete  Estimate <1 minute 
Number of items  4 items 
Domains & categories (#)  1
Name of domains/ categories  Fatigue
Scaling of items  7-point Scale (1=maximum impairment, 7=no impairment)
Scoring  Mean score of 4 items. Higher scores indicate less fatigue.
Test-retest/ reproducibility Test-retest reliability: reproducibility: Coefficient of variation (within person standard deviation divided by the mean) 9% for fatigue1; 0.90 (Rho; Spearman-Brown reliability coefficient; COPD) 3; 0.95 (ICC at 7 days in COPD); 0.87 (at 7 weeks) 2;0.80 (ICC; COPD; 3 months) 4
Internal consistency: (Cronbach's α in COPD) 0.71-0.94 3,5,6,7
Validity Criterium: r = -0.74 (POMS-fatigue) 8; r = 0.75 (SF36-vitality; COPD) 9
Convergent (in COPD): r = 0.55 (SCL-90–somatization) 3; r = -0.700 (SGRQ total) and .528 to -0.616 (subdomains) 6
Responsiveness to PR  Mean change: 0.68 points 95% CI 0.45 to 0.92 (COPD) 10
MID  0.5 points 11,12
Languages  20 languages (https://eprovide.mapi-trust.org/instruments/chronic-respiratory-disease-questionnaire)
References
  1. Guyatt GH et al. Thorax. 1987; 42:773-778.
  2. Williams JEA et.al. Thorax. 2001; 56:954-959.
  3. Wijkstra PJ et al. Thorax. 1994; 49:465-467.
  4. Güell R et al. Eur Respir J. 1998; 11:55-60.
  5. Harper R et al. Thorax. 1997; 52:879-887.
  6. Rutten-van Mölken M et al. Thorax. 1999; 54:995-1003.
  7. Hajiro T et al. Am J Respir Crit Care Med. 1998; 157(3 Pt 1):785-790.
  8. Larson JL et al . Am Rev Respir Dis. 1993; 147:A530.
  9. Waterhouse JC et al. Eur Respir J. 1994; 7(Suppl):419s.
  10. McCarthy B et al. Cochrane Database Syst Rev. 2015; 23: CD003793.
  11. Redelmeier DA et al. J Clin Epidemiol. 1996; 49:1215-1219.
  12. Jaeschke R et al. Control Clin Trials. 1989; 10:407-415.
Date of most recent changes  May 2022

 

Functional Assessment of Chronic Illness Therapy – Fatigue scale (FACIT-Fatigue)

  Description
Name of Questionnaire Functional Assessment of Chronic Illness Therapy – Fatigue Scale
Abbreviation/Alternate Name FACIT-Fatigue
Description A 13-item measure that assesses fatigue and its impact on daily activities and function1,2A 40-item FACIT-Fatigue scale (FACIT-F) and a modified shorter version 9-item FACIT-Fatigue scale (modified FACIT-Fatigue) exist.
Developer David Cella
E-mail https://www.facit.org/contact-us
Cost Non-commercial use is assessed on a case-by-case basis
License required Yes, however licensing fees typically not applied to investigator-initiated research, students, or clinical use
Self-or rater-administered Self-administered and by interview
Time to complete 5 minutes
Number of items 13
Domains & categories (#) 1
Name of domains/ categories Fatigue
Scaling of items 5-point Scale (0=not at all, 4=very much). Some items are reverse scored1,2,3
Scoring Scores range 0-52 points. Lower scores= worse level of fatigue. Score of ≤43 points indicate clinically relevant fatigue1,2,3
Test-retest/ reproducibility Test-retest in COPD: 0.86 [95% CI: 0.77; 0.92] (ICC; 2 days)4Internal consistency Cronbach’s α in COPD: 0.92 (self-administered)5; 0.83 (in-person/interview)4; 0.84 (telephone/interview)4
Validity Convergent in COPD: r =-0.705 and r=-0.616 (SGRQ Total Score); ρ =-0.60 (CAT)7;ρ =0.60 (EQ-5D-5L VAS)7; r =-0.59 (MaRSS) 8
Responsiveness to PR Mean change: 3.7±7.1 points, 95% CI 1.7 to 5.6 (p<0.01; 12-week community-based PR; COPD)9
MID 4.79
Languages 72 languages (https://www.facit.org/measure-languages/FACIT-Fatigue-Languages)
References
  1. Cella D. Center on Outcomes, Research and Education (Core), Evanston Northwestern Healthcare and Northwestern University, 1997.
  2. Cella D et al. Cancer. 2002; 94:528-538
  3. Webster K et al. Health Qual Life Outcomes. 2003; 16:1:79.
  4. Rocha V et al. Fron Rehabilit Sci. 2021; 2:729190.
  5. Al-shair K et al. Health Qual Life Outcomes. 2012; 23:10:100.
  6. Baghai-Ravary R et al. Respir Med. 2009; 103:216-223.
  7. Stridsman C et al. Ther Adv Respir Dis. 2018; 12:1753466618787380.
  8. Khan N et al. Int J Chron Obstruct Pulmon Dis. 2018; 13:3885-3894.
  9. Rebelo P et al. Chest. 2020; 158:550-561.
Date of most recent changes May 2022

 

Fatigue Severity Scale (FSS)

  Description
Name of Questionnaire Fatigue Severity Scale
Abbreviation/Alternate Name FSS
Description Initially developed to assess fatigue in Multiple Sclerosis and Systemic Lupus Erythematosus 1 . Used in various populations including COPD2. Evaluates effects of fatigue on motivation, physical activity, work, family and social life in the past week
Developer Lauren B. Krupp
E-mail lauren.krupp@stonybrook.edu / lkrupp@notes.cc.sunysb.edu
Cost Free
License required Contact developer by e-mail
Self-or rater-administered Self-administered
Time to complete <5 minutes
Number of items 9
Domains & categories (#) 1
Name of domains/ categories Fatigue
Scaling of items 7-point Scale (1 = strongly disagree, 7 = strongly agree)
Scoring Global score by summing and averaging scores on 9 items. Higher scores reflect greater fatigue. Score of ≥4 points considered a high level of fatigue3,4,5
Test-retest/ reproducibility Test-retest in COPD: Bland & Altman plots showed bias ratio was nearly zero2 Intra-rater reliability ICC in COPD: 0.90 [95% CI 0.81-0.94] at 2 weeks 2; 0.95 [95% CI 0.92-0.98] at 30-min intervals 2 Internal consistency Cronbach’s α in COPD 0.902
Validity Convergent in COPD: r =0.69 (MRC dyspnea)2; r =-0.77 (6MWD)2; r =0.37 (GOLD grade)2
Responsiveness to PR Decrease (pre: 4.6±1.7 points; post: 3.9±1.6; p<0.0208) in FSS 6-week outpatient PR; advanced lung diseases6
MID N/A
Languages Psychometric and Linguistic validity established for English1, Arabic 7, Chinese8, Swedish9, Danish10, Finnish11, Portuguese2,12, Turkish4, Persian13, Dutch14, German/Swiss5,  Greek15 
References
  1. Krupp LB et al. Arch Neurol. 1989;46:1121-1123.
  2. Valderramas S et al. J Bras Pneumol. 2013;39:427-433.
  3. Krupp LB et al. Neurology. 1995;45:1956-1961.
  4. Armutlu K et al. Int J Rehabil Res. 2007;30:81-85.
  5. Valko PO et al. Sleep. 2008;31:1601-1607.
  6. Talwar A et al. Pneumonol Alergol Pol. 2014;82:534-540.
  7. Al-Sobayel HI et al. Saudi Med J. 2016;37:73-78.
  8. Feng C et al. Health Qual Life Outcomes. 2019;17:71.
  9. Mattsson M et al. Scand J Rheumatol. 2008;37:269-77.
  10. Lorentzen K et al. Dan Med J. 2014;61:A4808.
  11. Rosti-Otajarvi E et al. Brain Behav. 2017;7:e00743.
  12. Laranjeira CA. Appl Nurs Res. 2012;25:212-217.
  13. Azimian M et al. Res J Biol Sci. 2009;4:974-977.
  14. Rietberg MB et al. Disabil Rehabil. 2010;32:1870-1876.
  15. Bakalidou D et al. V Springerplus. 2013;2:304 .
Date of most recent changes May 2022

 

Multidimensional Assessment of Fatigue (MAF)

  Description
Name of Questionnaire Multidimensional Assessment of Fatigue
Abbreviation/Alternate Name MAF
Description A revision of Piper Fatigue Scale1,2. Originally developed in rheumatoid arthritis, tested in other conditions including pulmonary disease and healthy controls. Fatigue patterns for the past week.
Developer Basia Belza
E-mail basiab@u.washington.edu
Cost Fees may apply for funded academic users, healthcare organizations, commercial users and IT companies. Free for students, physicians, clinical practice, non-funded academic users.
License required MAF © Basia Belza, 1993. All Rights Reserved. https://eprovide.mapi-trust.org/instruments/multidimensional-assessment-of-fatigue
Self-or rater-administered Self-administered
Time to complete 5-10 minutes
Number of items 16
Domains & categories (#) 4
Name of domains/ categories Severity (2 items), Distress (1 item), Degree of interference with ADLs (11 items), Timing (2 items)
Scaling of items Items 1-14, Visual Analogue Scales (1 = not at all, 10 = a great deal). Items 15-16 multiple-choice responses with categorical responses from 1 to 4 points2
Scoring Item 15 is converted to a 0-10 scale by multiplying the score by 2.5. Mean score of items 4-14 calculated. Global Fatigue Index (GFI), the following items are summed: item 1-3, mean of items 4-14, and newly calculated item 15. The GFI ranges from 1 (no fatigue) to 50 points (severe fatigue)2,3. Item 16 is not included in the GFI.
Test-retest/ reproducibility Not assessed for reliability/reproducibility in pulmonary diseases
Validity Concurrent in COPD for GFI: r=-0.64 (SOLDQ subscales physical); r =-0.55 (emotional function); r =-0.60 (coping skills); r=-0.53(SF-36 Veterans subscales physical), r =-0.62 (mental)4
Responsiveness to PR Mean change: -3.8±8.4 points (p≤0.001; stable obstructive and restrictive pulmonary disease; 8-week outpatient PR)4
MID NA
Languages >30 languages
References
  1. Piper B et al. New York: springer 1989, pp.199-208.
  2. Belza BL et al. Nursing Research, 1993; 42(2):93-99.
  3. Belza BL et al. J Nurs Meas. 2018 1;26(1):36-75.
  4. Belza B et al. J Cardiopulm Rehabil. 2005;25(2):107-14.
Date of most recent changes May 2022

 

Manchester COPD Fatigue Scale (MCFS)

  Description
Name of Questionnaire The Manchester COPD Fatigue Scale
Abbreviation/Alternate Name MCFS
Description A disease-specific evaluation of level of fatigue, in past 2 weeks1.
Developer The early COPD fatigue scale was developed through a collaboration between GlaxoSmithhKline and the clinical research organisation Oxford Outcomes
E-mail Khaled.Al-shair@postgrad.manchester.ac.uk
Cost NA
License required NA
Self-or rater-administered Self-administered
Time to complete 5-10 minutes
Number of items 27
Domains & categories (#) 3
Name of domains/ categories Physical (11 items), Cognitive (7), Psychosocial (9)
Scaling of items 5-point; 0 =never, 0.5 =rarely, 1 =sometimes, 1.5 =usually, 2 =always
Scoring Total score ranges =0-54 points, higher scores more severe fatigue
Test-retest/ reproducibility Test-retest in COPD:

ICC= 0.97 (total), 0.96 (physical), 0.91 (cognitive), 0.95 (psychosocial)1

Bland-Altman plot showed a small, statistically significant mean difference (p = 0.8 total, 0.5 physical, 0.6 cognitive, 0.6 psychosocial, and 95% limits of agreement of repeatability of -7.00 to +7.44 (total) -2.98 to +3.42 (physical), -2.77 to +3.07 (cognitive), -3.25 to +3.55 (psychosocial)1

Internal consistency Cronbach's α in COPD: 0.97 (total), 0.94 (physical), 0.92 (cognitive), 0.95 (psychosocial)1
Validity Criterium in COPD: r=-0.81 (FACIT-Fatigue)1

Convergent in COPD1: r = 0.53, and r = 0.63 (BORG fatigue pre and post 6MWD), r = 0.46 (BODE quartiles), r = 0.80 (SGRQ total score), r = 0.51 (MRC dyspnea)
Responsiveness to PR Mean change: -4.89 points 95% CI -7.90 to -3.79 (total score; COPD; 8-week outpatient PR); -1.89 points 95% CI -2.33 to -1.46 (physical); -1.37 points 95% CI -1.65 to -1.09 (cognition); -1.62 95% CI points -2.00 to -1.62 (psychosocial)2
MID N/A
Languages English1
References
  1. Al-shair K et al. Thorax. 2009;64(11):950-5.
  2. Yohannes AM et al. Ther Adv Chronic Dis. 2019;10:1-10.
Date of most recent changes May 2022

 

Multidimensional Fatigue Inventory (MFI)

  Description
Name of Questionnaire Multidimensional Fatigue Inventory-20 scale
Abbreviation/Alternate Name MFI-20
Description Designed to measure fatigue1,2. Five subscales measure; general fatigue and four types of domain-specific fatigue, rating how they have felt lately.
Developer Ellen M. A. Smets
E-mail e.m.smets@amc.uva.nl
Cost Free for academic use, charges for commercial use
License required Copyrighted of names of the authors. Users need to cite the following reference (#1)1.
Self-or rater-administered Self-administered
Time to complete 5 minutes
Number of items 20
Domains & categories (#) 5
Name of domains/ categories General (4 items), Physical (4), Mental (4), Reduced motivation (4), Reduced activity (4)
Scaling of items 5-point Scale (1= yes, that is true, 5= no, that is not true). Some items are reverse scored3,4,5
Scoring Total score a sum of sub-domains, each scored from 4-20. Total score ranges from 20-100. Higher scores indicate worse level of fatigue/more impairment due to fatigue
Test-retest/ reproducibility Test-retest: N/A

Internal consistency Cronbach's α:

Sarcoidosis: 0.94 (Total); 0.82 (general); 0.85 (physical), 0.87 (mental fatigue), 0.69 (reduced activity), 0.85 (motivation)6

COPD: 0.63 (general), 0.69 (physical), 0.76 (mental fatigue), 0.67 (reduced activity), 0.70 (motivation)7
Validity Criterium (Total score): r=0.86 (FAS Total), r=0.82 (physical), r=0.73 (mental fatigue) in sarcoidosis8.

Convergent (general fatigue):

COPD: r=0.32 (FEV1 % predicted); r=-0.55 (6MWD); r=0.75 (SGRQ Total score)9

Cystic Fibrosis: β =-0.735, p = 0.03 (total active hours per weekday)10
Responsiveness to PR Significant decrease pre (57.2±12.6) post (44.1±10.8) in Total score (6-week outpatient PR; COPD)11

Responsiveness to PR for domains found in references (#11-12)11,12
MID N/A
Languages English, Swedish, French, Dutch, Chinese, Korean, Polish, Hindi
References
  1. Smets EM et al. J Psychosom Res. 1995; 39:315-325.
  2. Smets EM et al. Br J Cancer. 1996; 73:241-245.
  3. Goodchild CE et al. Musculoskeletal Care. 2008; 6:31-48.
  4. Elbers RG et al. Parkinsonism Relat Disord. 2012; 18:532-6.
  5. Hedlund L et al. Community Ment Health J. 2015; 51:377-82.
  6. Hinz A et al. J Pain Symptom Manage. 2020; 59:717-723.
  7. Wong CJ et al. Int J Chron Obstruct Pulmon Dis. 2010; 5:319-26.
  8. Hinz A et al. Gen Hosp Psychiatry. 2011; 33:462-8.
  9. Breslin E et al. Chest. 1998; 114:958-64
  10. Orava C et al. Physiother Can. 2018; 70:42-8.
  11. Deng GJ et al. Int J Nurs Pract. 2013; 19:636-43.
  12. Lewko A et al. Respir Med. 2014; 108:95-102.
Date of most recent changes May 2022

 

Pulmonary Functional Status & Dyspnea Questionnaire – Modified (PFSDQ-M)

  Description
Name of Questionnaire Pulmonary Functional Status & Dyspnea Questionnaire-Modified-Fatigue domain
Abbreviation/ Alternate Name PFSDQ-M-fatigue
Description PFSDQ-M designed to assess frequency & intensity of dyspnea & fatigue (with and without activities) and changes in the ability of patients to engage in daily activities.1 Degree of tiredness with 10 activities (10) and independent questions (5) for frequency & intensity.
Developer Suzanne C. Lareau
E-mail SUZANNE.LAREAU@cuanschutz.edu
Cost Free
License required Not copyrighted
Self-or rater-administered Self-administered
Time to complete Estimate of 2 minutes for fatigue
Number of items 15
Domains & categories (#) Fatigue
Name of domains/ categories Fatigue with activities (10 items), frequency and intensity of fatigue under various conditions (5 items)
Scaling of items Degree of tiredness, 10-point scale (0 = none, 1-3 = mild, 4-6 = moderate, 7-9 = severe, 10 = very severe)1,2,3
Scoring Total score of 10 items, 0-100 points. Mean scores summation of points, divided by the number of items rated1. Frequency and intensity of 5 independent items (not included in Total score). Higher scores indicate worse fatigue
Test-retest/ reproducibility Test-retest ICC in COPD of fatigue: 0.92 (2 days)4 and 0.77 (7 days)5

Correlations (COPD, fatigue): r=0.79 (2 weeks)1 and r=0.88 (10-14 days)6

Internal consistency (Cronbach's α; in COPD of fatigue): 0.951, 0.944, 0.936, 0.897
Validity Criterium (fatigue):  r=-0.21 (CRQ fatigue; COPD)5

Convergent in COPD with SGRQ:  r=0.66 (total score)2; r=.50 (symptom), r=0.62 (physical activity), r=0.53 (impact)2  
Responsiveness to PR Mean change (fatigue in COPD): -5±7 points (3-month outpatient PR)5; and -4±8 points (12-week outpatient PR)8
MID 5 points5
Languages >10 languages available (including English1, Portuguese2, Chinese7, Swedish9, Dutch10)
References
  1. Lareau SC et al. Heart Lung. 1998; 27:159-168.
  2. Kovelis D et al. COPD. 2011; 8:334-9.
  3. Jones P et al. Int J Chron Obstruct Pulmon Dis. 2012; 7:697-709.
  4. Kovelis D et al. J Bras Pneumol. 2008; 34:1008-18.
  5. Regueiro EM et al. Respir Res. 2013; 14:58.
  6. Kojima S et al. Nihon Kokyuki Gakkai Zasshi. 2004; 42:486-90.
  7. Guo AM et al. Zhonghua Jie He He Hu Xi Za Zhi. 2010; 33:251-5.
  8. Trappenburg JC et al. Arch Phys Med Rehabil. 2005; 86:1788-1792.
  9. Wingårdh A et al. Scand J Occup Ther. 2007; 14:183-91.
  10. Burtin et al. ERJ 2011 38 (suppl 55): p1264.
Date of most recent changes May 2022

 

36-Item Short Form Health Survey – Vitality scale (SF-36 vitality)

  Description
Name of Questionnaire Vitality domain of 36 item Short Form health survey.
Abbreviation/Alternate Name SF-36–vitality; RAND-36–vitality; MOS SF-36–vitality
Description: One domain of questionnaire assesses energy and fatigue.1,2
Developer John E. Ware and Cathy D. Sherbourne
E-mail RANDHealthCare@rand.org
Cost Free
License required User will provide a credit line when printing and distributing this document acknowledging that it was developed at RAND as part of the Medical Outcomes Study
Self-or rater-administered Self-administered or by trained interviewer (in person or by telephone)
Time to complete <1 minute
Number of items 4
Domains & categories (#) 1
Name of domains/ categories Vitality/fatigue
Scaling of items 5-point scale (1=none of the time, 5=all of the time)1,2
Scoring Result presented as a mean score of items in the domain. Lower scores indicate greater fatigue
Test-retest/ reproducibility Reliability: N/A

Internal consistency: Cronbach’s α vitality subdomain

in COPD 0.86,4 0.86 in asthma,5 0.80 IPF6
Validity Criterium (vitality): r=0.524 (with CRQ-fatigue; in COPD)7

Construct (vitality): r=-0.37 (mMRC dyspnea; IPF),8 0.50 AQLQ total score and r=0.41 to r=0.45 in subdomains with asthma9
Responsiveness to PR Responsiveness studied in COPD10,11,12,13 and patients on a waiting list for lung transplantation14
MID 3-7 points on the vitality in patients with IPF6,8
Languages 191 languages
References
  1. Ware JE and Sherbourne CD. Med Care. 1992;30(6): 473-83.
  2. Ware JE. Boston MA; Nimrod Press, 1993.
  3. Brazier JE et al. BMJ. 1992;305(6846):160-4.
  4. Alonso J et al. J Clin Epidemiol. 1998;51(11) :1087-94.
  5. Bousquet J et al. Am J Respir Crit Care Med. 1994;149(2 Pt 1):371-5.
  6. Swigris JJ et al. Respir Med. 2010;104(2):296-304.
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Date of most recent changes May 2022