Self-reported fatigue: one dimension or more? Lessons from the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) questionnaire
Self-reported fatigue: one dimension or more? Lessons from the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) questionnaire
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DOI：
10.1007/s00520-010-0971-1
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发表时间：
2011-09-01
影响因子：
3.1
通讯作者：
Stone, Arthur
中科院分区：
文献类型：
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作者：
Cella, David;Lai, Jin-Shei;Stone, Arthur
在两个普通人群（总n = 1，878）和两个癌症（总n = 3，140）样本中，我们评估了自我报告疲劳的维度，通过慢性疾病治疗疲劳功能评估（FACIT-F）工具进行测量。在评估FACIT-F的维度后，我们比较了每个样本中概念上不同的疲劳体验与疲劳影响评分。13项量表的验证性因素分析显示，每个样本与单维度（“一维”）模型拟合良好（比较拟合指数范围= 0.92-0.97）。使用双因素模型比较每个项目的负荷与一般疲劳因子与确定的子域（经验或影响），我们发现项目一般负荷高于项目子域因子在52个比较（13个项目; 4个样本）。当单独评分时，经验和影响评分高度相关（范围= 0.80-0.88），但它们之间的差异是显著的（p < 0.001）。在所有样本中，经验分数系统性地高于（更多认可）影响分数，幅度为0.21-0.46 SD单位。这表明疲劳体验和疲劳对功能的影响是沿着一维连续体报告的，但在较低水平的疲劳下，这种体验比对功能的影响更有可能得到认可。疲劳作为结局或试验终点可以表示为单个数字，并且症状的经历更可能在轻度疲劳水平下得到认可，大概是在症状对功能产生不良影响之前。
Across two general population (total n = 1,878) and two cancer (total n = 3,140) samples, we evaluated the dimensionality of self-reported fatigue as measured by the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) instrument. After evaluating dimensionality of the FACIT-F, we compared the conceptually distinct fatigue experience versus fatigue impact scores in each sample. Confirmatory factor analysis of the 13-item scale showed very good fit to a single dimension ("unidimensional") model for each sample (comparative fit index range = 0.92-0.97). Using a bifactor model to compare the loading of each item with the general fatigue factor versus the identified sub-domain (experience or impact), we found the item-general loading to be higher than that of the item-sub-domain factor in 52 of 52 comparisons (13 items; four samples). When scored separately, experience and impact scores were correlated highly (range = 0.80-0.88), yet their difference relative to one another was significant (p < 0.001). Consistently across samples, experience scores were systematically higher (more endorsement) than impact scores, by a margin of 0.21-0.46 SD units. This suggests that the fatigue experience and the impact of fatigue upon function are reported along a single dimensional continuum, but that experience is more likely than impact upon function to be endorsed at lower levels of fatigue. Fatigue as an outcome or trial endpoint can be expressed as a single number, and the experience of the symptom is more likely to be endorsed at mild levels of fatigue, presumably before the symptom exerts an adverse impact upon function.