Selecting a fatigue rating scale by fred friedberg, phd. Fatigue is a common disabling symptom of multiple sclerosis ms. Percentagesof patients with sle and ms with positive responsesto items on fatiguequestionnare itemst sle ms heat exacerbates fatigue 37. The validity and reliability of the fatigue severity scale. Items are rated on a scale of 1 to 7 according to their level of agreement with a given statement, and include such statements as i am easily fatigued or fatigue interferes with carrying out. Fatigue is highly prevalent and has a negative impact on quality of life and performance in a variety of disorders. Fatigue is a common symptom experienced by people with ms. Originally developed for use among individuals with multiple sclerosis. The fatigue severity scale is a short questionnaire. Part ii, fatigue severity scale to measure the severity of fatigue. Fatigue severity scale fss of sleep disorders the fatigue severity scale fss is a method of evaluating the impact of fatigue on you.
The patient should also rate the severity of the fatigue. Among the more traditional fatigue scales, krupp, larocca, muirnash, and steinbergs 1989 fatigue severity scale had the best ability to differentiate cfs from healthy controls. Captures the individuals experience of mental or psychological fatigue and how it interferes with performing certain activities exercise, work and family life. Using the fatigue severity scale to inform healthcare.
Measures of fatigue the fatigue questionnaire, fatigue severity scale, multidimensional assessment of fatigue scale, and short form36 vitality energy fatigue subscale of the short form health survey geri b. After just one night of short sleep, individuals experience the effects of sleep deprivation the following day, which include difficulty focusing, irritability, impulsivity, and lack of balance. A study of fatigue in systemic lupus erythematosus. The aim of this study was to examine the psychometric properties of the fatigue severity scale fss to verify whether this instrument is a valid tool to measure fatigue in obese patients, and to examine the prevalence of fatigue in obese patients. Aug 29, 2012 fatigue is a common disabling symptom of multiple sclerosis ms. It is the most commonly used fatigue scale in pd and the only scale. Measures of fatigue the fatigue questionnaire, fatigue severity scale, multidimensional assessment of fatigue scale, and short form36 vitality energyfatigue subscale of the short form health survey geri b. A visual analogue scale is also included with the scale. The fatigue severity scale fss is designed to differentiate fatigue from clinical depression, since both share some of the same symptoms. Method the mfis was sent by post to patients with clinically definite multiple sclerosis in two centres. Sleeprelated complaints are second only to complaints of pain as a cause to seek medical attention. Sep 11, 2000 krupp lb, larocca ng, muirnash j, steinberg ad. Fatigue severity scale fss questionnaire for patients. Psychometric properties of the fatigue severity scale in.
Modern psychometric theory, in the form of the rasch measurement model, has set new quality standards for outcome measures by appraising a broad range of measurement properties in addition to the reliability and validity emphasized by classical test theory. In the study, experimenters developed the fss then. Application to patients with multiple sclerosis and systemic lupus erythematosus. The original fss is a nineitem unidimensional questionnaire developed by krupp, larocca, muirnash, and steinberg 1989 table 1. Rating scale updrs 15, and no separate measure has yet been developed speci. Fatigue severity scale fss american thoracic society. Validation of the fatigue severity scale in a swiss cohort. The 9item, fatigue severity scale fss9 has been widely used as an outcome measure in multiple sclerosis ms. Read each statement and circle a number from 1 to 7, depending on how appropriate they felt the statement applied to them over the preceding week.
Fatigue severity scale scores were lowered, but there was still a significant difference between them p fatigue severity scale 1 and fatigue severity scale 2 p0. Items are rated on a scale of 1 to 7 according to their level of agreement with a given statement, and include such statements as i am easily fatigued or fatigue interferes with carrying out certain duties and. Rasch analysis of the fatigue severity scale in multiple. To be able to discriminate between various levels of severe fatigue.
The fss is a selfreport scale that measures the severity of fatigue and how much it affects the persons activities and lifestyle in patients with a variety of disorders. To assess the severity of fatigue in general practice settings. Department of neurology, state university of new york, stony brook 117948121. Before and after a threeweek residential multidisciplinary integrated weight reduction program, 220 patients were. Krupps fatigue severity scale how is krupps fatigue. The fatigue severity scale fss was distinguishes fatigue from clinical depression.
There is a spectrum of apnea severity, and it can vary with a persons. Internal consistency for fatigue severity scale was good for multiple sclerosis patients icc0. However, these latter two scales measure only the amount of fatigue and the 1. Fatigue severity scale scores were lowered, but there was still a significant difference between them p fds as a tool to evaluate the severity and quality of fatigue in a group of patients suffering from ms.
The fatigue severity scale fss is one of the most frequently used inventories for measuring fatigue in people with chronic illnesses. Fatigue severity scale fss questionnaire for patients download and print pdf. A convenience sample of 65 adult hemodialysis patients was recruited. It contains questions that require a patient to rate his level of fatigue. Patients are asked to respond to each statement on a scale of 1 to 7, with 1 indicating strongly disagree and 7 indicating strongly agree. It consists of 9 items, which are scored on a 7point scale with 1 strongly disagree and 7 strongly agree. Also described in fibromyalgia, lyme borreliosis, postpolio, amyotrophic lateral sclerosis, brain injury, parkinsons disease, insomnia, sleep apnea. It was originally devised for people with multiple sclerosis or systemic lupus erythematosus1. Fatigue severity scale the fss questionnaire contains nine statements that attempt to explore severity of fatigue symptoms. Fatigue severity scale fss questionnaire sleepline. Objective to test if the mfis total score is valid by application of the rasch measurement model. Some studies indicate that fatigue affects approximately 85% of the ms population and nearly 66% of this population experiences it daily.
The fatigue severity scale is a frequently used patientreported measure of fatigue impact, but does not generate the health state utility values required to inform costeffectiveness analysis, limiting its applicability within decisionmaking contexts. Both of these other instruments also demonstrate a single factor that can be thought of as assessing severity of fatigue. The major study on the development of the fatigue severity scale was conducted by krupp, lb, et. Identification of ambiguities in the 1994 chronic fatigue. According to the cdc, more than a third of american adults dont get enough sleep on a regular basis. Insomnia describes a general difficulty falling or staying asleep. In clinic settings where a brief assessment of amount of fatigue is preferred, the 2. The fatigue severity scale the fatigue severity scale can be used to monitor change in fatigue over time or in response to therapeutic interventions.
Tool i, fatigue severity scale which consists of two parts. Each item consists of statements that are scored on a sevenpoint likert type scale ranging from 1. Fatigue can be assessed by either selfreport scales or performancebased measures. Items are rated on a scale of 1 to 7 according to their level of agreement with a given statement, and include such statements as i am easily fatigued or fatigue interferes with carrying out certain.
The relationship between social support and fatigue severity. Clinical studies have been conducted to ensure this distinction. Oct 30, 2003 in clinic settings where a brief assessment of amount of fatigue is preferred, the 2. Essentially, the fss consists of answering a short questionaire that requires the subject to rate his or her own level of fatigue. Nov 01, 2008 a recent bibliographic study of fatigue measurement scales has shown that the fss is the most commonly used fatigue specific questionnaire. The rapid assessment of fatigue severity in cancer patients.
Selecting a fatigue rating scale by fred friedberg, phd and. Although fatigue is common among multiple sclerosis ms patients, evaluation of this symptom is difficult due to the subjectivity and variability of the complaint. Sleep disorders types, symptoms, diagnosis, treatments. Neuberger fatigue questionnaire general description purpose. Modern psychometric theory, in the form of the rasch measurement model, has set new quality standards for outcome measures by appraising a broad range of measurement properties in addition to the reliability and validity emphasized by. Daily fatigue was measured using the fatigue severity scale fss that consists of 9 items developed to assess disabling fatigue on daily life.
Fatigue severity scale the fatigue severity scale fss is designed to differentiate fatigue from clinical depression, since both share some of the same symptoms. It is often considered a state of exhaustion distinct from depressed mood or physical weakness. To facilitate research in this area, we developed a fatigue severity scale, subjected it to tests of internal consistency and validity, and used it to compare fatigue in two chronic conditions. The fss is a short questionnaire that requires you to rate your level of fatigue. Fatigue is intrinsic to multiple sclerosis ms and is the most commonly reported symptom of the disease. The fatigue severity scale fss is a likert scale consisting of nine items that assess fatigue severity and functionality krupp et al. Fatigue is a prominent disabling symptom in a variety of medical and neurologic disorders. The fss questionnaire contains nine statements that rate the severity of your fatigue symptoms. Content comparison and reliability of the fatigue severity scale and the checklist individual strength. Fatigue severity scale or ffs is a nineitem questionnaire designed in 1989 by lauren b. The obvious problem with this measure is its subjectivity. The fatigue severity scale is a 9item scale which measures the severity of fatigue and its effect on a persons activities and lifestyle in patients with a variety of disorders.
Patients may be directed to download and complete the fatigue severity scale fss questionnaire by their haematologist, particularly in relation to their feelings of fatigue and the management of an associated iron deficiency. The validity and reliability of the fatigue severity scale in. We proposed the fatigue descriptive scale fds as a tool to evaluate the severity and quality of fatigue in a group of patients suffering from ms. The fatigue severity scale fss was developed by lauren krupp, md, a neurologist who specializes in ms, to address this. Rasch analysis of the modified fatigue impact scale mfis in. It consists of 9 items, which are scored on a 7point scale with. Outcome measure fatigue severity scale fss sensitivity to change yes population adult domain tbirelated symptomsfatigue type of measure selfreport icfcodes b4 description the fss is a 9item scale that measures the severity of fatigue and how much it affects the persons activities and lifestyle in patients with a variety of disorders. Nov 20, 2000 the performance of the bfi in this study is virtually interchangeable with a. Outcome measure fatigue severity scale fss sensitivity to change yes population adult domain tbirelated symptomsfatigue type of measure selfreport icfcodes b4 description the fss is a 9item scale that measures the severity of fatigue and how much it affects the persons activities and lifestyle in patients with a. The 9item fatigue severity scale fss is one of the most commonly used selfreport questionnaires to measure fatigue, but has only been validated in small samplesized studies and in single disorders.
The fss has been shown to be valid and reliable 30. It was originally devised for people with multiple sclerosis or systemic lupus erythematosus 1. Rasch analysis of the modified fatigue impact scale mfis. The rapid assessment of fatigue severity in cancer. The fatigue severity scale fss designed by krupp et al. References original publication krupp lb, larocca ng, muirnash j, steinberg ad. It was developed to measure fatigue in patients with neurological illnesses, in particular, multiple sclerosis and systemic lupus erythematosus.
Background the 21item modified fatigue impact scale mfis has been recommended as an outcome measure for use in multiple sclerosis and is commonly used to generate an overall score of fatigue. The majority of published studies have used one of two generic instruments, the fatigue severity scale fss 16 or fatigue assessment inventory fai 17. This refers to your usual way of life within the last week. Fatigue severity scale fss spinal cord injury research. A patient needs to answer how fatigue interferes with certain activities. The performance of the bfi in this study is virtually interchangeable with a. Higher scores on the scale are indicative of more severe fatigue. Fatigue has a major influence on the quality of life of people with multiple sclerosis. Fatigue severity scale an overview sciencedirect topics.
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