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Daily assessments can provide insight into the temporal characteristics of fatigue. They can demonstrate consistency or reveal variability, as when fatigue changes with the underlying medical condition, improves with therapy, or worsens as a medication side effect. We adapted a fatigue measure from the Patient-Reported Outcomes Measurement Informat...
Citations
... 19,20 Other psychometric properties, internal consistency, structural validity, test-retest reliability, construct validity, and responsiveness, of different PROMIS Fatigue short forms and CAT were supported across patient populations with a wide range of conditions, such as rheumatologic conditions, back pain, Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome, cancer, HIV, chronic heart failure, COPD, depression, and others. [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] Egerton et al. evaluated the measurement properties of self-report questionnaires for measuring fatigue in older people. PROMIS Fatigue item bank and short forms performed best out of 77 identified questionnaires. ...
... Therefore, our study adds to the accumulating evidence that fatigue can be measured validly and reliably across patients with a wide range of conditions with generic PROMIS Fatigue measures. [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] Previous research showed the relevance of the PROMIS Fatigue items across different patient populations. 15,19,20 A study in rheumatoid arthritis patients also showed that most patients would not give a different response when asked about a general sense of fatigue compared to fatigue attributed to their disease. ...
Background
There is little consensus on how to measure fatigue.
Objectives
To standardize the measurement of fatigue across populations, we aimed to assess the psychometric properties of the PROMIS Fatigue item bank in the Dutch general population and obtain reference values.
Methods
A sample of 1006 people participating in an internet panel completed the full v1.0 PROMIS Fatigue item bank (95 items). Structural validity (item response theory (IRT) assumptions and IRT model fit), measurement invariance/cross-cultural validity (absence of differential items functioning (DIF) for demographic variables and language, compared to data from US participants in PROMIS wave 1), and (internal) reliability (percentage of respondents with reliable estimates) were assessed.
Results
The IRT model assumptions were considered met (ECV 0.86, Omega-H 0.92), all items fitted the IRT model, no items showed DIF for demographic variables and seven for language, but with negligible impact on T-scores. Reliable fatigue T-scores were found for 98.3%, 69.8–82.6%, and 96.5% of the respondents with the full item bank, the standard short forms, and a simulated computerized adaptive test (CAT), respectively. The CAT administered on average only five items. A T-score of 49.1 represented the average score of the Dutch general population, T-scores <55 are considered within normal limits, T-scores of 55–59 indicate mild fatigue, T-scores of 60–70 indicate moderate fatigue, and T-scores >70 indicate severe fatigue.
Conclusions
The PROMIS Fatigue item bank showed sufficient structural validity, no measurement invariance for demographic characteristics, sufficient cross-cultural validity, and sufficient (internal) reliability in the Dutch general population.
... This was justifiable because comparisons between the daily and original 7day recall items found no evidence for differential item functioning between these 2 versions, which means that there are no significant differences between scores obtained with both instruments. 8,31 Because of the high number of potential combinations of items, number of measurement occasions, and distribution of measurement occasions, a large number of models were estimated. The numbers of possible item combinations were 63 for PI (between 1 and 6 items and different combinations of those) and 127 for pain behavior (between 1 and 7 items and combinations of those). ...
Despite tremendous efforts to increase the reliability of pain measures and other self-report instruments, improving or even evaluating the reliability of change scores has been largely neglected. In this study, we investigate the ability of two instruments from the Patient-Reported Outcomes Measurement Information System (PROMIS®), pain interference (6 items) and pain behavior (7 items), to reliably detect individual changes in pain during the postsurgical period of a hernia repair in 98 patients who answered daily diaries over almost 3 weeks following surgery. To identify the most efficient strategy for obtaining sufficiently reliable estimates of change (reliability >.9), the number of measurement occasions over the study period (sampling density), the number of items (test length), and the mode of administration (i.e., static short-form vs.computer-adaptive testing [CAT]) were manipulated in post-hoc simulations. Reliabilities for different strategies were estimated by comparing the observed change to the best approximation of "real" (i.e., latent) change. We found 1) that near perfect reliability can be achieved if measures from all days over the whole study period, obtained with all pain interference or pain behavior items, were used to estimate the observed change, 2) that various combinations of the number of items and the number of measurement occasions could achieve acceptable reliability, and, 3) that CATs were superior to short-forms in achieving sufficient reliability. We conclude that the specific strategy for assessing individual postoperative change in pain experience must be selected carefully.
... Fatigue was assessed with the short version of the Daily Fatigue Form [85]. The 7-item scale describes daily fatigue in the last day along a 5-point scale ranging from 1 (never) to 5 (always). ...
Disrupted sleep is common among nursing home patients and is associated with cognitive decline and reduced well-being. Sleep disruptions may in part be a result of insufficient daytime light exposure. This pilot study examined the effects of dynamic "circadian" lighting and individual light exposure on sleep, cognitive performance, and well-being in a sample of 14 senior home residents. The study was conducted as a within-subject study design over five weeks of circadian lighting and five weeks of conventional lighting, in a counterbalanced order. Participants wore wrist accelerometers to track rest-activity and light profiles and completed cognitive batteries (National Institute of Health (NIH) toolbox) and questionnaires (depression, fatigue, sleep quality, lighting appraisal) in each condition. We found no significant differences in outcome variables between the two lighting conditions. Individual differences in overall (indoors and outdoors) light exposure levels varied greatly between participants but did not differ between lighting conditions, except at night (22:00-6:00), with maximum light exposure being greater in the conventional lighting condition. Pooled data from both conditions showed that participants with higher overall morning light exposure (6:00-12:00) had less fragmented and more stable rest-activity rhythms with higher relative amplitude. Rest-activity rhythm fragmentation and long sleep duration both uniquely predicted lower cognitive performance.
... The FSS construction was based on theoretical and empirical analyses and examination of other existing methods. Among these instruments were: (1) the Karolinska Sleepiness Scale which was shown to correlate with some physiological indices of sleepiness (Åkerstedt & Gillberg, 1990), (2) a scale measuring daily fatigue based on the Patient-Reported Outcomes Measurement Information System (PROMIS; Christodoulou, Schneider, Junghaenel, Broderick, & Stone, 2014), (3) the Appraisal of Fatigue in Relation to Performance based on adaptation-oriented and emotion-related ways of appraising fatigue and performance (van Dam, Keijsers, Eling, & Becker, 2011), (4) the Subjective Fatigue Scale which consists of concentration thinking difficulty, languor, reduced activation, reduced motivation, drowsiness, and feeling of physical disintegration subscales (Kobayashi, Demura, & Nagasawa, 2003), (5) the Chalder's Fatigue Scale assessing severity of physical and mental fatigue symptoms (Chalder et al., 1993), and (6) the Fatigue Impact Scale which assess the patients' perception of the effects of fatigue on their quality of life (Fisk et al., 1994;cf. Naschitz et al., 2004). ...
In two correlational studies, we investigated the relationship between symptoms of mental fatigue connected with the ordinary daily activity of undergraduate students and the performance level in tasks engaging executive and attentional processes. We found that mild or moderate levels of fatigue are associated with only a few impairments in cognitive functioning, which suggests that the consequences of such a level of fatigue can be easily compensated by protection strategies adopted by participants. A notable exception was a significant positive correlation between the level of fatigue and higher accuracy switch cost in the Plus-minus task. Our participants also reported an increase in fatigue symptoms after performing several cognitive tasks and this change was larger for those who were more engaged in a sustained attention task. In a follow-up experiment, we investigated the effects of fatigue induced by the time on sustained attention task on switching task performance and reported symptoms of cognitive and executive fatigue. We confirmed that the level of accuracy switch cost is significantly higher in the participants who performed the sustained attention task than in the participants from the control group. We pointed out some possible practical implications of studies on the relationship between fatigue and cognition for such activities as driving a car.
... Diary investigators have used different instructional phrases to define the period of time that participants should consider when making their ratings. The 4 commonly used instructional phrases are today [8,[12][13][14], since waking up today [15,16], during the last 24 hours [3,17], or in the last day [18,19]. At face value, some of the instructional phrases seem clear as to the time frame they intend to target, whereas others are, we believe, open to interpretation. ...
... However, the phrase in the last day is less straightforward to interpret. Although investigators may intend for the phrase to inquire information about the day that has just passed (ie, today) [18,19], some may intend for the phrase to include parts of yesterday (ie, the previous night). However, whether EOD diary study participants assess their experiences with the prescribed time frames has not been examined. ...
Background: Daily diaries are extensively used for examining participants’ daily experience in behavioral and medical science. However, little attention is paid to whether participants recall their experiences within the time frames prescribed by the task.
Objective: This study aimed to describe survey respondents’ self-reported recall time frames and to evaluate the impact of different daily diary items on respondents’ reported affective states.
Methods: In this study, 577 participants completed a mood survey with one of the following 4 time frame instructions: (1) today, (2) since waking up today, (3) during the last 24 hours, or (4) in the last day. They were also asked to indicate the periods
they considered when answering these items and to recall the instructional phrases associated with the items.
Results: Almost all participants in the today (141/146, 96.6%) and since waking up today (136/145, 93.8%) conditions reported using periods consistent with our expectations, whereas a lower proportion was observed in the during the last 24 hours (100/145,
69.0%) condition. A diverse range of responses was observed in the in the last day condition. Furthermore, the instructions influenced the levels of some self-reported affects, although exploratory analyses were not able to identify the mechanism
underlying this finding.
Conclusions: Overall, these results indicate that today and since waking up today are the most effective instructional phrases for inquiring about daily experience and that investigators should use caution when using the other 2 instructional phrases.
... Fatigue was assessed using the 7-item Patient-Reported Outcomes Measurement Information System (PROMIS) Fatigue Adult Short Form. 27 The scale is generic rather than disease-specific, assessing both the experience of fatigue and the interference of fatigue on daily activities over the past week. It evaluates self-reported symptoms, ranging from mild subjective feelings of tiredness to an overwhelming, debilitating, and sustained sense of exhaustion. ...
Aims:
To quantify the contributions of atopic disorders, sleep disturbance, and other health conditions to five common pain conditions.
Methods:
This cross-sectional analysis used data from 655 participants in the OPPERA study. The authors investigated the individual and collective associations of five chronic overlapping pain conditions (COPCs) with medically diagnosed atopic disorders and self-reported sleep disturbance, fatigue, and symptoms of obstructive sleep apnea. Atopic disorders were allergies, allergic rhinitis, atopic dermatitis, allergic asthma, urticaria, allergic conjunctivitis, and food allergy. Logistic regression models estimated odds ratios as measures of association with temporomandibular disorders, headache, irritable bowel syndrome, low back pain, and fibromyalgia. Measures of sleep and atopy disorders were standardized to z scores to determine the relative strength of their associations with each COPC. Sociodemographic characteristics and body mass index were covariates. Random forest regression analyzed all variables simultaneously, computing importance metrics to determine which variables best differentiated pain cases from controls.
Results:
Fatigue and sleep disturbance were strongly associated with each COPC and with the total number of COPCs. An increase of one standard deviation in fatigue or sleep disturbance score was associated with approximately two-fold greater odds of having a COPC. In random forest models, atopic disorders contributed more than other health measures to differentiating between cases and controls of headache, whereas other COPCs were best differentiated by measures of fatigue or sleep.
Conclusion:
Atopic disorders, previously recognized as predictors of poor sleep, are associated with COPCs after accounting for sleep problems.
... Diary investigators have used different instructional phrases to define the period of time that participants should consider when making their ratings. The 4 commonly used instructional phrases are today [8,[12][13][14], since waking up today [15,16], during the last 24 hours [3,17], or in the last day [18,19]. At face value, some of the instructional phrases seem clear as to the time frame they intend to target, whereas others are, we believe, open to interpretation. ...
... However, the phrase in the last day is less straightforward to interpret. Although investigators may intend for the phrase to inquire information about the day that has just passed (ie, today) [18,19], some may intend for the phrase to include parts of yesterday (ie, the previous night). However, whether EOD diary study participants assess their experiences with the prescribed time frames has not been examined. ...
BACKGROUND
Daily diaries are extensively used for examining participants' daily experience in behavioral and medical science. Whether participants recall their experiences within the time frames prescribed by task has received little attention.
OBJECTIVE
The objectives of this study are to describe survey respondents' self-reported recall timeframe and to evaluate the impact of different daily diary items on respondents reported affective states.
METHODS
In this study, 577 participants completed a mood survey with one of four time frame instructions: 1) today, 2) since waking up today, 3) during the last 24 hours, or 4) in the last day. They were also asked to indicate the time periods they considered when answering these items and to recall the instructional phrases associated with the items.
RESULTS
Almost all participants in the "Today" (97%) and "Since waking up today" (94%)" conditions reported using time periods consistent with our expectations, while a lower proportion was observed in the "during the last 24 hours" (69%) condition. A diverse range of responses was observed in the "In the last day" condition. Furthermore, the instructions influenced the levels of some self-reported affects, although exploratory analyses were not able to identify the mechanism underlying this finding.
CONCLUSIONS
Overall, these results indicate that "Today" and "Since waking up today" are the most effective instructional phrases for inquiring about daily experience and that investigators should use caution when using the other two instructional phrases.
... For example, the prevalence of fatigue may be particularly high in very frail and multimorbid elders as those living in long term care, even up to 98% (Liao and Ferrell, 2000). Furthermore, different temporal characteristics and level of fatigue have been observed comparing data obtained from subjects recruited in the general population with those from patients affected by fatigue-related clinical disorders, with the latter showing higher and more consistent levels of the symptom (Murphy and Smith, 2010;Murphy et al., 2013;Christodoulou et al., 2014). Also the difference in physical activity capacity among subjects included in study samples could influence the evaluation of fatigue and make the observations not directly comparable. ...
... Recently, the National Institutes of Health has developed the Patient-Reported Outcome Measurement Information System (PROMIS) to provide reliable and precise assessment of reported outcomes, including fatigue. For example, a modified 7-item PROMIS-fatigue Short Form questionnaire for daily assessment has shown to be accurate and sensitive to changes over time, providing an interesting opportunity for better evaluating the temporal modifications of this symptom (Christodoulou et al., 2014). ...
Frailty has been identified as a promising condition for distinguishing different degrees of vulnerability among older persons. Several operational definitions have proposed fatigue as one of the features characterizing the frailty syndrome. However, such a subjective symptom is still not yet sufficiently explored and understood. Fatigue is a common and distressing self-reported symptom perceived by the person while performing usual mental and physical activities, highly prevalent in older people, and strongly associated to negative health-related events. The understanding of fatigue is hampered by several issues, including the difficulty at objectively operationalizing, the controversial estimates of its prevalence, and the complex pathophysiological mechanisms underlying its manifestation. Despite such barriers, the study of fatigue is important and might be encouraged. Fatigue may be the marker of the depletion of the body's homeostatic reserves to a threshold leading to its psycho-physical functional impairment, mirroring the concept of frailty. Its subjective and symptomatic nature resembles that of other conditions (e.g., pain, depression), which equally affect the individual's quality of life, expose to negative outcomes, and severely burden healthcare expenditures. In the present paper, we present an overview of the current knowledge on fatigue in older persons in order to increase awareness about its clinical and research relevance. Future research on this topic should be encouraged and developed because it could potentially lead to novel interventions against this symptom as well as against frailty and age-related conditions.
Copyright © 2015. Published by Elsevier Inc.
... Unfortunately, an assessment of fatigue on the job is not easy to accomplish. Many studies used questionnaires, however these do not provide objective data [3][4][5]. Others used objective measures such as EEG [6], heart rate variability [7], or cognitive function tests [2,8]. ...
Background:
Fatigue has a strong impact on workers' performance and safety, but expedient methods for assessing fatigue on the job are not yet available. Studies discuss posturography as an indicator of fatigue, but further evidence for its use in the workplace is needed. The purpose of the study is to examine whether posturography is a suitable indicator of fatigue in clerical workers.
Methods:
Thirty-six employees (Ø 34.8 years, standard deviation = 12.5) participated in postural tasks (eyes open, eyes closed, arm swinging, and dual task) in the morning and afternoon. Position of their center of pressure (COP) was registered using a Nintendo Wii Balance Board and commercial software. From registered COP time series, we calculated the following parameters: path length (mm), velocity (mm/s), anterior-posterior variance (mm), mediolateral variance (mm), and confidence area (mm(2)). These parameters were reduced to two orthogonal factors in a factor analysis with varimax rotation.
Results:
Statistical analysis of the first factor (path length and velocity) showed a significant effect of time of day: COP moved along a shorter path at a lower velocity in the afternoon compared with that in the morning. There also was a significant effect of task, but no significant interaction.
Conclusion:
Data suggest that postural stability of clerical workers was comparable in the morning and afternoon, but COP movement was greater in the morning. Within the framework of dynamic systems theory, this could indicate that the postural system explored the state space in more detail, and thus was more ready to respond to unexpected perturbations in the morning.
... Found negligible DIF, good internal reliability from average to high levels of fatigue, and evidence for discriminative validity and sensitivity to change. But, 30 % floor effect in GP, inability to discriminate between low levels of fatigue with the daily measure, and differences in the first 2 days' scores after which scores stabilised [81] Qual Life Res (2015) 24:2239-2255 2247 Several studies show that items correlated better with mental health subscale than with vitality scale [90][91][92][93], and correlation between vitality subscale was very high with mental health subscale and very low with physical health subscale [92][93][94] The questionnaire can differentiate people with relatively low fatigue well, but not people with moderate-to-severe fatigue [ * Where evidence for uni-dimensionality was lacking, the rating for methodological quality of the internal consistency studies may be overestimated and the rating for internal consistency of the total score may be inaccurate findings for measurement error and structural validity, and mixed or inconclusive results for hypothesis testing, responsiveness, and interpretability. One study showed that the items cannot be aggregated into a single overall score [27]. ...
The assessment of fatigue in older people requires simple and user-friendly questionnaires that capture the phenomenon, yet are free from items indistinguishable from other disorders and experiences. This study aimed to evaluate the content, and systematically review and rate the measurement properties of self-report questionnaires for measuring fatigue, in order to identify the most suitable questionnaires for older people.
This study firstly involved identification of questionnaires that purport to measure self-reported fatigue, and evaluation of the content using a rating scale developed for the purpose from contemporary understanding of the construct. Secondly, for the questionnaires that had acceptable content, we identified studies reporting measurement properties and rated the methodological quality of those studies according to the COSMIN system. Finally, we extracted and synthesised the results of the studies to give an overall rating for each questionnaire for each measurement property. The protocol was registered with PROSPERO (CRD42013005589).
Of the 77 identified questionnaires, twelve were selected for review after content evaluation. Methodological quality varied, and there was a lack of information on measurement error and responsiveness.
The PROMIS-Fatigue item bank and short forms perform the best. The FACIT-Fatigue scale, Parkinsons Fatigue Scale, Perform Questionnaire, and Uni-dimensional Fatigue Impact Scale also perform well and can be recommended. Minor modifications to improve performance are suggested. Further evaluation of unresolved measurement properties, particularly with samples including older people, is needed for all the recommended questionnaires.
