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Multiple Sclerosis
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Article

The development and validation of the Unidimensional Fatigue Impact Scale (U-FIS)

DM Meads1, LC Doward1*, SP McKenna1, J Fisk2, J Twiss1, and B Eckert3

1 Galen Research, Manchester, United Kingdom
2 Dalhousie University, Canada
3 Global Health Economics and Outcomes Research, Novartis Pharmaceuticals, New Jersey, United States

* To whom correspondence should be addressed.


  Abstract

Background

The multidimensional assessment of fatigue is complicated by the interrelation of its multiple causes and effects.

Objective

The purpose of the research was to develop a unidimensional assessment of fatigue (U-FIS).

Methods

Data collected with the Fatigue Impact Scale (FIS) were subjected to Rasch analysis to identify potential problems with the scale. Additional items for the U-FIS were generated from interviews with UK MS patients. The U-FIS was tested for face and content validity in patient interviews and included in a validation survey to determine dimensionality (Rasch model), reliability and validity.

Results

The original FIS was not unidimensional when subscale items were combined. The modification of the FIS and addition of a number of items allowed the development of a 22-item unidimensional scale (U-FIS) that was reliable (Cronbach Alpha = 0.96; test–retest = 0.86,) and valid given correlations with the Nottingham Health Profile and ability to distinguish between MS severity groups. There was no significant difference in U-FIS scores according to MS type.

Conclusion

It is valid to conceptualize the functional impact of fatigue as unidimensional. The U-FIS is a reliable and valid questionnaire that will allow the measurement of this construct in clinical studies.

Key Words: fatigue, multiple sclerosis, questionnaire, Rasch analysis, U-FIS, unidimensional

First published on June 25, 2009, doi:10.1177/1352458509106714

Multiple Sclerosis 2009;15:1228.

A more recent version of this article appeared on October 1, 2009

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