Validation of an Arabic version of Fatigue Severity Scale

Hana I Al-Sobayel, Hind A Al-Hugail, Ranyah M AlSaif, Nada M Albawardi, Ali H Alnahdi, Abdulkader M Daif, Hussein F Al-Arfaj, Hana I Al-Sobayel, Hind A Al-Hugail, Ranyah M AlSaif, Nada M Albawardi, Ali H Alnahdi, Abdulkader M Daif, Hussein F Al-Arfaj

Abstract

Objectives: To develop and test the psychometric properties of an Arabic version of Fatigue Severity Scale (FSS-Ar) that can be used to measure fatigue in Arabic patients with disorders where fatigue is a major symptom.

Methods: Forward and backward translations of FSS were undertaken to develop an Arabic version. The validity and reliability of the FSS-Ar was then tested on 28 patients with systemic lupus erythematosus (SLE), 24 patients with multiple sclerosis (MS), and 31 healthy subjects. Exploratory factor analysis and hypothesis testing methods were used to examine construct validity. The correlation between FSS-Ar and the vitality domain of the RAND 36-Item Health was examined to test construct validity. The study was conducted at the King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia between February and June 2012.

Results: Using a score of ≥4.05 to define fatigue, 39 of 52 (75%) participants were fatigued compared with 10 out of 31 (32%) healthy participants. The correlation between the FSS-Ar and the vitality domain of the RAND-36 was acceptable (r = -0.46). Factor analysis showed that items of the FSS-Ar measured one underlying construct, namely, fatigue. Test-retest reliability and internal consistency of the FSS-Ar was acceptable (intraclass correlation coefficient model 2,1 = 0.80; Cronbach's alpha = 0.84).

Conclusion: The Arabic version of the FSS demonstrated acceptable psychometric properties and was able to differentiate between patients with SLE or MS, and healthy subjects.

Figures

Figure 1
Figure 1
Factor analysis scree plot showing the inflexion point at the second factor indicating that only the first factor should be retained.
Figure 2
Figure 2
Receiver operating characteristic curve used to determine the optimal cutoff of the Fatigue Severity Scale Arabic version (FSS-Ar) to define fatigue. An asterisk (*) was placed on the optimal cutoff point in the FSS-Ar that provides the best balance between sensitivity and specificity to distinguish patients with multiple sclerosis, or systemic lupus erythematosus from healthy individuals.

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