Psychometric properties of the Fatigue Severity Scale in obese patients
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RESEARCH
Open Access
Psychometric properties of the Fatigue Severity Scale in obese patients Franco M Impellizzeri1*, Fiorenza Agosti2, Alessandra De Col2 and Alessandro Sartorio2,3,4
Abstract Background: 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. Methods: Before and after a three-week residential multidisciplinary integrated weight reduction program, 220 patients were asked to fill in the questionnaires: FSS, Profile of Mood States (Fatigue-Inertia subscale, POMS-Fatigue, and Vigor-Activity subscale, POMS-Vigor), and the Obesity-Related Well-Being (ORWELL-97). A subsample of 50 patients completed the questionnaire within two days. Results: The prevalence of fatigue using a cut-off value of 4 for the FSS score was 59%. Correlations were found between FSS and POMS-Fatigue and -Vigor scores (r = 0.58 and 0.53, respectively). A relation was also found between FSS and ORWELL97 (r = 0.52, 0.42 to 0.61). From the factorial analysis only 1 factor was extracted explaining 63% of variance, with factor loading values ranging from 0.71 (item 7) to 0.87 (item 6). Intraclass Correlation Coefficient was 0.89 (0.82 to 0.94), while the agreement as measured using the Standard Error of Measurement was 0.43 (0.36 to 0.54) corresponding to 13% (11 to 17%). Cronbach’s alpha values ranged from 0.94 to 0.93. The internal responsiveness of FSS was comparable to the ORWELL97 (Standardized Response Mean = 0.50 and 0.44, respectively). Conclusions: Fatigue is an important and frequent symptom in obese patients and therefore should be routinely assessed in both research and clinical practice. This can be achieved using the FSS, which is a short, simple, valid and reliable tool for assessing and quantifying fatigue in obese patients. Keywords: Obesity, Symptoms, Questionnaires, Psychometrics
Background Fatigue is a symptom frequently reported in both healthy [1] and several clinical populations such as patients with depression, rheumatoid disorders, post stroke, multiple sclerosis, mood disorders, psychiatric disturbances and cancer [2]. Given the subjective nature of fatigue, no exact definition exists. From a clinical point of view, fatigue can be defined “as difficulty in initiation or sustaining of voluntary activities” [2] and is characterized by symptoms such as lack of energy, physical and mental tiredness and apathy [2,3]. Fatigue has been associated with obesity in both adult and pediatric populations and is a common complaint in * Correspondence: [email protected] 1 Department of Research and Development, Schulthess Clinic, Lengghalde 2, 8008, Zurich, Switzerland Full list of author information is available at the end of the article
obese people [4-6]. Furthermore, the use of fatigue as a relevant outcome in intervention studies is increasing [7,8]. Since fatigue perception is a subjective experience, it can be me
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