Dutch multifactor fatigue scale: a new scale to measure the different aspects of fatigue after acquired brain injury

Abstract

Objectives: To develop the Dutch Multifactor Fatigue Scale (DMFS), a new scale to assess the nature and impact of fatigue and coping with fatigue in the chronic phase after acquired brain injury (ABI) and to analyze the psychometric properties of this scale in a mixed group of patients with ABI.

Design: Cross-sectional survey study.

Setting: Academic rehabilitation center.

Participants: A mixed sample of patients with ABI (N=134). For the development of the DMFS: community-dwelling adults with stroke (n=9) and traumatic brain injury (n=5). For analyses of the psychometric properties of the DMFS: community-dwelling adults with ischemic stroke (n=55), hemorrhagic stroke (n=22), traumatic brain injury (n=35), or other ABIs (n=22), all at least 6 months after brain injury.

Interventions: Not applicable.

Main outcome measures: DMFS, Hospital Anxiety and Depression Scale, Checklist Individual Strength, and Dutch Personality Questionnaire.

Results: Exploratory and confirmatory factor analyses on data of 134 patients showed that the final DMFS consisted of 5 factors (explaining 55% of the variance): Impact of fatigue, Mental fatigue, Signs and Direct consequences of fatigue, Physical fatigue, and Coping with fatigue. All subscales of the DMFS showed sufficient to good reliability, good convergent validity with an existing fatigue scale, and good divergent validity with measures of mood and self-esteem.

Conclusions: The DMFS is believed to improve the diagnostic process of fatigue in the chronic phase after ABI. As it measures several factors of fatigue after brain injury, therapeutic indications can be targeted to patients' needs.

Keywords: Brain injuries; Fatigue; Neuropsychology; Rehabilitation; Self-assessment.