Psychometric Properties of the COVID-19 Pandemic Fatigue Scale: Cross-sectional Online Survey Study

Abstract

Background: Pandemic fatigue is defined as feelings of demotivation to follow preventive measures against COVID-19, together with decreased trust in government and frequency of information-seeking behaviors.

Objective: This study aims to analyze the psychometric properties of the COVID-19-specific pandemic fatigue scale according to classical test theory (CTT) and Rasch model approaches in the general Spanish population.

Methods: This was a cross-sectional study in a representative sample of 1018 adults who completed an online survey in November 2020 in the framework of the COVID-19 Snapshot Monitoring (COSMO)-Spain project. The assessments included the 6-item COVID-19 Pandemic Fatigue Scale (CPFS) and other COVID-19-related variables: COVID-19 infection, adherence to preventive behaviors, information-seeking behavior, self-efficacy, worry, and cognitive and affective risk perception. Data quality, acceptability, reliability, and validity were analyzed according to CTT, and the fit to the Rasch model, unidimensionality, appropriateness of the response scale, item local independency, reliability (person-separation index [PSI]), and item-person distribution were also calculated.

Results: The mean CPFS score was 17.06 (SD 5.04, range 6-30), with higher scores for women, younger participants, participants who never seek information on COVID-19, those who think they would contract a mild disease in case of infection, those with higher level of worry about coronavirus/COVID-19, and those who felt depressed or felt the coronavirus/COVID-19 is spreading slowly (all P<.01). The Cronbach alpha for the CPFS was 0.74. In the confirmatory factor analysis, one factor was identified (root mean square error of approximation [RMSEA]=.02; comparative fit index [CFI]=.99; χ²₅=8.06, P=.15). The CPFS showed good fit to the Rasch model (χ ²₂₄=42.025, P=.01, PSI=.642), unidimensionality (binomial 95% CI -.005 to .045), and item local independency.

Conclusions: Our results suggest that the CPFS has moderate reliability and internal consistency and it is composed of a single dimension. It is a useful tool to ascertain the level of pandemic fatigue in the general population, which may help to guide the communication and information strategies to face the COVID-19 pandemic.

Keywords: COVID-19; Rasch analysis; fatigue; health information; information seeking; mental health; online survey; pandemic; pandemic fatigue; psychometric properties; validation.

Figure 1

Path diagram of the COVID-19 Pandemic Fatigue Scale (CPFS) model in the COVID-19 Snapshot Monitoring (COSMO)-Spain study, November 2020. CPFS items: 1. I am tired of all the COVID-19 discussions in TV shows, newspapers and radio programs, etc.; 2. I feel strained from following all of the behavioral regulations and recommendations around COVID-19; 3. I am sick of hearing about COVID-19; 4. I am tired of restraining myself to save those who are most vulnerable to COVID-19; 5. When friends or family members talk about COVID-19, I try to change the subject because I do not want to talk about it anymore; 6. I am losing my spirit to fight against COVID-19.

Figure 2

Differential item functioning for item 1, by age groups defined by the median (≤46 years, >46 years) in the COVID-19 Snapshot Monitoring (COSMO)-Spain study, November 2020.

Figure 3

Person-item threshold distribution of the COVID-19 Pandemic Fatigue Scale (CPFS) in the COVID-19 Snapshot Monitoring (COSMO)-Spain study, November 2020. Note: the distribution of persons (top part) and item thresholds (bottom part) locations are shown on the same logit scale. Persons with higher fatigue level and more difficult thresholds are represented on the right.