RT Journal Article
SR Electronic
T1 Development, dimensions, reliability and validity of the novel Manchester COPD fatigue scale
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 950
OP 955
DO 10.1136/thx.2009.118109
VO 64
IS 11
A1 Al-shair, K
A1 Kolsum, U
A1 Berry, P
A1 Smith, J
A1 Caress, A
A1 Singh, D
A1 Vestbo, J
YR 2009
UL http://thorax.bmj.com/content/64/11/950.abstract
AB Introduction: Fatigue is a prominent symptom in chronic obstructive pulmonary disease (COPD) and it has distinctive features; however, there is a need for a robust scale to measure fatigue in COPD.Methods: At baseline, 122 patients with COPD (forced expiratory volume in 1 s (FEV1) 52%, women 38%, mean age 66 years) completed a pilot fatigue scale covering a pool of 57 items and underwent a range of tests, including indicators of mood and a short general fatigue questionnaire. All patients responded to the 57-item scale and it was readministered to a subset of 30 patients. The pilot scale was first subjected to constructive validated shortening steps and then to a principal components analysis.Results: The Manchester COPD fatigue scale (MCFS) consists of 27 items, loading into three dimensions: physical, cognitive and psychosocial fatigue. Internal consistency (Cronbach’s α = 0.97) and test–retest repeatability (r = 0.97, p<0.001) were tested. It had significant convergent validity, correlating with the FACIT (Functional Assessment of Chronic Illness Therapy) fatigue scale and the fatigue in Borg scale at baseline and after a 6 minute walk distance (6MWD) test (r = −0.81, 0.53 and 0.63, respectively, p<0.001). Its scores were associated with BODE, SGRQ (St George’s Respiratory Questionnaire) and MRC (Medical Research Council) dyspnoea scores (r = 0.46, 0.8 and 0.51, respectively, p<0.001). The scale demonstrated meaningful discriminating ability; patients who walked <350 m in a 6MWD test as well as depressed patients (⩾16 scores in the Center for Epidemiologic Study on Depression (CES-D) scale) had nearly twice as high fatigue scores as those who walked ⩾350 m or were not depressed (p<0.001).Conclusion: The MCFS provides a simple, reliable and valid measurement of total and dimensional fatigue in moderate stable COPD.