Validation of the revised piper fatigue scale in Koreans ...

The revised Piper Fatigue Scale (PFS) is one of the popular instruments to assess perceived fatigue of patients with chronic disease such as ... BrowseSubjectAreas ? ClickthroughthePLOStaxonomytofindarticlesinyourfield. FormoreinformationaboutPLOSSubjectAreas,click here. Article Authors Metrics Comments MediaCoverage ReaderComments Figures Figures Abstract Purpose ThepurposeofthestudywastoevaluatetheconstructvalidityandreliabilityoftheKoreanversionoftherevisedPiperFatigueScale(PFS)inKoreanswithchronichepatitisB. Methods Atotalof146chronichepatitisBpatientscompletedtheKoreanversionoftherevisedPFS.Adescriptiveanalysiswasperformedtodeterminethesubjects’demographiccharacteristics;theconstructvaliditywasexaminedusingexploratoryfactoranalysis;andinternalconsistencyreliabilityofthescalewasestimatedforthemeaningfultotalscaleandfactors. Results Thefactoranalysissupportedtheoriginalfour-factorstructurebasedonKaiserCriterionandMinimumAveragePartial(MAP):Behavioral/Severity,Affectivemeaning,Sensory,&Cognitive/Mood.Inthe22itemsintheoriginalinstrument,patient/impatient,relaxed/tense,andexhilarated/depressedwerere-identifiedfromthecognitive/moodsubscaleandsensorysubscale.TheCronbach’salphaofthe22-itemKoreanversionoftherevisedPFSwas0.96forthetotalscale,andtherangeofCronbach’salphaforsubscaleswas0.90to0.93. Conclusions Theresultsofthestudyrevealedthatthe22-itemKoreanversionoftherevisedPFSisvalidandreliableinKoreanswithchronichepatitisB.FurtherstudiesascertainingthepsychometricpropertiesoftherevisedPFSneedtobeperformedinKoreanpatients. Citation:JangY,KimJH,LeeK(2017)ValidationoftherevisedpiperfatiguescaleinKoreanswithchronichepatitisB.PLoSONE12(5): e0177690. https://doi.org/10.1371/journal.pone.0177690Editor:UrsM.Nater,UniversityofMarburg,GERMANYReceived:December22,2016;Accepted:May2,2017;Published:May23,2017Copyright:©2017Jangetal.ThisisanopenaccessarticledistributedunderthetermsoftheCreativeCommonsAttributionLicense,whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalauthorandsourcearecredited.DataAvailability:AllrelevantdataarewithinthepaperanditsSupportingInformationfiles.Funding:ThisresearchwassupportedbyaNationalResearchFoundationofKoreagrantfundedbytheKoreangovernment,NRF-2011-0024717(http://www.nrf.re.kr/nrf_tot_cms/index.jsp?pmi-sso-return2=none).Thefunderhadnoroleinstudydesign,datacollectionandanalysis,decisiontopublish,orpreparationofthemanuscript.Competinginterests:Theauthorshavedeclaredthatnocompetinginterestsexist. IntroductionHepatitisBvirus(HBV)isthemostcommonchronicviralinfection[1].TwobillionpeoplehavebeeninfectedbyHBV,andmorethan240millionpeoplearelivingwithchronichepatitisB[2].TheprevalenceofhepatitisBhasdecreased,but4%ofadultsover30yearsoldorolderareinfectedwithHBVinKorea[3].Upto40%ofHBV-infectedpatientsdeveloplivercirrhosis,liverfailure,orhepatocellularcarcinoma[4],anditisknownthatabout15%to25%ofpeoplewithchronicHBVinfectiondiefromlivercirrhosisorhepatocellularcarcinoma[5].PatientswithHBVexperiencevarioustypesofphysical,psychological,andsocialproblems,whichdecreasetheirqualityoflife[6,7].HBVcauseshighsocialandeconomicburdenbecausemostpeoplewithHBVareofworkingage. Fatigueisamajorsymptominpeoplewithhepatitis[7,8].Tounderstandthecharacteristicsoffatiguesuchasseverityitmaybeimportanttoprovidetailoredinterventionsandtoimprovehealthoutcomesinthispopulation.However,littleisknownaboutfatigueamongpatientswithHBV,andthereisnosuitableinstrumenttomeasurethenatureoffatigueinthesepatients. TherevisedPiperFatigueScale(PFS)isoneofthepopularinstrumentstoassessperceivedfatigueofpatientswithchronicdiseasesuchascancer.Thisinstrumentconsistsof22itemsandfoursubscalestoassessmultidimensionalfatigue[9].Thescalewasoriginallydevelopedwith42itemsin1989,andthenitwasrevisedto22itemsbasedonastudyofwomenwithbreastcancerin1998[9,10].ThefinalversionofthePFSconsistsoffourdimensionsofsubjectivefatigue,andthesubscalesarebehavioral/severity(sixitems),affectivemeaning(fiveitems),sensory(fiveitems),andcognitive/mood(sixitems).1)Thebehavioral/severitysubscaleconsistsofitemsrelatedtotheimpactanddistressonactivitiesofdailyliving,2)theaffectivemeaningsubscaleconsistsofitemsrelatedtotheemotionalattributesoffatigue,3)thesensorysubscaleconsistsofitemsrelatedtophysicalsymptomsoffatigue,4)andthecognitive/moodsubscaleconsistsofitemsrelatedtomentalandmoodstatus[9]. Althoughitwasdevelopedforpatientswithcancer,thePFShasbeengloballyusedtomeasurefatigueindiversediseasepopulations[11–13].InKorea,thePFShasbeenusedformeasuringthefatiguelevelofcancerpatientssuchasbreastcancerandgynecologiccancer.ApreviousstudyreportedthatthefatiguelevelofKoreanwomencancerpatientsundergoingchemotherapywasmoderate,withthesensorysubscalebeingthehighest,followedbybehavioral/severityandthenaffectivemeaning[14].InKoreanbreastcancerpatients,thetotalfatiguescorewasmoderate,whilethehighestsubscalewasbehavioral/severity[15],representingadifferentpatternsofsubscalescomparedtothatinthefirststudy.Therefore,thepatternsoffatiguecanvarydependingondiseasetype.However,thePFSscalehasneverbeenusedtoassessormeasurethefatigueandpsychometricfeaturesofpatientswithHBV;however,thisassessmentisrequiredpriortoapplicationofthePFSinresearchandclinicalpractice.Therefore,thepurposeofthestudywastoevaluatetheconstructvalidityandreliabilityoftheKoreanversionoftherevisedPiperFatigueScale(PFS)inKoreanswithchronichepatitisB. Materialsandmethods Researchdesign ThisstudyisamethodologicalresearchdesigntoevaluatethevalidityandreliabilityoftheKoreanversionoftherevisedPFSforpatientswithHBV. Participantsanddatacollection TheparticipantswererecruitedfromMarchtoMayin2011attheoutpatientclinicofauniversitymedicalcenterinSeoul,Korea.Inclusioncriteriawereasfollows:1)patientswhowerediagnosedwithHBVoverthreemonthsafterdetectedHBsAgoversixmonths,2)agegreaterthan20years,3)patientswhohadnolivercirrhosisorhepatocellularcarcinoma,4)patientswhohadotherinfectiousdiseasesorimmunediseases,and5)patientswhowereabletounderstandandsigntheinformedconsentform. Therequiredsamplesizeforevaluatingthevalidityandreliabilityofaninstrumentisfivetimesthenumberofitems[16].Basedonthis,146HBVpatientsparticipatedinthestudyusingtherevised22-itemPFS.Thus,itsatisfiedwiththerequiredsamplesize. ThestudywasapprovedbytheInstitutionalReviewBoardofSHospital(IRBNo.4-2011-0746)inSeoul,Korea.Afterthepatientsvoluntarilyagreedtoparticipateinthestudyandsignedtheinformedconsentforms,theycompletedthequestionnaires. Questionnaires Demographic&clinicalcharacteristics.Sex,age,education,occupationstatus,maritalstatus,andhouseholdincomewerecollectedforthedemographiccharacteristics,anddiseaseduration,antiviraltherapy,AST/ALTratio,andfamilyhistorywerecollectedfortheclinicalcharacteristics. TherevisedPFS.TherevisedPFSconsistsof22numericalitemstoassessfatigueatthetimeofthequestionnaire[9].Theitemsarescoredona0–10Likertscaleandmeasurethefourdimensionsofbehavioral/severity(sixitems),affectivemeaning(fiveitems),sensory(fiveitems),andcognitive/mood(sixitems).Tocalculatethesubscalescore,thescoresoftheitemsonthespecificsubscalesaresummedanddividedbythenumberofitemsinthesubscale.Allitemscoresaresummedanddividedby22tocalculatethetotalfatiguescore,whichhasarangefrom0to10,withahighscoreindicatingahighfatiguelevel. TheinvestigatorgotapprovedfromtheauthorsoforiginalinstrumentandthetranslationprocessoftherevisedPFSproceededbasedonback-and–forthtranslationmethod[17,18]asfollowsteps:1)abilingualnursingresearchertranslatedfromEnglishintoKorean.2)anotherbilingualnursingresearcherindependentlyback-translatedfromtheKoreanversionintoEnglish.3)adoctorandanurseindivisionofGastroenterologyconfirmedtheKoreanversionofrevisedPFS. Thereliabilitycoefficientoftheoriginalscalewas0.97[9],whilethatoftheKoreanversionwas0.93amongpatientswithbreastcancer[19]. Statisticalanalysis TheSPSS/WIN20programandSTATA13wereusedtoanalyzethedata.Adescriptiveanalysiswasperformedtodeterminethedemographiccharacteristicsofparticipants.ThedistributionofscoresofallitemsofthePFSwasexaminedbymean,standarddeviation,andfloorandceilingeffects.Floorandceilingeffectswereexaminedusingthefrequencyofhighestandlowestscores.Floorandceilingeffectscanexplainskewnessofthedata,andthedatadistributioncanbeconsideredskewedif15~20%ormoreofthesubjectsaregroupedateitherextreme[20]. ExploratoryfactoranalysiswasconductedtoexaminetheconstructvalidityofthePFS.Todeterminetheappropriatenessoffactoranalysis,theKaiser-Meyer-OlkintestandBartlett’stestofsphericityweremeasuredforsamplingadequacy.Principalcomponentanalysiswasusedtocreatefactorswithdirectobliminrotation.Iffactorloadingsweregreaterthan0.50,theywereconsideredstatisticallysignificantbasedonthesamplesize[21].TheKaisercriterion(K1),thecut-offcriteriaofeigenvalue>1.0,wasusedtoselectthenumberoffactors,andtheMinimumAveragePartial(MAP)confirmedtheresultofK1. InternalconsistencyreliabilityofthescalewasestimatedusingCronbach’salphaforthetotalscaleandthefactors. Results Participantcharacteristics DemographicandclinicalcharacteristicsoftheparticipantsarepresentedinTable1.Among146participants,two-thirdsweremen,andthemeanagewas48.68±11.81years.Morethanhalfoftheparticipantscamehadlessthanahighschooleducation,55.5%ofparticipantshadjobs,andthemajorityweremarried.Themeanmonthlyincomewasrelativelyhigh.Forclinicalcharacteristics,thediseasedurationwas15.32±9.46years,and71.9%ofparticipantsweretakingantiviraldrugs.Themeanvaluesoftheliverfunctiontestwerewithinthenormalranges,and39%ofparticipantshadmaternalHBVhistory.Accordingtotheeligibilitycriteriaofthestudy,thepatientswhohadlivercirrhosisorhepatocellularcarcinomawerenotincluded. Download: PPTPowerPointslidePNGlargerimageTIFForiginalimageTable1.Demographic&clinicalcharacteristics. https://doi.org/10.1371/journal.pone.0177690.t001 Constructvalidity.Using15%ascut-offforfloorandceilingeffects[20],noitemsdemonstratedanyfloorandceilingeffects.Factoranalysiswasperformedtoevaluatetheconstructvalidity.TheKaiser-Meyer-Olkinscorewas.92,supportingtheadequacyofthedataforexploratoryfactoranalysis.Inaddition,Bartlett’stestofsphericity,atestforoverallsignificanceofcorrelationswithinamatrix,wasstatisticallysignificant(p<.001 basedonthek1rule download: pptpowerpointslidepnglargerimagetifforiginalimagetable2.factorloadingfortotalitems. https: pptpowerpointslidepnglargerimagetifforiginalimagetable3.velicer pptpowerpointslidepnglargerimagetifforiginalimagetable4.resultsofexploratoryfactoranalysis. pptpowerpointslidepnglargerimagetifforiginalimagetable5.comparisonofsubscalevaluesandcronbach reliability.inthisstudy discussionthisstudywasconductedtoevaluatetheconstructvalidityandreliabilityofthekoreanversionofthere visedpfsinkoreanswithhbv.theresultsofthisstudysupportthatthe22-itemkoreanversionoftherevisedpfsisval idandreliableinthissample.however thenumberoffactorsinthissamplewasalmostidenticaltothatintheoriginalversion hence thenumberoffactorswasthesameaswiththeoriginalscale ontheotherhand wemeasuredcronbach therearesomelimitationstothecurrentstudy.first althoughtherevisedpfswasdevelopedforcancerpatients conclusionsthestudydemonstratedthepsychometricpropertiesofthekoreanversionoftherevisedpfsastestedinp atientswithchronichepatitisb.theresultsofthestudyrevealedthatthe22-itemkoreanversionoftherevisedpfsi svalidandreliableinkoreanswithchronichepatitisb.furtherlargervalidationstudiesneedtobeperformedinkor eanpatients. supportinginformations1file.dataset.https: authorcontributions conceptualization:yjkl. datacuration:jkkl. formalanalysis:yjjkkl. fundingacquisition:yj. investigation:jkkl. methodology:jk. projectadministration:yjkl. resources:yj. software:jkkl. supervision:yjkl. validation:jkkl. visualization:jkkl. writing references1. tr viewarticle pubmed googlescholar nelsonnp kimya.trendinseroprevalenceofhepatitisbsurfaceantigen lavanchyd.hepatitisbvirusepidemiology schweitzera kimks yim kimj-s piperbf cranepb romkenste tsaysl parke-h jeongk tabachnickbg brislinrw.back-translationforcross-culturalresearch.journalofcross-culturalpsychology.1970 yud leeeh.constructvalidityoftherevisedpiperfatiguescaleinkoreanwomenwithbreastcancer.jkoreanacadnurs.19 andresenem.criteriaforassessingthetoolsofdisabilityoutcomesresearch.archivesofphysicalmedicineandreh abilitation.2000 hairj zwickwr schmittta.currentmethodologicalconsiderationsinexploratoryandconfirmatoryfactoranalysis.journalofpsy choeducationalassessment.2011 ledesmard ruscioj giacalonea velicerwf.determiningthenumberofcomponentsfromthematrixofpartialcorrelations.psychometrika.1976 velicerwf.therelationbetweenfactorscoreestimates jakobssons gledhillja annunziatama dagneliepc zagheritm parkha.problemsandissuesindevelopingmeasurementscalesinnursing.journalofnursingquery.2005 leeeo downloadpdf citation xml print printarticle reprints share reddit facebook linkedin mendeley twitter email advertisement subjectareas formoreinformationaboutplossubjectareas here. wewantyourfeedback.dothesesubjectareasmakesenseforthisarticle koreanpeople isthesubjectarea yes no thanksforyourfeedback. fatigue sensoryperception breastcancer factoranalysis hepatitisbvirus chronichepatitis materialfatigue>