Testing the psychometric properties of the Chinese version of the Neurological Fatigue Index-Stroke

Abstract

Objective: To test the psychometric properties of a Chinese version of the Neurological Fatigue Index-Stroke (C-NFI-Stroke) in stroke survivors. Design: This was a validation study. Cross-cultural adaptation of the scale was conducted according to standard guidelines. Reliability, validity, responsiveness, and interpretability were measured. Setting: Self-help groups and a community center. Subjects: One hundred and twelve Chinese stroke survivors and 65 healthy Chinese older people living in the community. Interventions: Not applicable. Main measures: The C-NFI-Stroke, Fatigue Severity Scale, Mental Fatigue Scale, General Self-Efficacy Scale, and Geriatric Depression Scale were used. Results: Cronbach’s α coefficients were 0.69–0.88; the item-level agreement was 70.4%–88.9%; the weighted Kappa value was 0.47–0.79; and the intra-class correlation coefficients were 0.88–0.93. The C-NFI-Stroke had no ceiling and floor effects. It had good content validity and had two factors, “lack of energy” and “tiredness/weakness.” The confirmatory factor analysis showed a good fit to the model. The C-NFI-Stroke significantly correlated with existing fatigue scales ( rs = 0.55–0.63), self-efficacy ( rs = −0.31 to −0.37), and depressive symptoms ( rs = 0.53–0.60). The C-NFI-Stroke could discern differences between stroke survivors and healthy older people. Conclusions: The C-NFI-Stroke is a reliable and valid tool for clinical and research use on people who have been diagnosed with stroke for a year or more, although its factor structure differs from that of the original English version.