The PedsQL Multidimensional Fatigue Scale in pediatric rheumatology: reliability and validity

Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, 3137 TAMU, College Station, TX 77843-3137, USA.
The Journal of Rheumatology (Impact Factor: 3.17). 01/2005; 31(12):2494-500.
Source: PubMed

ABSTRACT OBJECTIVE:. The PedsQL (Pediatric Quality of Life Inventory) is a modular instrument designed to measure health related quality of life (HRQOL) in children and adolescents ages 2-18 years. The recently developed 18-item PedsQL Multidimensional Fatigue Scale was designed to measure fatigue in pediatric patients and comprises the General Fatigue Scale (6 items), Sleep/Rest Fatigue Scale (6 items), and Cognitive Fatigue Scale (6 items). The PedsQL 4.0 Generic Core Scales were developed as the generic core measure to be integrated with the PedsQL Disease-Specific Modules. The PedsQL 3.0 Rheumatology Module was designed to measure pediatric rheumatology-specific HRQOL. Methods. The PedsQL Multidimensional Fatigue Scale, Generic Core Scales, and Rheumatology Module were administered to 163 children and 154 parents (183 families accrued overall) recruited from a pediatric rheumatology clinic. Results. Internal consistency reliability for the PedsQL Multidimensional Fatigue Scale Total Score (a = 0.95 child, 0.95 parent report), General Fatigue Scale (a = 0.93 child, 0.92 parent), Sleep/Rest Fatigue Scale (a = 0.88 child, 0.90 parent), and Cognitive Fatigue Scale (a = 0.93 child, 0.96 parent) were excellent for group and individual comparisons. The validity of the PedsQL Multidimensional Fatigue Scale was confirmed through hypothesized intercorrelations with dimensions of generic and rheumatology-specific HRQOL. The PedsQL Multidimensional Fatigue Scale distinguished between healthy children and children with rheumatic diseases as a group, and was associated with greater disease severity. Children with fibromyalgia manifested greater fatigue than children with other rheumatic diseases. CONCLUSION: The results confirm the initial reliability and validity of the PedsQL Multidimensional Fatigue Scale in pediatric rheumatology.

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    • "Health-related quality of life was assessed using the Pediatric Quality of Life inventory (PedsQL) generic core scales, version 4.0 [11], while for fatigue, the multidimensional fatigue scale [12] was employed. The PedsQL generic core scales version 4.0 consists of 23 items which can be completed independently by adolescents. "
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    ABSTRACT: Benign Joint Hypermobility Syndrome (BJHS) is a major source of morbidity in children and adolescents. Due to fatigue and pain, activities of daily living may be limited. Aim of the work To investigate the relationship between fatigue and health related quality of life in adolescents with BJHS. Patients and methods Thirty adolescents with BJHS and 30 controls were enrolled in the study. All participants were subjected to clinical and laboratory assessment to exclude other causes of fatigue. All were requested to complete self assessment Pediatric Quality of Life (PedsQL) and multidimensional fatigue scale questionnaires. Pain was assessed by Visual Analogue Scale (VAS). Results Compared to healthy adolescents, patients with BJHS had a significant lower total score for PedsQL scale (52.56 ± 8.40 and 87.63 ± 4.68 for patients and controls respectively, p < 0.001) and a significant lower total score for multidimensional fatigue scale (66.09 ± 13.05 and 91.32 ± 3.97 for patients and controls respectively, p < 0.001). General and cognitive fatigue that accompanied BJHS, were the only significant predictors of lower health related quality of life in patients’ group. Among patients with BJHS; general fatigue was a significant predictor for emotional and social function impairment, while cognitive fatigue was a significant predictor for school function reduction. Total multidimensional fatigue scale score, general and cognitive fatigue were predictors of physical function impairment in patients and controls. VAS was highly correlated to PedsQL (r = −0.88, p = <0.001) and multidimensional fatigue (r = −0.99, p = <0.001) scales. Conclusion This study highlights the importance of fatigue as a significant predictor of poor health related quality of life in adolescents with BJHS.
    04/2013; 35(2):77–85. DOI:10.1016/j.ejr.2012.12.002
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    • "Responses are on a fivepoint scale (0 = never to 4 = almost always), with higher scores indicating fewer difficulties with fatigue. This scale has demonstrated excellent reliability and validity with children and adolescents (Varni, et al., 2004); the reliability in the current sample was also excellent (α = .95). "
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    ABSTRACT: The aims of this study were to (a) assess and compare sleep disturbances (including daytime and nighttime sleep patterns) in adolescents with depressive disorders and healthy peers, (b) examine the prevalence of pain in adolescents with depressive disorders and healthy peers, and (c) examine pubertal development, pain intensity, and depressive symptom severity as predictors of sleep disturbance. One hundred six adolescents (46 depressed, 60 healthy), 12 to 18 years (M = 15.10 years; 67% female; 77% Caucasian) completed subjective measures of sleep, presleep arousal, fatigue, and pain. Participants also underwent 10 days of actigraphic monitoring to assess nighttime and daytime sleep duration, sleep efficiency, and wake after sleep onset. Results indicated that youth with depression exhibited greater sleep disturbances on subjective and actigraphic sleep variables than healthy controls. Depressed youth also reported more frequent and severe pain than healthy youth. Linear regression analysis indicated that pain intensity and depressive symptoms predicted worse sleep quality across groups. The interaction term was also significant, such that adolescents with high levels of depressive symptoms had poor sleep quality when pain intensity levels were high. These results indicate that sleep is important to assess in youth with depression, and that pain may be an important target for sleep intervention in this population.
    Journal of Clinical Child & Adolescent Psychology 03/2012; 41(4):482-90. DOI:10.1080/15374416.2012.658613 · 1.92 Impact Factor
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    • "It is useful to note that other measures assessing physical functioning in children with chronic pain do exist but to date, none of these alternative measures have empiricallyderived classification systems for describing the extent of pain-related disability. Relevant measures include the Child Activity Limitations Interview self-report questionnaire version (CALI-21; [32]), the Bath Adolescent Pain Questionnaire (BAPQ; [7]), and the Pediatric Quality of Life Inventory (Peds-QL; [38] [37] [36]). Each of these measures has subscales that specifically assess physical functioning and/or pain related disability, which overlap considerably with the content and format of the FDI. "
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    ABSTRACT: The Functional Disability Inventory (FDI) is a well-established and commonly used measure of physical functioning and disability in youth with chronic pain. Further validation of the measure has been called for, in particular, examination of the clinical utility and factor structure of the measure. To address this need, we utilized a large multicenter dataset of pediatric patients with chronic pain who had completed the FDI and other measures assessing pain and emotional functioning. Clinical reference points to allow for interpretation of raw scores were developed to enhance clinical utility of the measure, and exploratory factor analysis was performed to examine its factor structure. Participants included 1300 youth ages 8 to 18 years (mean=14.2 years; 76% female) with chronic pain. Examination of the distribution of FDI scores and validation with measures of depressive symptoms and pain intensity yielded 3 distinct categories of disability: No/Minimal Disability, Moderate Disability, and Severe Disability. Factor analysis of FDI scores revealed a 2-factor solution representing vigorous Physical Activities and non-physically strenuous Daily Activities. The 3-level classification system and factor structure were further explored via comparison across the 4 most commonly encountered pain conditions in clinical settings (head, back, abdominal, and widespread pain). Our findings provide important new information regarding the clinical utility and validity of the FDI. This will greatly enhance the interpretability of scores for research and clinical use in a wide range of pediatric pain conditions. In particular, these findings will facilitate use of the FDI as an outcome measure in future clinical trials.
    Pain 03/2011; 152(7):1600-7. DOI:10.1016/j.pain.2011.02.050 · 5.84 Impact Factor
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