P242. Development and psychometric testing of an inflammatory bowel disease fatigue (IBD-F) patient self-assessment scale
W. Czuber-Dochan1, C. Norton1, P. Bassett2, S. Berliner3, F. Bredin4, M. Darvell5, A. Forbes6, M. Gay7, I. Nathan8, E. Ream1, H. Terry5, 1King's College London, Florence Nightingale School of Nursing & Midwifery, London, United Kingdom, 2Statsconsultancy, Medical Statistician, Amersham, United Kingdom, 3Crohn's and Colitis UK Trustee, Fatigue Steering Group, St Albans, United Kingdom, 4The Queen Elizabeth Hospital NHS Trust & Addenbrookes Hospital, Gastroenterology, King's Lynn & Cambridge, United Kingdom, 5Crohn's & Colitis UK Charity, CCUK, St Albans, United Kingdom, 6University College London, Gastroenterology, London, United Kingdom, 7Crohn's and Colitis UK, Fatigue Steering Group, St Albans, United Kingdom, 8University College London, Centre for Gastroenterology and Nutrition, London, United Kingdom
Fatigue is one of the main symptoms of inflammatory bowel disease (IBD) and is frequently reported by people in both active and quiescent disease. Many different fatigue assessment scales have been used to measure fatigue, but none has been developed or tested in IBD. This study aimed to develop a new fatigue scale specific to the needs and experiences of people with IBD.
A five-step sequential mixed methods design was used: a qualitative phase (Phase 1) to assess patients' experience of fatigue and its impact on their lives, and four mixed qualitative-quantitative phases (Phase 2–5) to refine the scale and to assess its psychometric properties. Phase 1–4 participants were purposively selected from a group of volunteers who self reported their fatigue, and participants for Phase 5 were randomly selected from the Crohn's and Colitis UK membership database. Alongside the IBD-F scale development we also tested two other generic fatigue scales (MFI and MAF) which have been previously tested in other chronic conditions.
567 people participated in the 5 phases. The resulting IBD-F questionnaire has 3 sections: Section 1 assesses fatigue frequency and severity (5 questions); Section 2 assesses the experience and impact of fatigue (30 questions); and Section 3 is a free-text section asking for patients' comments and additional issues related to their fatigue (4 questions). Initial validation suggests that the questionnaire has good face and content validity and acceptable to excellent test–retest stability (ICC 0.74 for section 1 and 0.83 for section 2) and a high degree of internal consistency with Cronbach's alpha value of over 0.9.
The participants in the study confirmed that fatigue in IBD is burdensome. Items generated and refined by people with IBD-fatigue reflect their experience and form the basis of this new IBD-fatigue scale, which is psychometrically robust and its reliability falls within statistically acceptable ranges. The fatigue scores obtained by the newly developed, disease specific IBD-F self-assessment scale strongly correlated with the existing fatigue scales (MFI and MAF) developed with other diseases. The scale can be used by patients and practitioners to assess severity and impact of fatigue in people with IBD. An electronic copy of IBD-F scale can be accessed through website link http://www.fatigueinibd.co.uk from early spring of 2014.