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Translation and Validation of Post-Dialysis Fatigue Scale Among Vietnamese Patients With Hemodialysis
Nga Thi Thuy Nguyen1,2, Tsai-Wei Huang2,3,4,5, Yeu-Hui Chuang2,3,4
1Faculty of Nursing and Midwifery, Hanoi Medical University, Hanoi, Vietnam.
Background:
Fatigue is a prevalent symptom among patients undergoing hemodialysis, significantly impacting their quality of life. There are several instruments to measure fatigue. However, most of these instruments measure general fatigue, with no specific emphasis on fatigue related to hemodialysis. Recently, a validated scale, the Post-Dialysis Fatigue (PDF) scale, was developed to address this gap by directly measuring post-dialysis fatigue.
Objectives:
The aim of this study was to translate the English version of the PDF scale into Vietnamese and to examine its reliability and validity, taking into account potential cultural differences in the experience of fatigue.
Design:
A cross-sectional study was applied with participants obtained through convenience sampling at two hospitals.
Participants:
Three hundred and twenty-eight participants undergoing hemodialysis treatment were recruited.
Measurements:
The validity of the 13-item Vietnamese version of Post-Dialysis Fatigue scale was evaluated by examining the content validity, concurrent validity, and construct validity. Both exploratory and confirmatory factor analyses were employed to factorize the underlying structure of the scale and confirm whether the data fit a hypothesized measurement model. The reliability was examined by using Cronbach's alpha and test-retest reliability.
Results:
The scale had an excellent content validity index (CVI: 0.86-1.00), good internal consistency (Cronbach's alpha of 0.90), and acceptable test-retest reliability (interclass correlation coefficient of 0.84). Exploratory factor analysis constituted two factors (behavioral fatigue and sensory fatigue) accounting for 59.38% of the variance. The confirmatory factor analysis showed a good model fit (CFI = 0.952, NFI = 0.912, RMSEA = 0.073). Receiver operating characteristic curve analysis identified an optimal cutoff score of 41 by maximizing the combined sensitivity and specificity for screening significant fatigue, according to Youden's Index.
Conclusions:
The post-dialysis fatigue scale is a valid and reliable scale for assessing fatigue in patients undergoing hemodialysis and consists of two factors: behavioral fatigue and sensory fatigue. The translated scale provides a reliable and valid method for assessing dialysis-related fatigue in Vietnamese patients, and the identified cutoff point can facilitate quick screening in clinical settings.
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