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Updated: Jan 11, 2026
Collecting Sleep, Circadian, Fatigue, and Performance Data in Complex Operational Environments
Published on: August 8, 2019
Development and initial validation of Healthcare Worker Occupational Fatigue Scale: a cross-sectional study
Lanhui Tan1, Ying Zhang2, Yifan Liao3
1Department of Nursing, Zhongnan Hospital of Wuhan University, No. 169, Shuiguohu Street, Wuchang District, Wuhan, Hubei, 430071, China.
Background:
Healthcare workers are at high risk of occupational fatigue. However, the lack of a specific assessment tool hinders understanding of the prevalence of fatigue and the effectiveness of interventions, posing a significant threat to physical and mental well-being.
Objective:
This study aimed to develop and preliminarily validate a scale specifically designed to assess occupational fatigue among healthcare workers, thereby providing a practical tool for self-assessment and occupational health management.
Methods:
An initial item pool was generated through a comprehensive review of literature related to this topic and existing fatigue scales. Content and face validity were assessed via a two-round Delphi expert consultation and a pilot survey, resulting in a preliminary scale version. Psychometric properties were evaluated using data from 475 healthcare workers recruited through convenience sampling from a tertiary Grade A general hospital in Wuhan, Hubei Province. The structural validity was examined using exploratory factor analysis and confirmatory factor analysis. Reliability was assessed using Cronbach's alpha and Guttman Split-Half reliability. Data analysis was performed using SPSS 26.0 and AMOS 23.0.
Results:
The final Healthcare Worker Occupational Fatigue Scale (HWOFS) comprises 35 items across five dimensions: physical, cognitive and emotional, social, sleep-related, and auditory fatigue. The scale demonstrates excellent internal consistency (Cronbach's alpha = 0.973, Guttman Split-Half reliability coefficient = 0.924). Content validity was strong, with item-level content validity indices ranging from 0.867 to 1.000 and a scale-level content validity index of 0.925. The confirmatory factor analysis supported the five-factor structure, showing good model fit. All standardized factor loadings were ≥ 0.532 (all p < 0.01).
Conclusion:
This study demonstrated the robust reliability and validity of the newly developed HWOFS. These initial findings support the potential of HWOFS as a tool for healthcare institutions to establish fatigue warning systems, optimize human resource allocation, and develop occupational health protection policies. However, further validation in larger healthcare populations is required before broader application.
