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Cross-Cultural Adaptation and Validation of the Japanese Charité Alarm Fatigue Questionnaire (CAFQa) Among ICU Nurses
Tomoo Sato1,2, Mitsuko Ishiseki3, Yuki Kataoka2,4,5,6,7,8
1Department of Nursing, Faculty of Nursing, Kindai University, Sakai City, Osaka, Japan.
Abstract:
Alarm fatigue threatens patient safety in intensive care units (ICUs), yet no validated Japanese instrument exists. We cross-culturally adapted the Charité Alarm Fatigue Questionnaire (CAFQa) into Japanese following COSMIN guidelines and evaluated it in 129 clinicians (103 nurses, 26 physicians) at five hospitals, with 102 retested. Confirmatory factor analysis supported the two-factor structure (CFI = 0.922; RMSEA = 0.041; SRMR = 0.076), but the inter-factor correlation was near zero (r = 0.05), suggesting that Alarm Stress and Alarm Coping behave as largely independent dimensions. Cronbach's alpha was 0.805 (Stress) and 0.649 (Coping); test-retest ICCs ranged 0.62-0.75. Alarm Stress correlated with job stress (r = 0.256) and insomnia (r = 0.369), whereas Alarm Coping related selectively to relational and environmental factors and to ICU experience. Given the orthogonal subscales, we recommend subscale-level rather than total-score interpretation.