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Development of the Fatigue Coping Strategies Questionnaire: a Scleroderma Patient-Centred Intervention Network (SPIN)
Cassidy Dal Santo1, Meira Golberg2, Marie-Eve Carrier2
1Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC; and Department of Psychiatry, McGill University, Montréal, QC, Canada.
Objectives:
To develop and validate the Fatigue Coping Strategies Questionnaire (FCSQ), a self-report measure to assess coping with fatigue in systemic sclerosis (SSc).
Methods:
We generated an initial pool of items by combining content from existing coping questionnaires and fatigue management programs. Items were added, removed, or modified according to Nominal Group Technique (NGT) sessions conducted with individuals with SSc. Candidate items were administered to SPIN Cohort participants. Exploratory factor analysis (EFA) was used to determine factor structure, with item reduction based on factor loadings, cross-loadings, and conceptual overlap. Measurement properties were assessed using confirmatory factor analysis, differential item functioning (DIF) by language and disease subtype, and Cronbach's alpha.
Results:
73 items were reviewed during the 5 NGT sessions (2 English-language, 3 French language) with 19 participants. 36 items were retained and administered to 645 SPIN Cohort participants. EFA identified a 7-factor structure, resulting in a 21-item questionnaire across 7 domains: Rest and Energy Conservation (2 items), Focus on Fatigue (3), Time and Activity Management (6), Ignoring Fatigue (4), Faith-Based Coping (2), Stress Management (2), and Physical Activity (2). Internal consistency was close to or above acceptable across domains (α=0.66 to 0.83). Five items showed significant DIF by language, but none meaningfully influenced scores (r>0.99 between DIF-adjusted and unadjusted models). No DIF was observed by disease subtype.
Conclusions:
The FCSQ is a valid and reliable measure of fatigue-related coping in SSc. Future research should evaluate the measure's responsiveness to change and potential adaptation for other chronic conditions.
