Fatigue after stroke: The development and evaluation of a case definition

• Published in: Journal of psychosomatic research Vol. 63; no. 5; pp. 539 - 544
• Main Authors: Lynch, Joanna, Mead, Gillian, Greig, Carolyn, Young, Archie, Lewis, Susan, Sharpe, Michael
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Inc 01.11.2007; New York, NY Elsevier
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Case definition; Fatigue; Fatigue - diagnosis; Fatigue - etiology; Female; Humans; Interview; Interviews; Male; Medical sciences; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychometric properties; Psychometrics. Diagnostic aid systems; Psychopathology. Psychiatry; Reliability; Severity of Illness Index; Stroke; Stroke - psychology; Strokes; Techniques and methods; Fatigue; Stroke; Case definition; Reliability; Interview; Human; Evaluation; Nervous system diseases; Definition; Cardiovascular disease; Psychometrics; Test reliability; Semidirective interview; Intertrial interval; Cerebral disorder; Vascular disease; Test validation; Construct validity; Face validity; Interrater agreement; Convergent validity; Central nervous system disease; Elderly; Cerebrovascular disease
• ISSN: 0022-3999; 1879-1360
• DOI: 10.1016/j.jpsychores.2007.08.004

Abstract Objective While fatigue after stroke is a common problem, it has no generally accepted definition. Our aim was to develop a case definition for post-stroke fatigue and to test its psychometric properties. Methods A case definition with face validity and an associated structured interview was constructed. After initial piloting, the feasibility, reliability (test–retest and inter-rater) and concurrent validity (in relation to four fatigue severity scales) were determined in 55 patients with stroke. Results All participating patients provided satisfactory answers to all the case definition probe questions demonstrating its feasibility For test–retest reliability, kappa was 0.78 (95% CI, 0.57–0.94, P <.01) and for inter-rater reliability kappa was 0.80 (95% CI, 0.62–0.99, P <.01). Patients fulfilling the case definition also had substantially higher fatigue scores on four fatigue severity scales ( P <.001) indicating concurrent validity. Conclusion The proposed case definition is feasible to administer and reliable in practice, and there is evidence of concurrent validity. It requires further evaluation in different settings.