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Construct Validity of the Swedish version of the Revised Piper Fatigue Scale in an oncology sample – a Rasch analysis.

Journal article
Authors Åsa Lundgren Nilsson
Anna Dencker
Sofie Jakobsson
Charles Taft
Alan Tennant
Published in Value in Health
Volume 17
Issue 4
Pages 360–363
ISSN 1098-3015
Publication year 2014
Published at University of Gothenburg Centre for person-centred care (GPCC)
Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation
Pages 360–363
Language en
Keywords Cancer-related fatigue, Rasch analysis, Revised Piper Fatigue Scale
Subject categories Health Sciences


Abstract Objectives Fatigue is a common and distressing symptom in cancer patients due to both the disease and its treatments. The concept of fatigue is multidimensional and includes both physical and mental components. The 22-item Revised Piper Fatigue Scale (RPFS) is a multidimensional instrument developed to assess cancer-related fatigue. This study reports on the construct validity of the Swedish version of the RPFS from the perspective of Rasch measurement. Methods The Swedish version of the RPFS was answered by 196 cancer patients fatigued after 4 to 5 weeks of curative radiation therapy. Data from the scale were fitted to the Rasch measurement model. This involved testing a series of assumptions, including the stochastic ordering of items, local response dependency, and unidimensionality. A series of fit statistics were computed, differential item functioning (DIF) was tested, and local response dependency was accommodated through testlets. Results The Behavioral, Affective and Sensory domains all satisfied the Rasch model expectations. No DIF was observed, and all domains were found to be unidimensional. The Mood/Cognitive scale failed to fit the model, and substantial multidimensionality was found. Splitting the scale between Mood and Cognitive items resolved fit to the Rasch model, and new domains were unidimensional without DIF. Conclusions The current Rasch analyses add to the evidence of measurement properties of the scale and show that the RPFS has good psychometric properties and works well to measure fatigue. The original four-factor structure, however, was not supported.

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