ABSTRACT
OBJECTIVE: To test the psychometric properties of a Chinese version of the Neurological Fatigue Index-Stroke (C-NFI-Stroke) in stroke survivors. DESIGN: This was a validation study. Cross-cultural adaptation of the scale was conducted according to standard guidelines. Reliability, validity, responsiveness, and interpretability were measured. SETTING: Self-help groups and a community center. SUBJECTS: One hundred and twelve Chinese stroke survivors and 65 healthy Chinese older people living in the community. INTERVENTIONS: Not applicable. MAIN MEASURES: The C-NFI-Stroke, Fatigue Severity Scale, Mental Fatigue Scale, General Self-Efficacy Scale, and Geriatric Depression Scale were used. RESULTS: Cronbach's α coefficients were 0.69-0.88; the item-level agreement was 70.4%-88.9%; the weighted Kappa value was 0.47-0.79; and the intra-class correlation coefficients were 0.88-0.93. The C-NFI-Stroke had no ceiling and floor effects. It had good content validity and had two factors, "lack of energy" and "tiredness/weakness." The confirmatory factor analysis showed a good fit to the model. The C-NFI-Stroke significantly correlated with existing fatigue scales (rs = 0.55-0.63), self-efficacy (rs = -0.31 to -0.37), and depressive symptoms (rs = 0.53-0.60). The C-NFI-Stroke could discern differences between stroke survivors and healthy older people. CONCLUSIONS: The C-NFI-Stroke is a reliable and valid tool for clinical and research use on people who have been diagnosed with stroke for a year or more, although its factor structure differs from that of the original English version.
