多维疲劳量表(MFI-20)在类风湿关节炎患者的运用

Application of Multidimensional Fatigue Scale (MFI-20) in Patients with Rheumatoid Arthritis

目的验证中文版多维疲劳量表(MFI-20)在类风湿关节炎(RA)患者的信效度并运用。方法选择2019年1月至2020年1月在汕头大学医学院第一附属医院风湿内科住院的225例RA患者,采用一般资料调查表、中文版多维疲劳量表(MFI-20)、中文版BRAF-MDQ 量表、疾病家庭负担量表(FBS)对研究对象进行问卷调查。采用探索性因素分析、中文版BRAF-MDQ 量表作为效标关联效度评价MFI-20的效度,内在信度、外在信度分别采用 Cronbach’s α系数、重测信度进行检验,并对RA患者的疲劳水平与疾病家庭负担情况进行相关性分析。结果探索性因素分析共抽取4个共同因子,累计贡献率为60.34%,各条目因子负荷为0.41-0.737,效标关联效度:MFI-20与 BRAF-MDQ (r=0.758,P<0.01),得分均呈高度正相关,Cronbach’s α系数为0.874,重测信度ICC值为0.98。RA 患者MFI-20得分为(62.98±12.54),疲劳情况与FBS得分及其各维度项目均存在正相关性。结论 MFI-20量表应用于RA患者具有良好的信度和效度,家庭负担情况(FBS得分)影响着RA患者的疲劳程度。建议医护人员了解RA患者的家庭负担情况及支持力度,做好桥梁作用,加强宣教及指导工作,改善患者疲劳状况,提高生活质量。

Objective To verify the reliability and validity of the Chinese version of Multidimensional Fatigue Inventory (MFI-20) in patients with rheumatoid arthritis (RA),and employ the scale.Methods A convenience sample of 225 patients diagnosed with rheumatoid arthritis hospitalized in rheumatology department in the First Affiliated Hospital of Shantou University Medical College during January 2019 and January 2020 were recruited.A set of questionnaires comprised socio-demographic questionnaire,the Chinese version of MFI-20,the Chinese version of the Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire (BRAF-MDQ),Family Burden Scale of Disease (FBS) were employed to collect data.The validity of MFI-20 was assessed by Exploratory Factor Analysis (CFA) and the Chinese version of BRAF-MDQ was used as criterion-related validity.The internal consistency and the external consistency of the Chinese version of MFI-20 was tested by Cronbach’s alpha coefficient and test-retest reliability respectively.Correlation analysis was implied to compare the fatigue level of the patients and their family disease burden.Results CFA extracted four dimensions that explained 60.34% of the variation.Factor loadings for each item were range from 0.410 to 0.737.Significant positive correlations were found between the scores of MFI-20 and BRAF-MDQ (r=0.758,P<0.01).Cronbach’s alpha was 0.874 and the ICC (intraclass correlation coefficient) of test-retest reliability was 0.98.The score of MFI-20 was (62.98±12.54) and the patients’ fatigue was positive related with the total scores and the score of each dimension in FBS.Conclusion MFI-20 is a reliable and valid instrument for measuring the fatigue of patients with RA.Besides,the RA patients’ family burden (FBS score) affects their fatigue.Therefore,the advice here is medical staff should have certain acquaintance about RA patients’ family burden and provide support to them,do a better job bridging the gap,put more effort in health education and guidance,relieve patients’ fatigue condition and improve their quality of life.