CROSS-CULTURE ADAPTATION AND VALIDATION OF THE CHINESE VERSION OF MANCHESTER COPD FATIGUE SCALE (MCFS)

Abstract Fatigue is an aching, complex, and multifaceted sensation that is the second most prominent and disabling symptom of COPD, approximately 50% of COPD patients suffer from severe fatigue. Various scales or questionnaires has been developed to measure fatigue in COPD patients. The Manchester COPD fatigue scale (MCFS) has been proved to be a robust, simple, reliable, and valid scale in the American population with COPD. As a disease-specific measurement, MCFS can precisely identify the features of fatigue among COPD patients in the physical, cognitive, and psychosocial domains. The Brislin’s translation model was used to for cross-cultural adaptation. Internal consistency, test-retest reliability, constructive validity, convergent validity, and criterion validity were used to test the reliability and validity of MCFS. Diagnostic accuracy was used to determine the optimal cut-off point. Overall, a convenience sampling of 371 patients completed the fatigue scale. The results showed that the scale has acceptable constructive validity (CFI = 0.877, IFI = 0.878, SRMR = 0.027), excellent internal consistency (Cronbach’s alpha = 0.97) and test-retest reliability (Cronbach’s alpha=0.93). MCFS presented good convergent validity. Using the BFI fatigue scale as a reference criterion, the areas under the curve were 0.941 and 0.900, respectively. The optimal cut-off points for mild, moderate, and severe fatigue were ≤16, >16 and ≤29.5, and >29.5 (sensitivity: 94.7% and 82.6%; specificity: 80.8% and 86.0%, respectively). The Chinese version of MCFS could be used to measure fatigue among Chinese patients with COPD.