Validation of the German Inflammatory Bowel Disease Fatigue (IBD-F) Questionnaire

Abstract

Introduction Fatigue is a common symptom in patients with inflammatory bowel diseases (IBD). To date, there is no instrument to assess IBD-specific fatigue in German. The aim of this study was to translate the IBD Fatigue (IBD-F) scale and to test its psychometric properties in a German IBD population.

Methods After completing the translation process, 20 IBD patients participated in a pilot testing phase. For further analyses, 180 IBD patients with fatigue answered the IBD-F (Sections I, II, III) and the IBD Questionnaire (IBDQ-D). Reliability was tested by using Cronbach's alpha and corrected item–total correlation. Exploratory factor analyses (EFA) were carried out. Spearman’s correlation was calculated between the IBD-F and IBDQ-D . 78 patients could be included to calculate the test–retest reliability.

Results The German version of the IBD-F shows high face and content validity. Internal consistency was excellent, with a Cronbach's alpha of 0.93–0.98. Corrected item–total correlations ranged from 0.51 to 0.89. The correlation between the IBD-F and the IBDQ-D was statistically significant for Section I (rs=-0.59; p<0.01) and Section II (rs=-0.76; p<0.01) of the IBD-F. The EFA identified one relevant factor for each section. Test-retest reliability was acceptable for Section I (intraclass correlation coefficient (ICC)=0.73) and Section II (ICC=0.84).

Conclusion The German version of the IBD-F is a reliable and valid tool to assess fatigue in IBD.

Zusammenfassung

Einleitung Fatigue ist ein häufiges Symptom bei chronisch-entzündlichen Darmerkrankungen (CED). Derzeit existiert kein geeignetes deutschsprachiges Instrument zur Erfassung von Fatigue bei CED. Ziel ist es, den Inflammatory Bowel Disease Fatigue (IBD-F)-Fragebogen zu übersetzen und die Gütekriterien an einer deutschsprachigen Stichprobe zu validieren.

Methodik Nach Übersetzung des IBD-F nahmen 20 PatientInnen an einer Probetestung teil. Für weitere Analysen beantworteten 180 CED-PatientInnen mit Fatigue den IBD-F (Teil I, II, III) und den Inflammatory Bowel Disease Questionnaire (IBDQ-D). Die Reliabilität wurde mithilfe von Cronbachs α und Trennschärfen ermittelt. Explorative Faktorenanalysen (EFA) wurden durchgeführt. Die Korrelationen von IBD-F und IBDQ-D wurden evaluiert. 78 PatientInnen wurden zur Berechnung der Test-Retest-Reliabilität eingeschlossen.

Ergebnisse Die deutsche Version des IBD-F hat eine hohe Inhalts- und Augenscheinvalidität. Die interne Konsistenz war exzellent (Cronbachs α = 0.93–0.98). Die Trennschärfekoeffizienten lagen zwischen 0.51 und 0.89. Die Korrelationen zwischen IBD-F und IBDQ-D waren statistisch signifikant für Teil I (rs=-0.59; p<0.01) und Teil II (rs=-0.76; p<0.01) des IBD-F. Die einfaktorielle Struktur konnte für beide Teile bestätigt werden. Die Test-Retest-Reliabilität kann für Teil I (Intraklassenkorrelationskoeffizient (ICC)=0.73) und Teil II (ICC=0.84) als akzeptabel bewertet werden.

Schlussfolgerung Die deutsche Version des IBD-F ist ein zuverlässiges und valides Instrument zur Erfassung von Fatigue bei CED.

Schlüsselwörter

chronisch entzündliche Darmerkrankung - IBD - Fatigue - Validierung - Fragebogen

Keywords

Inflammatory Bowel Disease - IBD - Fatigue - Validation - Questionnaire

Publication History

Received: 03 December 2021

Accepted after revision: 11 March 2022

Article published online:
09 May 2022

• References

• 1 Burisch J, Jess T, Martinato M. et al. The burden of inflammatory bowel disease in Europe. J Crohns Colitis 2013; 7: 322-337 DOI: 10.1016/j.crohns.2013.01.010. (PMID: 23395397)
• 2 Keyashian K, Dehghan M, Sceats L. et al. Comparative Incidence of Inflammatory Bowel Disease in Different Age Groups in the United States. Inflamm Bowel Dis 2019; 25: 1983-1989 DOI: 10.1093/ibd/izz092. (PMID: 31095681)
• 3 Viazis N, Mantzaris G, Karmiris K. et al. Inflammatory bowel disease: Greek patients’ perspective on quality of life, information on the disease, work productivity and family support. Ann Gastroenterol 2013; 26: 52-58 (PMID: 24714294)
• 4 Kemp K, Griffiths J, Lovell K. Understanding the health and social care needs of people living with IBD: a meta-synthesis of the evidence. World J Gastroenterol 2012; 18: 6240-6249 DOI: 10.3748/wjg.v18.i43.6240. (PMID: 23180944)
• 5 Singh S, Blanchard A, Walker JR. et al. Common symptoms and stressors among individuals with inflammatory bowel diseases. Clin Gastroenterol Hepatol 2011; 9: 769-775 DOI: 10.1016/j.cgh.2011.05.016. (PMID: 21645640)
• 6 Czuber-Dochan W, Norton C, Bassett P. et al. Development and psychometric testing of inflammatory bowel disease fatigue (IBD-F) patient self-assessment scale. J Crohns Colitis 2014; 8: 1398-1406 DOI: 10.1016/j.crohns.2014.04.013. (PMID: 24856864)
• 7 Borren NZ, van der Woude CJ, Ananthakrishnan AN. Fatigue in IBD: epidemiology, pathophysiology and management. Nat Rev Gastroenterol Hepatol 2019; 16: 247-259 DOI: 10.1038/s41575-018-0091-9. (PMID: 30531816)
• 8 Langenberg DR, Gibson PR. Systematic review: fatigue in inflammatory bowel disease. Aliment Pharmacol Ther 2010; 32: 131-143 DOI: 10.1111/j.1365-2036.2010.04347.x. (PMID: 20456309)
• 9 Graff LA, Vincent N, Walker JR. et al. A population-based study of fatigue and sleep difficulties in inflammatory bowel disease. Inflamm Bowel Dis 2011; 17: 1882-1889 DOI: 10.1002/ibd.21580. (PMID: 21830266)
• 10 Cohen BL, Zoëga H, Shah SA. et al. Fatigue is highly associated with poor health-related quality of life, disability and depression in newly-diagnosed patients with inflammatory bowel disease, independent of disease activity. Aliment Pharmacol Ther 2014; 39: 811-822 DOI: 10.1111/apt.12659. (PMID: 24612278)
• 11 Villoria A, García V, Dosal A. et al. Fatigue in out-patients with inflammatory bowel disease: Prevalence and predictive factors. PLoS ONE 2017; 12: e0181435 DOI: 10.1371/journal.pone.0181435. (PMID: 28749985)
• 12 Jewanski V, Hoyer H, Ziegler J. et al. Fatigue bei Patienten mit chronisch entzündlichen Darmerkrankungen (CED): häufig und durch Laboruntersuchungen nicht zu erkennen! In: 74. Jahrestagung der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten mit Sektion Endoskopie – 13. Herbsttagung der Deutschen Gesellschaft für Allgemein- und Viszeralchirurgie gemeinsam mit den Arbeitsgemeinschaften der DGAV. Zeitschrift für Gastroenterologie. Georg Thieme Verlag KG; 2019. DOI: 10.1055/s-0039-1695617
• 13 Jonefjäll B, Simrén M, Lasson A. et al. Psychological distress, iron deficiency, active disease and female gender are independent risk factors for fatigue in patients with ulcerative colitis. United European Gastroenterol J 2018; 6: 148-158 DOI: 10.1177/2050640617703868. (PMID: 29435325)
• 14 Gennep S, Evers SW, Rietdijk ST. et al. High Disease Burden Drives Indirect Costs in Employed Inflammatory Bowel Disease Patients: The WORK-IBD Study. Inflamm Bowel Dis 2020; DOI: 10.1093/ibd/izaa082. (PMID: 32378704)
• 15 Jelsness-Jørgensen L-P, Bernklev T, Henriksen M. et al. Chronic fatigue is more prevalent in patients with inflammatory bowel disease than in healthy controls. Inflamm Bowel Dis 2011; 17: 1564-1572 DOI: 10.1002/ibd.21530. (PMID: 21674713)
• 16 Liebert A, Gawron-Kiszka M, Budzyńska A. et al. P175 Fatigue and its severity depends on demographic and clinical factors in the Polish population of patients with inflammatory bowel disease – results of a cross-sectional study. Journal of Crohn’s and Colitis 2018; 12: S186-S186 DOI: 10.1093/ecco-jcc/jjx180.302.
• 17 Goldenberg BA, Graff LA, Clara I. et al. Is iron deficiency in the absence of anemia associated with fatigue in inflammatory bowel disease?. Am J Gastroenterol 2013; 108: 1392-1397 DOI: 10.1038/ajg.2013.14. (PMID: 24005345)
• 18 Bager P, Befrits R, Wikman O. et al. Fatigue in out-patients with inflammatory bowel disease is common and multifactorial. Aliment Pharmacol Ther 2012; 35: 133-141 DOI: 10.1111/j.1365-2036.2011.04914.x. (PMID: 22059387)
• 19 Frigstad SO, Høivik ML, Jahnsen J. et al. Fatigue is not associated with vitamin D deficiency in inflammatory bowel disease patients. World J Gastroenterol 2018; 24: 3293-3301 DOI: 10.3748/wjg.v24.i29.3293. (PMID: 30090009)
• 20 Kucharzik T, Dignass AU, Atreya R. et al. Aktualisierte S3-Leitlinie Colitis ulcerosa – Living Guideline. Z Gastroenterol 2020; 58: e241-e326 DOI: 10.1055/a-1296-3444. (PMID: 33260237)
• 21 Sturm A, Atreya R, Bettenworth D. et al. Aktualisierte S3-Leitlinie „Diagnostik und Therapie des Morbus Crohn“ der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS). 021. Aufl. AWMF online. 2021
• 22 Czuber-Dochan W, Ream E, Norton C. Review article: Description and management of fatigue in inflammatory bowel disease. Aliment Pharmacol Ther 2013; 37: 505-516 DOI: 10.1111/apt.12205. (PMID: 23311461)
• 23 Czuber-Dochan W, Dibley LB, Terry H. et al. The experience of fatigue in people with inflammatory bowel disease: an exploratory study. J Adv Nurs 2013; 69: 1987-1999 DOI: 10.1111/jan.12060. (PMID: 23215959)
• 24 Janke K-H, Steder-Neukamm U, Bauer M. et al. Lebensqualität bei chronisch entzündlichen Darmerkrankungen (CED): die deutsche Version des Inflammatory Bowel Disease Questionnaire (IBDQ-D) zur krankheitsspezifischen Lebensqualitätsmessung -- erste Anwendung und Vergleich mit anderen internationalen Fassungen. Gesundheitswesen 2005; 67: 656-664 DOI: 10.1055/s-2005-858579.
• 25 Janke K-H, Klump B, Steder-Neukamm U. et al. Validierung der Deutschen Version (Kompetenznetz „Chronisch entzündliche Darmerkrankungen”) des Inflammatory Bowel Disease Questionnaire IBDQ-D. Psychother Psych Med 2006; 56: 291-298 DOI: 10.1055/s-2006-932661.
• 26 Harvey RF, Bradshaw JM. A Simple index of Crohn’s-disease activity. The Lancet 1980; 315: 514 DOI: 10.1016/s0140-6736(80)92767-1. (PMID: 6102236)
• 27 Lewis JD, Chuai S, Nessel L. et al. Use of the noninvasive components of the Mayo score to assess clinical response in ulcerative colitis. Inflamm Bowel Dis 2008; 14: 1660-1666 DOI: 10.1002/ibd.20520. (PMID: 18623174)
• 28 Peyrin-Biroulet L, Panés J, Sandborn WJ. et al. Defining Disease Severity in Inflammatory Bowel Diseases: Current and Future Directions. Clin Gastroenterol Hepatol 2016; 14: 348-354.e17 DOI: 10.1016/j.cgh.2015.06.001. (PMID: 26071941)
• 29 Nunnally JC. Psychometric theory. McGraw-Hill series in psychology. 2nd ed.. New York: McGraw-Hill; 1978
• 30 Holcomb ZC, Cox KS. Interpreting Basic Statistics: A Workbook Based on Excerpts from Journal Articles. 8th ed.. Milton: Taylor and Francis; 2017
• 31 Terwee CB, Bot SDM, de Boer MR. et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol 2007; 60: 34-42 DOI: 10.1016/j.jclinepi.2006.03.012. (PMID: 17161752)
• 32 Kline P. A psychometrics primer. London: Free Association; 2000
• 33 Lage AC, Oliveira CC, Batalha APDB. et al. The inflammatory bowel disease-fatigue patient self-assessment scale: translation, cross-cultural adaptation and psychometric properties of the brazilian version (IBD-F Brazil). Arq Gastroenterol 2020; 57: 50-63 DOI: 10.1590/S0004-2803.202000000-10. (PMID: 32294736)
• 34 Vestergaard C, Dahlerup JF, Bager P. Validation of the Danish version of Inflammatory Bowel Disease Self-assessment Scale. Dan Med J 2017; 64: A5394-A5394 (PMID: 28869029)
• 35 Keightley P, Reay RE, Pavli P. et al. Inflammatory bowel disease-related fatigue is correlated with depression and gender. Australas Psychiatry 2018; 26: 508-513 DOI: 10.1177/1039856218772245. (PMID: 29737197)
• 36 Fatigue in IBD. Accessed August 17, 2020 at: http://www.fatigueinibd.co.uk/questionnaire/