Cross-cultural adaptation and validation of the universal Portuguese-version of the Pediatric Functional Assessment of Chronic Illness Therapy - Fatigue (pedsFACIT-F)

Fernandes, Karla P.; Teixeira, Bruno S.; Arnold, Benjamin J.; Mendonça, Tânia M. da S.; Oliveira, Sthela M.; Silva, Carlos Henrique M. da

doi:10.1016/j.jped.2019.01.003

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Original articles • J. Pediatr. (Rio J.) 96 (4) • Jul-Aug 2020 • https://doi.org/10.1016/j.jped.2019.01.003 copy

Cross-cultural adaptation and validation of the universal Portuguese-version of the Pediatric Functional Assessment of Chronic Illness Therapy - Fatigue (pedsFACIT-F)^☆ ☆ Please cite this article as: Fernandes KP, Teixeira BS, Arnold BJ, Mendonça TM, Oliveira SM, Silva CH. Cross-cultural adaptation and validation of the universal Portuguese-version of the Pediatric Functional Assessment of Chronic Illness Therapy - Fatigue (pedsFACIT-F). J Pediatr (Rio J). 2020;96:456-63.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To cross-culturally adapt and validate the universal Portuguese version of the Pediatric Functional Assessment of Chronic Illness Therapy - Fatigue (pedsFACIT-F).

Method:

The universal Portuguese version of the pedsFACIT-F was cross-culturally adapted and validated in 323 children and adolescents aged 8-18 years, 173 healthy individuals, and 150 with chronic diseases (cancer, juvenile idiopathic arthritis, and diabetes). Reliability (internal consistency and test-retest reliability) was assessed. Item response theory model assumptions were evaluated using confirmatory and exploratory factor analyses. Items were calibrated using a graded response model. Differential item functioning was assessed regarding age, gender, and clinical condition (healthy vs. chronic diseases).

Results:

No major cultural adaptations were needed. Internal consistency (Cronbach's alpha = 0.84) and test-retest reliability (intraclass correlation coefficient = 0.92) were good. CFA (CFI = 0.92, TLI = 0.90, RMSEA = 0.097) and CFE analysis confirmed sufficient unidimensionality. The data also fit the GRM and demonstrated good coverage of the fatigue construct (threshold parameters range: -1.42 to 4.56). No items demonstrated significant differential item functioning.

Conclusion:

The universal Portuguese version of the pedsFACIT-F provides a reliable, precise, and valid measure after being assessed by robust psychometric properties. Stability of the measurement properties of the pedsFACIT-F scale allows its use to assess fatigue in clinical research in Portuguese-speaking children and adolescents.

KEYWORDS
Fatigue; Children; Cross cultural translation; Validation; Calibration; Item response theory

Characteristics	Chronic diseases ( n = 150)	Healthy individuals ( n = 173)
Mean age; months (SD)	138.0 (28.0)	138.2 (26.8)
Age range (%)
8-12 years	106 (70.6)	114 (65.9)
13-18 years	44 (29.3)	59 (34.1)
Gender (%)
F	77 (51.3)	99 (57.2)
M	73 (48.7)	74 (42.8)
Level of schooling (%)
Elementary school	38 (25.3)	47 (27.2)
Middle school	98 (65.3)	121 (69.9)
High school	14 (9.3)	5 (2.9)
Chronic diseases (%)
Juvenile arthritis	42 (28.0)	_
Cancer	46 (30.6)	_
Diabetes	62 (41.3)	_

Items	a	Thresholds of response categories				SS-X²
Items	a	b ₁	b ₂	b ₃	b ₄	SS-X²
I feel tired pF1	1.61	-1.42	-0.22	1.40	2.22	0.39
I have energy (or strength) pF2	1.07	0.01	1.75	3.20	4.56	0.03
I managed to do my usual things at home pF3	0.84	0.45	1.83	3.05	4.37	0.24
I had difficulty getting things done because I was too tired pF4	2.10	-0.39	0.46	1.43	2.15	0.11
I had difficulty finishing things because I was too tired pF5	1.62	-0.34	0.64	1.75	2.69	0.17
I had to sleep during the day pF6	0.95	-0.51	0.67	1.86	2.46	0.06
I was irritated because I was too tired to do the things I wanted to pF7	2.28	-0.09	0.48	1.04	1.57	0.10
I had difficulty playing or going out with my friends as much as I wanted to because I was tired pF8	1.76	0.54	1.15	1.77	2.27	0.01
I needed help to do my usual things at home pF9	0.96	-0.07	1.11	2.35	2.96	0.02
I feel weak pF10	1.52	0.05	0.98	2.05	2.93	0.20
I was too tired to eat pF11	1.19	1.26	2.05	2.92	4.42	0.00
Being tired makes me feel sad pF12	1.56	0.52	1.31	1.82	2.41	0.37
Being tired makes me feel angry pF13	1.68	0.08	0.78	1.32	1.81	0.22

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[1] * Corresponding author. E-mail: fernandeskp@uol.com.br (K.P. Fernandes).