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    Development and Validation of a Brief Version of the Vanderbilt Fatigue Scale for Adults: The VFS-A-10

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    Publication date
    2023
    Author
    Hornsby, B.W.Y.
    Camarata, S.
    Cho, S.-J.
    Davis, H.
    McGarrigle, Ronan
    Bess, F.H.
    Keyword
    Hearing loss
    Listening-related fatigue
    Clinical scale
    Vanderbilt Fatigue Scale
    Rights
    (c) 2023 LWW. Full-text reproduced in accordance with the publisher's self-archiving policy. This is a non-final version of an article published in final form in Ear and Hearing xxxx.
    Peer-Reviewed
    Yes
    Open Access status
    embargoedAccess
    
    Metadata
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    Abstract
    Objectives: Listening-related fatigue can be a significant problem for adults who struggle to hear and understand, particularly adults with hearing loss. However, valid, sensitive, and clinically useful measures for listening-related fatigue do not currently exist. The purpose of this study was to develop and validate a brief clinical tool for measuring listening-related fatigue in adults. Design: The clinical scale was derived from the 40-item version of the Vanderbilt Fatigue Scale for Adults (VFS-A-40), an existing, reliable, and valid research tool for measuring listening9 related fatigue. The study consisted of two phases. Phase 1 (N = 580) and Phase 2 (N = 607) participants consisted of convenience samples of adults recruited via online advertisements, clinical records review, and a pool of prior research participants. In Phase 1, results from item response theory (IRT) analyses of VFS-A-40 items were used to identify high quality items for the brief (10-item) clinical scale: the VFS-A-10. In Phase 2, the characteristics and quality of the VFS-A-10 were evaluated in a separate sample of respondents. Dimensionality was evaluated using exploratory factor analyses (EFA) and item quality and characteristics were evaluated using IRT. VFS-A-10 reliability and validity were assessed multiple ways. IRT reliability analysis was used to examine VFS-A-10 measurement fidelity. In addition, test-retest reliability was assessed in a subset of Phase 2 participants (n = 145) who completed the VFS-A-10 a second time approximately one month after their initial measure (range 5-90 days). IRT differential item functioning (DIF) was used to assess item bias across different age, gender, and hearing loss subgroups. Convergent construct validity was evaluated by comparing VFS-A-10 responses to two other generic fatigue scales and a measure of hearing disability. Known-groups validity was assessed by comparing VFS-A-10 scores between adults with and without self reported hearing loss Results: EFA suggested a unidimensional structure for the VFS-A-10. IRT analyses confirmed all test items were high quality. IRT reliability analysis revealed good measurement fidelity over a wide range of fatigue severities. Test-retest reliability was excellent (rs = .88, collapsed across participants). IRT DIF analyses confirmed the VFS-A-10 provided a valid measure of listening29 related fatigue regardless of respondent age, gender, or hearing status. An examination of associations between VFS-A-10 scores and generic fatigue/vigor measures revealed only weak31 to-moderate correlations (Spearman’s correlation coefficient rs = -.36 to .57). Stronger associations were seen between VFS-A-10 scores and a measure of perceived hearing difficulties (rs = .79 to .81) providing evidence of convergent construct validity. In addition, the VFS-A-10 was more sensitive to fatigue associated with self-reported hearing difficulties than generic measures. It was also more sensitive than generic measures to variations in fatigue as a function of degree of hearing impairment. Conclusions: These findings suggest that the VFS-A-10 is a reliable, valid, and sensitive tool for measuring listening-related fatigue in adults. Its brevity, high sensitivity, and good reliability make it appropriate for clinical use. The scale will be useful for identifying those most affected by listening-related fatigue and for assessing benefits of interventions designed to reduce its negative effects.
    URI
    http://hdl.handle.net/10454/19408
    Version
    Accepted manuscript
    Citation
    Hornsby BWY, Camarata S, Cho S-J et al (2023) Development and Validation of a Brief Version of the Vanderbilt Fatigue Scale for Adults: The VFS-A-10. Ear and Hearing. Accepted for publication.
    Link to publisher’s version
    https://doi.org/10.1097/AUD.0000000000001369
    Type
    Article
    Notes
    The full-text of this article will be released for public view at the end of the publisher embargo, 12 months after first publication.
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