Development and validation of a physical fatigue assessment scale for patients undergoing maintenance hemodialysis

OBJECTIVE: This study aimed to develop and validate a physical fatigue assessment tool for maintenance hemodialysis (MHD) patients, which enables them to self-evaluate their fatigue intensity through analysis of its impact on their daily physical activities. METHODS: The physical fatigue assessment tool was developed based on expert evaluation and cognitive interviews. Concurrent validity was assessed by comparing the newly developed tool Physical Fatigue Assessment Ruler with the fatigue numeric rating scale (NRS). Convergent validity was evaluated by examining the relationship between fatigue scores and objective physical activity data obtained from ActiGraph accelerometers. RESULTS: This study included a total of fifty-six MHD patients (58.6 ± 12.6 years, 50% male). There was a significant positive correlation between scores on the Physical Fatigue Assessment Ruler and those on the fatigue NRS (rho = 0.784, P < 0.01). Furthermore, physical fatigue scores exhibited significant negative correlations with ActiGraph-estimated physical activity metrics, including energy expenditure (rho = -0.264, P < 0.001) and step counts (rho = -0.291, P < 0.001). CONCLUSIONS: This study developed the Physical Fatigue Assessment Ruler for MHD patients with acceptable validity. Its ability to quantify fatigue intensity based on impacts on daily physical activities provides healthcare providers with crucial information for personalizing interventions. CLINICAL TRIAL NUMBER : Not applicable.