title: The Brief Fatigue Inventory is reliable and valid for the burn patient cohort.
abstract: OBJECTIVE
  After burn, patients are at risk of fatigue which may influence negatively their capacity to participate in activity, rehabilitation and other treatments. Fatigue may stem from the wound healing and systemic responses to burn which drive a hypermetabolic state that may persist for months. However, an established method is not available for objectively measuring fatigue after burns. The Brief Fatigue Inventory (BFI) was hypothesised to be an appropriate option for assessments following severe burn. The primary aim of the study was to establish if the BFI was reliable and valid in a burn patient sample.
  
  
  METHODS
  Adult patients admitted between 2009 and 2013 to Royal Perth Hospital Burn Center were included. Patients completed the BFI and Burns Specific Health Scale Brief (BSHS-B) in tandem at one, three, six and 12 months after burn. Reliability was assessed using Cronbach's alpha; construct validity using factor analysis and multi-variable regression of BFI; and, criterion validity with longitudinal regression of BFI with BSHS-B.
  
  
  RESULTS
  The sample (n=587) had a median TBSA of 3% (range=<1-75%). The BFI demonstrated excellent reliability (α>0.90). The factor analysis confirmed a single-domain construct, centred around the first scale item. Good correlation between BFI and BSHS-B scores (p<0.001) on longitudinal analysis confirmed criterion validity. There was a significant difference in fatigue scores between minor and major burn patients and a significant association of fatigue levels over time with TBSA.
  
  
  CONCLUSIONS
  The BFI is a reliable and valid tool for fatigue measurement in patients during the first 12 months after burn.
authors.affiliation: Burn Service of WA, Royal Perth Hospital, WA, Australia; School of Medicine and Pharmacology, University of Western Australia, Australia.
authors.forename: Christopher
authors.initials: C
authors.lastname: Toh
authors.affiliation: Burn Service of WA, Royal Perth Hospital, WA, Australia; School of Medicine and Pharmacology, University of Western Australia, Australia.
authors.forename: Marie
authors.initials: M
authors.lastname: Li
authors.affiliation: Fiona Wood Foundation, Perth, WA, Australia.
authors.forename: Vidya
authors.initials: V
authors.lastname: Finlay
authors.affiliation: Fiona Wood Foundation, Perth, WA, Australia.
authors.forename: Teresa
authors.initials: T
authors.lastname: Jackson
authors.affiliation: School of Medicine and Pharmacology, University of Western Australia, Australia; Perkins Medical Research Institute, Perth, WA, Australia.
authors.forename: Sally
authors.initials: S
authors.lastname: Burrows
authors.affiliation: Burn Service of WA, Royal Perth Hospital, WA, Australia; Fiona Wood Foundation, Perth, WA, Australia; Burn Injury Research Unit, University of Western Australia, Australia.
authors.forename: Fiona M
authors.initials: FM
authors.lastname: Wood
authors.affiliation: Burn Service of WA, Royal Perth Hospital, WA, Australia; Fiona Wood Foundation, Perth, WA, Australia; Burn Injury Research Node, Institute of Health and Rehabilitation Research, University of Notre Dame, Fremantle, WA, Australia. Electronic address: dale.edgar@health.wa.gov.au.
authors.forename: Dale W
authors.initials: DW
authors.lastname: Edgar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001830:Body Surface Area; D002053:Burn Units; D002056:Burns / Q000150:complications*; D005163:Factor Analysis, Statistical; D005221:Fatigue / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012737:Sex Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Acute burns; Fatigue; Participant response outcome; Quality of life