Psychometric evaluation of a Chinese version of the Lee Fatigue Scale-Short Form in women during pregnancy and postpartum

Background: Fatigue is among the most prevalent and distressing symptoms in pregnant and postpartum women. Estimating fatigue severity with a psychometrically sound instrument provides the most fundamental information for understanding women's fatigue experience and assessing the need for intervention to improve maternal and infant health outcomes.

Objectives: To evaluate the psychometric properties of a Chinese version of the 7-item Lee Fatigue Scale-Short Form (C-LFS-SF) in pregnant and postpartum women.

Methods: The study was composed of two phases: translation of the scale into Chinese and examination of content validity, and testing to establish the reliability and validity. A convenience sample of 124 women completed health-related questionnaires, kept a fatigue diary and wore a wrist actigraph for 7 days during the third trimester of pregnancy and within three months postpartum.

Results: The C-LFS-SF showed satisfactory internal consistency (Cronbach's alpha≥.97) and stability over the 7 days at each time point (intraclass correlation coefficient>.87). Exploratory factor analysis showed that 88-94% of the total variance was explained by the one-factor fatigue model. Significant associations among the C-LFS-SF and actigraphic sleep quantity and quality variables supported adequate construct validity.

Conclusions: The C-LFS-SF has satisfactory psychometric properties and is an easy and promising tool for assessing maternal fatigue during routine prenatal and postpartum care. This scale needs to be further tested in a more diverse population of pregnant and postpartum women, like women with high risk pregnancies or with medical conditions.