Psychometric Properties of the Chinese Version of the Occupational Fatigue Exhaustion/Recovery Scale: A Test in a Nursing Population

The measurement of fatigue in clinicians within hospital settings: A systematic review of measurement properties

Medical staff fatigue leads to accidents and mistakes and puts patient safety at risk. A measure of fatigue in the workplace may help to quantify, predict, and manage fatigue. This review aimed to evaluate instruments used to measure fatigue in medical staff within hospitals. A systematic review following the JBI methodology was undertaken. A search for articles was conducted in 2021. Included articles (all validation studies) were assessed for methodological quality using the COSMIN checklist. Measurement property data was evaluated for Quality of Evidence using GRADE methodology. Ten studies representing five instruments were reviewed: Occupational Fatigue Exertion and Recovery scale (now superseded); Occupational Fatigue Exertion and Recovery scale (15-item); Multidimensional Fatigue Inventory; Need for Recovery Scale; and the Swedish Occupational Fatigue Inventory. Four instruments show promise for measuring fatigue in hospital medical staff, however, there is limited certainty in the measure property estimates. The Quality of Evidence for measurement properties for all instruments is insufficient. Further validation studies following the COSMIN standards are needed before recommendations for use can be made.

Psychometric properties of the Japanese version of the Occupational Fatigue Exhaustion Recovery Scale among shift-work nurses

Objectives

Shift‐work nurses are at a higher risk of inadequate recovery from fatigue and developing maladaptive fatigue with significant health consequences. Therefore, it is necessary to monitor fatigue and recovery levels with a reliable scale. We investigated psychometric properties of the Japanese version of the Occupational Fatigue Exhaustion Recovery scale (OFER‐J) for shift‐work nurses.

Methods

Japanese shift‐work nurses responded to self‐administered questionnaires at baseline (n = 942) and one month later (n = 334). The confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) were conducted to verify the structural validity and the correlation analysis and one‐way analysis of variance were conducted to test the construct and discriminative validity. Cronbach's alpha coefficient, intra‐class correlation coefficient (ICC), and smallest detectable change (SDC) were calculated to assess reliability.

Results

The CFA showed high correlations between the factors and whilst the goodness‐of‐fit of the three‐factor model was suboptimal, it was in an acceptable range. Most modifications included the error covariance of the Acute Fatigue (AF) and Intershift Recovery (IR) items. The EFA showed that Chronic Fatigue (CF) and AF were not clearly separated, indicating that the two AF items dropped out. Construct and discriminative validity were also well indicated. Cronbach's alpha coefficients were 0.75–0.85. Only CF showed sufficient reproductivity (ICC = 0.74). The SDC for CF, AF, and IR was 14.0, 17.1, and 18.7, respectively.

Conclusions

The validity and reliability of the OFER‐J were verified as acceptable for shift‐work nurses. The OFER‐J could contribute to a data‐based approach to fatigue management in nursing management practice.

Psychometric properties of the Portuguese version of the occupational fatigue exhaustion/recovery (OFER) scale among industrial shift workers

Reliable and valid instruments are essential for understanding fatigue in occupational settings. This study analyzed the psychometric properties of the Portuguese version of the Occupational Fatigue Exhaustion/Recovery (OFER). A cross-sectional study was conducted with 260 workers (M = 46.52 ± 13.16 years) from a textile industry, exposed to shift work. Convergent and discriminant validity, internal consistency reliability and exploratory and confirmatory factor analysis were performed. Results showed an adequate fit to data (χ² (84) = 209,102, CFI = 0.936, GFI = 0.902, RMSEA = 0.076 CI90% (0.063-0.089)), yielding a 13-item, three factor structure. Two items were removed due to low factor loading. The OFER presented an adequate internal consistency, with the subscales presenting good reliability values (Chronic Fatigue (α = 0.81), Acute Fatigue (α = 0.84) and Recovery between Shifts (α = 0.77)). Findings suggest that the Portuguese version of OFER can be a useful tool to assess occupational fatigue of shift workers and prevent work related injuries.

Relationship among faculty fatigue, academic rank, and scholarship and service productivity

AIM

To examine the relationship among the level of fatigue, academic rank, workload (credit hours) and faculty productivity (as measured by scholarship and service activities).

DESIGN

Descriptive cross-sectional correlational design.

PARTICIPANTS

All full-time faculty in national year-round nursing college.

METHODS

An Internet survey was distributed May/June 2017 to all full-time faculty (n = 318). Responses reported are from 81 faculty members in the prelicensure baccalaureate programme. Survey items included workload, scholarship and service activities and demographic data. Fatigue was measured by the trait version of Occupational Fatigue, Exhaustion Recovery scale which has three subscales: Acute, Persistent, and Chronic.

RESULTS

Mean fatigue for all traits ranged from 45.9 to 52.48. More service activities were reported than scholarship activities. There was a significant positive correlation between chronic fatigue and credit hours. No significant differences existed in fatigue scores based on frequency of scholarship and service activities.

CONCLUSION

This first study of fatigue in nursing faculty establishes the existence of fatigue in this group. This can be serious related to the existence of chronic fatigue. Strategies to reduce fatigue are important to support the long-term employment of nursing faculty.

IMPACT

What problem did the study address? Fatigue in faculty members and its relationship to academic rank and scholarship and service productivity. What were the main findings? Fatigue in faculty members exists. Higher rank was associated with more scholarship and service activities. Chronic fatigue is less than acute or persistent fatigue. Chronic fatigue is related to workload. Where and on whom will the research have impact? Findings may impact retention of nursing faculty members and academic leaders responsible for supporting work-life balance among nursing faculty.

Effects of Work Environments and Occupational Fatigue on Care Left Undone in Rotating Shift Nurses

PURPOSE

This study aimed to examine the effects of work environments and occupational fatigue on care left undone in rotating shift nurses, and to identify the indirect (mediation) effect of work environments on care left undone through nurses' occupational fatigue in South Korean acute care hospitals.

DESIGN

This study employed a cross-sectional design using an online survey to collect data from 488 rotating shift nurses of acute care hospitals in Korea between November and December 2018.

METHODS

A mobile schedule management application for shift nurses was used to advertise the study and to send a link to the online survey. The survey included questions on the nurses' work environment characteristics, care left undone activities, and the Korean version of the Occupational Fatigue Exhaustion/Recovery scale. Poisson regression was used to explore the relationships among work environments, occupational fatigue, and care left undone. Hayes' Model 4 and a bootstrapping analysis were used to identify the mediating effect of occupational fatigue on the relationship between work environments and care left undone.

FINDINGS

The average number of tasks left undone was 3.45 (SD = 2.19). The higher the acute and chronic fatigue levels noted among nurses, the higher were the occurrences of care left undone. Conversely, the higher the intershift recovery level, the lower were the occurrences of care left undone. The results showed a positive relationship between care left undone and overtime hours and the number of patients per nurse. Moreover, nurses' occupational fatigue mediated the relationship between work environments and care left undone. Night shifts per month and the number of consecutive days off had an indirect effect on care left undone through occupational fatigue.

CONCLUSIONS

High levels of occupational fatigue and poor intershift recovery among nurses can lead to care left undone. Nurses' occupational fatigue mediates the effect of work environment on care left undone.

CLINICAL RELEVANCE

It is crucial for healthcare administrators and leaders to develop policies and mandatory regulations to facilitate better working conditions for nurses, consequently reducing their occupational fatigue and decreasing the occurrence of care left undone in acute care hospitals.

Psychometric properties of the Korean version of the Occupational Fatigue Exhaustion Recovery Scale in a nurse population

Most nurses in Korea work rotating shifts, an important contributor to fatigue. The Occupational Fatigue Exhaustion Recovery (OFER) Scale assesses work-related fatigue among nurses. In this study, we aimed to translate and culturally adapt the Korean version of this scale (OFER-K) with nurses working rotating shifts in Korea. Instrument adaptation was performed using committee-based translation, cognitive interviewing, and expert panel interviewing. Criterion validity, convergent validity, construct validity, internal consistency, and test-retest reliability were examined as psychometric properties of the OFER-K. An online survey was completed by 331 nurses; 107 of these nurses completed a second survey after 1 month to assess test-retest reliability. The overall Cronbach's alpha was 0.88. The correlation between participants' initial and retest responses for the total scale was 0.64 (p < .001). The chronic fatigue subscale was stable over time, t(106) = -1.76, p = .08. Criterion and convergent validity were supported by correlations between the OFER-K scale and the Chalder Fatigue Questionnaire, Epworth Sleepiness Scale, and Pittsburgh Sleep Quality Index. Confirmatory factor analysis showed a good fit using a three-factor model. The findings of this study showed that the OFER-K scale is a reliable and valid instrument for assessing chronic fatigue, acute fatigue, and inter-shift recovery in Korean nurses. Future research using this scale may lead to a better understanding of the antecedents and consequences of nurse fatigue and could provide important information to nurse researchers, administrators, and policymakers for developing interventions to reduce nurse fatigue.