Yes / 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. / Starkey Inc, NIH National Institute on Deafness and Other Communication Disorders (NIDCD) Grant #R21DC012865, NICHD Grant P30HD15052 to the Vanderbilt Kennedy Center for Research on Human Development, Vanderbilt Institute for Clinical and Translational Research grant (UL1 TR000445 from NCATS/NIH)
| Identifer | oai:union.ndltd.org:BRADFORD/oai:bradscholars.brad.ac.uk:10454/19408 |
| Date | 28 March 2023 |
| Creators | Hornsby, B.W.Y., Camarata, S., Cho, S.-J., Davis, H., McGarrigle, Ronan, Bess, F.H. |
| Source Sets | Bradford Scholars |
| Language | English |
| Detected Language | English |
| Type | Article, Accepted manuscript |
| 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 44(5): 1251-1261., Unspecified |
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