Background/Purpose:

The Multidimensional Assessment of Fatigue (MAF) scale was originally developed in 1990 for adults with rheumatoid arthritis. Since then, the MAF has been translated to 25 languages and used for patients with various diseases due to its relatively short, thus low burden for patients and potential for clinical usefulness. The purpose of this paper was to comprehensively review the MAF with particular attention to clinical relevance, reliability, and validity, and evaluate how the MAF has been used over the past 25 years.

Methods:

Database, and hand searches were conducted. We searched databases including CINAHL Plus, Health Source Nursing, MEDLINE, PsycINFO, and PubMed using multidimensional assessment of fatigue or MAF as key terms. All selected articles were peer-reviewed, published papers in English from January 1993 through May 2015. We located 463 articles on the topic and 98 articles met inclusion criteria.

Results:

Of the 98 articles, 79 (81%) were empirical studies and 19 (19%) were reviews/evaluations. The main purposes of the empirical studies were to 1) measure the level of fatigue in different types of disease; 2) investigate relationships between fatigue and health-related variables; and 3) assess fatigue as the outcome to evaluate efficacy, effectiveness and safety of interventions. The review/evaluation studies were comparisons of the MAF with other fatigue measures. Research was conducted in 17 countries (U.S., Turkey, U.K., Korea, Taiwan) and tested in 9 different languages (English, Turkish, Italian, Korean, Chinese) for 24 different diseases (rheumatic diseases, osteoarthritis, depression, HIV, ankylosing spondylitis, cancer, chronic fatigue syndrome, fibromyalgia, multiple sclerosis, systemic lupus erythematosus). The sample sizes varied  from 12 to 2193. The mean of global fatigue index ranged from 18.7 to 44.6, and its Cronbach’s alpha was, on average, 0.93 (0.88 to 0.99). Strengths of the MAF were noted as an easy-to-use instrument with good reliability and validity in various populations, its multidimensionality, and adaptability in different languages while weakness was the needs of further validation of fatigue in more diseases and cultures.  

Conclusion:

We conclude that the MAF is an appropriate assessment tool to measure fatigue, as well as intervention effectiveness in various diseases in clinical settings. Its feasibility with good internal consistency, adaptability with consistent, high reliability and validity, sensitivity to the levels of fatigue, and multidimensionality have allowed its applicability for international use. Continued use, translations, and assessments in different populations will enhance the cultural sensitivity as well as comprehensiveness of the MAF and strengthen its validity as a culturally sensitive fatigue instrument.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-multidimensional-assessment-of-fatigue-scale-a-25-year-review-and-evaluation/