| Objective1. To import a tool for HIV-related fatigue measurement by translating the English version of HIV-Related Fatigue Scale (HRFS) to fit Chinese culture; and to evaluate the psychometric properties of the Chinese version HRFS in Chinese people living with HIV/AIDS (PLWHA);2. To describe the status of HIV-related fatigue of PLWHA;3. To describe the level of depression and quality of sleep of PLWHA in Hunan;4. To analyze the relationship between depression and HIV-related fatigue, quality of sleep and HIV-related fatigue among the PLWHA;5. To identify the factors related to HIV-related fatigue of Chinese PLWHA in Hunan Province, and find the most important factor to provide basis for improving the quality of life of Chinese PLWHA.MethodsEnglish version HRFS was translated and back-translated, and revised according Chinese culture. Five experts evaluated the content validity. A pilot study was taken for making sure the feasibility and stability of the questionnaire, estimating the sample size, and testing validity and reliability. It was a cross-sectional survey.The target population was PLWHA. Three treatment sites in Hunan Province were chosen by cluster random sampling. The subjects who met inclusion criteria were recruited at these sites. The questionnaire included four parts, the general information questionnaire, Chinese version of the HIV-Related Fatigue Scale(C-HRFS), Pittsburgh Sleep Quality Index(PSQI), Self-Rating Depression Scale(SDS). All data were input into SPSS 13.0 software for statistical analysis. Statistic methods included descriptive statistics, t test, F test, Pearson correlation coefficients, exploratory factor analysis and multiple linear regression analysis and so on. Results1. The Chinese version of HRFS was consistent with the original version and the result from the invited experts'assessment was satisfactory. The content validity index (CVI) was 0.852.①Internal consistency analysis showed that the correlations between items and total scores ranged from 0.149 to 0.722, the correlations among subscales ranged from 0.416 to 0.973, the correlations between each subscale and total scores ranged from 0.725 to 0.941, All correlations were significant (p<0.05); Exploratory principal component analysis of the items indentified the scale had 3 factors by limited extraction, explaining 50.414% of the total variance. Some items change the subscales they once located in.②Reliability verification:The Cronbach's a coefficients for the C-HRFS subscales ranged from 0.818 to 0.948, and 0.953 for the total csale; The split-half reliability coefficients for the C-HRFS subscales ranged from 0.838 to 0.965, and 0.971 for the total csale; The test-retest reliability coefficients for the C-HRFS subscales ranged from 0.928 to 0.968, and 0.976 for the total csale.2. The mean Fatigue Severity Index (FSI) of this group was 33.21±15.76,33.9% of the Chinese PLWHA were in fatigue status; The mean score for level of fatigue most days is 5.40±2.43, mean score for fatigue severity in the week before the first study visit was 5.40±2.43, and mean score for distress degree caused by fatigue was 5.97±3.04 (each on a 1-10 scale); 47.3% of Chinese PLWHA's fatigue had gone up and down.3. The results of quality of sleep survey showed that the mean total score of PSQI was 8.84±4.65,56.5% of the total scores of PSQI were more than seven points, and 40.9% subjects felt themselves had poor sleep; among the scores of each dimension, the highest score was the dimension of daytime dysfunction(1.90±1.01), and the lowest was he dimension of hypnotics(0.35±0.83).4. The results of depression survey showed that the mean total score of depression severity index was 0.57±0.13,75.1% of the subjects had different levels of depression, among the scores of each dimension, the highest score was the dimension of psychomotor disturbance (2.65±0.82), and the second was the dimension of mental disorder (2.48±0.62).5. Bivariate correlation analysis showed that the scores of FSI and all subscales of C-HRFS was positively correlated with the total score of PSQI and depression severity index, the scores of all dimensions of PSQI and SDS(p<0.01).6. Multiple regression analysis showed that the influence factors of HIV-related fatigue were side effect of antiviral therapy, infectious diseases, the route of HIV infection, depression and sleep were included to the regression equations in which FSI was dependent variables (F= 55.489, p=0.000).Conclusion1. C-HRFS was proved possessing good reliability and validity. It can be used to measure HIV-related fatigue of Chinese PLWHA.2. Fatigue in people living with HIV/AIDS is more common, and among kinds of fatigue, mental fatigue is much severer, fatigue has a big impact on their work and activities of daily living, medical personnel should pay more attention to it.3. Depression in people living with HIV/AIDS is much more common, and main is psychomotor disturbance and mental disorder; quality of sleep in people living with HIV/AIDS is poorer, and main sleep problem is daytime dysfunction, but their night's sleep time is long enough.4. HIV-related fatigue was closely related to side effect of antiviral therapy, infectious diseases, the route of HIV infection, especially to depression and sleep. |
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