2.2. Methods
Development and testing of the IBD-F scale entailed five
phases.
2.2.1. Phase one: item generation
A qualitative study using unstructured in-depth interviews
with 20 participants self-reporting IBD-fatigue was conducted
by a single researcher (WCD) to gain insight into the
experience of IBD-fatigue to determine if the MFI and MAF
scales reflected their experience and concerns with IBD
fatigue, and to identify items and questions for the new
scale. The unstructured interviews started with an open
question ‘Tell me about your experience of fatigue’, and
followed with reflective questioning seeking clarification
and further information when and if required.
The participants were purposively selected from volunteers
to reflect diversity of characteristics including: age;
gender; diagnosis (UC or CD); time since diagnosis; fatigue
severity; and geographical location in the UK. The interviews
were audio recorded, transcribed verbatim and analysed
using Moustakas' method of data analysis.26 Data analysis
identified that all areas of concern in IBD fatigue were not
reflected in the existing MAF and MFI, and guided development
of the items and questions for the first draft of the
questionnaire, which was reviewed by the steering group
members consisting of a gastroenterologist, IBD nurse, nurse
academics, project researchers and lay members (co-authors).
Existing fatigue scales did not fully match the experience and
concerns of people with IBD fatigue and therefore development
of new scale specific to IBD fatigue was further justified.