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Fatigue at Work: Scale Validation with Airline Pilots

ABSTRACT

In the organizational context, the study of occupational stress encompasses constructs of fatigue at work. Within the air transportation sector, fatigue at work is a potential issue influencing both safety and occupational stress. The objective of the present study was to perform a convergent-discriminant validity analysis of the Feeling of Fatigue scale in the area of Administration. Data from an observational cross-sectional study involving a sample of 1,066 airline pilots were analyzed using quantitative modeling. Confirmatory factor analysis with the structural equations model was performed to determine the validity of a Portuguese version of the Feeling of Fatigue scale in the organizational context of civil aviation. This study fills a gap in the literature on occupational stress in Administration, highlighting the relevance of research on fatigue at work. The results confirmed the validity of a Portuguese version of a mature scale for subjective assessment of fatigue in Administration, thereby contributing to fatigue management in organizational settings.

Keywords:
occupational stress; fatigue at work; feeling of fatigue; convergent-discriminant validity; civil aviation

INTRODUCTION

Most research in Administration addresses stress and burnout, with the latter defined as a psychophysiological state of occupational exhaustion and incapacity to work (Monteiro, Pereira, Daniel, Silva, & Matos, 2017Monteiro, R., Pereira, M., Daniel, F., Silva, A. G. da, & Matos, F. R. N. (2017). The influence of organizational reconciliation policies and culture on workers stress perceptions. BAR - Brazilian Administration Review, 14(3), e170005. https://doi.org/10.1590/1807-7692bar2017170005
https://doi.org/10.1590/1807-7692bar2017...
; Vasconcelos, Vasconcelos, & Crubellate, 2008Vasconcelos, F. C. de, Vasconcelos, I. F. G. de, & Crubellate, J. M. (2008). Stress in organizations: Between efficiency and the institutionalization of fear. BAR - Brazilian Administration Review, 5(1), 37-52. https://doi.org/10.1590/s1807-76922008000100004
https://doi.org/10.1590/s1807-7692200800...
). However, fatigue at work has received far less research attention in Administration journals, as evidenced by the dearth of studies found by the authors in a review of the relevant literature.

In the health sector, the impact of the recent pandemic on health workers has highlighted the need for further research investigating fatigue at work and burnout (Sasangohar, Jones, Masud, Vahidy, & Kash, 2020Sasangohar, F., Jones, S. L., Masud, F. N., Vahidy, F. S., & Kash, B. A. (2020). Provider burnout and fatigue during the Covid-19 pandemic: Lessons learned from a high-volume intensive care unit. Anesthesia and Analgesia, 131(1), 106-111. https://doi.org/10.1213/ANE.0000000000004866
https://doi.org/10.1213/ANE.000000000000...
) to better identify and study these related (yet different) constructs. Another organizational area concerned with fatigue at work is transportation, particularly the air transport sector. In this sector, fatigue is a potential issue in terms of both safety and occupational stress, largely in relation to the inherent intense work schedules (Drongelen, Boot, Hlobil, Beek, & Smid, 2017Drongelen, A. van, Boot, C. R. L., Hlobil, H., Beek, A. J. van der, & Smid, T. (2017). Cumulative exposure to shift work and sickness absence: Associations in a five-year historic cohort. BMC Public Health, 17(1), 67. https://doi.org/10.1186/s12889-016-3906-z
https://doi.org/10.1186/s12889-016-3906-...
).

A considerable proportion of workers (pilots) regularly report fatigue. This is partly the result of long irregular working days, crossing of time zones, and insufficient sleep opportunities (Drongelen et al., 2017Drongelen, A. van, Boot, C. R. L., Hlobil, H., Beek, A. J. van der, & Smid, T. (2017). Cumulative exposure to shift work and sickness absence: Associations in a five-year historic cohort. BMC Public Health, 17(1), 67. https://doi.org/10.1186/s12889-016-3906-z
https://doi.org/10.1186/s12889-016-3906-...
). Research on the effects of shift work has focused mainly on physiological, psychosocial, and sleep health. However, few investigations have evaluated shift workers’ personal experiences (Matheson, O’Brien, & Reid, 2014Matheson, A., O’Brien, L., & Reid, J.-A. (2014). The impact of shiftwork on health: A literature review. Journal of Clinical Nursing, 23(23-24), 3309-3320. https://doi.org/10.1111/jocn.12524
https://doi.org/10.1111/jocn.12524...
). There is a particular need for more studies measuring the phenomenon of feeling of fatigue at work.

Feeling of fatigue can be a direct result of overexertion to achieve task objectives and assure performance levels during periods of higher workload. The feeling of fatigue has properties resembling a generalized background emotion, incorporating characteristics of other basic emotions (Hockey, 2013Hockey, R. (2013). The psychology of fatigue: Work, effort and control. Cambridge: Cambridge University Press.). Fatigue at work has been assessed using a variety of instruments (Gawron, 2016Gawron, V. J. (2016). Overview of self-reported measures of fatigue. The International Journal of Aviation Psychology, 26(3-4), 120-131. https://doi.org/10.1080/10508414.2017.1329627
https://doi.org/10.1080/10508414.2017.13...
; Sagherian & Brown, 2016Sagherian, K., & Brown, J. G. (2016). In-depth review of five fatigue measures in shift workers. Fatigue: Biomedicine Health and Behavior, 4(1), 24-38. https://doi.org/10.1080/21641846.2015.1124521
https://doi.org/10.1080/21641846.2015.11...
; Winwood, Winefield, Dawson, & Lushington, 2005Winwood, P. C., Winefield, A. H., Dawson, D., & Lushington, K. (2005). Development and validation of a scale to measure work-related fatigue and recovery: The occupational fatigue exhaustion/recovery scale (OFER). Journal of Occupational and Environmental Medicine, 47(6), 594-606. https://doi.org/10.1097/01.jom.0000161740.71049.c4
https://doi.org/10.1097/01.jom.000016174...
). However, the Feeling of Fatigue scale (Yoshitake, 1971Yoshitake, H. (1971). Relations between the symptoms and the feeling of fatigue. Ergonomics, 14(1), 175-186. https://doi.org/10.1080/00140137108931236
https://doi.org/10.1080/0014013710893123...
) is widely used for subjectively measuring this emotion (Matthews, Desmond, Neubauer, & Hancock, 2018Matthews, G., Desmond, P. A., Neubauer, C., & Hancock, P. A. (2018). An overview of operator fatigue. In The Handbook of Operator Fatigue (pp. 3-23). Boca Raton, FL: CRC Press.).

Against this background, the objective of the present work was to perform a convergent-discriminant validity analysis of the Portuguese version of the Feeling of Fatigue scale among airline pilots. This study contributes by filling a gap in the field of fatigue in the workplace, emphasizing its relevance for Administration research and demonstrating the validity of a Portuguese version of the Feeling of Fatigue scale. There are few subjective instruments available for assessing fatigue in professions where it poses a major challenge, both in terms of the health of these professionals and enhancement of operational safety (Gander, Mangie, Phillips, Santos-Fernandez, & Wu, 2018Gander, P., Mangie, J., Phillips, A., Santos-Fernandez, E., & Wu, L. J. (2018). Monitoring the effectiveness of fatigue risk management: A survey of pilots’ concerns. Aerospace Medicine and Human Performance, 89(10), 889-895. https://doi.org/10.3357/AMHP.5136.2018
https://doi.org/10.3357/AMHP.5136.2018...
; Morris, Wiedbusch, & Gunzelmann, 2018Morris, M. B., Wiedbusch, M. D., & Gunzelmann, G. (2018). Fatigue incident antecedents, consequences, and aviation operational risk management resources. Aerospace Medicine and Human Performance, 89(8), 708-716. https://doi.org/10.3357/AMHP.5019.2018
https://doi.org/10.3357/AMHP.5019.2018...
; Zaslona, O’Keeffe, Signal, & Gander, 2018Zaslona, J. L., O’Keeffe, K. M., Signal, T. L., & Gander, P. H. (2018). Shared responsibility for managing fatigue: Hearing the pilots. PLOS ONE, 13(5), e0195530. https://doi.org/10.1371/journal.pone.0195530
https://doi.org/10.1371/journal.pone.019...
), aspects also addressed by the present study.

THEORETICAL BACKGROUND

Fatigue at work

Societal transformations in the workplace have led to studies on pleasure and mental suffering, together with their causes and consequences for work performance (Silva et al., 2015Silva, A. C. da, Queija, C. C. S., Ferreira, S. G., Vargas, L. S., Benício, P. R., & Bueno, A. D. A. (2015). Contemporary perception of pleasure and suffering in the organizational environment. Revista de Enfermagem UFPE on Line, 9(8), 8908-8915. https://doi.org/10.5205/1981-8963-v9i8a10677p8908-8915-2015
https://doi.org/10.5205/1981-8963-v9i8a1...
). Among the approaches reported in the literature, occupational stress considers that people have an ability to confront stimuli in an intermediate state between health and disease (Silva et al., 2015), requiring actions for individual and collective mental health management. A study of the occupational stress resulting from effects of different organizational variables showed that support from managers and colleagues at work (Monteiro et al., 2017Monteiro, R., Pereira, M., Daniel, F., Silva, A. G. da, & Matos, F. R. N. (2017). The influence of organizational reconciliation policies and culture on workers stress perceptions. BAR - Brazilian Administration Review, 14(3), e170005. https://doi.org/10.1590/1807-7692bar2017170005
https://doi.org/10.1590/1807-7692bar2017...
) was more important than human resources services or the organizational culture. The mainstream belief holds that occupational stress is manageable by the organization and adaptable to the environment in which it operates. Another study explored the relationship between organizational stress-inducing practices and employee responses/performance, concluding that “stress in organizations is as complex as the level of stress in society: it will depend on the control of stress levels coming from society” (Vasconcelos et al., 2008Vasconcelos, F. C. de, Vasconcelos, I. F. G. de, & Crubellate, J. M. (2008). Stress in organizations: Between efficiency and the institutionalization of fear. BAR - Brazilian Administration Review, 5(1), 37-52. https://doi.org/10.1590/s1807-76922008000100004
https://doi.org/10.1590/s1807-7692200800...
, p. 48). Instead of serving as a management tool to induce behaviors, occupational stress can result in unforeseen organizational consequences, including risk of fatigue at work.

In a review of a century of research on occupational stress, the authors anticipated a future trend in which theory and research continue to develop toward gathering evidence for causal inference, through greater integration of psychophysiological data and work-life models (Bliese, Edwards, & Sonnentag, 2017Bliese, P. D., Edwards, J. R., & Sonnentag, S. (2017). Stress and well-being at work: A century of empirical trends reflecting theoretical and societal influences. Journal of Applied Psychology, 102(3), 389-402. https://doi.org/10.1037/apl0000109
https://doi.org/10.1037/apl0000109...
). Thus, this field of study should continue to seek theory and research that support applied knowledge in order to assist organizations in managing current and future stressors that may emerge in the next 100 years. Despite the importance of the theme, a bibliographical review of occupational stress literature published from 2010 to 2014 (Ferreira, Reis, Kilimnik, & Santos, 2016Ferreira, C. A. A., Reis, M. T., Neto Kilimnik, Z. M., & Santos, A. S. dos. (2016). O contexto do estresse ocupacional dos trabalhadores da saúde: Estudo bibliométrico. Revista de Gestão em Sistemas de Saúde, 5(2), 84-99. https://doi.org/10.5585/rgss.v5i2.233
https://doi.org/10.5585/rgss.v5i2.233...
) determining whether the topic continues to be investigated, how and where, found few papers in major Brazilian Administration journals (Ferreira et al., 2016). Occupational stress is important in Administration given its impact on health and well-being at work, which, in turn, can negatively affect performance, increase costs, and reduce the effectiveness of organizations.

The term ‘occupational stress’ has been employed in the literature with various different meanings (Hancock & Desmond, 2001Hancock, P. A., & Desmond, P. A. (2001). Stress, worload, and fatigue. Boca Raton: CRC Press.; Paschoal & Tamayo, 2004Paschoal, T., & Tamayo, Á. (2004). Validação da escala de estresse no trabalho. Estudos de Psicologia, 9(1), 45-52. http://dx.doi.org/10.1590/S1413-294X2004000100006.
http://dx.doi.org/10.1590/S1413-294X2004...
). Within the broader concept of occupational stress, jobs in some sectors, such as transportation, medicine, and energy, still face the challenge of how to deal with occupational safety, particularly fatigue at work. The key issue tends to center on defining optimum conditions in which humans and technology can work together safely and sustainably (Nunes & Cabon, 2015Nunes, A., & Cabon, P. (2015). The fatigue conundrum. American Scientist, 103(3), 218-223. https://doi.org/10.1511/2015.114.218
https://doi.org/10.1511/2015.114.218...
). Another bibliometric study reviewed 100 years of research in occupational safety, showing how this evolved from basic protections and job analysis to a systemic and multi-level view of safety and risk (Hofmann, Burke, & Zohar, 2017Hofmann, D. A., Burke, M. J., & Zohar, D. (2017). 100 years of occupational safety research: From basic protections and work analysis to a multilevel view of workplace safety and risk. Journal of Applied Psychology, 102(3), 375-388. https://doi.org/10.1037/apl0000114
https://doi.org/10.1037/apl0000114...
). The study concluded that, although much progress has been made, too many injuries, fatalities, and cases of occupational diseases still occur in the workplace. Thus, there is still much to be researched.

It is noteworthy that the concepts of fatigue and stress, due to a long history of use (in science, work, and by the general public), are often reported in the workplace as if their meaning is clear, overlooking the complexity involved (Sonnentag & Frese, 2003Sonnentag, S., & Frese, M. (2003). Stress in organizations. In W. C. Borgman, D. R. Ilgen, R. J. Klimoski, & I. B. Weiner (Eds.), Handbook of psychology: Industrial and organizational psychology (Vol. 12, pp. 453-491). Hoboken: John Wiley & Sons.; Tepas & Price, 2001Tepas, D. I., & Price, J. M. (2001). What is stress and what is fatigue? In P. A. Hancock & P. A. Desmond (Eds.), Stress, workload and fatigue (pp. 607-622). Boca Raton, FL: CRC Press.). Research has not only found differences, but also shown that fatigue and stress are multidimensional constructs that interact. Fatigue and stress states can occur simultaneously and are difficult to distinguish, but should not be considered synonymous (Gaillard, 2001Gaillard, A. W. (2001). Stress, workload and fatigue as three biobehavioral states: A general overview. In P. A. Hancock & P. A. Desmond (Eds.), Stress, workload and fatigue (pp. 623-639). Boca Raton, FL: CRC Press .; Glendon, Clarke, & Mckenna, 2006Glendon, A. I., Clarke, S. G., & Mckenna, E. F. (2006). Human safety and risk management (2nd ed.). Boca Raton, FL: CRC Press.). The ISO 10075-1 standard - Ergonomic principles related to mental workload. General terms and definitions - proposes the standardization of definitions related to occupational stress. For the purpose of this study, the definition for fatigue proposed below was adopted (ISO, 2017):

Fatigue (Mental): temporary impairment of mental and physical functional efficiency, depending on the intensity, duration, and temporal pattern of the preceding mental strain. Recovery from mental fatigue is achieved by rest rather than changes in activity. This reduced functional efficiency becomes apparent in feelings of tiredness, less favorable relationships between performance and effort, type and frequency of errors. The extent of this impairment is also determined by individual preconditions (online).

Fatigue should not be reduced to a single dimension, given that it entails aspects that are multidimensional, dynamically interdependent, and not fully correlated (Phillips, 2015Phillips, R. O. (2015). A review of definitions of fatigue: And a step towards a whole definition. Transportation Research Part F: Traffic Psychology and Behaviour, 29, 48-56. https://doi.org/10.1016/j.trf.2015.01.003
https://doi.org/10.1016/j.trf.2015.01.00...
). To study fatigue at work, from a systemic theoretical perspective, psychophysiological data must be collected to determine the boundary conditions for the lives of the individual and/or group, by modeling the complexity of relationships between constructs such as cognition, emotion, and action, which can be treated as subsystems. Thus, this system can be analyzed in terms of multiple physiological, neuropsychological, and socio-political aspects. Finally, the literature recommends that convergent-discriminant validation should be sought, based on models for analyzing the effect of fatigue precursors, such as stressors at work (Melan & Cascino, 2014Mélan, C., & Cascino, N. (2014). A multidisciplinary approach of workload assessment in real-job situations: Investigation in the field of aerospace activities. Frontiers in Psychology, 5, 964. https://doi.org/10.3389/fpsyg.2014.00964
https://doi.org/10.3389/fpsyg.2014.00964...
).

Fatigue in the aviation work environment

Worker (pilot) fatigue is a significant problem in modern aviation operations, mainly due to work shifts, variable journeys, desynchronization of circadian rhythm, and insufficient sleep, factors that are prevalent in both civil and military flight operations. The negative effect of fatigue has proven a contributory factor for errors and accidents (Caldwell et al., 2009Caldwell, J. A., Mallis, M. M., Caldwell, J. L., Paul, M. A., Miller, J. C., & Neri, D. F. (2009). Fatigue countermeasures in aviation. Aviation, Space, and Environmental Medicine, 80(1), 29-59. https://doi.org/10.3357/asem.2435.2009
https://doi.org/10.3357/asem.2435.2009...
). Within aviation and other safety-critical fields, such as transportation, medicine, and energy, fatigue risk management systems (FRMS) represent a novel regulatory approach that combines advances in understanding of worker fatigue and factors that contribute to accidents, as well as advancements in safety management (Gander et al., 2011Gander, P., Hartley, L., Powell, D., Cabon, P., Hitchcock, E., Mills, A., & Popkin, S. (2011). Fatigue risk management: Organizational factors at the regulatory and industry/company level. Accident Analysis & Prevention, 43(2), 573-590. https://doi.org/10.1016/j.aap.2009.11.007
https://doi.org/10.1016/j.aap.2009.11.00...
). FRMS work on the basis of data and the combination of scientific and operational knowledge, including processes for monitoring safety performance and for continuous improvement.

Prescriptive limits on working hours are familiar to shift workers, but these are more suited to circumstances of low-risk safety-related fatigue. However, economic needs have placed pressure on a society with 24/7 shift workers requiring more customized and flexible approaches to fatigue management, such as FRMS (Gander, 2015Gander, P. H. (2015). Evolving regulatory approaches for managing fatigue risk in transport operations. Reviews of Human Factors and Ergonomics, 10(1), 253-271. https://doi.org/10.1177/1557234X15576510
https://doi.org/10.1177/1557234X15576510...
). Although the implementation of FRMS is growing in aviation, there is still little consensus on which constructs and associated safety performance indicators should be measured (Gander et al., 2014). Initiatives are scarce in both academia and industry, with insufficient results to draw any meaningful conclusions about a safe or unsafe condition from the indicators measured. Thus, a relative comparison of indicators, analyzed based on different operational contexts, is necessary to allow compilation of a database on psychobiological and operational factors and foster cooperation in the global effort to standardize acceptable indicators.

In order to manage fatigue responsibly, decisions cannot be based on a single measurement or sole technology to determine an absolute safety value. Human fatigue risk management systems should instead adopt a comprehensive approach (Mallis & James, 2012Mallis, M. M., & James, F. O. (2012). The role of alertness monitoring in sustaining cognition during sleep loss. In N. J. Wesensten (Ed.), Sleep deprivation, stimulant, medications, and cognition (pp. 209-222). Cambridge: Cambridge University Press.). Evidence-based non-prescriptive approaches to fatigue management are needed in aeronautical operations (Mallis, Banks, & Dinges, 2010). Therefore, an FRMS must be multi-layered and utilize multiple risk identification methods and risk reduction controls (Gander et al., 2011Gander, P., Hartley, L., Powell, D., Cabon, P., Hitchcock, E., Mills, A., & Popkin, S. (2011). Fatigue risk management: Organizational factors at the regulatory and industry/company level. Accident Analysis & Prevention, 43(2), 573-590. https://doi.org/10.1016/j.aap.2009.11.007
https://doi.org/10.1016/j.aap.2009.11.00...
; Lerman et al., 2012Lerman, S. E., Eskin, E., Flower, D. J., George, E. C., Gerson, B., Hartenbaum, N., Hursh, S. R., & Moore-Ede, M. (2012). Fatigue risk management in the workplace. Journal of Occupational and Environmental Medicine, 54(2), 231-258. https://doi.org/10.1097/jom.0b013e318247a3b0
https://doi.org/10.1097/jom.0b013e318247...
). There is growing evidence that subjective assessments can serve as an effective, efficient, and cost-effective tool in managing fatigue-related risk. Such assessments, however, should be based on a validated instrument and always be used as part of a more comprehensive FRMS (Smith, Browne, Armstrong, & Ferguson, 2016Smith, B. P., Browne, M., Armstrong, T. A., & Ferguson, S. A. (2016). The accuracy of subjective measures for assessing fatigue related decrements in multi-stressor environments. Safety Science, 86, 238-244. https://doi.org/10.1016/j.ssci.2016.03.006
https://doi.org/10.1016/j.ssci.2016.03.0...
).

The reliable use of subjective assessments in FRMS depends on a just culture, where individuals are encouraged and supported in reporting fatigue and elevated impairment (Darwent, Dawson, Paterson, Roach, & Ferguson, 2015Darwent, D., Dawson, D., Paterson, J. L., Roach, G. D., & Ferguson, S. A. (2015). Managing fatigue: It really is about sleep. Accident Analysis and Prevention, 82, 20-26. https://doi.org/10.1016/j.aap.2015.05.009
https://doi.org/10.1016/j.aap.2015.05.00...
). Within a system such as FRMS, all stakeholders should be made aware of contributing factors that might affect their performance, through a system design able to capture and utilize the information from these reports. A recent systematic literature review (Bendak & Rashid, 2020Bendak, S., & Rashid, H. S. J. (2020). Fatigue in aviation: A systematic review of the literature. International Journal of Industrial Ergonomics, 76, 102928. https://doi.org/10.1016/j.ergon.2020.102928
https://doi.org/10.1016/j.ergon.2020.102...
) concluded that risk associated with fatigue in aviation is diverse and ambiguous in nature. This study also revealed that many aspects related to this risk have not yet been fully investigated, and therefore further research identifying mitigation strategies for this risk is warranted.

Subjective measures of fatigue

The use of subjective measures of fatigue has been restricted mainly to laboratory-based methodologies (Smith et al., 2016Smith, B. P., Browne, M., Armstrong, T. A., & Ferguson, S. A. (2016). The accuracy of subjective measures for assessing fatigue related decrements in multi-stressor environments. Safety Science, 86, 238-244. https://doi.org/10.1016/j.ssci.2016.03.006
https://doi.org/10.1016/j.ssci.2016.03.0...
), producing satisfactory results. A simulated field study showed that, at a group level, subjective assessments of fatigue correlated with objective performance, but that subjects’ ability to predict performance varied significantly, both across conditions and between individuals (Smith et al., 2016). As expected, variation in fatigue tolerance was identified (Van Dongen, Maislin, & Dinges, 2004Van Dongen, H. P. A., Maislin, G., & Dinges, D. F. (2004). Dealing with inter-individual differences in the temporal dynamics of fatigue and performance: Importance and techniques. Aviation Space and Environmental Medicine, 75(3), A147-A154. Retrieved from https://pubmed.ncbi.nlm.nih.gov/15018277/
https://pubmed.ncbi.nlm.nih.gov/15018277...
). In particular, individuals with higher objective performance were worse at predicting their performance than those with lower objective performance. Two possible explanations have been proposed (Smith et al., 2016), whereby either weak correlations between objective and subjective assessments occur due to the range of the objective performance measure (less variability due to fatigue) or some individuals have an optimism bias and underestimate their impairment. The fact that individuals with some degree of tolerance to fatigue may be more confident in their resilience has major implications for fatigue risk management. This should be expected because such individuals may be unaware of their performance decline and may be unwilling to admit any fallibility due to professional and social pressures (Smith et al., 2016).

Fatigue at work has been assessed using a range of instruments (Gawron, 2016Gawron, V. J. (2016). Overview of self-reported measures of fatigue. The International Journal of Aviation Psychology, 26(3-4), 120-131. https://doi.org/10.1080/10508414.2017.1329627
https://doi.org/10.1080/10508414.2017.13...
; Sagherian & Brown, 2016Sagherian, K., & Brown, J. G. (2016). In-depth review of five fatigue measures in shift workers. Fatigue: Biomedicine Health and Behavior, 4(1), 24-38. https://doi.org/10.1080/21641846.2015.1124521
https://doi.org/10.1080/21641846.2015.11...
; Winwood et al., 2005Winwood, P. C., Winefield, A. H., Dawson, D., & Lushington, K. (2005). Development and validation of a scale to measure work-related fatigue and recovery: The occupational fatigue exhaustion/recovery scale (OFER). Journal of Occupational and Environmental Medicine, 47(6), 594-606. https://doi.org/10.1097/01.jom.0000161740.71049.c4
https://doi.org/10.1097/01.jom.000016174...
). Although internationally there are few validated scales available, “it is clear that there is no gold standard for fatigue assessment” (Aghdam, Alizadeh, Rasoulzadeh, & Safaiyan, 2019Aghdam, S. R., Alizadeh, S. S., Rasoulzadeh, Y., & Safaiyan, A. (2019). Fatigue assessment scales: A comprehensive literature review. Archives of Hygiene Sciences, 8(3), 145-153. https://doi.org/10.29252/archhygsci.8.3.145
https://doi.org/10.29252/archhygsci.8.3....
). Of the fatigue assessment instruments available, the Feeling of Fatigue scale (Yoshitake, 1971Yoshitake, H. (1971). Relations between the symptoms and the feeling of fatigue. Ergonomics, 14(1), 175-186. https://doi.org/10.1080/00140137108931236
https://doi.org/10.1080/0014013710893123...
) stands out for measuring subjectivity of this emotion. The scale was developed in 1969 by the Research Committee on Industrial Fatigue of the Japan Society of Occupational Health. It has since been applied to workers from a variety of sectors and countries (Chang, Sun, Chuang, & Hsu, 2009Chang, F.-L., Sun, Y.-M., Chuang, K.-H., & Hsu, D.-J. (2009). Work fatigue and physiological symptoms in different occupations of high-elevation construction workers. Applied Ergonomics, 40(4), 591-596. https://doi.org/10.1016/j.apergo.2008.04.017
https://doi.org/10.1016/j.apergo.2008.04...
). Unfortunately, most publications on the Feeling of Fatigue scale, including its originally validation (Saito, 1982Saito, Y. (1982). The validity of japanese fatigue feeling scale [abstract]. Ergonomics, 25(6), 473.), were published in Japanese only.

The Feeling of Fatigue scale (Yoshitake, 1971Yoshitake, H. (1971). Relations between the symptoms and the feeling of fatigue. Ergonomics, 14(1), 175-186. https://doi.org/10.1080/00140137108931236
https://doi.org/10.1080/0014013710893123...
) consists of a checklist of 30 items that explore the presence of symptoms, classified into three groups of fatigue symptoms (Yoshitake, 1978): (a) drowsiness and dullness, (b) lack of ability to concentrate, and (c) projection of physical discomfort. Generally, the higher the number of symptoms, the greater the feeling of fatigue. Both A and C symptom sets are physical, with A ‘general’ and C ‘specific (sensory and neuronal).’ B symptoms are purely mental. Of the A, B, and C symptoms, the strongest correlation with feeling of fatigue is found for B. Because these symptoms do not exist independently and are mutually related, a multifactorial construct was originally proposed.

In the first study, involving 170 office workers (Yoshitake, 1971Yoshitake, H. (1971). Relations between the symptoms and the feeling of fatigue. Ergonomics, 14(1), 175-186. https://doi.org/10.1080/00140137108931236
https://doi.org/10.1080/0014013710893123...
), each symptom was evaluated on a Likert scale for the presence or absence of the symptom, and not only with ‘yes’ or ‘no’ answers, as was implemented in a subsequent study. The latter study confirmed the three-factor Feeling of Fatigue scale through a comprehensive field study assessing subjective symptoms of fatigue at work in 17,789 workers on 250 occasions (Yoshitake, 1978). The labor activities evaluated included both physical (in several industries) and mental (pilots, train drivers, drivers, factory operators, at offices, researchers) work during different shifts (day, night, and shift work).

The internal structure of the three-factor Feeling of Fatigue scale was validated originally in Japan (Saito, 1982Saito, Y. (1982). The validity of japanese fatigue feeling scale [abstract]. Ergonomics, 25(6), 473.) among railway workers. The workers were assessed before and after work shifts for different schedules. Results showed that B symptoms were also associated with motivation. The content of the Feeling of Fatigue scale has been validated for use in Latin America (Almirall & Reyes, 1982Almirall, P., & Reyes, M. (1982). Relación entre índices subjetivos y objetivos de fatiga. Validación de una prueba. Revista Cubana de Higiene y Epidemiología, 20, 239-248.), where it has been consistently applied (Barrientos-Gutierrez, Martinez-Alcantara, & Mendez-Ramirez, 2004Barrientos-Gutierrez, T., Martinez-Alcantara, S., & Mendez-Ramirez, I. (2004). Validez de constructo, confiabilidad y punto de corte de la prueba de síntomas subjetivos de fatiga en trabajadores mexicanos. Salud Publica De Mexico, 46(6), 516-523. https://doi.org/10.1590/s0036-36342004000600006
https://doi.org/10.1590/s0036-3634200400...
; Parody, Viloria, Hernandez, Niño, & Cervera, 2020Parody, A., Viloria, A., Hernandez, M., Niño, A., & Cervera, J. (2020). Integration of statistical techniques to evaluate the fatigue of operators on the productivity of a company. In Advances in Intelligent Systems and Computing (Vol. 1039, pp. 53-62). https://doi.org/10.1007/978-3-030-30465-2_7
https://doi.org/10.1007/978-3-030-30465-...
). In the 1990s, Prof. Dr. Frida Fischer translated the Feeling of Fatigue scale into Brazilian Portuguese as part of her habilitation thesis (Privatdozent German Degree) (Fischer, 1990). Although the version was not formally validated, it has since been used in Brazil for several studies on fatigue at work (Metzner & Fischer, 2001Metzner, R. J., & Fischer, F. M. (2001). Fadiga e capacidade para o trabalho em turnos fixos de doze horas. Rev Saúde Pública, 35(6), 548-553. http://dx.doi.org/10.1590/S0034-89102001000600008.
http://dx.doi.org/10.1590/S0034-89102001...
; Metzner, Fischer, & Nogueira, 2008; Vasconcelos, Fischer, Reis, & Moreno, 2011Vasconcelos, S. P., Fischer, F. M., Reis, A. O. A., & Moreno, C. R. de C. (2011). Fatores associados à capacidade para o trabalho e percepção de fadiga em trabalhadores de enfermagem da Amazônia ocidental. Revista Brasileira de Epidemiologia, 14(4), 688-697. https://doi.org/10.1590/S1415-790X2011000400015
https://doi.org/10.1590/S1415-790X201100...
).

MATHERIAL AND METHODS

Instrument

The Feeling of Fatigue scale (Yoshitake, 1971Yoshitake, H. (1971). Relations between the symptoms and the feeling of fatigue. Ergonomics, 14(1), 175-186. https://doi.org/10.1080/00140137108931236
https://doi.org/10.1080/0014013710893123...
) is composed of three constructs (latent variables), each with 10 items measuring the presence of fatigue symptoms: FFA01-10 (drowsiness and dullness), FFB11-20 (lack of ability to concentrate), and FFC21-30 (projection of physical discomfort). The scores of the three latent variables (A, B, and C) are referred to as feelings of fatigue A, B, and C, denoted FFA, FFB, and FFC, respectively. The overall score of the 30 items is denoted FFS. Figure 1 depicts the instrument structure. Table 1 shows the instrument together with a proposed symptoms checklist in English (Yoshitake, 1971) and the translated version in Portuguese (Fisher, 1990) used in Brazil since 1990 by several studies, as outlined in section ‘Subjective measures of fatigue’. Each indicator is assessed on a Likert scale with values ranging from 1 to 5, where respondents answer the question ‘how often do you present the following symptoms?’ by choosing one of the following alternatives: ‘never,’ ‘rarely,’ ‘sometimes,’ ‘many times,’ or ‘always.’

Table 1
Symptoms checklist of Feeling of Fatigue scale
Figure 1
Feeling of Fatigue scale structure.

Developed by the authors based on Yoshitake, H. (1971). Relations between the symptoms and the feeling of fatigue. Ergonomics, 14(1), 175-186. https://doi.org/10.1080/00140137108931236


Study design

Adopting a deductive epistemological approach drawing on the theoretical background presented, we did a quantitative modeling study (Cauchik-Miguel et al., 2018Cauchik-Miguel, P. A., Fleury, A., Mello, C. H. P., Nakano, D. N., Lima, E. P., Turrioni, J. B., Ho, L. L., Morabito, R., Martins, R., Sousa, R., Costa, S., & Pureza, V. (2018). Metodologia de pesquisa em engenharia de produção e gestão de operações. Rio de Janeiro: Elsevier Brasil.; Creswell, 2014Creswell, J. W. (2014). Research design: Qualitative, quantitative and mixed methods approaches (4th ed.). Thousand Oaks: Sage Publications.) to test the convergent-discriminant validity of the Feeling of Fatigue scale. We collected data by a cross-sectional observational study (Breakwell, Smith, & Wright, 2012Breakwell, G. M., Smith, J. A., & Wright, D. B. (2012). Research methods in psychology (4th ed.). London: Sage Publications.; Fontelles, Simões, Farias, & Fontelles, 2009Fontelles, M. J., Simões, M. G., Farias, S. H., & Fontelles, R. G. S. (2009). Metodologia da pesquisa científica: Diretrizes para a elaboração de um protocolo de pesquisa. Revista Paraense de Medicina, 23(3), 1-8.) carried out as part of a larger study on Chronic fatigue, working conditions, and health of Brazilian pilots (Marqueze, Diniz, & Nicola, 2014Marqueze, E. C., Diniz, D. H. M. D., & Nicola, A. C. B. (2014). Fadiga crônica, condições de trabalho e saúde em pilotos brasileiros [Working Paper]. Associação Brasileira de Pilotos da Aviação Civil - ABRAPAC, São Paulo, SP, Brazil.) in a Brazilian sample.

Study population and sample

The target population of the larger study comprised 2,350 regular aviation pilots, members of the Brazilian Association of Civil Aviation Pilots (Abrapac). Of this total, 1,234 answered an online questionnaire, representing 52.5% of the study population. Initially, the sample size was calculated (G*Power) to meet the objectives of the larger study Chronic fatigue, working conditions, and health of Brazilian pilots (Marqueze et al., 2014Marqueze, E. C., Diniz, D. H. M. D., & Nicola, A. C. B. (2014). Fadiga crônica, condições de trabalho e saúde em pilotos brasileiros [Working Paper]. Associação Brasileira de Pilotos da Aviação Civil - ABRAPAC, São Paulo, SP, Brazil.), in which the primary outcome was fatigue and sample power was 99%. Of the overall total of 1,234 pilots, most participants (97.1%) were male and average age of the pilots was 39.1 years (SD = 9.8 years). Most of the respondents were captains (57.9%), and the others were co-pilots/first officers (42.1%). In terms of pilots’ personal profile, 84.3% had a marital partner and 61.3% did not have children younger than 12 years. The average number of persons who contributed to family income was 1.6 (SD = 0.7). Most pilots (82.4%) were attending or had already completed college education. Of the sample, 53.7% did not reside near their primary work base, requiring long commutes between residence and base.

The professional environment reported indicated that mean time practicing as a pilot was 15.2 years (SD = 10.1 years) and mean time engaged with the current airline was 5.8 years (SD = 4.8 years). The type of time off varied among pilots, but 27.6% usually had a single day off per week. A high percentage of pilots reported frequent or constant delays due to operational, maintenance, and dispatch issues (40.7%). Most pilots (91.2%) were predominantly flying domestically with basic crews. Pilots flew for an average of 65 hours monthly. The work shifts of almost all pilots (94.1%) were irregular and involved night shifts (from 10 p.m. to 5 a.m.). Working hours were longest during the day shift (typically with early starts before 6 a.m.), followed by the afternoon shift (with late finishes after 10 p.m.) and night shifts (usually starting before 10 p.m.). Finally, regarding working conditions potentially associated with increased fatigue, main factors reported by pilots were long working hours, number of flying hours, short rest periods between work shifts, and working night shifts (Marqueze, Nicola, Diniz, & Fischer, 2017Marqueze, E. C., Nicola, A. C. B., Diniz, D. H. M. D., & Fischer, F. M. (2017). Working hours associated with unintentional sleep at work among airline pilots. Revista de Saúde Pública, 51, 61. https://doi.org/10.1590/S1518-8787.2017051006329
https://doi.org/10.1590/S1518-8787.20170...
).

After the application of inclusion and exclusion criteria, 1,066 pilots remained in the present study sample, representing a large proportion of the overall pilot population in Brazil. The effort involved in achieving this sample size was considerable, as this population is usually averse to research surveys. Similar, more recent, attempts have failed to enroll more than a few dozen respondents. As operational conditions have not changed greatly since 2014, this data remains valid for the analysis performed.

Pilots actively working and flying with airlines at the time of the study, of both sexes, who were members of the Abrapac, were invited to participate in the study. Executive aviation, cargo, and air taxi pilots were excluded. Respondents with missing data on the Fatigue Scale were also excluded. A total of 168 cases with missing data (13.6%) were excluded.

Data collection

After confirmation of the adequacy of the questionnaire via pilot testing conducted with Abrapac’s Board of Directors (Brazilian aviation captains or co-pilots), invitations were sent out for participation in the study. Data were collected using a free online questionnaire tool, from December 2013 to March 2014. To avoid duplicate responses, individual emails were sent out. Questionnaire completion time was around 40-60 minutes. The data collection instrument contained questions gathering information on sociodemographics, work, health, lifestyle, and sleep variables used in the present study. The study evaluated the Feeling of Fatigue scale (Yoshitake, 1971Yoshitake, H. (1971). Relations between the symptoms and the feeling of fatigue. Ergonomics, 14(1), 175-186. https://doi.org/10.1080/00140137108931236
https://doi.org/10.1080/0014013710893123...
) and sociodemographic variables (age, sex, and job position) as multiple groups for cross-validation.

Ethical aspects related to research involving humans were duly observed and all participants signed a Consent Form (Resolution 466/12 of the National Health Council). The study was supported by the Abrapac and approved by the Ethics Committee of the Federal Institute of Education, Science, and Technology of São Paulo (Opinion No. 625.158 / CET-IFSP).

Data analysis

The American Psychological Association (APA) standards for educational and psychological testing specify that evidence of validity based on internal structure be obtained by several statistical methods to evaluate the dimensionality, invariance of measurement, and reliability of an instrument (Rios & Wells, 2014Rios, J., & Wells, C. (2014). Validity evidence based on internal structure. Psicothema, 26(1), 108-116. https://doi.org/10.7334/psicothema2013.260
https://doi.org/10.7334/psicothema2013.2...
). The statistical method employed in this study was structural equations modeling (Bido, 2019Bido, D. S. (2019). Modelagem de equações estruturais: Uma visão aplicada para a engenharia. In P. A. Cauchik-Miguel (Ed.), Metodologia científica para engenharia (pp. 81-108). Rio de Janeiro: Elsevier Brasil.; Gana & Broc, 2018Gana, K., & Broc, G. (2018). Structural equation modeling with lavaan. London: Wiley-ISTE; Hair, Black, Babin, & Anderson, 2009Hair, J. F., Jr. Black, W., Babin, B. J, & Anderson, R. E. (2009). Análise multivariada de dados (6th ed.). Porto Alegre: Bookman) for convergent-discriminant validation analysis (Campbell & Fiske, 1959Campbell, D. T., & Fiske, D. W. (1959). Convergent and discriminant validation by the multitrait-multimethod matrix. Psychological Bulletin, 56(2), 81-105. https://doi.org/10.1037/h0046016
https://doi.org/10.1037/h0046016...
; Hair et al., 2009; Hutz, Bandeira, & Trentini, 2015Hutz, C. S., Bandeira, D. R., & Trentini, C. M. (2015). Psicometria. Porto Alegre: Artmed.; Pasquali, 2007Pasquali, L. (2007). Validade dos testes psicológicos: Será possível reencontrar o caminho? Psicologia: Teoria e Pesquisa, 23(spe), 99-107. https://doi.org/10.1590/S0102-37722007000500019
https://doi.org/10.1590/S0102-3772200700...
). The structural equations models (SEM) and associated analysis were performed using R language version 3.6.1 (R Core Team, 2019) with R Studio (R Studio Team, 2019) and the lavaan package (Bido, 2019; Gana & Broc, 2018; Rosseel, 2012Rosseel, Y. (2012). Lavaan : An R package for structural equation modeling. Journal of Statistical Software, 48(2), 1-36. https://doi.org/10.18637/jss.v048.i02
https://doi.org/10.18637/jss.v048.i02...
).

Respondents whose standardized fatigue score exceeded three standard deviations (Z < - 3 or > 3) (i.e., outliers) were first identified (Cousineau & Chartier, 2010Cousineau, D., & Chartier, S. (2010). Outliers detection and treatment: A review. International Journal of Psychological Research, 3(1), 58-67. https://doi.org/10.21500/20112084.844
https://doi.org/10.21500/20112084.844...
; Hair et al., 2009Hair, J. F., Jr. Black, W., Babin, B. J, & Anderson, R. E. (2009). Análise multivariada de dados (6th ed.). Porto Alegre: Bookman). The latent variables FFA, FFB, and FFC were incorporated in a recursive reflexive measurement model (Bido, 2019Bido, D. S. (2019). Modelagem de equações estruturais: Uma visão aplicada para a engenharia. In P. A. Cauchik-Miguel (Ed.), Metodologia científica para engenharia (pp. 81-108). Rio de Janeiro: Elsevier Brasil.; Gana & Broc, 2018Gana, K., & Broc, G. (2018). Structural equation modeling with lavaan. London: Wiley-ISTE; Hair et al., 2009) with multiple groups represented by the sociodemographic variables assessed (age group, sex, job position). The measurement model with the lavaan code (Bido, 2019; Gana & Broc, 2018; Rosseel, 2012Rosseel, Y. (2012). Lavaan : An R package for structural equation modeling. Journal of Statistical Software, 48(2), 1-36. https://doi.org/10.18637/jss.v048.i02
https://doi.org/10.18637/jss.v048.i02...
) is shown in Table 2. The symbol “=~” denotes a reflexive model, where the exogenous latent variables on the left explain the variances of the endogenous variables (indicators) on the right side of the measurement model equations (Bido, 2019).

Table 2
Feeling of Fatigue scale — measurement model

Convergent validity is obtained when indicators of a construct converge and share a large proportional of common variance (Hair et al., 2009Hair, J. F., Jr. Black, W., Babin, B. J, & Anderson, R. E. (2009). Análise multivariada de dados (6th ed.). Porto Alegre: Bookman). The first indicator involves standardized factor loadings (ideally > 0.5) after confirmatory factor analysis (CFA) using structural equation modeling (SEM). Another metric is derived from average extracted variance (preferably > 0.5). Finally, reliability measures > 0.6 should be attained for convergent validity (Hair et al., 2009).

When comparing different instruments for discriminant validity, each construct should be unique and capture phenomena not measured by the others (Hair et al., 2009Hair, J. F., Jr. Black, W., Babin, B. J, & Anderson, R. E. (2009). Análise multivariada de dados (6th ed.). Porto Alegre: Bookman). Discriminant validity can be assessed by two criteria: Fornell-Larcker (Fornell & Larcker, 1981Fornell, C., & Larcker, D. F. (1981). Evaluating structural equation models with unobservable variables and measurement error. Journal of Marketing Research, 18(1), 39-50. https://doi.org/10.2307/3151312
https://doi.org/10.2307/3151312...
) or Heterotrait-Monotrait (HTMT) ratio of correlation (Henseler, Ringle, & Sarstedt, 2015Henseler, J., Ringle, C. M., & Sarstedt, M. (2015). A new criterion for assessing discriminant validity in variance-based structural equation modeling. Journal of the Academy of Marketing Science, 43(1), 115-135. https://doi.org/10.1007/s11747-014-0403-8
https://doi.org/10.1007/s11747-014-0403-...
). The Fornell-Larcker criterion is based on the comparison of the square of the correlations between one construct and all others and the average variance extracted (AVE) by the construct. The HTMT criterion evaluates the ratio of the correlation between two constructs to the square root of the product of the reliability of the two latent variables. A cut-off of 0.85 is proposed in the literature for HTMT (Voorhees, Brady, Calantone, & Ramirez, 2016Voorhees, C. M., Brady, M. K., Calantone, R., & Ramirez, E. (2016). Discriminant validity testing in marketing: An analysis, causes for concern, and proposed remedies. Journal of the Academy of Marketing Science, 44(1), 119-134. https://doi.org/10.1007/s11747-015-0455-4
https://doi.org/10.1007/s11747-015-0455-...
), below which discriminant validity is shown. For discriminant validity, indicators should be related to a single latent variable without cross-loadings (Hair et al., 2009). In the present study, discriminant validity was assessed based on these two criteria for the three latent variables comprising the multifactorial Feeling of Fatigue scale (FFA, FFB, and FFC). Correlations were measured and comparisons against AVE and reliability were analyzed for each pair. Given that all three latent variables measure aspects of the feeling of fatigue (Yoshitake, 1971Yoshitake, H. (1971). Relations between the symptoms and the feeling of fatigue. Ergonomics, 14(1), 175-186. https://doi.org/10.1080/00140137108931236
https://doi.org/10.1080/0014013710893123...
), discriminant validity is expected to be rejected.

In this study, group comparisons were also performed to show cross-validation. Loose cross-validation and loadings equivalence procedures (Hair et al., 2009Hair, J. F., Jr. Black, W., Babin, B. J, & Anderson, R. E. (2009). Análise multivariada de dados (6th ed.). Porto Alegre: Bookman) were applied. The former procedure verified that loadings, correlations between latent variables, and error variances (uniqueness) were similar for both groups. For the latter, non-standardized loadings are forced to be equal in both groups for model estimation and the difference in the chi-square statistic is evaluated. Other measures of fit were also determined.

In accordance with literature guidelines (Graham, 2006Graham, J. M. (2006). Congeneric and (essentially) tau-equivalent estimates of score reliability: What they are and how to use them. Educational and Psychological Measurement, 66(6), 930-944. https://doi.org/10.1177/0013164406288165
https://doi.org/10.1177/0013164406288165...
; Raykov, 1997aRaykov, T. (1997a). Estimation of composite reliability for congeneric measures. Applied Psychological Measurement, 21(2), 173-184. https://doi.org/10.1177%2F01466216970212006
https://doi.org/10.1177%2F01466216970212...
, 1997b), congeneric, tau-equivalent, and parallel measurement models were also considered to assess for adequate compromise among internal consistency, reliability, and parsimony. Of the models evaluated, this study sought to validate the first order trifactorial model as that which best expressed the internal structure of the Feeling of Fatigue scale. To evaluate the fit quality of the measurement model, based on literature guidelines (Hooper, Coughlan, & Mullen, 2008Hooper, D., Coughlan, J., & Mullen, M. (2008). Evaluating model fit: A synthesis of the structural equation modelling literature. European Conference on Research Methodology for Business and Management Studies, London, United Kingdom, 7. https://doi.org/10.21427/D79B73
https://doi.org/10.21427/D79B73...
), the chi-square statistics, degrees of freedom and p value, comparative fit index (CFI), root mean square error of approximation (RMSEA), standardized root mean square residual (SRMR), and the Akaike information criterion (AIC) were employed to assess parsimony between alternative models. These indices were selected over others because they have proven less sensitive to sample size, erroneous model specification, and parameter estimation (Hooper et al., 2008).

Recommended standards to evaluate cut-off values for these quality indicators can be found in the literature. In this study, the recommendations proposed by Hair, Black, Babin and Anderson and Black (2009Hair, J. F., Jr. Black, W., Babin, B. J, & Anderson, R. E. (2009). Análise multivariada de dados (6th ed.). Porto Alegre: Bookman) were adopted. Even for very large samples and many variables, chi-square statistics should yield significant values to reject the null hypotheses that the estimated model resembles the measured covariance (Hair et al., 2009). Therefore, the fact that the chi-square statistic is not usually significant is irrelevant, especially when the analysis needs to consider a distribution that violates the normality assumption, usual and acceptable for a Likert scale (Norman, 2010Norman, G. (2010). Likert scales, levels of measurement and the “laws” of statistics. Advances in Health Sciences Education, 15(5), 625-632. https://doi.org/10.1007/s10459-010-9222-y
https://doi.org/10.1007/s10459-010-9222-...
). CFI values > 0.92 are sought, while RMSEA and SRMR should be < 0.08 (Hair et al., 2009).

RESULTS

Convergent validity of internal structure of constructs

The preliminary step was the removal of outliers. As the lowest standardized fatigue score was -2, only participants with Z > 3 were excluded. Although only six outlier scores (observations 347, 484, 681, 704, 890, 1057) existed for the aggregated Feeling of Fatigue score (FFS), a total of 18 observations were excluded, including additional outliers for FFA (547, 775), FFB (50, 306, 921), and FFC (192, 228, 301, 597, 694, 708, 905).

The relevant variables for the final sample of 1,048 pilots are described in Table 3, with the analysis of variance indicating significant mean differences between groups (p-value < 0.05).

Table 3
Sample description - relevant variables

The next stage entailed the assessment of the measurement model. As initial assessments showed inadequate fit measures, modification indices were introduced by adding correlations between indicators that were related only to the same latent variable in order to avoid cross-loadings. Although some indicators with poor loadings could have been eliminated in order to improve the model, this approach was rejected for two main reasons. First, the validated version of the scale contained all indicators. Secondly, the Bartlett sphericity test and Keiser-Meyer-Olkin test for sample adequacy (Hair et al., 2009Hair, J. F., Jr. Black, W., Babin, B. J, & Anderson, R. E. (2009). Análise multivariada de dados (6th ed.). Porto Alegre: Bookman) showed that the three scales with all indicators had acceptable values.

While modification indices should be avoided in general, they can be useful for representing known effects, such as the correlation between the errors in the measurement process or data collection (Hair et al., 2009Hair, J. F., Jr. Black, W., Babin, B. J, & Anderson, R. E. (2009). Análise multivariada de dados (6th ed.). Porto Alegre: Bookman), a frequent phenomenon in psychometric measures such as the Feeling of Fatigue scale. Thus, 40 correlations were added to the measurement model, based on modification indices above an improvement cut-off of 20 (0.5%) on the chi-square statistics exhibiting significance (p < 0.05) (Table 4).

Table 4
Modification indices included

Table 5 compares fit measures and reliability before and after inclusion of modification indices. Adequate fit measures and reliability were obtained for the measurement model. Although the chi-square statistics remained non-significant, the other quality indices (CFI, RMSEA, SRMR) presented satisfactory results. The model incorporating modification indices had the best parsimony (AIC). In addition, the coefficient alpha values confirmed the reliability and internal consistency of the instrument. Therefore, these results confirm the convergent validation of the internal structure.

Table 5
Fit measures and reliability

Finally, cross-validation between groups with the final measurement model was performed only for groups with significant differences on mean comparisons (Table 3). The following models were evaluated: Model 1 - all available data; Model 2 - age group comparison; Model 3 - job group comparisons. First, a loose cross-validation (Hair et al., 2009Hair, J. F., Jr. Black, W., Babin, B. J, & Anderson, R. E. (2009). Análise multivariada de dados (6th ed.). Porto Alegre: Bookman) was applied in order to check measurement invariance of latent variable correlations, loadings, and error variances. Table 6 shows similar correlations between latent variables for Models 1, 2, and 3. Tables 7, 8, and 9 show comparisons of loadings and error variances (uniqueness) for latent variables (FFA, FFB, and FFC), respectively. In Table 7, similar loadings result in similar average variance extracted (AVE), representing the sum of communalities divided by 10. Error variances (uniqueness) were also similar. In Table 8, similar loadings and error variances were also obtained. As results proved similar in Table 9, a loose cross-validation was shown.

Table 6
Group comparisons — latent variable correlations
Table 7
FFA — group cross-validation — age group — standardized values
Table 8
FFB — group cross-validation — job position — standardized values
Table 9
FFC — group cross-validation — age group — standardized values

For loadings equivalence cross-loading, Models 2 and 3 were compared, with free estimation and non-standardized loadings set to be equal in the respective models. The results in Table 10 also confirm cross-validation by this alternative procedure. Therefore, convergent validity was confirmed for the first-order trifactorial tau-equivalent measurement model of the Feeling of Fatigue scale.

Table 10
Group cross-validation — loadings equivalence

Discriminant validity of constructs

The final stage involved the assessment of discriminant validity among the three constructs (FFA, FFB, and FFC). Composite reliability (CR) derived from coefficient alpha. Average variance extracted (AVE) and correlations among the three constructs were measured to evaluate Fornell-Larcker criterion (Fornell & Larcker, 1981Fornell, C., & Larcker, D. F. (1981). Evaluating structural equation models with unobservable variables and measurement error. Journal of Marketing Research, 18(1), 39-50. https://doi.org/10.2307/3151312
https://doi.org/10.2307/3151312...
) and compare Heterotrait-Monotrait (HTMT) criterion (Voorhees et al., 2016Voorhees, C. M., Brady, M. K., Calantone, R., & Ramirez, E. (2016). Discriminant validity testing in marketing: An analysis, causes for concern, and proposed remedies. Journal of the Academy of Marketing Science, 44(1), 119-134. https://doi.org/10.1007/s11747-015-0455-4
https://doi.org/10.1007/s11747-015-0455-...
) against the cut-off of 0.85 (Table 11).

Table 11
Discriminant validity

For discriminant validity according to Fornell-Larcker criterion, the square root of AVE in the diagonal of the correlation matrix must be larger than the off-diagonal terms. Alternatively, using the HTMT criterion, calculated ratios between correlation and the square root of reliability term products must be less than 0.85. The results failed for both criteria. Although it was ensured that indicators were related to a single latent variable and there were no cross-loadings, discriminant validity was rejected. This outcome confirms that the three constructs are interrelated for measuring feeling of fatigue (Yoshitake, 1971Yoshitake, H. (1971). Relations between the symptoms and the feeling of fatigue. Ergonomics, 14(1), 175-186. https://doi.org/10.1080/00140137108931236
https://doi.org/10.1080/0014013710893123...
).

DISCUSSION

The measurement of feeling of fatigue at work is particularly important in the case of shift workers, such as civil aviation pilots, the target population of the present study. As outlined earlier, fatigue is a major issue affecting the occupational health and safety of pilots, exacerbated by a number of factors inherent to the profession. In this study, a convergent-discriminant validation analysis of a Portuguese version of the Feeling of Fatigue scale was performed in the organizational context of civil aviation. As recommended in the literature (Hutz et al., 2015Hutz, C. S., Bandeira, D. R., & Trentini, C. M. (2015). Psicometria. Porto Alegre: Artmed.), construct validity of the Feeling of Fatigue scale was evaluated by confirmatory factor analysis and analysis of internal consistency, with the latter approach based on reliability measures.

Different procedures were applied to confirm convergent validity, including group comparisons for cross-validation. No comparison was performed for sex, because no significant gender differences in fatigue scores were found for the three latent variables. Discriminant validity was rejected by two alternative methods, confirming that the three latent variables indeed measure different interrelated aspects of fatigue (Yoshitake, 1971Yoshitake, H. (1971). Relations between the symptoms and the feeling of fatigue. Ergonomics, 14(1), 175-186. https://doi.org/10.1080/00140137108931236
https://doi.org/10.1080/0014013710893123...
). The various fit quality indicators in the structural equations model (Hair et al., 2009Hair, J. F., Jr. Black, W., Babin, B. J, & Anderson, R. E. (2009). Análise multivariada de dados (6th ed.). Porto Alegre: Bookman) were compared. Reliability measured by coefficient alpha for tau-equivalent models was included as part of the overall convergent-discriminant validation analysis carried out. The results provided confirmation of psychometric validity of the first-order trifactorial tau-equivalent measurement model of the Feeling of Fatigue scale.

Confirmatory factor analysis is often used to assess scale reliability and construct validity through convergent and discriminant analyses in Administration research studies (Demo, Neiva, Nunes, & Rozzett, 2012Demo, G., Neiva, E. R., Nunes, I., & Rozzett, K. (2012). Human resources management policies and practices scale (HRMPPS): Exploratory and confirmatory factor analysis. BAR - Brazilian Administration Review, 9(4), 395-420. https://doi.org/10.1590/s1807-76922012005000006
https://doi.org/10.1590/s1807-7692201200...
; Santos & Brito, 2012Santos, J. B., & Brito, L. A. L. (2012). Toward a subjective measurement model for firm performance. BAR - Brazilian Administration Review, 9(spe), 95-117. https://doi.org/10.1590/S1807-76922012000500007
https://doi.org/10.1590/S1807-7692201200...
). Sometimes, exploratory factor analyses are also applied (Neiva, Odelius, & Ramos, 2015; Wimalasiri, 1995Wimalasiri, J. S. (1995). An examination of the influence of human resource practices, organizational commitment and job satisfaction on work performance. International Journal of Management, 12(3), 352-363.), but only sample adequacy was proved in the present study, given the scale was originally validated with the same first-order trifactorial model. Previous studies have shown that content validity of a scale, in a cultural adaptation to another language, can be inferred from the analysis of the internal structure and reliability of the instrument (Boada-Grau, Merino-Tejedor, Gil-Ripoll, Segarra-Perez, & Vigil-Colet, 2014Boada-Grau, J., Merino-Tejedor, E., Gil-Ripoll, C., Segarra-Perez, G., & Vigil-Colet, A. (2014). Adaptación al español del inventario multidimensional de fatiga al entorno laboral. Universitas Psychologica, 13(4), 1279-1287. Retrieved from https://psycnet.apa.org/record/2016-43640-005
https://psycnet.apa.org/record/2016-4364...
; Gouveia et al., 2015Gouveia, V. V, Oliveira, G. F. de, Mendes, L. A. de C., Souza, L. E. C. de, Cavalcanti, T. M., & Melo, R. L. P. de. (2015). Escala de avaliação da fadiga: Adaptação para profissionais da saúde. Revista Psicologia Organizações e Trabalho, 15(3), 246-256. https://doi.org/10.17652/rpot/2015.3.594
https://doi.org/10.17652/rpot/2015.3.594...
; Hutz et al., 2015Hutz, C. S., Bandeira, D. R., & Trentini, C. M. (2015). Psicometria. Porto Alegre: Artmed.). Validation of a scale based on the measure of its reliability is a widely used technique (Hutz et al., 2015).

Although this study validated the first-order trifactorial model originally proposed, it is believed that a one-dimensional instrument could evaluate fatigue at work. In a previous study (De Vries, Michielsen, & Van Heck, 2003De Vries, J., Michielsen, H. J., & Van Heck, G. L. (2003). Assessment of fatigue among working people: A comparison of six questionnaires. Occupational and Environmental Medicine, 60(suppl 1), i10-i15. https://doi.org/10.1136/oem.60.suppl_1.i10
https://doi.org/10.1136/oem.60.suppl_1.i...
), failure to confirm multidimensionality might have been due to the fact that fatigue manifests itself as a one-dimensional construct for healthy individuals. However, fatigue can manifest multidimensionality owing to symptoms reported by patients. Results of the Feeling of Fatigue scale are usually expressed as an aggregate score. However, it is also accepted that fatigue should not be reduced to a single dimension, because it encompasses multidimensional, dynamically interdependent, yet not fully correlated aspects. These aspects provide a description of how fatigue reflects psychophysiological states and performance, and should be considered from a systemic perspective (Phillips, 2015Phillips, R. O. (2015). A review of definitions of fatigue: And a step towards a whole definition. Transportation Research Part F: Traffic Psychology and Behaviour, 29, 48-56. https://doi.org/10.1016/j.trf.2015.01.003
https://doi.org/10.1016/j.trf.2015.01.00...
). Consequently, the analysis of multiple constructs in the Feeling of Fatigue scale proves important.

The absence of robust results on fatigue measurements precludes the ranking of measuring instruments by effectiveness (Phillips, Kecklund, Anund, & Sallinen, 2017Phillips, R. O., Kecklund, G., Anund, A., & Sallinen, M. (2017). Fatigue in transport: A review of exposure, risks, checks and controls. Transport Reviews, 37(6), 742-766. https://doi.org/10.1080/01441647.2017.1349844
https://doi.org/10.1080/01441647.2017.13...
). A lack of consistency in the use of these instruments hampers comparison and validation of different fatigue measurements. There is also no golden rule for establishing the existence of fatigue and the validity of instruments measuring fatigue cannot be proven (Beurskens et al., 2000Beurskens, A., Bultmann, U., Kant, I., Vercoulen, J., Bleijenberg, G., & Swaen, G. M. H. (2000). Fatigue among working people: Validity of a questionnaire measure. Occupational and Environmental Medicine, 57(5), 353-357. https://doi.org/10.1136/oem.57.5.353
https://doi.org/10.1136/oem.57.5.353...
). In the absence of this consensus, convergent-discriminant validation is applied. The results of the present analysis of convergent-discriminant validation serve to confirm the validity of the Feeling of Fatigue scale. Therefore, the present study helps further knowledge on the measurement of fatigue.

FINAL COMMENTS AND FURTHER RESEARCH

Discussions on fatigue risk management systems (FRMS) recommend that validated instruments measuring fatigue be applied to capture different related constructs. FRMS are a fast-growing regulatory trend set to further research on occupational stress in Administration.

This study fills a gap in the occupational stress literature in Administration by highlighting the relevance of research on fatigue at work and validating the Portuguese version of the Feeling of Fatigue scale in Brazil. The instrument is important for fatigue management in the workplace. The scarcity of similar studies in Administration journals should be addressed, given the relevance of the subject in the international scientific literature.

Follow-up studies involving further analysis and collection of new data samples are underway. These investigations may help determine a more accurate prevalence of fatigue based on the Feeling of Fatigue scale in the organizational context, and support validation of other scales measuring fatigue and related constructs. The authors believe this research in the Administration area will likely increase, as more and more organizations from different sectors strive to implement and operationalize fatigue management systems.

ACKNOWLEDGMENTS

The authors acknowledge the support of the Brazilian Association of Civil Aviation Pilots (Abrapac), associated with the IFALPA (International Federation of Airline Pilots’ Associations), for providing the research database on Brazilian pilots’ chronic fatigue, work conditions, and health.

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Edited by

Editor-in-chief: Carlo Gabriel Porto Bellini (Universidade Federal da Paraíba, João Pessoa, PB, Brazil)
Associate editors: Daniel Viana Abs da Cruz (Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil) and Carlo Gabriel Porto Bellini (Universidade Federal da Paraíba, João Pessoa, PB, Brazil)
Reviewers: Alexsandro Luiz de Andrade (Universidade Federal do Espírito Santo, Brazil) and Clarissa Socal Cervo (Universidade Federal Fluminense, Brazil)
Editorial assistants: Kler Godoy and Simone Rafael (ANPAD, Maringá, PR, Brazil)

Publication Dates

  • Publication in this collection
    19 Oct 2020
  • Date of issue
    2020

History

  • Received
    06 Mar 2019
  • Accepted
    18 Sept 2020
  • Published
    06 Oct 2020
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E-mail: bar@anpad.org.br