Scoping review of fatigue assessment tools for hemodialysis patients: Focusing on clinical application, psychometric properties and Chinese localization

Fatigue is a common symptom in hemodialysis (HD) patients, and effective assessment is crucial for management. While there are various assessment tools, clinical consensus on their selection is lacking. Most reviews focus on the introduction of tools but overlook systematic evaluations of their psychometric properties, and there is limited focus on localization challenges in Chinese clinical practice. This review systematically evaluates the status of fatigue assessment tools for HD patients, their psychometric properties, and the needs for optimizing their application in Chinese localization. The system searched Chinese and English databases, including CNKI, Wanfang, Web of Science, PubMed, Embase, and CINAHL, from their inception to September 30, 2025, for literature on fatigue assessment tools for HD patients. A scoping review method was used for systematic summarization. A total of 38 articles were included, involving 13 fatigue assessment tools for HD patients, including 1 objective assessment tool and 12 subjective self-assessment scales, namely FSS, SF36-V, CFS, MFI-20, VAFS, FACIT-F, RPFS, BFI, PROMIS, PFS-12, PDF, and SONG-HD. These tools varied in dimensions, recall periods, adaptation status, and usage frequency. While some showed good reliability, most still lacked robust evidence for construct and cross-cultural validity. Clinically, tools should be chosen based on scenarios like screening, evaluation, or research. In China’s HD field, fatigue assessment needs to transition from using borrowed tools to culturally adapted ones. Existing Chinese tools should be revalidated per international standards, and a core assessment system should be developed to align with the cultural and clinical context of Chinese patients.