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Fatigue symptoms are reported by a majority of patients with multiple sclerosis (MS). Reliable assessment, however, is a demanding issue as the symptoms are experienced subjectively and as objective assessment strategies are missing. The objective of this study was to develop and validate a new tool, the Fatigue Scale for Motor and Cognitive Functions (FSMC), for the assessment of MS-related cognitive and motor fatigue. A total of 309 MS patients and 147 healthy controls were included into the validation study. The FSMC was tested against several external criteria (e.g. cognition, motivation, personality and other fatigue scales). The item-analysis and validation procedure showed that the FSMC is highly sensitive and specific in detecting fatigued MS patients, that both subscales significantly differentiated between patients and controls (p < 0.01), and that internal consistency (Cronbach's alpha alpha > 0.91) as well as test-retest reliability (r > 0.80) were high. Cut-off values were determined to classify patients as mildly, moderately or severely fatigued. In conclusion, the FSMC is a new scale that has undergone validation based on a large sample of patients and that provides differential quantification and graduation of cognitive and motor fatigue.

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PurposeCustomer satisfaction and image are important factors for service companies because of their impact on loyalty. Although much research has looked at the relationship of both of these factors individually, little is known about them when they are considered together. Furthermore, experience with the service or product has largely been neglected in this line of research. This paper aims to undertake a first step to fill this gap.Design/methodology/approachThis research, with data from one of Europe's most modern night‐train companies, employs structural equation modelling to test the proposed hypotheses.FindingsDifferentiating new customers from experienced ones, the results show that for new customers satisfaction is crucial whereas image plays a much smaller role in terms of loyalty. For experienced customers, however, the importance of satisfaction decreases whereas the impact of image increases.Research limitations/implicationsSatisfaction and image were both measured by a single item. Although they show high face validity, the findings should be replicated using a multiple‐item approach. Future research should also consider distinguishing between transaction‐specific satisfaction and cumulative satisfaction.Practical implicationsThis paper concludes that customers' experience plays a decisive role in predicting loyalty. Managers should therefore be aware of the level of their customers' experience and may even consider developing different retention programmes tailored to the level of customers' experience.Originality/valueThis research proposes an integrative model of satisfaction, image, and loyalty, and analyses the impact of experience within this model. It is pioneering work that empirically investigates the relationships between these constructs.