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Cancer-related fatigue in Italian cancer patients: validation of the Italian version of the Brief Fatigue Inventory (BFI)

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Cancer-related fatigue (CRF) is one of the most common symptoms experienced by cancer patients (CPs). The Brief Fatigue Inventory (BFI) is a reliable instrument to assess CRF in CPs. The aim of this study was to evaluate the psychometric properties of the Italian version of the BFI (BFI-I).


The BFI-I was developed by using the forward–backward translation approach. The psychometric properties of the BFI-I were assessed in terms of acceptability, internal consistency, and validity. Outpatient CPs filled in BFI-I along with the Medical Outcome Study Quality of Life Short Form 36 (SF36). Demographic and health data were collected.


The BFI-I had an overall Cronbach alpha for the nine items of 0.94. The inter-item mean correlation was 0.64, and coefficients ranged from 0.47 to 0.81 for the nine items. The results of the factor analysis suggested a 1-factor solution explaining 68 % of the variance, supporting the hypothesis of unidimensionality of the BFI-I. The BFI-I score was compared to SF36 subscales score to evaluate concurrent validity. An expected inverse correlation between the BFI-I and the vitality subscale of the SF36 was observed (r = −0.67, 95 % confidence interval −0.73 to −0.59). The correlation with the other subscales of the SF36 ranged between −0.56 and −0.13. Discriminant validity analysis showed the BFI-I mean score significantly increased with increasing Eastern Cooperative Oncology Group values (p < 0.001).


BFI-I is a clinical instrument with satisfactory psychometric properties to assess CRF in Italian CPs.

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The authors have declared that no conflict of interest exists. The authors have full control of all primary data and agree to allow the Supportive Care in Cancer journal to review their data if requested.

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Correspondence to Gianluca Catania.

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Catania, G., Bell, C., Ottonelli, S. et al. Cancer-related fatigue in Italian cancer patients: validation of the Italian version of the Brief Fatigue Inventory (BFI). Support Care Cancer 21, 413–419 (2013).

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