Quality of Life Research

, Volume 9, Issue 7, pp 847–854 | Cite as

Measurement of fatigue in cancer patients: Further validation of the Fatigue Symptom Inventory

  • Danette M. Hann
  • Maxine M. Denniston
  • Frank Baker
Article

Abstract

Fatigue is one of the most common and debilitating symptoms experienced by cancer patients, yet until recent years it has received little systematic attention, due in part to the lack of adequate instruments to measure fatigue. The primary aim of this report is to further validate a recently developed measure of fatigue for use with cancer patients: the Fatigue Symptom Inventory (FSI). This 13-item self-report measure was designed to measure the intensity and duration of fatigue and its interference with quality of life. The FSI was originally validated in a sample of breast cancer patients and a sample of healthy individuals. In this study, the FSI was evaluated in an outpatient sample that included male and female cancer patients, as well as some older patients, with a variety of cancer diagnoses. A seven-item interference scale was found to have good internal consistency, with α coefficients above 0.90. Convergent validity was demonstrated via comparisons with an existing measure of fatigue. Construct validity was demonstrated via comparisons with measure of life satisfaction and depression as well as comparisons among subgroups of patients expected to differ in their experience of fatigue. Overall, the FSI was further established as a valid and reliable measure of fatigue in cancer patients. The potential application of this measure in psychosocial oncology research is discussed.

Fatigue Neoplasms Quality of life 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Irvine DM, Vincent L, Bubela N, Thompson L, Graydon J. A critical appraisal of the research literature investigating fatigue in the individual with cancer. Cancer Nurs 1991; 14(4): 188–199.PubMedCrossRefGoogle Scholar
  2. 2.
    Winningham ML, Nail LM, Burke MB, et al. Fatigue and the cancer experience: The state of knowledge. Oncol Nurs Forum 1994; 21(1): 23–36.PubMedGoogle Scholar
  3. 3.
    Piper BG, Lindsey AM, Dodd MJ, Ferketich S, Paul SM, Weller S. Development of an instrument to measure the subjective dimension of fatigue. In: Funk S, Tournquist E, Champagne M, Copp L, Weise R (eds), Key Aspects of Comfort: Management of Pain and Nausea. Philadelphia: Springer, 1989: 199–208.Google Scholar
  4. 4.
    Nail L, Winningham M. Fatigue. In: Groenwalk SL, Frogge M, Goodman M, Yarbo C (eds), Cancer nursing: principles and practice, 3rd edn. Boston: Jones & Bartlett, 1993: 608–619.Google Scholar
  5. 5.
    Smets EMA, Garrsen B, Bonke B, deHaes JC. The Multidimensional Fatigue Inventory (MFI). Psychometric qualities of an instrument to assess fatigue. J Psychosom Res 1995; 39(5): 315–325.PubMedCrossRefGoogle Scholar
  6. 6.
    Hann D, Jacobsen P, Martin S, et al. Measurement of fatigue in cancer patients: Development and validation of the Fatigue Symptom Inventory. Qual Life Res 1998; 7: 301–310.PubMedGoogle Scholar
  7. 7.
    Piper BF, Dibble SL, Dodd MJ, Weiss MC, Slaughter RE, Paul SM. The revised Piper Fatigue Scale: Psychometric evaluation in women with breast cancer. Oncol Nurs Forum 1998; 25(4): 677–684.PubMedGoogle Scholar
  8. 8.
    Cella D. The Functional Assessment of Cancer Therapy-Anemia (FACT-An) Scale: A new tool for the assessment of outcomes in cancer anemia and fatigue. Semin Hematol 1997; 34(3): 13–19.PubMedGoogle Scholar
  9. 9.
    Schwartz A. The Schwartz Cancer Fatigue Scale: Testing and reliability and validity. Oncol Nurs Forum 1998; 25(4): 711–717.PubMedGoogle Scholar
  10. 10.
    McNair DM, Lorr M, Droppleman LF. The Manual for the Profile of Mood States. San Diego, CA: Educational and Industrial Testing Service, 1981.Google Scholar
  11. 11.
    Baker F, Curbow B, Wingard J. Development of the Satisfaction with Life Domains Scale for Cancer (SLDS-C). J Psychosoc Oncol 1992; 10: 75–90.CrossRefGoogle Scholar
  12. 12.
    Baker F, Denniston M, Hann D, et al. Further validation of the Satisfaction with Life Domains Scale for Cancer (SLDS-C). Manuscript submitted for publication.Google Scholar
  13. 13.
    Radloff LS. The CES-D Scale: A self report depression scale for research in the general population. Applied Psychol Meas 1977; 1(3): 385–401.Google Scholar
  14. 14.
    Devins GM, Orme CM, Costello CG, Binik YM. Measuring depressive symptoms in illness populations: Psychometric properties of the Center for Epidemiologic Studies Depression (CES-D) Scale. Psychology & Health 1988; 2(2): 139–156.Google Scholar
  15. 15.
    Hann D, Winter K, Jacobsen P. Measurement of depressive symptoms in cancer patients: Evaluation of the CES-D. J Psychosom Research (in press) 1999; 46(5): 437–443.CrossRefGoogle Scholar
  16. 16.
    Nunnally JM, Bernstein IH. Psychometric Theory 3rd edn. New York: McGraw-Hill, 1994.Google Scholar
  17. 17.
    Hann D, Jacobsen P, Azzarello L, Martin S, Greenberg H. Fatigue and quality of life following radiotherapy for breast cancer: A comparative study. J Clin Psychol in Medical Settings 1998; 5(1): 19–33.CrossRefGoogle Scholar
  18. 18.
    Baker F, Jodrey D, Zabora J, Douglas C, Fernandez-Kelly P. Empirically selected instruments for measuring quality of life dimensions in culturally diverse populations. J Natl Cancer Inst Mono 1996; 20: 39–47.Google Scholar
  19. 19.
    Jacobsen P, Hann D, Azzarello L, Horton J, Balducci L, Lyman G. Fatigue in women receiving adjuvant chemotherapy for breast cancer: characteristics, course, and correlates. J Pain Symptom Manage (in press) 1999; 18(4): 233–242.PubMedCrossRefGoogle Scholar
  20. 20.
    Hann D, Jacobsen P, Martin S, Kronish L, Azzarello L, Fields K. Fatigue in women treated with bone marrow transplantation for breast cancer: A comparison with women with no history of cancer. Support Care Cancer 1997; 5: 44–52.PubMedCrossRefGoogle Scholar
  21. 21.
    Hann D, Garovoy N, Finklestein B, Azzarello L, Jacobsen P, Fields K. Fatigue and quality of life in cancer patients undergoing high dose therapy and autologous stem cell rescue: A longitudinal comparative study. J Pain Symptom Manage 1999; 17(5): 311–319.PubMedCrossRefGoogle Scholar

Copyright information

© Kluwer Academic Publishers 2000

Authors and Affiliations

  • Danette M. Hann
    • 1
  • Maxine M. Denniston
    • 1
  • Frank Baker
    • 1
  1. 1.American Cancer SocietyBehavioral Research CenterAtlantaUSA

Personalised recommendations