The Fatigue Pictogram: Assessing the psychometrics of a new screening tool
Abstract
Fatigue is one of the most distressing side effects of cancer for patients, yet clinicians often do not focus on it during busy clinic appointments. The purpose of this project was to evaluate the psychometric properties of a new instrument designed to quickly identify patients experiencing difficulties with fatigue. The evaluation was conducted with a mixed group of 220 patients receiving chemotherapy. The two-item Fatigue Pictogram had good reliability for test-retest over a 24-hour period (Spearman Coefficient 0.69 for Question 1 and 0.72 for Question 2) and for equivalence of method (in person versus phone) (Spearman Coefficient 0.69 for Question 1 and 0.59 for Question 2). Validity was assessed by comparing results of the new tool against the Multidimensional Fatigue Inventory and the FACT-an. Overall, patients who indicated high fatigue levels did so on all respective scales. The new Fatigue Pictogram was easy to administer and score in a busy clinical setting. It provides a standardized reliable and valid instrument to screen patients experiencing difficulty with fatigue and set the stage for a conversation about this bothersome side effect.
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Ancoli-Israel, S., Liu, L., Marler, M., Parker, B., Jones, B., Sadler, G.,
et al, (2006). Fatigue, sleep and circadian rhythms prior to
chemotherapy for breast cancer. Supportive Cancer in Care,
(3), 201–209. doi:10.1007/s00520-005-0861-0
Berglund, G., Bolund, C., Fornander, T., Rutqvist, L.E., & Sjoden, P.
(1991). Late effects of adjuvant chemotherapy and post operative
radiotherapy on quality of life among breast cancer patients.
European Journal of Cancer, 27(9), 1075–1081.
Cella, D. (1997). The Functional Assessment of Cancer Therapy
Anemia (FACT-AN) Scale: A new tool for the assessment of
outcomes in cancer anemia. Seminars in Haematolology, 34(3
Suppl. 2), 13–19.
Cella, D., Lai, J.S., Chang, C.H., Peterman, A., & Slavin, M. (2002).
Fatigue in cancer patients compared with fatigue in the general
United States population. Cancer, 94(2), 528–538. doi:10.1002/
cncr.10245
Donovan, K.A., Jacobson, P.B, Andrykowski, M.A., Winters, E.M.,
Balucci, L., Malik, V., et al. (2004). Course of fatigue in women
receiving chemotherapy for early stage breast cancer. Journal of
Pain & Symptom Management, 28(4), 373–380. doi:10.1016/j.jpai
nsymman.2004.01.012
Ferrell, B.R, Grant, M., Dean, G.E., Funk, B., & Ly, J. (1996). “Bone
tired”: The experience of fatigue and its impact on quality of life.
Oncology Nursing Forum, 23,1539–1547.
Fitch, M.I. (In press). Supportive care needs of patients with advanced
disease undergoing radiotherapy for symptom control. Canadian
Oncology Nursing Journal.
Fitch, M.I., Bunston, T., Bakker, D., Mings, D., & Sevean, P. (2011).
The Fatigue Pictogram: Psychometric evaluation of a new
clinical tool. Canadian Oncology Nursing Journal, 21(4), 205–
doi:10.5737/1181912x214205210
Fitch, M.I., & Steele, R. (2010). Supportive care needs of individuals
with lung cancer. Canadian Oncology Nursing Journal, 20(1), 15–
Fitch, M.I., Mings, D., & Lee, A. (2008). Exploring patient initiated
strategies for living with treatment-related fatigue. Canadian
Oncology Nursing Journal, 18(3), 124–140.
Irvine, D., Vincent, L., Grayson, J.E., Bubela, N., & Thompson, L. (1994).
The prevalence and correlates of fatigue in patients receiving
treatment with chemotherapy and radiotherapy: A comparison
with the fatigue experienced by healthy individuals. Cancer
Nursing, 17(5), 367–378. doi:10.1097/00002820-199410000-00001
Mitchell, S., Beck, S.L., Hood, L.E., Moore, K., & Tanner, E.R. (2007).
Putting evidence into practice: Evidence-based interventions for
fatigue during and following cancer and its treatment. Clinical
Journal of Oncology Nursing, 11(1), 99–113. doi:10.1188/07.
CJON.69-78
National Comprehensive Cancer Network. (2007). NCCN Guidelines
for Supportive Care. Retrieved from http://www.nccn.org/
professionals/physician_gls/PDF/fatigue.pdf
Nunnally, J.C., & Bernstein, I. (1994). Psychometric theory. McGraw-
Hill: Toronto.
Olson, K., Tom, B., Hewitt, J., Whittingham, J., Buchanan, L., &
Ganton, G. (2002). Evolving routines: Managing fatigue associated
with lung and colorectal cancer. Qualitative Health Research,
(5), 655–70. doi:10.1177/104973202129120160
Olson, K., Krawchuk, A., & Qudussi, T. (2007). Fatigue in
individuals with advanced cancer in active treatment and
palliative settings. Cancer Nurse, 30(6), 1–10. doi:10.1097/01.
NCC.0000281736.25609.74
Piper, B.F. (1990). Piper fatigue scale available for clinical testing.
Oncology Nursing Forum, 17(5), 661–662.
Portenoy, R.K., & Itri, L.M. (1999). Cancer related fatigue: Guidelines
for evaluation and management. Oncologist, 4(1) 1–10.
Servaes, P.F., Verhagen, C.F., & Bleijenberg, G. (2002). Fatigue in
cancer patients during and after treatment: Prevalence, correlates
and interventions. European Journal of Cancer, 38(1), 27–43.
Smets, E.M.A., Garssen, B., Cull, A., & de Haes, J.C.J.M. (1996).
Application of the multidimensional fatigue inventory (MFI-20) in
cancer patients receiving radiotherapy. British Journal of Cancer,
(2), 241–245. doi:10.1038/bjc.1996.42
Steele, R., & Fitch, M.I. (2008). Supportive care needs of women with
gynecological cancer. Cancer Nursing, 31(4), 284–291.
Stone, P., Richardson, A., Ream, E., Smith, A.G., Kerr, D.J., & Kearney,
N. (2000). Cancer related fatigue: Inevitable, unimportant and
untreatable? Results of a multi-centered patient survey. Cancer
Fatigue Forum. Annals of Oncology, 11(8), 971–975.
Truong, T.P., Berthelet, E., Lee, C.J., Petersen, R., Lim, T.W., Gaul,
A.C., et al. (2006). Prospective evaluation of the prevalence and
severity of fatigue in patients with prostate cancer undergoing
radical external beam radiotherapy and neoadjuvant hormone
therapy. The Canadian Journal of Urology, 13(3), 3139–46.
Windsor, P.M., Nicol, K.F., & Poller, J. (2004). A randomized
controlled trial of aerobic exercise for treatment-related fatigue
in men receiving radical external beam radiotherapy for localized
prostate carcinoma. Cancer, 101(3) 550–57. doi:10.1002/
cncr.20378
Winningham, M.L., Nail, L.M., Burke M.B., Brophy, L., Cimprich, B.,
Jone, L.S., et al. (1994). Fatigue and the cancer experience: The
state of the knowledge. Oncology Nursing Forum, 21(1), 23–35.
Yates, P., Aranda, S., Hargraves, M., Mirolo, B., Clavarino, A.,
McLachlan, S.I., et al. (2005). Randomized controlled trial of
an educational intervention for managing fatigue in women
receiving adjuvant chemotherapy for early stage breast cancer.
Journal of Clinical Oncology, 23(25), 6027–36. doi:10.1200/
JCO.2005.01.271
Yellen, S.B., Cella, D.F., Webster, K., Blendowski, C., & Kaplan, E. (1997).
Measuring fatigue and other anemia related symptoms with the
Functional Assessment of Cancer Therapy (FACT) Measurement
System. Journal of Pain & Symptom Management, 13(2), 63–74.
Zubrod, C.G., Schneiderman, M., Frei, E., Brindley, C., Gold, G.L.,
Snider, B., et al. (1960). Appraisal of methods for study of
chemotherapy of cancer in man. Journal of Chronic Diseases,
(1), 7–33.
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