The Fatigue Pictogram: Assessing the psychometrics of a new screening tool

Margaret I. Fitch, Terry Bunston, Deborah Mings


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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