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Carr D, Goudas L, Lawrence D, et al. Management of Cancer Symptoms: Pain, Depression, and Fatigue. Rockville (MD): Agency for Healthcare Research and Quality (US); 2002 Jul. (Evidence Reports/Technology Assessments, No. 61.)

  • This publication is provided for historical reference only and the information may be out of date.

This publication is provided for historical reference only and the information may be out of date.

Cover of Management of Cancer Symptoms

Management of Cancer Symptoms: Pain, Depression, and Fatigue.

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Appendix B. Glossary for Fatigue Assessment Scales

Brief Fatigue Inventory -: 9 items, scored 1-10 to assess severity of fatigue, amount of interference with function caused by fatigue, presence of factors that worsen fatigue.

Cancer Fatigue Scale -: 15 items and 3 subscales (physical, affective, and cognitive) generated by factor analysis. Maximum score = 60. Physical = easily tired, urge to lie down, exhaustion, etc. Affective = lack of energy, lack of interest, lack of concentration. Cognitive = forgetfulness, speaking errors, carelessness. Each item is rated on a scale from 1-5.

Cancer-Related Fatigue Distress Scale (CRFDS) -: 35 cognitive distress questions reduced to 3; 147 physical distress questions reduced to 8; 142 psychological distress questions reduced to 7; 52 social distress questions reduced to 3; 21 spiritual distress questions reduced to 2. Total = 20 items, rated on a scale of 0 (none) to 10 (severe).

Checklist Individual Strength (CIS) -: 20 item questionnaire measuring 4 aspects of fatigue: fatigue severity (8 items); concentration (5 items); motivation (4 items); physical activity (3 items). Each item is scored on a 7-point Likert scale.

EORTC QLQ-C30 -: 6 functioning scales: physical functioning (5 items); role functioning (2 items); cognitive (2 items); emotional (4 items); social (2 items); QOL (2 items). 3 symptom scales: pain (2 items); fatigue (3 items); emesis (2 items).

Fatigue Questionnaire -: to estimate severity. Asks about fatigue symptoms in last month. Two items ask about duration and extent of fatigue. Seven items cover physical fatigue. Four cover mental fatigue.

Fatigue Severity Scale -: 9 item scale with statements scored from 1 (strongly disagree) to 7 (strongly agree).

Fatigue Symptom Inventory -: 13 item self-report measure for intensity and duration of fatigue and impact on QOL.

Functional Assessment of Cancer Therapy/Anemia (FACT-An) -: Composed of FACT-F plus 7 miscellaneous nonfatigue items related to anemia. FACT-F is composed of FACT-G plus Fatigue Subscale (13 items) = 20 items total.

GLQ-8 -: 8 item LASA instrument to measure cancer related QOL.

Lee Fatigue Scale -: VAS modified to numeric rating of 1-10, with descriptions of anchors from 1 (least) to 10 (extremely tired).

McCorkle and Young -: see Symptom Distress Scale.

Memorial Symptom Assessment Scale (MSAS) -: patient rates frequency, severity, distress for 32 symptoms. Frequency and severity are rated from 1-4, and distress is rated on a 5-point scale.

Multidimensional Assessment of Fatigue (MAF) -: severity, distress, interference items scaled from 0-10, ends anchored by "not at all" to "a great deal". Frequency item is categorical scale (0-4). Global fatigue calculated by summing severity and distress, adding item mean for interference, and adding the product of the categorical score on frequency by 2.5.

Multidimensional Fatigue Inventory (MFI-20) -: 5 scales relating to general fatigue, physical and mental fatigue, reduced activity and motivation. Each scale has 4 items, and each is rated on a 5-point response.

Multidimensional Fatigue Symptom Inventory (MFSI) -: 83 items to assess global (11 items), somatic (21 items), affective (17 items), cognitive (14 items), and behavioral (7 items) symptoms of fatigue.

Nottingham Health Profile (NHP) -: 6 subscales: energy (3 items); pain (8 items); emotional reactions (9 items); sleep (5 items); social isolation (5 items); physical mobility (9 items). Items were scored in a yes/no format.

Pearson Byars Fatigue Feeling Checklist -: 13 statements describing fatigue symptoms, rated on a scale of 1 (better than), 2 (same as) or 3 (worse than) and having a total range of 13-39.

Piper Fatigue Scale -: 22 items rated from 0-10 measuring 4 dimensions of subjective fatigue for a total score between 0-220. Each item is anchored by strong/weak.

Profile of Mood States (POMS): Fatigue Subscale -: self-rating measure of six emotions; tension/anxiety, depression/dejection, anger/hostility, vigor, fatigue, and confusion. Seven items, rated on a scale of 0-28.

Rhoten Fatigue Scale (RFS) -: 1 item VAS to measure fatigue. Stem is 'not tired; full of energy' and the other is 'totally exhausted'.

Rotterdam Symptom Checklist -: 30 items assessing physical and psychological symptom distress on a 4-point scale. 8 other items describe performance of daily activities. 2 items (tiredness and lack of energy) selected.

Schwartz Cancer Fatigue Scale (SCFS) -: 28 items measured using a 5-point scale.

SF-36 -: 5 variables: "lots of energy" rated from 1-6; "worn out" rated from 1-6; "tired" rated from 1-6; "full of pep" rated from 1-6; "vitality" rated from 4-24.

Subjective Symptom Test of Fatigue (Japanese Association of Industrial Health) -: 30 items in 3 categories (drowsiness/dullness, difficulty in concentration, projection of physical disintegration). Rated on a 4-point scale.

Swedish Occupational Fatigue Inventory (SOFI) -: 25 verbal expressions rated on a scale of 0-6. 0 = not at all → 6 = high degree.

Symptom Distress Scale (SDS) (also referred to as McCorkle and Young) -: 13 items: nausea, insomnia, pain, fatigue, bowel pattern, concentration, appearance, outlook, breathing, and cough.

Symptom Transition Scale -: measured severity of illness aspect of side effects burden.

Therapy-Related Symptom Checklist (TRSC) -: 25 items rated on a 5-point scale.

Visual Analogue Scale (VAS) -: 100 mm scale


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