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Comparison of SF-36 vitality scale and Fatigue Symptom Inventory in assessing cancer-related fatigue

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Abstract

Purpose

Cancer-related fatigue (CRF) is an important symptom in clinical practice and research. The best way to measure it, however, remains unsettled. The SF-36 vitality scale, a general measure of energy/fatigue, is a frequently cited measure. With only four items, however, its ability to adequately represent multiple CRF facets has been questioned. The 13-item Fatigue Symptom Inventory (FSI) was developed to assess multidimensional aspects of CRF. Our objectives were to assess the convergent validity and to compare the sensitivity to change of the two scales.

Methods

We administered both scales at 1 month (n = 68) and 6 months (n = 96) to a subset of heterogeneous patients receiving treatment in 16 cancer centers who were enrolled in a clinical trial of pain and depression. Distributions of standardized response means (SRMs) were compared to assess sensitivity to change. Results of both scales were compared to scores on a single fatigue item from the Patient Health Questionnaire (PHQ).

Results

Mean scores for both the FSI and the vitality scale demonstrated clinically significant fatigue in the sample. The vitality scale was strongly correlated with all three FSI scales (r = −0.68 to −0.77). The vitality and FSI scales also correlated strongly with the PHQ fatigue item. Moreover, distributions of SRMs for both scales were approximately normal.

Conclusions

Both the FSI and the vitality scale are supported as valid measures of CRF. Both demonstrated sensitivity to change across a range of effect sizes. The vitality scale may be an excellent choice when brevity is paramount; the FSI may be more appropriate when tapping specific dimensions is warranted.

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Acknowledgments

This manuscript was supported by a grant from the National Cancer Institute to Dr. Kroenke (R01 CA-115369) and a grant from the National Cancer Institute (R25 CA-117865-01A11).

Conflicts of interest

None declared.

Author information

Authors and Affiliations

  1. Department of Psychology, Indiana University Purdue University Indianapolis, C/O Donna Burgett, Regenstrief Institute, Inc., 1050 Wishard Blvd., RG5, Indianapolis, IN, 46202, USA

    Linda F. Brown

  2. Department of Medicine, Indiana University, Indianapolis, IN, USA

    Kurt Kroenke & Jingwei Wu

  3. Regenstrief Institute, Indianapolis, IN, USA

    Kurt Kroenke & Jingwei Wu

  4. Center on Implementing Evidence-Based Practice, Roudebush VA Medical Center, Indianapolis, IN, USA

    Kurt Kroenke

  5. Community Health Network, Indianapolis, IN, USA

    Dale E. Theobald

Authors
  1. Linda F. Brown
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  2. Kurt Kroenke
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  3. Dale E. Theobald
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  4. Jingwei Wu
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Corresponding author

Correspondence to Linda F. Brown.

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Brown, L.F., Kroenke, K., Theobald, D.E. et al. Comparison of SF-36 vitality scale and Fatigue Symptom Inventory in assessing cancer-related fatigue. Support Care Cancer 19, 1255–1259 (2011). https://doi.org/10.1007/s00520-011-1148-2

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  • DOI: https://doi.org/10.1007/s00520-011-1148-2

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