Skip to main content

Advertisement

SpringerLink
Log in

Fatigue in breast cancer patients: psychometric evaluation of the fatigue questionnaire EORTC QLQ-FA13

  • Original Article
  • Published:
Breast Cancer Aims and scope Submit manuscript

Abstract

Background

Fatigue is a frequent symptom in breast cancer patients and breast cancer survivors. The aims of this study were to test a newly developed fatigue questionnaire (EORTC QLQ-FA13) and to detect prognostic factors of fatigue.

Methods

A total of 308 breast cancer patients (response rate: 91 %) were tested with the fatigue questionnaire EORTC QLQ-FA13 and the fatigue scale of the EORTC QLQ-C30. In addition, several other questionnaires were also adopted.

Results

The youngest age group of breast cancer patients was most strongly affected by fatigue. The psychometric analysis of the EORTC QLQ-FA13 supported a three-dimensional structure (physical, emotional, and cognitive fatigue). The reliability (Cronbach’s alpha = 0.94) was very good. Clinical factors such as time since diagnosis and received therapy did not significantly predict the level of fatigue.

Conclusion

Fatigue remains a severe problem in breast cancer patients, especially in younger women. Researchers or clinicians who want to measure fatigue have the choice between the short 3-item fatigue scale of the EORTC QLQ-C30, stressing the physical aspect of fatigue, and the long 13-item EORTC QLQ-FA13 scale with slightly better psychometric properties, including cognitive and emotional aspects of fatigue.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Ahlberg K, Ekman T, Gaston-Johansson F, Mock V. Assessment and management of cancer-related fatigue in adults. Lancet. 2003;362:640–50.

    Article  PubMed  Google Scholar 

  2. Bruera E, Yennurajalingam S. Challenge of managing cancer-related fatigue. J Clin Oncol. 2010;28:3671–2.

    Article  CAS  PubMed  Google Scholar 

  3. Weis J. Cancer-related fatigue: prevalence, assessment and treatment strategies. Expert Rev Pharmacoeconom Outcomes Res. 2011;11:441–6.

    Article  Google Scholar 

  4. Allemani C, Minicozzi P, Berrino F, Bastiaannet E, Gavin A, Galceran J, et al. Predictions of survival up to 10 years after diagnosis for European women with breast cancer in 2000–2002. Int J Cancer. 2013;132:2404–12.

    Article  CAS  PubMed  Google Scholar 

  5. Allemani C, Sant M, Weir HK, Richardson LC, Baili P, Storm H, et al. Breast cancer survival in the US and Europe: a CONCORD high-resolution study. Int J Cancer. 2013;132:1170–81.

    Article  CAS  PubMed  Google Scholar 

  6. Sant M, Allemani C, Santaquilani M, Knijn A, Marchesi F, Capocaccia R. EUROCARE-4. Survival of cancer patients diagnosed in 1995–1999. Results and commentary. Eur J Cancer. 2009;45:931–91.

    Article  PubMed  Google Scholar 

  7. Arndt V, Merx H, Sturmer T, Stegmaier C, Ziegler H, Brenner H. Age-specific detriments to quality of life among breast cancer patients one year after diagnosis. Eur J Cancer. 2004;40:673–80.

    Article  CAS  PubMed  Google Scholar 

  8. Waldmann A, Pritzkuleit R, Raspe H, Katalinic A. The OVIS study: health related quality of life measured by the EORTC QLQ-C30 and-BR23 in German female patients with breast cancer from Schleswig-Holstein. Qual Life Res. 2007;16:767–76.

    Article  CAS  PubMed  Google Scholar 

  9. Kramer JA, Curran D, Piccart M, De Haes JCJM, Bruning P, Klijn J, et al. Identification and interpretation of clinical and quality of life prognostic factors for survival and response to treatment in first-line chemotherapy in advanced breast cancer. Eur J Cancer. 2000;36:1498–506.

    Article  CAS  PubMed  Google Scholar 

  10. Kuhnt S, Ernst J, Singer S, Rüffer JU, Kortmann R-D, Stolzenburg J-U, et al. Fatigue in cancer survivors—prevalence and predictors. Onkologie. 2009;32:312–7.

    Article  PubMed  Google Scholar 

  11. Schleife H, Sachtleben C, Finck BC, Singer S, Hinz A. Anxiety, depression, and quality of life in German ambulatory breast cancer patients. Breast Cancer. 2014;. doi:10.1007/s12282-012-0378-6.

    PubMed  Google Scholar 

  12. Schou I, Ekeberg O, Sandvik L, Hjermstad MJ, Ruland CM. Multiple predictors of health-related quality of life in early stage breast cancer. Data from a year follow-up study compared with the general population. Qual Life Res. 2005;14:1813–23.

    Article  PubMed  Google Scholar 

  13. Vollrath M, Zenger M, Singer S, Einenkel J, Hinz A. The course of fatigue in patients with gynecologic and breast cancer. J Gynecol Oncol. 2013;24:280–6.

    Article  PubMed Central  PubMed  Google Scholar 

  14. Singer S, Kuhnt S, Zwerenz R, Eckert K, Hofmeister D, Dietz A, et al. Age- and sex-standardised prevalence rates of fatigue in a large hospital-based sample of cancer patients. Br J Cancer. 2011;105:445–51.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  15. Seyidova-Khoshknabi D, Davis MP, Walsh D. A systematic review of cancer-related fatigue measurement questionnaires. Am J Hospice Palliative Med. 2011;28:119–29.

    Article  Google Scholar 

  16. Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, et al. The European-Organization-For-Research-And-Treatment-Of-Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993;85:365–76.

    Article  CAS  PubMed  Google Scholar 

  17. Smets EMA, Garssen B, Bonke B, Dehaes JCJM. The Multidimensional Fatigue Inventory (MFI): psychometric qualities of an instrument to assess fatigue. J Psychosom Res. 1995;39:315–25.

    Article  CAS  PubMed  Google Scholar 

  18. Beutel ME, Hinz A, Albani C, Brahler E. Fatigue Assessment Questionnaire: standardization of a cancer-specific instrument based on the general population. Oncology. 2006;70:351–7.

    Article  CAS  PubMed  Google Scholar 

  19. Reeve BB, Stover AM, Alfano CM, Smith AW, Ballard-Barbash R, Bernstein L, et al. The Piper Fatigue Scale-12 (PFS-12): psychometric findings and item reduction in a cohort of breast cancer survivors. Breast Cancer Res Treat. 2012;136:9–20.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Weis J, Arraras JI, Conroy T, Efficace F, Fleissner C, Gorog A, et al. Development of an EORTC quality of life phase III module measuring cancer-related fatigue (EORTC QLQ-FA13). Psychooncology. 2013;22:1002–7.

    Article  PubMed  Google Scholar 

  21. Schwarz R, Hinz A. Reference data for the quality of life questionnaire EORTC QLQ-C30 in the general German population. Eur J Cancer. 2001;37:1345–51.

    Article  CAS  PubMed  Google Scholar 

  22. Lowe B, Wahl I, Rose M, Spitzer C, Glaesmer H, Wingenfeld K, et al. A 4-item measure of depression and anxiety: validation and standardization of the Patient Health Questionnaire-4 (PHQ-4) in the general population. J Affect Disord. 2010;122:86–95.

    Article  PubMed  Google Scholar 

  23. Henrich G, Herschbach P. Questions on Life Satisfaction (FLZ(M)): a short questionnaire for assessing subjective quality of life. Eur J Psychol Assess. 2000;16:150–9.

    Article  Google Scholar 

  24. Brooks R. EuroQoL: the current state of play. Health Policy. 1996;37:53–72.

    Article  CAS  PubMed  Google Scholar 

  25. Scheier MF, Carver CS, Bridges MW. Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): a reevaluation of the Life Orientation Test. J Pers Soc Psychol. 1994;67:1063–78.

    Article  CAS  PubMed  Google Scholar 

  26. Hu LT, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Model. 1999;6:1–55.

    Article  Google Scholar 

  27. Cohen J. Statistical power analysis for the behavioral sciences, 2nd ed. Erlbaum, Hillsdale, NJ; 1988.

  28. Derogar M, van der Schaaf M, Lagergren P. Reference values for the EORTC QLQ-C30 quality of life questionnaire in a random sample of the Swedish population. Acta Oncol. 2012;51:10–6.

    Article  PubMed  Google Scholar 

  29. Michelson H, Bolund C, Nilsson B, Brandberg Y. Health-related quality of life measured by the EORTC QLQ-C30—reference values from a large sample of the Swedish population. Acta Oncol. 2000;39:477–84.

    Article  CAS  PubMed  Google Scholar 

  30. Romito F, Cormio C, Giotta F, Colucci G, Mattioli V. Quality of life, fatigue and depression in Italian long-term breast cancer survivors. Support Care Cancer. 2012;20:2941–8.

    Article  PubMed  Google Scholar 

  31. Prinsen H, Bleijenberg G, Heijmen L, Zwarts MJ, Leer JWH, Heerschap A, et al. The role of physical activity and physical fitness in postcancer fatigue: a randomized controlled trial. Support Care Cancer. 2013;21:2279–88.

    Article  CAS  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Medical Psychology and Medical Sociology, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany

    Kerstin Fuhrmann, Kristina Geue & Andreas Hinz

  2. Section of Psycho-Oncology, University of Leipzig, Leipzig, Germany

    Anja Mehnert

Authors
  1. Kerstin Fuhrmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anja Mehnert
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kristina Geue
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Andreas Hinz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Andreas Hinz.

About this article

Cite this article

Fuhrmann, K., Mehnert, A., Geue, K. et al. Fatigue in breast cancer patients: psychometric evaluation of the fatigue questionnaire EORTC QLQ-FA13. Breast Cancer 22, 608–614 (2015). https://doi.org/10.1007/s12282-014-0527-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12282-014-0527-1

Keywords

Search

Navigation