Assessing fatigue in childhood cancer survivors: Psychometric properties of the Checklist Individual Strength and the Short Fatigue Questionnaire––a DCCSS LATER study

Adriaan Penson*, Iris Walraven, Ewald Bronkhorst, Martha A. Grootenhuis, Wim J.E. Tissing, Helena J.H. van der Pal, Andrica C.H. de Vries, Marry M van den Heuvel-Eibrink, Sebastian Neggers, Birgitta A.B. Versluys, Marloes Louwerens, Saskia M.F. Pluijm, Nicole Blijlevens, Margriet van der Heiden-van der Loo, Leontien C.M. Kremer, Eline van Dulmen-den Broeder, Hans Knoop, Jacqueline Loonen

*Corresponding author for this work

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Abstract

Background: Fatigue is often reported by patients with childhood cancer both during and after cancer treatment. Several instruments to measure fatigue exist, although none are specifically validated for use in childhood cancer survivors (CCS). The aim of the current study was to present norm values and psychometric properties of the Checklist Individual Strength (CIS) and Short Fatigue Questionnaire (SFQ) in a nationwide cohort of CCS. Methods: In total, 2073 participants were included from the Dutch Childhood Cancer Survivor Study (DCCSS) LATER cohort. Normative data, construct validity, structural validity, and internal consistency were calculated for the CIS and SFQ. In addition, reliability and a cutoff score to indicate severe fatigue were determined for the SFQ. Results: Correlations between CIS/SFQ and vitality measures asking about fatigue were high (>0.8). Correlations between CIS/SFQ and measures of different constructs (sleep, depressive emotions, and role functioning emotional) were moderate (0.4–0.6). Confirmatory factor analysis resulted in a four-factor solution for the CIS and a one-factor solution for the SFQ with Cronbach's alpha for each (sub)scale showing good to excellent values (>0.8). Test–retest reliability of the SFQ was adequate (Pearson's correlation = 0.88; ICC = 0.946; weighted Cohen's kappa item scores ranged 0.31–0.50) and a cut-off score of 18 showed good sensitivity and specificity scores (92.6% and 91.3%, respectively). Conclusion: The current study shows that the SFQ is a good instrument to screen for severe fatigue in CCS. The CIS can be used as a tool to assess the multiple fatigue dimensions in CCS.

Original languageEnglish
Pages (from-to)1172-1180
Number of pages9
JournalCancer Medicine
Volume11
Issue number4
Early online date24 Dec 2021
DOIs
Publication statusPublished - Feb 2022

Bibliographical note

Funding Information:
The authors thank all cancer survivors participating in the study and the VOKK and VOX for their contribution to the DCCSS LATER study. The authors also thank the complete LATER study group for their contribution to the study. The DCCSS LATER program was funded by KIKA/ODAS (grant 171 “DCOG LATER program”) and the Dutch Cancer Society (grant KUN 2014‐6985).

Funding Information:
The DCCSS LATER program was funded by KIKA/ODAS (grant 171 “DCOG LATER program”) and the Dutch Cancer Society (grant KUN 2014‐6985).

Publisher Copyright:
© 2021 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

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