A New Tool for Assessing Fatigue in Individuals With Advanced Cancer

Development of a Rapid Assessment Tool for Fatigue in Palliative Care

Fatigue is a common problem in advanced cancer and palliative care. The development of tools to measure fatigue, however, has been slowed by their inability to distinguish between fatigue and other related symptoms, such as tiredness. Our work suggests that these distinctions are important because they serve as markers for stressors associated with advancing disease. We have developed a tool that we believe will distinguish between these two states as well as exhaustion. In this study we will conduct some initial tests of this tool in preparation for its use as an outcome indicator in future studies.

Study Overview

• Status: Completed
• Conditions: Neoplasms
• Intervention / Treatment: Other: ACI instrument

Detailed Description

Based on a series of qualitative studies, our group is developing a new rapid fatigue assessment screening tool (rFAST) for use with individuals who have advanced cancer and are receiving care in either an active treatment or palliative setting.

Hypotheses:

1. The three tools (tiredness, fatigue, and exhaustion) in the rFAST are each defined by the same six dimensions: decline in stamina, decline in cognition, decline in sleep quality, diminished social network, and increased emotional reactivity
2. The five subscales of the tiredness, fatigue, and exhaustion scales are internally consistent.
3. Tiredness, fatigue, and exhaustion are distinct states that are manifested by unique patterns of scores on their 6 subscales
4. The mean POMS-Vsf scores of individuals who meet the definition of fatigue will be lower than the mean POMS-Vsf scores of individuals who meet the definition of tiredness and higher than the mean POMS-Vsf scores of individuals who meet the definition of exhaustion.

Objectives

1. To examine the factor structure of the tiredness, fatigue, and exhaustion scales of the rFAST.
2. To examine the internal consistency of the 5 subscales within the tired, fatigue, and exhaustion scales.
3. To compare actual rFAST scale scores to hypothesized scale profiles for tiredness, fatigue, and exhaustion.

• Study Type: Observational
• Enrollment (Actual): 228

Contacts and Locations

Study Locations

• Canada
  • Alberta
    • Edmonton, Alberta, Canada, T6G 2T4
      • Faculty of Nursing, University of Alberta

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Individuals with advanced cancer

Description

Inclusion Criteria:

• Patients with advanced cancer currently receiving treatment for either hematologic or lung cancer at the Jewish General Hospital in Montreal, or patients with advanced cancer currently receiving care through the Alberta Cancer Board (Cross Cancer Institute or Tom Baker Cancer Centre), or the palliative care programs associated with the regional health authority in Edmonton, Alberta who are at least 18 years old, able to read and write English, have a Folstein Mini Mental Status Exam score of at least 22.

Exclusion Criteria:

• Patients unable to give informed consent in English.

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
ACI Instrument; 228 individuals completed the ACI instrument and other tools	Other: ACI instrument; Following ethics approval, 17 experts in symptom management assisted with content validation during the pilot phase. In the main study, participants complete the FACT-F, the POMS-Vsf, and the ACI Instrument. A research assistant collected demographic information and assigned an ECOG score.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
ACI score	Adaptive Capacity Index Score	day 1

Collaborators and Investigators

• Sponsor: University of Alberta
• Investigators: Principal Investigator: Karin L Olson, Ph.D., University of Alberta

Publications and helpful links

General Publications

• Olson K, Rogers WT, Cui Y, Cree M, Baracos V, Rust T, Mellott I, Johnson L, Macmillan K, Bonville N. Development and psychometric testing of the Adaptive Capacity Index, an instrument to measure adaptive capacity in individuals with advanced cancer. Int J Nurs Stud. 2011 Aug;48(8):986-94. doi: 10.1016/j.ijnurstu.2011.01.013. Epub 2011 Feb 18.

Study record dates

Study Major Dates

• Study Start: October 1, 2005
• Primary Completion (Actual): October 1, 2007
• Study Completion (Actual): October 1, 2010

Study Registration Dates

• First Submitted: January 26, 2007
• First Submitted That Met QC Criteria: January 26, 2007
• First Posted (Estimate): January 30, 2007

Study Record Updates

• Last Update Posted (Actual): May 18, 2022
• Last Update Submitted That Met QC Criteria: May 12, 2022
• Last Verified: March 1, 2020

More Information

Terms related to this study

• Keywords: fatigue; screening
• Additional Relevant MeSH Terms: Fatigue
• Other Study ID Numbers: G118160539

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: No plan to share data. This was an instrument development study.