Section of Patient Centered Analytics, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
MD Anderson Center for INSPiRED Cancer Care (Integrated Systems for Patient-Reported Data), The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Qual Life Res. 2024 Sep;33(9):2361-2373. doi: 10.1007/s11136-024-03705-0. Epub 2024 Jul 9.
To develop a PRO assessment of multidimensional cancer-related fatigue based on the PROMIS fatigue assessments.
Cancer patients reporting fatigue were recruited from a comprehensive cancer care center and completed a survey including 39 items from the PROMIS Cancer Item Bank-Fatigue. Component and factor structures of the fatigue items were explored with Monte Carlo parallel factor and Mokken analyses, respectively. Psychometric properties were determined using item response theory, ensuring unidimensionality, scalability, and item independence.
Fatigue scores from a sample of 333 fatigued cancer patients (mean age = 59.50, SD = 11.62, 67% women) were used in all scale development analyses. Psychometric analyses yielded 3 dimensions: motivational fatigue (15 items), cognitive fatigue (9 items), and physical fatigue (9 items). The subscales showed strong unidimensionality, were scalable, and were free of differential item function. Confirmatory factor analyses in a new sample of 182 patients confirmed the findings.
The resulting 33-item PROMIS multidimensional cancer-related fatigue (mCRF) form provides a novel measure for the assessment of the different dimensions of cancer-related fatigue. It is the only multidimensional scale specific for cancer patients that has been developed using modern psychometric approaches. With its 3 dimensions (motivational, cognitive, and physical fatigue), this scale accurately captures the fatigue experienced by cancer patients, allowing clinicians to optimize fatigue management and improve patient care. The scale could also advance research on the nature and experience of cancer-related fatigue.
基于 PROMIS 疲劳评估开发多维癌症相关疲劳 PRO 评估。
从综合癌症护理中心招募报告疲劳的癌症患者，完成一项包括来自 PROMIS 癌症项目库-疲劳的 39 个项目的调查。使用蒙特卡罗并行因子和 Mokken 分析分别探索疲劳项目的组成和因子结构。使用项目反应理论确定心理测量特性，确保维度单一性、可扩展性和项目独立性。
对 333 名疲劳癌症患者（平均年龄=59.50，标准差=11.62，67%为女性）的样本进行了疲劳评分。所有量表开发分析均使用该数据。心理测量分析得出 3 个维度：动机疲劳（15 个项目）、认知疲劳（9 个项目）和身体疲劳（9 个项目）。亚量表表现出很强的维度单一性、可扩展性和无差异项目功能。在 182 名新患者的样本中进行的验证性因子分析证实了这些发现。
由此产生的 33 项 PROMIS 多维癌症相关疲劳（mCRF）形式为评估癌症相关疲劳的不同维度提供了一种新的测量方法。它是唯一使用现代心理测量方法开发的针对癌症患者的多维量表。该量表有 3 个维度（动机、认知和身体疲劳），准确地捕捉了癌症患者的疲劳，使临床医生能够优化疲劳管理，改善患者护理。该量表还可以推进对癌症相关疲劳的性质和体验的研究。
