Cella D
Division of Psychosocial Oncology Rush-Presbyterian-St Luke's Medical Center, Chicago, IL, USA.
Semin Hematol. 1997 Jul;34(3 Suppl 2):13-9.
Anemia, frequently associated with cancer and cancer treatment, can use a variety of symptoms that diminish overall quality of life (QOL). Fatigue is the most commonly reported symptom among cancer patients and can significantly affect their daily lives. Using the Functional Assessment of Cancer Therapy-General (FACT-G) instrument, which measures general QOL, as a core questionnaire, 20 new questions related to the impact of fatigue and other anemia-related symptoms on patients with cancer were developed. Two new instruments were produced: the FACT-Fatigue (FACT-F), consisting of the FACT-G plus 13 fatigue items (the Fatigue Subscale), and the FACT-Anemia (FACT-An), consisting of the FACT-F plus seven items addressing other concerns related to anemia, but unrelated to fatigue. FACT-F and FACT-An demonstrated good stability (r = .87 for both) and strong internal consistency (alpha = .95 and .96, respectively). Test-retest reliability coefficients for the Fatigue Subscale and nonfatigue items also showed good stability (r = .84 to .90), and the Fatigue Subscale showed strong internal consistency (alpha = .93 to .95). Convergent and discriminant validity testing revealed a significantly positive relationship with other known measures of fatigue, a significant negative relationship with vigor, and an anticipated lack of relationship with social desirability. The FACT-An, FACT-F, and Fatigue Subscale were found to successfully discriminate patients based on hemoglobin (Hb) level and Eastern Cooperative Oncology Group (ECOG) performance status. When patients were divided into two groups by Hb levels, patients with Hb levels greater than 12 g/dL reported significantly less fatigue, fewer nonfatigue anemia symptoms, better physical well-being, better functional well-being, and higher general QOL. The FACT-An, the FACT-F, and the Fatigue Subscale are useful measures of QOL in cancer patients and add focus to the widespread clinical problems of anemia and fatigue.
贫血常与癌症及癌症治疗相关，会引发多种症状，降低整体生活质量（QOL）。疲劳是癌症患者最常报告的症状，会严重影响他们的日常生活。以用于测量总体生活质量的癌症治疗功能评估通用量表（FACT-G）作为核心问卷，编制了20个与疲劳及其他贫血相关症状对癌症患者的影响有关的新问题。由此产生了两个新量表：癌症治疗功能评估疲劳量表（FACT-F），由FACT-G加上13个疲劳项目（疲劳子量表）组成；癌症治疗功能评估贫血量表（FACT-An），由FACT-F加上7个涉及与贫血相关但与疲劳无关的其他问题的项目组成。FACT-F和FACT-An显示出良好的稳定性（两者的r均为0.87）和较强的内部一致性（α分别为0.95和0.96）。疲劳子量表和非疲劳项目的重测信度系数也显示出良好的稳定性（r = 0.84至0.90），且疲劳子量表显示出较强的内部一致性（α = 0.93至0.95）。收敛效度和区分效度测试表明，该量表与其他已知的疲劳测量方法呈显著正相关，与活力呈显著负相关，且预期与社会期望无关。研究发现，FACT-An、FACT-F和疲劳子量表能够根据血红蛋白（Hb）水平和东部肿瘤协作组（ECOG）体能状态成功区分患者。当根据Hb水平将患者分为两组时，Hb水平大于12 g/dL的患者报告的疲劳明显更少，非疲劳性贫血症状更少，身体状况更好，功能状况更好，总体生活质量更高。FACT-An、FACT-F和疲劳子量表是评估癌症患者生活质量的有用工具，有助于关注贫血和疲劳这两个普遍存在的临床问题。
