Validation of the Amharic Version of the Brief Fatigue Inventory for Assessment of Cancer-Related Fatigue in Ethiopian Cancer Patients.

Abstract

Although cancer-related fatigue (CRF) is a highly prevalent and distressing symptom associated with cancer and its treatment, it is mostly underscreened, underassessed, and undertreated. The Brief Fatigue Inventory (BFI) is a reliable and valid instrument to assess CRF. To validate the Amharic version of the BFI (BFI-Am) for assessment of CRF in Ethiopian cancer patients. The BFI-Am was developed from its original English version through standard forward-backward translation approach. Two hundred eight consented cancer patients filled the questionnaires, along with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30, version 3. In addition, sociodemographic and clinical information were collected. Psychometric properties of the BFI-Am were evaluated in terms of acceptability, internal consistency, construct validity, concurrent validity, and known group validity. Linear regression analysis was performed to identify possible predictors of fatigue severity. Two hundred two cancer patients completed the questionnaires and included in the data analysis. The BFI-Am had an overall Cronbach's alpha of 0.97. The results of the principal axis factor analysis suggested a one-factor solution explaining 78.4% of the variance, supporting the hypothesis of unidimensionality of the BFI-Am. The global BFI-Am interference items score was highly correlated with fatigue subscale score of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 than single items, showing an inverse correlation between the BFI-Am and the global health status/quality of life (r = -0.324; P = 0.000). The BFI-Am significantly detected the differences in fatigue severity in patients with poor performance status (P < 0.001), indicating known group validity. The BFI-Am is an excellent assessment tool with adequate psychometric properties for use in both clinical management and symptom research of CRF in Ethiopian cancer patients.