title: Application of the Chinese version of the MFI-20 in detecting the severe fatigue in cancer patients.
abstract: OBJECTIVE
  This study aimed to apply the Multidimensional Fatigue Inventory Scale (MFI-20) for detecting severe fatigue in cancer patients, estimating the prevalence rates of severe fatigue in patients with various tumors and those receiving various treatments, as well as assessing the risk factors for severe fatigue in cancer patients after treatment.
  
  
  METHODS
  This study was divided into two stages. In the first stage, we randomly selected 353 residents and obtained their scores in the Chinese version of MFI-20. We then calculated the 95th percentile of their MFI-20 score. In the second stage, we selected 715 hospital cancer patients diagnosed from 2010 to 2011 and obtained their data on fatigue, resilience, and quality of life. The 95th percentile of the MFI-20 score in the residents was deemed as the cutoff score for detecting patients with severe fatigue. The χ (2) test was used to detect the differences among the prevalence rates of severe fatigue, and multivariate logistic regression was used to detect the predictors of severe fatigue after treatment.
  
  
  RESULTS
  The 95th percentile of the MFI-20 score in the residents was 60. The difference between the quality of life of patients with MFI-20 score ≤ 60 and patients with MFI-20 score >60 was statistically significant (92.33 ± 12.86 and 75.03 ± 15.85, t = 10.44, P < 0.0001). The prevalence of severe fatigue in cancer patients after treatment was 18.88 % (95 % confidence interval, 16.01-21.75 %). The prevalence rates of severe fatigue among patients with various tumors were significantly different (χ(2) = 17.59, P = 0.007), and the prevalence rates of severe fatigue among patients receiving various treatments were different (χ(2) = 8.25, P = 0.04). Patients with nasopharyngeal cancer were at the highest risk for severe fatigue (RR = 3.22), followed by patients with lung cancer and digestive tract cancer (RR = 2.41). Apart from the tumor site, old age (P = 0.01), advanced disease stage (P < 0.01), low resilience (P < 0.01), and radiotherapy (P = 0.03) were risk factors for severe fatigue after treatment.
  
  
  CONCLUSIONS
  The cutoff score of 60 is suitable for determining severe fatigue in the Chinese-version MFI-20. The prevalence of severe fatigue in cancer patients after treatment is moderate. Patients receiving radiotherapy are more likely to suffer from severe fatigue than those not receiving radiotherapy. The prevalence of severe fatigue in patients with nasopharynx, lung, and digestive tract cancers is higher than that in patients with other tumors. Patients with advanced disease stage, old age, and low resilience are at high risk for severe fatigue after treatment.
authors.affiliation: Department of Epidemiology and Health Statistics, Fujian Medical University, Fuzhou, 350004, Fujian Province, China. tianjunfjmu@126.com
authors.forename: Jun
authors.initials: J
authors.lastname: Tian
authors.forename: Jin-Sheng
authors.initials: JS
authors.lastname: Hong
mesh_terms: D000328:Adult; D002681:China; D005221:Fatigue / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000453:epidemiology; D015995:Prevalence; D011788:Quality of Life; D055500:Resilience, Psychological; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires