A preliminary validation of an Italian version of the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF-I)

Abstract

Background: Fatigue is one of the most common and distressing side effects of cancer and its treatment. The National Comprehensive Cancer Network defines Cancer‐Related Fatigue (CRF) as a persistent, subjective sense of physical, emotional and/or cognitive exhaustion that is not proportional to recent activity. It can range from mild to severe, and may be either temporary or a long‐term effect. Percentages of patients who experience CRF vary across studies from 25% to 100% according to the type of cancer, treatments, and method of assessment. Screening for fatigue before, during and after cancer treatment is today a core part of clinical evaluation and quality of life assessments. Material and methods: The aim of this study was to report the preliminary validation results of an Italian version of the Multidimensional Fatigue Symptom Inventory‐Short Form (MFSI‐SF‐I), one of the most used and validate CRF‐assessing tool. A total of 121 cancer patients (44 men and 77 women) were recruited to this study from the outpatient oncology clinic at the Santa Maria Annunziata Hospital in Florence. The Italian version of the MFSI‐SF was developed through a forward‐backward translation procedure, according to the EORTC Quality of Life Group Translation Procedure. We estimated internal consistency using Cronbach's alpha and split‐half technique. Test‐criterion validity was evaluated through ANOVA. The convergent validity was evaluated by estimating the Pearson's r correlation with the Italian version of the Brief Fatigue Inventory (BFI‐I). Results: This Italian version of MFSI‐SF revealed adequate internal consistency (alpha = .919) and convergent validity (r = .683; p < .01) and confirmed the original unidimensional structure (explained variance = 51%). More than the 50% of participants showed a significant CRF. Patients in the adjuvant and first line setting showed a lower level of fatigue as compared to more advanced lines of treatment (p < .05), although with a significant higher score (F = 3.844; p < .05) at the item 17 ("I feel sluggish"). Moreover, patients with low scholarization rate (primary and secondary school degree) showed a significant higher score (F = 3.829; p < .05) at the item 19 ("I ache all over"). Conclusions: While further studies are needed in order to extend the sample size (n = 300) and verify the validity and the sensitivity of this Italian version of MFSI‐SF, it seems a reliable tool to detect clinically significant fatigue in cancer patients.