Adolescents undergoing treatment for cancer rate fatigue as their most prevalent and
intense cancer- and treatment-related effect. Parents and staff rate it similarly.
Despite its reported prevalence, intensity, and distressing effects, cancer-related
fatigue in adolescents is not routinely assessed during or after cancer treatment.
We contend that the insufficient clinical attention is primarily due to the lack of
a reliable and valid self-report instrument with which adolescent cancer-related fatigue
can be measured. Our aim was to determine the reliability and construct validity of
a new instrument and its ability to measure change in fatigue over time. Initial testing
involved 64 adolescents undergoing curative treatment of cancer who completed the
Fatigue Scale-Adolescent (FS-A) at two to four key points in treatment in one of four
studies. Internal consistency estimates ranged from 0.67 to 0.95. Validity estimates
involving the FS-A with the parent version ranged from 0.13 to 0.76; estimates involving
the staff version and the Reynolds Depression Scale were 0.27 and 0.87, respectively.
Additional validity findings included significant fatigue differences between anemic
and nonanemic patients (P=0.042) and the emergence of four factors in an exploratory
factor analysis. Findings further indicate that the FS-A can be used to measure change
over time (t=2.55, P<0.01). In summary, the FS-A has moderate to strong reliability
and impressive validity coefficients for a new research instrument.