An assessment of
fatigue also may consider broader concerns, such as global
quality of life and symptom distress. Some of the fatigue
scales, such as the unidimensional three-item scale of the
EORTC QLQ-C30 and the multidimensional fatigue subscale of
the Functional Assessment of Cancer Therapy (FACT), are themselves
modules of well validated quality of life instruments. The
larger scale may be included if additional evaluation of quality
of life is valuable. For the other fatigue scales, a separate
quality of life questionnaire will be needed to accomplish
the same goal.
Most patients with
cancer or AIDS have multiple symptoms. Fatigue, pain, and
psychological distress are the most prevalent in most populations.
Given the likelihood of multiple symptoms, it may be informative
to add a measure of symptom prevalence and distress to the
fatigue assessment strategy. This approach also can clarify
the extent to which fatigue associates with other symptoms.