Validation of the German Version of the Brief Fatigue Inventory
Open accessAbstract
Sedation and tiredness are among the most frequent symptoms among cancer patients. A detailed assessment of these symptoms is necessary to evaluate therapeutic effects, such as the use of methylphenidate or comparison of different opioids. The Brief Fatigue Inventory (BFI) has been validated as a short and comprehensive instrument to assess severity of fatigue and fatigue-related impairment in cancer patients. We validated the German version of the BFI in patients with chronic cancer-related and noncancer-related pain treated in a tertiary pain center. Patients treated in the Pain Clinic of the Department of Anesthesiology completed the BFI, the minimal documentation system (MIDOS) and the short form SF-36 quality-of-life questionnaire (SF-36). Test-retest reliability was assessed with a second BFI immediately after the consultation and in a subgroup of patients after 3 to 7 days. Nineteen percent of the 117 patients were treated for cancer-related pain (C); the other patients suffered from chronic severe pain of nonmalignant origin (NC). Patients reported mean values for average fatigue of 3.9 (C) and 4.9 (NC), and for worst fatigue of 5.5 (C) and 6.2 (NC). The mean score of the 6 impairment items was 4.3 in both groups. Factor analysis led to a solution with one common factor for all nine items. Fatigue on the BFI correlated highly with 'feeling tired' in the SF-36 and with 'sedation' in MIDOS, and less with 'being worn out' in SF-36 and 'weakness' in MIDOS. Internal consistency was high, as was test-retest reliability, with a correlation of the intensity, mean scores of 0.93 and the impairment mean scores of 0.87. In conclusion, we found the German version of the BFI to be reliable and valid for cancer and noncancer patients. Minor differences were seen in the validation compared to the original version.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The BFI is validated in German and reliability was .94 for the total score.
“The Brief Fatigue Inventory (BFI; Mendoza et al., 1999) is validated in German (Radbruch et al., 2003) and assesses fatigue in clinical populations.”
From The relationship between acceptance, fatigue, and subjective cognitive impairment in hematologic cancer survivors (2019) · cites this paper as Radbruch et al., 2003
Cites
Smets, E. M. A., Garssen, B., Bonke, B., & de Haes, J. C. J. M. (1995) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(94)00125-o · Cited by 3,622 · see citing works
Yellen, S. B., Cella, D. F., Webster, K., Blendowski, C., & Kaplan, E. (1997) · Journal of Pain and Symptom Management · doi:10.1016/s0885-3924(96)00274-6 · Cited by 1,964 · see citing works
Buccheri, G., Ferrigno, D., & Tamburini, M. (1996) · European Journal of Cancer · doi:10.1016/0959-8049(95)00664-8 · Cited by 627 · see citing works
Walsh, D., Donnelly, S. M., & Rybicki, L. A. (2000) · Supportive Care in Cancer · doi:10.1007/s005200050281 · Cited by 620 · see citing works
Chronic fatigue in primary care. Prevalence, patient characteristics, and outcome
Kroenke, K. (1988) · JAMA · doi:10.1001/jama.260.7.929 · Cited by 518 · see citing works
Bullinger, M., Kirchberger, I., & Ware, J. E. (1995) · Journal of Public Health · doi:10.1007/bf02959944 · Cited by 387 · see citing works
Tired, weak, or in need of rest: fatigue among general practice attenders.
David, A. S., Pelosi, A. J., McDonald, E. A., Stephens, D., Ledger, D., Rathbone, R., & MANN, A. H. (1990) · BMJ · doi:10.1136/bmj.301.6762.1199 · Cited by 375 · see citing works
Fatigue, depression and quality of life in cancer patients: how are they related?
Visser, M. R. M., & Smets, E. M. A. (1998) · Supportive Care in Cancer · doi:10.1007/s005200050142 · Cited by 348 · see citing works
Chronic Fatigue in Primary Care
Kroenke, K. (1988) · JAMA · doi:10.1001/jama.1988.03410070057028 · Cited by 313 · see citing works
The symptoms of advanced cancer.
Donnelly, S. M., & Walsh, D. (1995) · PubMed · Cited by 283 · see citing works
Fatigue in patients with cancer
Stone, P. C., Richards, M., & Hardy, J. R. (1998) · European Journal of Cancer · doi:10.1016/s0959-8049(98)00167-1 · Cited by 268 · see citing works
Grond, S., Zech, D. F. J., Diefenbach, C., & Bischoff, A. (1994) · Journal of Pain and Symptom Management · doi:10.1016/0885-3924(94)90174-0 · Cited by 265 · see citing works
Fatigue associated with cancer and its treatment
Morrow, G. R., Andrews, P. L. R., Hickok, J. T., Roscoe, J. A., & Matteson, S. E. (2001) · Supportive Care in Cancer · doi:10.1007/s005200100293 · Cited by 241 · see citing works
Glaus, A., Crow, R. A., & Hammond, S. (1996) · Supportive Care in Cancer · doi:10.1007/bf01845757 · Cited by 208 · see citing works
Assessment of fatigue in cancer and non-cancer patients and in healthy individuals
Glaus, A. (1993) · Supportive Care in Cancer · doi:10.1007/bf00364968 · Cited by 159 · see citing works
Servaes, P., van der Werf, S. P., Prins, J. B., Verhagen, S. C. A. H. H. V. M., & Bleijenberg, G. (2001) · Supportive Care in Cancer · doi:10.1007/s005200000165 · Cited by 145 · see citing works
Cognitive and mood disturbance as causes and symptoms of fatigue in cancer patients
Valentine, A. D., & Meyers, C. A. (2001) · Cancer · doi:10.1002/1097-0142(20010915)92:6+ · Cited by 106 · see citing works
Fatigue in patients with cancer. Analysis and assessment.
Glaus, A. (1998) · PubMed · Cited by 103 · see citing works
Radbruch, L., Sabatowski, R., Loick, G., et al. (2000) · Der Schmerz · doi:10.1007/s004820070028 · Cited by 68 · see citing works
Self-citation[MIDOS--validation of a minimal documentation system for palliative medicine].
Radbruch, L., Sabatowski, R., Loick, G., et al. (2000) · PubMed · doi:10.1007/s004820000034 · Cited by 58 · see citing works
Self-citationCystic pulmonary metastatic sarcoma
Traweek, S. T., Rotter, A. J., Swartz, W., & Azumi, N. (1990) · Cancer · doi:10.1002/1097-0142(19900415)65:8 · Cited by 58 · see citing works
Fatigue in advanced cancer — meaning before measurement?
Krishnasamy, M. (2000) · International Journal of Nursing Studies · doi:10.1016/s0020-7489(00)00019-5 · Cited by 55 · see citing works
Clinical trial procedures clarified.
Zimmerman, J. F. (1991) · PubMed · Cited by 35 · see citing works
Field, D. J., Clark, D. A., Corner, J. L., et al. (2001) · DigitalGeorgetown (Georgetown University Library) · Cited by 30 · see citing works
Glaus, A. (1998) · Recent results in cancer research/Recent Results in Cancer Research · doi:10.1007/978-3-642-51466-1_1 · Cited by 27 · see citing works
MIDOS Validierung eines minimalen Dokumentationssystems fr die Palliativmedizin
Radbruch, L., Sabatowski, R., Loick, G., et al. (2000) · Der Schmerz · Cited by 24 · see citing works
Self-citationFatigue and cachexia in cancer patients
Glaus, A. (1998) · Supportive Care in Cancer · doi:10.1007/s005200050137 · Cited by 17 · see citing works
The rapid assessment of fatigue severity in cancer patients
Mendoza, T. R., Wang, X. S., Cleeland, C. S., Morrissey, M., Johnson, B. A., Wendt, J. K., & Huber, S. L. (1999) · Cancer · doi:10.1002/(sici)1097-0142(19990301)85:5 · Cited by 1 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Holtdirk, F., Mehnert, A., Weiss, M., Mayer, J., Meyer, B., Bröde, P., Claus, M., & Watzl, C. (2021) · PLOS ONE · doi:10.1371/journal.pone.0251276 · Cited by 62 · see citing works
Mehnert, A., Koranyi, S., Philipp, R., Scheffold, K., Kriston, L., Lehmann‐Laue, A., Engelmann, D., Vehling, S., Eisenecker, C., Oechsle, K., et al. (2020) · Psycho-Oncology · doi:10.1002/pon.5521 · Cited by 47 · see citing works
Yoga in addition to standard care for patients with haematological malignancies
Felbel, S., Meerpohl, J. J., Monsef, I., Engert, A., & Skoetz, N. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010146.pub2 · Cited by 31 · see citing works
Kuba, K., Weißflog, G., Götze, H., García-Torres, F., Mehnert, A., & Esser, P. (2019) · International Journal of Clinical and Health Psychology · doi:10.1016/j.ijchp.2018.12.001 · Cited by 26 · see citing works
Screening Properties of the Diagnostic Criteria for Cancer-Related Fatigue
Kuhnt, S., Friedrich, M., Schulte, T., Cella, D., & Hinz, A. (2019) · Oncology Research and Treatment · doi:10.1159/000501128 · Cited by 18 · see citing works
- Authors
- Radbruch, L., Sabatowski, R., Elsner, F., Everts, J., Mendoza, T., & Cleeland, C.
- Affiliations
- RWTH Aachen University (DE)
- University of Cologne (DE)
- The University of Texas MD Anderson Cancer Center (US)
- Corresponding author
- Radbruch, Lukas
- Venue
- Journal of Pain and Symptom Management
- Publisher
- Elsevier BV
- Published
- 2003-05
- Volume
- 25
- Issue
- 5
- Pages
- 449-458
- ISSN
- 0885-3924 (ISSN-L)
- OpenAlex
- W1971709946
- Cited by
- 136
- References
- 28
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 6 · 2023: 13 · 2022: 7 · 2021: 6 · 2020: 10 · 2019: 6 · 2018: 6 · 2017: 10 · 2016: 5 · 2015: 6 · 2014: 9 · 2013: 3 · 2012: 6
- FWCI
- 1.50
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Pain and Symptom Management (publishedVersion)
- PubMed (publishedVersion)
- RWTH Publications (RWTH Aachen) (submittedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
- Keywords
- Brief Fatigue Inventory, German version, fatigue analysis, cancer-related fatigue, chronic nonmalignant pain, sedation, test-retest reliability, internal consistency, SF-36, psychometric validation
- MeSH terms
- Adult, Aged, Aged, 80 and over, Fatigue, Female, Germany, Humans, Male, Middle Aged, Neoplasms, Pain, Pain Measurement, Severity of Illness Index, Time Factors, Reproducibility of Results
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review