Psychometric Evaluation of Hindi Version of Fatigue Pictogram in Individuals with Breast Cancer: A Cross-sectional Study
Year: 2025
Type: article
Abstract: Introduction: Cancer Related Fatigue (CRF) is the most prevalent and distressing symptom among women with Breast Cancer (BC) which is underestimated and undertreated by healthcare professional. Barrier to under-reporting and under treatment of CRF include more focus on patient survival, busy clinical settings with patient overload, and lengthy CRF evaluation tools. Fatigue Pictogram (FP) is a brief, valid and reliable Fatigue Screening Tool (FST) which can be promptly administered in busy clinical settings. There is lack of brief, easily applicable FST in Hindi language which can be promptly administered in busy Oncology Clinics. Aim: To evaluate the psychometric properties of Hindi version of FP among women with BC. Materials and Methods: The present cross-sectional study was conducted in two phases. In phase 1, original English version of FP underwent forward and backward translation and a prefinal Hindi version of FP was created. The prefinal version was then pilot tested on 10 women with BC. In phase 2, psychometric properties of final Hindi version of FP were evaluated. Criterion validity was evaluated on a sample of 101 women with BC by testing against Hindi version of Fatigue Severity Scale (FSS-H) and test-retest reliability was evaluated on a sample of 50 BC survivors by administering Hindi version of FP on two occasions. Data analysis was carried out using Statistical Package for Social Sciences (SPSS) version 24.0. FP has two items (Item A and Item B) which evaluate two dimensions of CRF (severity and impact of fatigue on activity level), and has no overall cut-off score, therefore, both the items of FP were separately evaluated for psychometric properties. Spearman’s rho Correlation Coefficients (r) were calculated for establishing criterion validity of Hindi version of FP and Spearman correlation coefficient, and Wilcoxon signed-ranks test were calculated to evaluate test-retest reliability of each item separately. Results: Validity testing revealed a moderate positive correlation between Item A and FSS-H (r=0.680, p<0.001) scores and item B and FSS-H (r=0.643, p<0.001) scores. Reliability testing revealed a highly significant correlation between the Hindi version of FP scores on two occasions for both the Items (r=0.901, p<0.001 for Item A, and r=0.917, p<0.001, for Item B). Conclusion: Despite high prevalence rate, CRF is understated and undermanaged symptom. Acceptable criterion validity and excellent test-retest reliability support the application of Hindi version of FP as a FST in Hindi speaking individuals with BC.
Authors: Suman Mehra, Pragya Kumar, Abhishek Soni
Language: English
Topic: Cancer survivorship and care
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $275
OpenAlex ID: W7083589011
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