Fatigue Scale for Children With Cancer: A Systematic Review and Reliability Generalization Meta-analysis

Abstract

Objectives: This study aimed to evaluate the overall reliability of the Fatigue Scale, the most widely used instrument for assessing fatigue severity in paediatric oncology patients, and to identify factors influencing the magnitude of reliability estimates.

Methods: PubMed, CINAHL, PsycINFO, Medline, Scopus, Embase, and Google Scholar were systematically searched. From an initial 492 articles identified, 21 were selected for the final analysis. Reliability generalization meta-analyses were performed using Cronbach's alpha extracted from individual studies. A random-effects model was applied for the analysis.

Results: Most studies employed a cross-sectional design to assess fatigue symptoms in children and adolescents with various types of cancer. The mean weighted effect size for the total sample (n = 3,750) was 0.915 (95% CI = [0.888, 0.934]). A diagnosis of leukaemia/lymphoma was a significant moderator in the parent sample (effect estimate = 0.003, P < .01), while the use of a language other than English significantly moderated reliability in both the parent (effect estimate = 0.301, P < .01) and staff (effect estimate = -0.306, P < .01) samples.

Conclusions: The Fatigue Scale is a highly reliable tool for assessing fatigue symptoms across different paediatric oncology populations. However, the reliability of the scale may be influenced by a diagnosis of leukaemia/lymphoma in children and language translation when used by parents and staff, requiring careful consideration when comparing and interpreting results.

Implications for nursing practice: A reliable tool, the Fatigue Scale, is crucial for guiding clinical nurses and researchers. They can adopt the scale to assess the effects of an intervention aimed at relieving fatigue in paediatric oncology patients.