Validation of the Amharic Version of the Brief Fatigue Inventory for Assessment of Cancer-Related Fatigue in Ethiopian Cancer Patients

Girma Tekle Gebremariam, Abel Tesfaye Anshabo, Wondemagegnhu Tigeneh, Ephrem Engidawork

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12 Citations (Scopus)


Background: Although cancer-related fatigue (CRF) is a highly prevalent and distressing symptom associated with cancer and its treatment, it is mostly underscreened, underassessed, and undertreated. The Brief Fatigue Inventory (BFI) is a reliable and valid instrument to assess CRF. 

Objective: To validate the Amharic version of the BFI (BFI-Am) for assessment of CRF in Ethiopian cancer patients. 

Methods: The BFI-Am was developed from its original English version through standard forward-backward translation approach. Two hundred eight consented cancer patients filled the questionnaires, along with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30, version 3. In addition, sociodemographic and clinical information were collected. Psychometric properties of the BFI-Am were evaluated in terms of acceptability, internal consistency, construct validity, concurrent validity, and known group validity. Linear regression analysis was performed to identify possible predictors of fatigue severity. 

Results: Two hundred two cancer patients completed the questionnaires and included in the data analysis. The BFI-Am had an overall Cronbach's alpha of 0.97. The results of the principal axis factor analysis suggested a one-factor solution explaining 78.4% of the variance, supporting the hypothesis of unidimensionality of the BFI-Am. The global BFI-Am interference items score was highly correlated with fatigue subscale score of European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 than single items, showing an inverse correlation between the BFI-Am and the global health status/quality of life (r = −0.324; P = 0.000). The BFI-Am significantly detected the differences in fatigue severity in patients with poor performance status (P < 0.001), indicating known group validity. 

Conclusion: The BFI-Am is an excellent assessment tool with adequate psychometric properties for use in both clinical management and symptom research of CRF in Ethiopian cancer patients.

Original languageEnglish
Pages (from-to)264-272
Number of pages9
JournalJournal of Pain and Symptom Management
Issue number2
Publication statusPublished - Aug 2018
Externally publishedYes


  • assessment
  • BFI Amharic
  • Cancer-related fatigue
  • psychometric properties

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