dissertationThe main purposes of this descriptive, repeated measures methodological study were to (a) examine the psychometric properties (reliabilities and validities) of the Chinese versions of the Cancer Fatigue Scale (C-CFS), the Fatigue Symptom Inventory (C-FSI), and the Schwartz Cancer Fatigue Scale-revised (C-SCFS-r) in cancer outpatients receiving chemotherapy and (b) evaluate the instruments in terms of the ease of use, sensitivity to change, and cultural appropriateness (i.e., semantic equivalence, content equivalence, and conceptual equivalence) for Taiwanese cancer outpatients. Convenience sampling was used to recruit cancer outpatients receiving chemotherapy in a clinical setting in northern Taiwan. Data were collected twice: on the day when cancer patients were receiving chemotherapy treatment (T1), and 2 days posttreatment at home (T2). Two hundred forty-three cancer outpatients were recruited at T1 and 149 patients completed T2. Findings indicated that the three scales had good internal consistency (Cronbach's alphas for three total scales > .80), were brief (less than 6 min to complete), valid (confirmed by convergent, divergent, and discriminant validity), and feasible measures (completion rates > 97%) of fatigue for use with Taiwanese cancer patients. However, 27% of cancer patients reported that the C-FSI was difficult for them to complete. The content in the three scales were relevant to the phenomena of fatigue but did not represent the whole concept of fatigue in Taiwan. Only the C-CFS was similar to the original construct. The three scales were sensitive to change over 2 days. Cohen's effect sizes for the C-CFS, C-SCFS-r, and C-FSI were 0.87, 0.90, and 0.70, respectively. Glass's effect sizes for the C-CFS, C-SCFS-r, and C-FSI were 1.02, 1.40, and 0.65, respectively. The scores for the 'small change' group for the C-CFS, C-SCFS-r and C-FSI were .51, .73, and 1.11, respectively. Even though the three translated scales have been validated, further study is needed to explore the experience of fatigue among cancer patients in Taiwan from the patients' perspective. This study helps support the psychometric properties of the three scales and also emphasizes the importance of assessing scales' cultural appropriateness in a specific population
