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Table 2 Diagnostic interview guide for cancer-related fatigue

From: An examination of cancer-related fatigue through proposed diagnostic criteria in a sample of cancer patients in Taiwan

Diagnostic Interview Guide for Cancer-Related Fatigue

NOTE: Capitalized text represents instructions to the interviewer. Text in quotations represents statements to be read verbatim to respondent.

1 "Over the past month, has there been at least a 2-week period when you had significant fatigue, a lack of energy, or an increased need to rest every day or nearly every day?"

CIRCLE ONE:

YES

NO

IF NO, STOP HERE. IF YES, CONTINUE

   

"For each of the following questions, focus on the worst 2 weeks in the past month (or else tha past 2 weeks if you felt equally fatigued for the entire month)."

2. "Did you feel weak all over or heavy all over? (every day or nearly every day?)"

CIRCLE ONE:

YES

NO

3. "Did you have trouble concentrating or paying attention? (every day or nearly every day?)"

CIRCLE ONE:

YES

NO

4. "What about losting your interest or desire to the things you usually do? (every day or nearly every day?)"

CIRCLE ONE:

YES

NO

5. "How were you sleeping? Did you have trouble falling asleep, staying asleep, or waking too early? Or did you find yourself sleeping too much compared to what you usually sleep? (every day or nearly every day?)"

CIRCLE ONE:

YES

NO

6. "Have you found that you usually don't feel rested or refreshed after you have slept? (every day or nearly every day?)"

CIRCLE ONE:

YES

NO

7. "Did you have struggle or push yourself to do anything? (every day or nearly every day?)"

CIRCLE ONE:

YES

NO

8. "Did you find yourself feeling sad, frustrated, or irritable because you felt fatigued? (every day or nearly every day?)"

CIRCLE ONE:

YES

NO

9. "Did you have difficulty finishing something you had started to do because of feeling fatigued? (every day or nearly every day?)"

CIRCLE ONE:

YES

NO

10. "Did you have trouble remembering things? For example, did you have trouble remembering where your keys were or what someone had told you a little while ago? (every day or nearly every day?)"

CIRCLE ONE:

YES

NO

11. "Did you find yourself feeling sick or unwell for several hours after you had done something that took some effort(every time or nearly every time?)"

CIRCLE ONE:

YES

NO

IF LESS THAN SIX ITEMS INCLUDING #1 ARE MARKED YES, STOP HERE.

  

12. "Has fatigue made it hard for you to do your work, take care of things at home, or get along with other people?"

CIRCLE ONE:

YES

NO

IF #12 IS NO, STOP HERE

   

13. IS THERE EVIDENCE FROM THE HISTORY, PHYSICAL

EXAMINATION, OR LABORATORY FINDINGS THAT THE SYMPTOMS ARE A CONSEQUENCE OF CANCER OR CANCER TREATMENT?

CIRCLE ONE:

YES

NO

IF #13 IS NO, STOP HERE

   

14. ARE THE SYMPTOMS PRIMARILY A CONSEQUENCE OF CO-MORBID PSYCHIATRIC DISORDERS SUCH AS MAJOR DEPRESSION, SOMATIZATION DISORDER, SOMATOFORM DISORDER, OR DELIRIUM?

CIRCLE ONE:

YES

NO

IF #14 IS YES, PATIENT DOES NOT MEET CRITERIA FOR CANCER-RELATED FATIGUE

 

IF #14 IS NO, PATIENT MEETS CRITERIA FOR CANCER-RELATED FATIGUE

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