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Table 2 Instruments to assess which CBT modules are indicated

From: Study protocol of the TIRED study: a randomised controlled trial comparing either graded exercise therapy for severe fatigue or cognitive behaviour therapy with usual care in patients with incurable cancer

CBT Module

Instrument

Rating (RANGE)

Cut-off value

Sleep problems and deregulated sleep-wake cycle

Sleep-wake diary

Bedtimes and wake up times of 12 consecutive days and nights

Visual inspection of bedtimes and wake up times

Sickness Impact Profile [41]:

subscale Sleep and Rest

Number and type of items endorsed, weighted according to a standardised weighting scheme

Score ≥ 60

Symptom Checklist-90 [52]:

subscale Sleeping Problems

5-point Likert scale (3–15)

Score ≥ 6

Dysfunctional cognitions regarding cancer (prognosis) and cancer treatment

Impact of Event Scale [53]:

subscale Intrusion

subscale Avoidance

4-point Likert scale (7–28)

4-point Likert scale (8–32)

Score ≥ 10

Score ≥ 10

Pictorial Representation of Illness and Self Measure [54]

Self-illness separation (SIS) in cm

Self-fatigue separation (SFS) in cm

Fatigue-related suffering: SIS > SFS

Illness-related suffering: SFS > SIS

Illness Cognition Questionnaire [55, 56]:

subscale Acceptance

subscale Helplessness

4-point Likert scale (6–24)

4-point Likert scale (6–24)

Score ≤ 12

Score > 14

Beck Depression Inventory-II Primary Care [57]

4-point Likert scale (0–21)

Score ≥ 4

Hospital Anxiety and Depression Scale [58]:

subscale Anxiety

subscale Depression

4-point Likert scale (0–21)

4-point Likert scale (0–21)

Score ≥ 9

Score ≥ 9

Dysfunctional fatigue-related cognitions

Fatigue Catastrophising Scale [45]

5-point Likert scale (10–50)

Score ≥ 16

Self-Efficacy Scale [26, 59]

4-point Likert scale (7–28)

Score ≤ 19

Illness Management Questionnaire-factor III [60]

6-point Likert scale (9–54)

Score ≥ 30

Anxiety for Fatigue

4-point Likert scale (8–32)

Score ≥ 14

Deregulated activity pattern

Actigraphy during 12 consecutive days

Number of days with a mean physical activity level > 66

Low-active: 0-1

Relatively-active: ≥ 2

Sickness Impact Profile [41]:

subscale Social Interactions

Number and type of items endorsed, weighted according to a standardised weighting scheme

Score ≥ 100

Checklist Individual Strength [33]: subscale Concentration

7-point Likert scale (5–35)

Score ≥ 18

Negative social interactions and low perceived social support

Van Sonderen Social Support Inventory [61] (shortened version):

subscale Negative Interactions

subscale Discrepancies

4-point Likert scale (7–28)

4-point Likert scale (8–32)

Score ≥ 10

Score ≥ 14