Original Article Multidimensional Measurement of Fatigue in Advanced Cancer Patients in Palliative Care: An Application of the Multidimensional Fatigue Inventory Tina Noergaard Munch, MD, Annette S. Stro ¨mgren, PhD, Lise Pedersen, DrMSci, Morten A. Petersen, MSSci, Linda Hoermann, RN, and Mogens Groenvold, PhD The Research Unit (T.N.M., A.S.S., L.P., M.A.P., L.H., M.G.), Department of Palliative Medicine, Bispebjerg Hospital, Copenhagen; and Institute of Public Health (M.G.), University of Copenhagen, Copenhagen, Denmark Abstract To investigate the level, dimensionality, and correlates associated with fatigue in patients receiving specialist palliative care, 278 advanced cancer patients referred to a department of palliative medicine during a 2-year period were asked to complete the Multidimensional Fatigue Inventory (MFI-20), a self-assessment questionnaire measuring five dimensions of fatigue, and the Hospital Anxiety and Depression Scale. Of 267 eligible patients, 130 (49%) participated. Mean fatigue scores (0--100 scale) were very high, especially for general fatigue (81), physical fatigue (87), and reduced activity (85). Only some of the MFI-20 subscales were significantly correlated. Fatigue was not correlated with sociodemographic factors. Depressed patients had higher scores on all five subscales except physical fatigue. Anxious patients had higher levels on the mental fatigue subscale only. The variation in fatigue explained by depression varied markedly (4%--31%) among subscales. Fatigue levels were very high in this population. The lack of significant correlation between some subscales indicates that they measure different aspects of fatigue. This is also supported by the differences in associations between fatigue subscales and depression and anxiety. J Pain Symptom Manage 2006;31:533--541. Ó 2006 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved. Key Words Fatigue, asthenia, depression, advanced cancer, palliative care, multidimensional This research was supported by the Research Fund of Copenhagen University Hospital and by a grant from the Danish Cancer Society. Portions of this work were presented at the Euro- pean Association of Palliative Care Congress, Lyon, France, May 23--26, 2002; the 2nd Interna- tional Symposium of Research in Palliative Care, Montreal, Quebec, Canada, October 4--5, 2002; and International Society of Quality of Life Re- search Congress, Orlando, FL, USA, October 31--November 3, 2002. Address reprint requests to: Tina Noergaard Munch, MD, Peter Fabers Gade 35, 2th, DK-2200 Copenhagen N, Denmark. E-mail: doktormunch@hotmail.com Accepted for publication: November 1, 2005. Ó 2006 U.S. Cancer Pain Relief Committee Published by Elsevier Inc. All rights reserved. 0885-3924/06/$--see front matter doi:10.1016/j.jpainsymman.2005.11.012 Vol. 31 No. 6 June 2006 Journal of Pain and Symptom Management 533