br a scale with more body
a scale with more body constitution types in order to diﬀerentiate the conditions in cancer patients.
The reliability and validity were previously evaluated on 2500 participants recruited from five diﬀerent geographical districts in China. Good internal consistency with Cronbach’s α ranged from 0.76 to 0.90 and good test-retest reliability ranged from 0.76 to 0.90 for the nine sub-scales were reported. In addition, good criterion validity was demonstrated by the correlations between CCMQ and health-related quality of life scores.24
Furthermore, the psychometric properties of the CCMQ were eval-uated in 1084 adult patients attending a Western medicine outpatient clinic and two Chinese medicine outpatient clinics in Hong Kong. Satisfactory internal reliability with a Cronbach’s α > 0.6 and good test-retest reliability with intraclass correlation coeﬃcients ranged from 0.71 to 0.88 was obtained. In addition, content validity of the CCMQ was confirmed using convenience samples of 10 patients and 10 Chinese medicine practitioners. Construct validity was supported by moderate correlations between CCMQ and health-related quality of life scores. Moreover, confirmatory factor analysis showed a reproducible structure as hypothesized.21
2.4. Measurement of cancer-related fatigue
Cancer-related fatigue was measured using the Taiwanese version of the Brief Fatigue Inventory (BFI-T). The original scale was developed at the University of Texas MD Anderson Cancer Center to rapidly assess fatigue severity in cancer patients.25 The scale consists of 9 items based on an 11-point (0–10) rating scale. The first three items assess fatigue severity of the current level, usual level during the past 24 h, and the worst level during the past 24 h. The other six items assess fatigue in-terference with daily activities during the past 24 h, including general activity, mood, walking ability, normal work, relations with other people, and enjoyment of life. Factor analysis revealed that Ferrostatin-1 the original scale was uni-dimensional with an excellent internal consistency (Cronbach’s α = 0.96). The severity of cancer-related fatigue for each patient was calculated by dividing the total BFI-T score by 9. A mean score of < 4 points indicated mild fatigue, 4–6 points indicated mod-erate fatigue, and > 7 points indicated severe fatigue. Moderate or se-vere fatigue suggests that quality of life might have been adversely aﬀected by cancer-related fatigue, and therefore, we dichotomized our data into patients with mild fatigue or with moderate-to-severe cancer-related fatigue in subsequent analyses.25,26 A validation study of the BFI-T based on 439 Taiwanese patients with multiple cancer diagnoses revealed that apocrine glands is a reliable, valid, sensitive, and clinically easy-to-use
scale for measuring cancer-related fatigue. The study also found that the BFI-T measured a single construct, with high factor loadings ranged from 0.80 to 0.94 for the nine items, and therefore the mean of the nine items could be used as an overall score for fatigue. Internal consistency was indicated by Cronbach’s α of 0.97, and convergent validity was established by correlating the BFI-T worst fatigue and fatigue severity composite scores with the vigor and fatigue subscales scores of the Profile of Mood States (POMS).27
2.5. Statistical analysis
Data are presented as means and standard deviations (SD) or fre-quencies and percentages. Diﬀerences between groups were compared using the Chi-square test or Fisher’s exact test for categorical variables and Student t-test for continuous variables. The association between moderate-to-severe cancer-related fatigue and TCMBC was assessed using multiple logistic regression analysis with a backward selection procedure based on the likelihood ratio test. Potential confounding variables evaluated during model development included age, sex, body mass index, systolic blood pressure, diastolic blood pressure, cancer treatment, and cancer stage. The existence of multicollinearity in the independent variables was evaluated using variance inflation factor. All statistical analyses were performed using IBM SPSS Statistics for Windows, Version 24.0 (IBM Corp. Armonk, NY). The significance level was set at 0.05 and all P values were two-tailed.
Table 1 compares demographic and clinical characteristics between the two groups of patients with BFI-T < 4 or ≥ 4. The mean age of the 170 patients was 58 years and 58% of them were females. Slightly over a half of the patients (51%) received inpatient chemotherapy treatment, and 66% were at cancer stage III–IV. The most common types of cancer,