Outcome Measures of Fatigue in Adults With Cancer Receiving Radiation Therapy: A Scoping Review.
Courtney Apostol, Danielle Hitch
Most fatigue scales used in radiation therapy clinics barely ask about daily activities or roles.
Occupational therapists should pair whatever fatigue tool they use with their own occupation-focused assessment, since no single scale captures how fatigue affects a patient's daily life.
Key findings
1Only six of the 13 fatigue measures identified included items about daily activities, social participation, or role performance, leaving most tools poorly aligned with what occupational therapists need to assess.
2No single fatigue measure fully covers the physical, emotional, cognitive, and spiritual dimensions of cancer-related fatigue as defined by the NCCN, and none comprehensively addresses occupational therapy's focus on functional outcomes.
3The authors recommend that occupational therapists combine fatigue-specific tools with occupation-focused assessment and observation to get a complete picture of how fatigue affects a patient's daily life.
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What it does not show
Most included studies came from high-income Western countries, and breast, head and neck, and prostate cancers made up 83% of the sample—findings may not transfer to other cancer types or healthcare settings. No formal quality appraisal was performed, so the rigour of the 12 included studies was not evaluated. Only English-language publications were included and grey literature was excluded, potentially missing emerging tools or non-English validation work. No eligible studies published after 2022 met the criteria, so the evidence base may be dated. The review adopts an occupational therapy lens (activity and participation), which may not reflect the primary purpose of most fatigue measures, which are designed to assess symptom severity rather than functional impact.
Declared interests
The authors declare no conflicts of interest. Open-access publishing was facilitated by Deakin University through a Wiley–Deakin University agreement via the Council of Australasian University Librarians.
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