2.50
Hdl Handle:
http://hdl.handle.net/10755/211688
Type:
Research Study
Title:
COMPARISON OF PATTERNS OF FATIGUE BY CHILDREN WITH CANCER AND THEIR PARENTS
Abstract:
Purpose: This study compared patterns of fatigue among school-age children with cancer as reported by children and their parents during an inpatient admission for chemotherapy.  Background: Fatigue is the most frequently reported symptom by children and adolescents with cancer. Perceptions of fatigue are influenced by children’s developmental stage with school-age children more likely to conceptualize fatigue as a sense of weakness or being tired that interferes with the child’s ability to engage in day-to-day activities. Methods The setting for this exploratory, descriptive, multiple-case study was an inpatient pediatric oncology unit in a tertiary pediatric hospital in the Intermountain West. Participants were 15 school-age children (mean = 8.8 years; SD = 2.3) with cancer who were receiving inpatient chemotherapy for three days or longer. Fatigue was assessed daily, beginning with the day of admission, using the Fatigue Scale: Child Version (FSC) which assesses children’s perceived fatigue intensity and the Fatigue Scale: Parent Version (FSP), which assesses parents’ perception of their child’s fatigue intensity as well as perceived sources of their child’s fatigue. Hematocrit levels were identified at the time of admission. Nonparametric statistics evaluated correlations between child- and parent-reported fatigue and within-subjects differences between fatigue scores during the study period. Graphical analyses evaluated individual patterns of fatigue across the hospitalization. Results: Children’s self-reported fatigue scores were greater than those previously reported among hospitalized children with cancer and were indicative of high levels of fatigue. Children’s self-reported fatigue intensity on the day of admission was not correlated with hemocrit levels; however, a moderate negative correlation was present between children’s admission hematocrit levels and parents’ reports of children’s fatigue intensity (r=-.57; p<.05). Children’s reported fatigue intensity was positively correlated with parents’ perception of the child’s fatigue intensity (r=.58; p<.01) and the parents’ perceived sources of the child’s fatigue (r=.31; p<.05). Within-subjects differences were not present based on child- or parent-reported fatigue scores. Graphical analyses of children’s fatigue scores revealed four patterns:  1) initial increase in fatigue followed by a decrease below baseline level, 2) moderate fatigue with minimal variation, 3) steady increase in fatigue with increased variability, and 4) gradual decline in fatigue. Graphical analyses of parents’ reports of the child’s fatigue revealed three patterns: 1) increasing fatigue scores, 2) a steep increase followed by a decrease, and 3) initial elevation followed by a decrease. Implications: Findings highlight the importance of using developmentally appropriate self-report measures for children as well as challenges when using parent proxy reporting of subjective symptoms such as fatigue. Although parents’ perceptions of children’s fatigue may be more closely related to trends in clinical measures, such as hematocrit, children’s perceptions may not. Children’s perceptions of changes in symptoms also may differ from their parents’. Clinicians need to recognize the importance of seeking children’s self report of their symptoms, especially when assessing more subjectively experienced symptoms. Funding Sources: Individual NRSA 1F31NR010175-01A1. National Institute for Nursing Research. Doctoral Scholarship in Cancer Nursing, DSCN-06-204-1. American Cancer Society. Dissertation Scholarship Grant. Western Institute of Nursing/Council for the Advancement of Nursing Science.
Keywords:
School-age children; Fatigue
Repository Posting Date:
20-Feb-2012
Date of Publication:
20-Feb-2012
Other Identifiers:
4434
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typeResearch Studyen_GB
dc.titleCOMPARISON OF PATTERNS OF FATIGUE BY CHILDREN WITH CANCER AND THEIR PARENTSen_GB
dc.identifier.urihttp://hdl.handle.net/10755/211688-
dc.description.abstractPurpose: This study compared patterns of fatigue among school-age children with cancer as reported by children and their parents during an inpatient admission for chemotherapy.  Background: Fatigue is the most frequently reported symptom by children and adolescents with cancer. Perceptions of fatigue are influenced by children’s developmental stage with school-age children more likely to conceptualize fatigue as a sense of weakness or being tired that interferes with the child’s ability to engage in day-to-day activities. Methods The setting for this exploratory, descriptive, multiple-case study was an inpatient pediatric oncology unit in a tertiary pediatric hospital in the Intermountain West. Participants were 15 school-age children (mean = 8.8 years; SD = 2.3) with cancer who were receiving inpatient chemotherapy for three days or longer. Fatigue was assessed daily, beginning with the day of admission, using the Fatigue Scale: Child Version (FSC) which assesses children’s perceived fatigue intensity and the Fatigue Scale: Parent Version (FSP), which assesses parents’ perception of their child’s fatigue intensity as well as perceived sources of their child’s fatigue. Hematocrit levels were identified at the time of admission. Nonparametric statistics evaluated correlations between child- and parent-reported fatigue and within-subjects differences between fatigue scores during the study period. Graphical analyses evaluated individual patterns of fatigue across the hospitalization. Results: Children’s self-reported fatigue scores were greater than those previously reported among hospitalized children with cancer and were indicative of high levels of fatigue. Children’s self-reported fatigue intensity on the day of admission was not correlated with hemocrit levels; however, a moderate negative correlation was present between children’s admission hematocrit levels and parents’ reports of children’s fatigue intensity (r=-.57; p<.05). Children’s reported fatigue intensity was positively correlated with parents’ perception of the child’s fatigue intensity (r=.58; p<.01) and the parents’ perceived sources of the child’s fatigue (r=.31; p<.05). Within-subjects differences were not present based on child- or parent-reported fatigue scores. Graphical analyses of children’s fatigue scores revealed four patterns:  1) initial increase in fatigue followed by a decrease below baseline level, 2) moderate fatigue with minimal variation, 3) steady increase in fatigue with increased variability, and 4) gradual decline in fatigue. Graphical analyses of parents’ reports of the child’s fatigue revealed three patterns: 1) increasing fatigue scores, 2) a steep increase followed by a decrease, and 3) initial elevation followed by a decrease. Implications: Findings highlight the importance of using developmentally appropriate self-report measures for children as well as challenges when using parent proxy reporting of subjective symptoms such as fatigue. Although parents’ perceptions of children’s fatigue may be more closely related to trends in clinical measures, such as hematocrit, children’s perceptions may not. Children’s perceptions of changes in symptoms also may differ from their parents’. Clinicians need to recognize the importance of seeking children’s self report of their symptoms, especially when assessing more subjectively experienced symptoms. Funding Sources: Individual NRSA 1F31NR010175-01A1. National Institute for Nursing Research. Doctoral Scholarship in Cancer Nursing, DSCN-06-204-1. American Cancer Society. Dissertation Scholarship Grant. Western Institute of Nursing/Council for the Advancement of Nursing Science.en_GB
dc.subjectSchool-age childrenen_GB
dc.subjectFatigueen_GB
dc.date.available2012-02-20T12:08:33Z-
dc.date.issued2012-02-20T12:08:33Z-
dc.date.accessioned2012-02-20T12:08:33Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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