Pediatric quality of life multidimensional fatigue scale (PedsQL-MFS) detects the effects of a 3-week Inpatient body weight reduction program for children and adolescents with obesity

Background Fatigue is a frequent complaint amongst children and adolescents with obesity, and it interferes with adherence to dietary and exercise regimes that could reduce obesity. The present study evaluated the effect of an inpatient 3-week body weight reduction program on body weight and fatigue. Method One hundred children and adolescents with obesity (64% female; aged 11–18 years) undertook an inpatient program of personalized diet, daily exercise, education, and counselling. Results The sample evidenced a mean reduction in body mass (females: ΔM = 4.3 (sd = 2.1) kg, p < .001), males: ΔM = 6.2 (sd = 2.6) kg, p < .001), BMI standard deviation score (females: ΔM = 0.17 (sd = 0.07), males: ΔM = 0.24 (sd = 0.08), p < .001) and fatigue (females: ΔM = 7.8 (sd = 9.7), males: ΔM = 5.0 (sd = 6.9), p < .001) as measured by the Pediatric Quality of Life Multidimensional Fatigue Scale (PedsQL-MFS) and improvements on the Attention problems subscale of the Youth Self Report (total sample: ΔM = 0.89 (sd = 2.44), p < .001). Reliable change analyses revealed fatigue changes were achieved by up to 34% females and 17% males, but the majority did not achieve reliable change and changes in fatigue were not correlated with changes in body mass. Conclusions The program achieved clinically significant improvements in some children and adolescents. Future studies should explore predictors of treatment responsiveness. Trial registration Observational study. Not registered.

Hubungan Kelelahan Terhadap Kualitas Hidup Anak Dengan Kanker Yang Menjalani Pengobatan

LATAR BELAKANG : Kanker merupakan suatu penyakit yang dapat menyerang semua golongan umur termasuk anak-anak. Anak yang menderita kanker, harus menjalani berbagai pengobatan untuk dapat mematikan sel-sel kanker yang ada ditubuh mereka. Salah satu efek samping dari pengobatan yaitu kelelahan yang dapat menyebabkan kualitas hidup pada anak dengan kanker terganggu. TUJUAN : Tujuan penelitian ini untuk mengindentifikasi apakah kelelahan dapat memengaruhi kualitas hidup pada anak dengan kanker METODE : Jenis penelitian deskriptif korelasi dengan pendekatan cross sectional. Sampel dalam penelitian ini berusia 2-18 tahun sebanyak 45 orang yang berada di Yayasan Kasih Anak Kanker Indonesia (YKAKI) Riau. Teknik pengambilan sampel yang digunakan yaitu accidental sampling. Kelelahan dan kualitas hidup pada anak dengan kanker diukur dengan menggunakan PedsQoL Multidimensional Fatigue Scale dan PedsQoL Generic 4.0. Analisis data menggunakan uji spearman rank. HASIL : Hasil penelitian menunjukkan bahwa terdapat hubungan kelelahan terhadap kualitas hidup pada anak dengan kanker (p value = 0.031), serta menunjukkan rerata skor kelelahan yang dialami anak dengan kanker yang menjalani pengobatan yaitu 46.80 (semakin tinggi skor kelelahan semakin ringan kelelahan yang dirasakan), sedangkan kualitas hidup sebanyak 34 orang (75.6%) anak kanker memiliki kualitas hidup terganggu. Hasil penelitian ini diharapkan mampu membantu dalam meningkatkan kualitas hidup pada anak dengan kanker untuk mengurangi terjadinya kelelahan akibat dari pengobatan yang dijalaninya yang dapat memengaruhi kualitas hidup pada anak KESIMPULAN : Terdapat hubungan secara signifikan kelelahan dengan kualitas hidup pada anak dengan kanker yang menjalani pengobatan

O047 Sleep quality and fatigue in children and adolescents with multiple sclerosis

Background Fatigue is common in children and adolescents with multiple sclerosis (MS) and its aetiology is assumed to be multifactorial, however, its relationship to sleep quality in this population remains unknown. This study aims to examine the prevalence of fatigue and sleep disturbance in this population and their relationship to mood, quality of life, physical activity, and MS disease characteristics. Methods Children with pediatric onset multiple sclerosis (POMS) aged 0–18 were recruited. Subjective sleep quality was assessed by the Pediatric Daytime Sleepiness Scale (PDSS), Sleep Disturbance Scale for Children (SDSC) and OSA-18. All children were referred for polysomnography (PSG) including transcutaneous CO2 and video monitoring. Fatigue was assessed using the PedsQL Multidimensional Fatigue Scale (PedsQL-MFS). Progress to date: Fifteen children with relapsing remitting MS (mean age 15.73±1.44, mean EDSS score 1.11±1.12) have been enrolled to date. 73% of children were fatigued according to the PedsQL-MFS (mean transformed score 52.04). 67% and 60% of children scored higher than the clinical cutoff for the PDSS (17.87) and SDSC (42.73) respectively. However, all children scored within the normal range for the OSA-18 (34.00). To date, eleven children have completed PSG. Intended outcome and impact: This is the first study utilising PSG to objectively assess sleep quality in children with POMS. Findings from this study will document the magnitude of sleep disturbance in this population and have implications for the management of fatigue and other related impairments observed in paediatric MS.

Physical Exercise Reduce Fatigue in Children With Leukemia

Fatigue is a complaint that many children with Acute lymphoblastic leukemia (ALL) feel while undergoing chemotherapy and is a multidimensional problem. The condition of fatigue that children continuously feel requires treatment from health workers. To optimize physical exercise interventions, researchers combined physical exercise with Levine theory based on four conservation principles to increase patient activity during treatment. The goal of the study was to provide physical exercise to children with ALL undergoing chemotherapy. The research method is quantitative with Quasy Experimen With Control Group Pre-Test-Post-Test Design. This study sample of ALL children aged 8-13 years who underwent maintenance phase chemotherapy. The sample was taken using consecutive sampling techniques with a total of 22 people. The data collection tool uses the Multidimensional Fatigue Scale questionnaire. The results showed that the average fatigue scale in the pre-test intervention group was 31.18 and post-test 47.64. The pre-test control group was 27.27 and post-test 39.18. The level of fatigue experienced by children decreased (p 0.000) after being given physical exercise walking 5 minutes, six times in 14 days. The involvement of health workers is expected in conducting a comprehensive assessment of fatigue symptoms, and the results of this study can be used as one of the physical exercise interventions in the management of fatigue in children with leukemia.

Perceived Listening Difficulty in the Classroom, Not Measured Noise Levels, Is Associated With Fatigue in Children With and Without Hearing Loss

Purpose The purpose of this study was to examine if classroom noise levels and perceived listening difficulty were related to fatigue reported by children with and without hearing loss. Method Measures of classroom noise and reports of classroom listening difficulty were obtained from 79 children (ages 6–12 years) at two time points on two different school days. Forty-four children had mild to moderately severe hearing loss in at least one ear. Multiple regression analyses were conducted to evaluate if measured noise levels, perceived listening difficulty, hearing status, language abilities, or grade level would predict self-reported fatigue ratings measured using the Pediatric Quality of Life Inventory Multidimensional Fatigue Scale. Results Higher perceived listening difficulty was the only predictor variable that was associated with greater self-reported fatigue. Conclusions Measured classroom noise levels showed no systematic relationship with fatigue ratings, suggesting that actual classroom noise levels do not contribute to increased reports of subjective fatigue. Instead, perceived challenges with listening appears to be an important factor for consideration in future work examining listening-related fatigue in children with and without hearing loss.

Fatigue Following Pediatric Arterial Ischemic Stroke: Prevalence and Associated Factors

Background and Purpose: The aims of this study were to assess the prevalence of multidimensional fatigue symptoms 5 years after pediatric arterial ischemic stroke and identify factors associated with fatigue. Methods: Thirty-one children (19 males) with pediatric arterial ischemic stroke, participating in a larger prospective, longitudinal study, were recruited to this study at 5 years poststroke. Parent- and self-rated PedsQL Multidimensional Fatigue Scale scores were compared with published normative data. Associations between parent-rated PedsQL Multidimensional Fatigue Scale, demographics, stroke characteristics, and concurrent outcomes were examined. Results: Parent-rated total, general and cognitive fatigue were significantly poorer than population norms, with more than half of all parents reporting fatigue symptoms in their children. One-third of children also reported experiencing fatigue symptoms, but their ratings did not differ significantly from normative expectations, as such, all further analyses were on parent ratings of fatigue. Older age at stroke and larger lesion size predicted greater general fatigue; older age, female sex, and higher social risk predicted more sleep/rest fatigue. No significant predictors of cognitive fatigue were identified and only older age at stroke predicted total fatigue. Greater fatigue was associated with poorer adaptive functioning, motor skills, participation, quality of life, and behavior problems but not attention. Conclusions: Fatigue is a common problem following pediatric arterial ischemic stroke and is associated with the functional difficulties often seen in this population. This study highlights the importance of long-term monitoring following pediatric arterial ischemic stroke and the need for effective interventions to treat fatigue in children.

Fatigue among children with a chronic disease: a cross-sectional study

ObjectiveTo determine: (1) which biological/lifestyle, psychological and/or social factors are associated with fatigue among children with a chronic disease and (2) how much each of these factors contributes to explaining variance in fatigue.Design and settingThis was a cross-sectional study across two children’s hospitals.PatientsWe included children aged 8–18 years who visited the outpatient clinic with cystic fibrosis, an autoimmune disease or postcancer treatment.Main outcome measuresFatigue was assessed using the PedsQL Multidimensional Fatigue Scale. Generic biological/lifestyle, psychological and social factors were assessed using clinical assessment tools and questionnaires. Multiple linear regression analyses were used to test the associations between these factors and fatigue. Finally, a multivariable regression model was used to determine which factor(s) have the strongest effect on fatigue.ResultsA total of 434 out of 902 children were included (48% participation rate), with a median age of 14.5 years; 42% were male. Among these 434 children, 21.8% were severely fatigued. Together, all biopsychosocial factors explained 74.6% of the variance in fatigue. More fatigue was uniquely associated with poorer physical functioning, more depressive symptoms, more pressure at school, poorer social functioning and older age.ConclusionsFatigue among children with a chronic disease is multidimensional. Multiple generic biological/lifestyle, psychological and social factors were strongly associated with fatigue, explaining 58.4%; 65.8% and 50.0% of the variance in fatigue, respectively. Altogether, almost three-quarters of the variance in fatigue was explained by this biopsychosocial model. Thus, when assessing and treating fatigue, a transdiagnostic approach is preferred, taking into account biological, psychological and social factors.