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

• Główni autorzy: Merel M Nap-van der Vlist (Autor), Geertje W Dalmeijer (Autor), Martha A Grootenhuis (Autor), Marry M van den Heuvel-Eibrink (Autor), Joost F Swart (Autor), Elise M van de Putte (Autor), Sanne L Nijhof (Autor), Kors van der Ent (Autor)
• Format: Książka
• Wydane: BMJ Publishing Group, 2021-07-01T00:00:00Z.
• Hasła przedmiotowe: article
• Dostęp online: Connect to this object online.
• Notes: 10.1136/bmjpo-2020-000958; 2399-9772
• Keywords: Pediatrics; RJ1-570
• Source: BMJ Paediatrics Open, Vol 5, Iss 1 (2021)

Objective To 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 setting This was a cross-sectional study across two children's hospitals.Patients We included children aged 8-18 years who visited the outpatient clinic with cystic fibrosis, an autoimmune disease or postcancer treatment.Main outcome measures Fatigue 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.Results A 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.Conclusions Fatigue 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.