Fatigue in Children and Adolescents With Cancer

Abstract

Fatigue is a common symptom found in the adult oncology literature. However, little is known about its occurrence, causes, conceptual and operational definitions, and effective interventions in children and adolescents with cancer.The purpose of this study was to define and describe fatigue experienced by children and adolescents receiving treatment for cancer. A focus group approach was used to reveal the contextual understanding of fatigue through discussions. Eleven focus groups were convened during a 2-month period at two major children's cancer centers. Twenty-nine children participated in the focus groups: 14 were 7 to 12 years of age and 15 were 13 to 16 years of age. Focus groups were held separately for each age group, lasted from 30 to 45 minutes, and were audiotaped. The audiotapes were transcribed verbatim, and Ethnograph software was used to number the data to sort and code the information. Researchers at both study sites coded the data independently within the context of the unit of analyses, which, in this study, were the study questions. Codes and descriptions were developed for the definitions of fatigue, causes of fatigue, and what helps. Eight codes emerged from the children groups and 12 from the adolescent groups to define fatigue. Six codes were developed from the children groups and 12 from the adolescent groups to describe causes of fatigue. Three codes from the children groups and eight from the adolescent groups described what helps. This study is the first to evaluate fatigue as a symptom in children and adolescents with cancer. Findings from this study will provide the foundation for developing a conceptual model for cancer-related fatigue in children and adolescents.

The lived experience of fatigue in children and adolescents with cancer: a systematic review

“…[44] One study solely used focus groups, [46] and one used diaries only [36]. One study used focus groups with the adolescent subsample participating in semi-structured interviews [18] and one study used questionnaire interview sheets [40].…”

“…Fatigue has physical, mental, and emotional components and may be characterized by a lack of energy, decreased physical ability, and feelings of tiredness. [16][17][18] Fatigue is a subjective, multidimensional construct [3] that may occur acutely, episodically, or chronically [3,17,19] with multifactorial etiology [3,20].…”

The PedsQL™ in pediatric cancer

“…24 -26 In pediatric cancer, the measurement of fatigue is exemplified by the work of HockenberryEaton, Hinds, and colleagues. 8,27 In the development of the PedsQL Multidimensional Fatigue Scale, multidimensional constructs were derived from reviews of both the adult and pediatric cancer fatigue literature and integrated into the PedsQL Measurement Model.…”

Reliability and Validity of Turkish Versions of the Child, Parent and Staff Cancer Fatigue Scales

“…As a cancer related symptom, fatigue has often been focused in a number of studies from a variety of perspectives and several scales have been consequently developed to identify the symptom in detail and adapted into different languages (Cleeland et al, 2000;Radbruch et al, 2003;Wang et al, 2004;Lin et al, 2006;Shun et al, 2006;Wu et al, 2006). Neverthless, it is worth noting that the studies on fatigue in pediatric populations still remain insufficient and based on one group (Hinds et al, 1999a(Hinds et al, : 1999bHinds and Hockenberry, 2001;Hockenberry et al, 1998Hockenberry et al, : 1999.…”

“…It is therefore concluded that both subjective and objective evaluation would provide the most precise data in the assessment of fatigue as a perception based symptom in children and adolescents. An analysis of the pediatric oncology literature illustrated that the cancer related fatigue has been evaluated not only by children with cancer but also by their parents and staffs (Hockenberry et al, 1998(Hockenberry et al, : 2003Hinds et al, 1999b;Hinds & Hockenberry-Eaton 2001;Braud et al, 2003;Gibson et al, 2005Gibson et al, : 2006Ekti and Conk, 2008;Yeh et al, 2008;Perdikaris et al, 2009). Children and their parents may be adversely influenced when the symptoms can't be managed effectively during the long and painstaking cancer treatment which may lead to disintegrity and dysfunctionality in the family, the deterioriation of the quality of life, loss of energy, and increasing care burden and despair (Woodgate and Degner, 2004).…”