title: Clinical factors associated with fatigue over time in paediatric oncology patients receiving chemotherapy The Memorial Symptom Assessment Scale: an instrument for the evaluation of symptom prevalence, characteristics and distress. Chemotherapy-Related Fatigue in Childhood Cancer: Correlates, Consequences, and Coping Strategies The measurement of symptoms in young children with cancer: the validation of the Memorial Symptom Assessment Scale in children aged 7-12. Clinical field testing of an enhanced-activity intervention in hospitalized children with cancer. Impact of Effective Nursing Interventions to the Fatigue Syndrome in Children Who Receive Chemotherapy Changes in children's fatigue during the course of treatment for paediatric cancer.
abstract: The purpose of this study was to investigate the relationships between clinical factors ( including haemoglobin value , chemotherapeutic agents , and corticosteroid use ) and changing patterns of fatigue before and for the next 10 days following the start of a new round of chemotherapy in children with cancer . A prospect i ve longitudinal design was used to collect data from 48 paediatric oncology patients who were about to begin a new round of chemotherapy and their parents .  Fatigue levels were assessed using multidomain question naires with three categories of patient self-report ( including ‘ General Fatigue ’ , ‘ Sleep/Rest Fatigue ’ , and ‘ Cognitive Fatigue ’ ) and four categories of parent proxy-report ( including ‘ Lack of Energy ’ , ‘ Unable to Function ’ , ‘ Altered Sleep ’ , and ‘ Altered Mood ’ ) . The findings suggest that fatigue from both patient self-report and parent proxy-report changed significantly over time . The major findings from this study are that patients have more problems with fatigue in the first few days after the start of a cycle of chemotherapy . Corticosteroid use and haemoglobin value were associated with significant increases in fatigue that were sustained for several days and reached the highest level of fatigue at day 5 for those receiving concurrent steroids . The association of chemotherapeutic agents with fatigue varied between patient self-report and parent report , but the type of chemotherapeutic agents used was not associated with most changes in fatigue The Memorial Symptom Assessment Scale ( MSAS ) is a new patient-rated instrument that was developed to provide multidimensional information about a diverse group of common symptoms . This study evaluated the reliability and validity of the MSAS in the cancer population . R and omly selected in patients and out patients ( n = 246 ) with prostate , colon , breast or ovarian cancer were assessed using the MSAS and a battery of measures that independently evaluate phenomena related to quality of life . Symptom prevalence in the 218 evaluable patients ranged from 73.9 % for lack of energy to 10.6 % for difficulty swallowing . Based on a content analysis , three symptoms were deleted and two were added ; the revised scale evaluates 32 physical and psychological symptoms . A factor analysis of variance yielded two factors that distinguished three major symptom groups and several subgroups . The major groups comprised psychological symptoms ( PSYCH ) , high prevalence physical symptoms ( PHYS H ) , and low prevalence physical symptoms ( PHYS L ) . Internal consistency was high in the PHYS H and PSYCH groups ( Cronback alpha coefficients of 0.88 and 0.83 , respectively ) , and moderate in the PHYS L group ( alpha = 0.58 ) . Although the severity , frequency and distress dimensions were highly intercorrelated , canonical correlations and other analyses demonstrated that multidimensional assessment ( frequency and distress ) augments information about the impact of symptoms . High correlations with clinical status and quality of life measures support the validity of the MSAS and indicate the utility of several subscale scores , including PSYCH , PHYS , and a brief Global Distress Index . The MSAS is a reliable and valid instrument for the assessment of symptom prevalence , characteristics and distress . It provides a method for comprehensive symptom assessment that may be useful when information about symptoms is desirable , such as clinical trials that incorporate quality of life measures or studies of symptom epidemiology The aim of this research is to examine the experience and impact of  chemotherapy-related fatigue in recently diagnosed pediatric oncology patients . A repeated- measures , within-subjects , mixed ( quantitative plus qualitative ) design was used to prospect ively assess fatigue during early chemotherapy cycles and to compare fatigue to depressive symptoms . Parental interviews collected concurrently were analyzed for descriptions of the child 's fatigue and mood states and for strategies to cope with fatigue . Results indicated a significant correlation between fatigue and depression , but qualitative analyses suggested that the 2 phenomena may be unique and distinguishable . Qualitative analyses of parent interviews also identified specific strategies that were frequently used in response to high levels of fatigue . The findings illustrate the significant impact of chemotherapy-related fatigue in children being treated for cancer . The study also provides guidance for the assessment of fatigue and related symptoms and identifies specific strategies for coping with fatigue Few studies have attempted to describe the experience of symptoms in young children with cancer . This is due , in part , to the lack of vali date d symptom assessment scales for this patient population . The objective of this study was to evaluate the reliability and validity of a revised Memorial Symptom Assessment Scale ( MSAS ) in patients aged 7 - 12 as an instrument for the assessment of symptoms in young children with cancer . The MSAS ( 7 - 12 ) was administered to 149 children ( in patients and out patients ) who were undergoing treatment at either the Royal Marsden NHS Trust , London , United Kingdom or The Children 's Hospital at Westmead , Sydney , Australia . Validity was evaluated by comparison with the medical record , parental report , and concurrent assessment on visual analogue scales for selected symptoms . The data provide evidence of the reliability and validity of MSAS ( 7 - 12 ) and demonstrate that children with cancer as young as 7 years can report clinical ly relevant and consistent information about their symptom experience . Young children with cancer experience multiple symptoms . Approximately one-third had experienced lethargy and /or pain and /or insomnia during the 48 hours prior to the completion of MSAS ( 7 - 12 ) . The completion rate for MSAS ( 7 - 12 ) was high and the majority of children completed the instrument in a short period of time and with little difficulty . The instrument appears to be age appropriate and may be helpful to older children unable to independently complete MSAS ( 10 - 18 ) . Systematic symptom assessment may be useful in future epidemiological studies of symptoms and in cancer chemotherapy drug trials This prospect i ve , two-site , r and omized , controlled pilot study assessed the feasibility of an enhanced physical activity ( EPA ) intervention in hospitalized children and adolescents receiving treatment for a solid tumor or for acute myeloid leukemia ( AML ) , and assessed different statistical techniques to detect the intervention 's sleep and fatigue outcomes .  Twenty-nine patients ( 25 with a solid tumor and 4 with AML ) participated . Data were collected from actigraph ; patient , parent , and staff nurse reports of patient fatigue ; parent sleep diaries ; and patient charts . The intervention was successfully implemented 85.4 % of the scheduled times . We used two different statistical methods to analyze the longitudinal data . Using an ANOVA model , sleep was significantly more efficient in the experimental arm than in the control arm when daily differences from baseline sleep efficiency values were averaged and compared ( F=4.17 , P=0.053 ) . However , in a mixed model ( repeated measures ) analysis , sleep duration ( F=0.54 , P=0.47 ) and sleep efficiency ( F=0.04 , P=0.85 ) were not seen to differ between study arms . We conclude that an inpatient intervention of EPA can be delivered to children and adolescents receiving chemotherapy . Our findings identify design and statistical considerations for a future effectiveness study of the EPA intervention in hospitalized pediatric oncology patients This experimental , r and omized controlled study was conducted for children with cancer who are 7 to 12 years of age and receiving chemotherapy treatment to detect the impact of appropriate nursing interventions on decreasing the fatigue syndrome . The research sample is composed of a total of 60 children with cancer , with 30 children being included in the experimental group and 30 children included in the control group with their mothers . In the experimental group , after the 7th to 10th day of the chemotherapy treatment , throughout a week , the research er conducted the effective nursing interventions every day for 45 to 60 minutes . In the control group , routine nursing interventions were carried out . The experimental and control group children 's mean scores for the Fatigue Scale-Child and those of mothers for Fatigue Scale-Parent were compared . A statistically significant difference was found between the Fatigue Scale-Child and Fatigue Scale-Parent mean scores of the experimental and the control group children ( P < .00 ) . These results suggest that fatigue of children with cancer can be reduced by implementing appropriate nursing interventions BACKGROUND Fatigue is described as one of the most distressing symptoms of cancer therapy ; yet it has received limited clinical attention . Children are suffering from a symptom that is under-diagnosed during their treatment . AIM The aim of this study is : ( a ) to assess the change in fatigue scores during cancer treatment according to children 's perspectives , and ( b ) to describe the possible causes of fatigue from children 's points of view . SAMPLE AND METHODS The present study is part of an ongoing prospect i ve study . The research group consisted of 40 ( n = 40 ) children aged 7 - 12 years with cancer who are being followed up in the oncology clinic of a Greek children 's hospital . After parental consent was obtained , data were collected using the Child Fatigue Scale and a sociodemographic data form . RESULTS The children with cancer reported a statistically significant increase in fatigue scores during their treatment ( F = 6.846 , P = 0.003 ) . Gender was the only demographic factor associated with a significant increase in the fatigue scores ( F = 4.857 , P = 0.034 ) . CONCLUSIONS Cancer treatment was found significantly to increase children 's fatigue levels . Medical procedures and the hospital environment seemed to be major causative factors of the fatigue experienced by children with cancer during their treatment
target: These two scales show similar attributes with reasonably good internal consistency and responsiveness .
  Either the Fatigue Scale or PedsQL Multidimensional Fatigue Scale can be incorporated into clinical research .
background: CONTEXT Despite the recognized distressing symptom of fatigue in children with cancer , little information is available to assist in the selection of an instrument to be used to measure fatigue .
  OBJECTIVES The objectives of this study were to 1 ) describe the instruments that have been used to measure cancer-related fatigue in children and adolescents and 2 ) summarize the psychometric properties of the most commonly used instruments used to measure fatigue in children and adolescents with cancer .