Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 686 Bay Street, Toronto, ON, M5G 0A4, Canada.
Pediatric Hematology/Oncology, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, 94305, USA.
Support Care Cancer. 2019 Jul;27(7):2665-2671. doi: 10.1007/s00520-018-4555-9. Epub 2018 Nov 26.
Objectives were to describe bothersome fatigue in children with cancer and hematopoietic stem cell (HSCT) recipients and to identify factors associated with severely bothersome fatigue.
We included children ages 8-18 years treated for cancer or HSCT recipients from three groups: [1] receiving active cancer treatment and admitted to hospital for at least 3 days, [2] attending outpatient clinic for acute lymphoblastic leukemia maintenance therapy, and [3] attending outpatient clinic following treatment completion. Fatigue was measured using the Symptom Screening in Pediatrics Tool (SSPedi); severely bothersome fatigue was defined as a lot or extremely bothersome fatigue (score of 3-4 on 0-4 scale). Factors associated with severely bothersome fatigue were examined using univariate and multiple logistic regression.
Of 502 children included, 414 (82.5%) reported some degree of bothersome fatigue (scores 1-4), and 123 (24.5%) reported severely bothersome fatigue (score 3 or 4). In multiple regression analysis, factors significantly associated with severely bothersome fatigue were child age 11-14 and 15-18 years vs 8-10 years (odds ratio (OR) 2.11, 95% confidence interval (CI) 1.21-3.77 and OR 2.96, 95% CI 1.66-5.44), and inpatients receiving cancer treatment vs outpatients who had completed therapy (OR 3.85, 95% CI 2.17-7.27).
We found that 82.5% of children with cancer or HSCT recipients reported bothersome fatigue and 24.5% of children reported severely bothersome fatigue. Risk factors for severely bothersome fatigue were older age and inpatients receiving active cancer treatment. Future work should evaluate systematic symptom screening in clinical practice and apply interventions to reduce fatigue.
本研究旨在描述癌症患儿和造血干细胞（HSCT）受者的困扰性疲劳，并确定与严重困扰性疲劳相关的因素。
我们纳入了三组儿童：[1]正在接受癌症治疗并住院至少 3 天的儿童；[2]接受急性淋巴细胞白血病维持治疗的门诊患儿；[3]完成治疗后在门诊就诊的儿童。使用儿科症状筛查工具（SSPedi）测量疲劳；严重困扰性疲劳定义为疲劳程度严重（0-4 分制中 3-4 分）。采用单因素和多因素逻辑回归分析严重困扰性疲劳的相关因素。
在纳入的 502 名儿童中，414 名（82.5%）报告存在一定程度的困扰性疲劳（评分 1-4），123 名（24.5%）报告存在严重困扰性疲劳（评分 3 或 4）。多因素回归分析显示，与严重困扰性疲劳显著相关的因素为年龄 11-14 岁和 15-18 岁（比值比（OR）2.11，95%置信区间（CI）1.21-3.77 和 OR 2.96，95% CI 1.66-5.44）和住院接受癌症治疗的患儿（OR 3.85，95% CI 2.17-7.27）。
我们发现 82.5%的癌症或 HSCT 受者儿童报告存在困扰性疲劳，24.5%的儿童报告存在严重困扰性疲劳。严重困扰性疲劳的危险因素为年龄较大和住院接受癌症治疗。未来的研究应评估临床实践中的系统性症状筛查，并应用干预措施来减轻疲劳。
