title: The relationships between fatigue, quality of life, and family impact among children with special health care needs.
abstract: OBJECTIVE
  To examine the relationships among pediatric fatigue, health-related quality of life (HRQOL), and family impact among children with special health care needs (CSHCNs), specifically whether HRQOL mediates the influence of fatigue on family impact.
  
  
  METHODS
  266 caregivers of CSHCNs were studied. The Pediatric Quality of Life Inventory Multidimensional Fatigue Scale, Pediatric Quality of Life Inventory Generic Scale, and Impact on Family Scale were used to measure fatigue, HRQOL, and family impact, respectively. Linear regressions were used to analyze the designated relationships; path analyses were performed to quantify the mediating effects of HRQOL on fatigue-family impact relationship.
  
  
  RESULTS
  Although greater fatigue was associated with family impact (p < .05), the association was not significant after accounting for HRQOL. Path analyses indicated the direct effect of fatigue on family impact was not significant (p > .05), whereas physical and emotional functioning significantly mediated the fatigue-family impact relationship (p < .001).
  
  
  CONCLUSIONS
  Fatigue is related to family impact among CSHCNs, acting through the impairment in HRQOL.
authors.affiliation: Department of Health Outcomes and Policy, College of Medicine, University of Florida, Gainesville, FL 32610, USA. ichuang@ufl.edu
authors.forename: I-Chan
authors.initials: IC
authors.lastname: Huang
authors.forename: Mary
authors.initials: M
authors.lastname: Anderson
authors.forename: Pranav
authors.initials: P
authors.lastname: Gandhi
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Tuli
authors.forename: Kevin
authors.initials: K
authors.lastname: Krull
authors.forename: Jin-Shei
authors.initials: JS
authors.lastname: Lai
authors.forename: John
authors.initials: J
authors.lastname: Nackashi
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Shenkman
mesh_terms: D000293:Adolescent; D000328:Adult; D017028:Caregivers / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease / Q000145:classification / Q000523:psychology*; D005190:Family / Q000523:psychology*; D005221:Fatigue / Q000523:psychology*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010290:Parents / Q000523:psychology; D011788:Quality of Life / Q000523:psychology*; D016032:Randomized Controlled Trials as Topic / Q000523:psychology
keywords: children with special health care needs; chronic condition; family impact; fatigue; quality of life