title: Fatigue in child chronic health conditions: a systematic review of assessment instruments.
abstract: OBJECTIVE
  Fatigue is common in chronic health conditions in childhood, associated with decreased quality of life and functioning, yet there are limited data to compare assessment instruments across conditions and childhood development. Our objective was to describe fatigue assessment instruments used in children with chronic health conditions and critically appraise the evidence for the measurement properties of identified instruments.
  
  
  METHODS
  Data sources included Medline, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO (using the EBSCOhost platform). Study selection included quantitative assessment of fatigue in children with health conditions. Data extraction was as follows: (1) study design, participant and fatigue instruments, (2) measurement properties of fatigue instruments, (3) methodological quality of included studies, and (4) synthesis of the quality of evidence across studies for the measurement properties of fatigue instruments.
  
  
  RESULTS
  Twenty fatigue assessment instruments were identified (12 child reports, 7 parent reports, 1 staff report), used in 89 studies. Fatigue was assessed in over 14 health conditions, most commonly in children with cancer and chronic fatigue syndrome. Evidence for the measurement properties of instruments varied, and overall quality was low. Two fatigue instruments demonstrated strong measurement properties for use in children with diverse health conditions and children with cancer.
  
  
  CONCLUSIONS
  The review is limited to children younger than 18 years and results are specific to health conditions described, limiting generalizability of findings to other populations. Evidence for the measurement properties of fatigue instruments varied according to the population in which instruments were used and informant. Further evidence is required for assessment of fatigue in younger children, and children with particular health conditions.
authors: Victorian Pediatric Rehabilitation Service, Monash Children's, Melbourne, Australia; Murdoch Childrens Research Institute, Melbourne, Australia; School of Psychological Sciences and ali.crichton@mcri.edu.au.
authors: Alison
authors: A
authors: Crichton
authors: Victorian Pediatric Rehabilitation Service, Monash Children's, Melbourne, Australia; Murdoch Childrens Research Institute, Melbourne, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia; and.
authors: Sarah
authors: S
authors: Knight
authors: Murdoch Childrens Research Institute, Melbourne, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia; and Royal Children's Hospital, Melbourne, Australia.
authors: Ed
authors: E
authors: Oakley
authors: Murdoch Childrens Research Institute, Melbourne, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia; and Royal Children's Hospital, Melbourne, Australia.
authors: Franz E
authors: FE
authors: Babl
authors: Murdoch Childrens Research Institute, Melbourne, Australia; School of Psychological Sciences and Royal Children's Hospital, Melbourne, Australia.
authors: Vicki
authors: V
authors: Anderson
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease / Q000145:classification*; D019317:Evidence-Based Medicine; D005221:Fatigue / Q000145:classification / Q000175:diagnosis* / Q000209:etiology*; D015673:Fatigue Syndrome, Chronic / Q000175:diagnosis; D005260:Female; D006304:Health Status; D006801:Humans; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000175:diagnosis; D011795:Surveys and Questionnaires
keywords: child; chronic disease; evidence-based medicine; fatigue; health status; parents; questionnaires; symptom assessment