title: Fatigue in Children With Sickle Cell Disease: Association With Neurocognitive and Social-Emotional Functioning and Quality of Life.
abstract: Children with sickle cell disease (SCD) report fatigue in addition to acute and chronic pain, which can decrease overall health-related quality of life (HRQL). The primary objective of the current study was to investigate the relationship between fatigue and HRQL. Given limited prior research, secondary objectives included investigation of associations between fatigue and functional outcomes, including child neurocognitive and social-emotional functioning. Children aged 8 to 16 years (N=32) and a caregiver completed measures of fatigue, HRQL, pain, and neurocognitive and social-emotional functioning. Controlling for pain and number of SCD-related hospitalizations, hierarchical linear regression models were used to determine the impact of child-reported and parent-reported fatigue on child HRQL. Correlational analyses were used to explore the relationship between fatigue and additional child outcomes. Data indicated that children with SCD experience clinically relevant levels of fatigue, which independently predicts lower HRQL. Fatigue was also associated with lower working memory, executive functioning, and higher levels of internalizing symptoms. Given its observed impact on HRQL and relationship to functional outcomes, fatigue may be an important target of clinical, home, or school interventions. This practice may attenuate the burden of fatigue in these patients, and in turn, help improve the quality of life of children living with SCD.
authors.affiliation: *Department of Psychology and Neuroscience, Duke University §Department of Psychiatry, Duke University Medical Center, Durham, NC †Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medicine, Baltimore, MD ‡Department of Pediatrics, University of California San Diego, La Jolla, CA.
authors.forename: Lindsay M
authors.initials: LM
authors.lastname: Anderson
authors.forename: Taryn M
authors.initials: TM
authors.lastname: Allen
authors.forename: Courtney D
authors.initials: CD
authors.lastname: Thornburg
authors.forename: Melanie J
authors.initials: MJ
authors.lastname: Bonner
mesh_terms: D000293:Adolescent; D000328:Adult; D000342:Affective Symptoms / Q000209:etiology / Q000523:psychology; D000755:Anemia, Sickle Cell / Q000150:complications* / Q000523:psychology; D001294:Attitude to Health; D017028:Caregivers / Q000523:psychology; D002648:Child; D002653:Child Behavior Disorders / Q000209:etiology / Q000523:psychology; D059350:Chronic Pain / Q000209:etiology / Q000523:psychology; D003072:Cognition Disorders / Q000209:etiology* / Q000523:psychology; D056344:Executive Function; D005221:Fatigue / Q000209:etiology* / Q000523:psychology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007361:Intelligence Tests; D008297:Male; D008569:Memory Disorders / Q000209:etiology / Q000523:psychology; D008570:Memory, Short-Term; D010147:Pain Measurement; D010290:Parents / Q000523:psychology; D011788:Quality of Life; D057566:Self Report; D012720:Severity of Illness Index; D012919:Social Behavior