title: Health-related quality of life and its association with self-esteem and fatigue among children diagnosed with cancer.
abstract: OBJECTIVE
  To identify the links between self-esteem, fatigue and health-related quality of life for children and young people during and following treatment for cancer.
  
  
  BACKGROUND
  Measures to minimise adverse outcomes for survivors of childhood cancer have been developed, but the crucial periods of returning to school and transition to adult life and adult services are not addressed so well. Screening of quality of life, fatigue and self-esteem in childhood cancer patients during and after treatment is important for optimising the nursing response and improving outcomes for children.
  
  
  METHODS
  A cross-sectional, descriptive, correlational, comparative survey was designed.
  
  
  METHODS
  Validated measures of the attributes being studied were used. This study was conducted in private rooms on the ward and in the outpatient clinic of a major oncology hospital in Jordan in 2015. Seventy children aged 5-16 years were included. Ethical approval was secured.
  
  
  RESULTS
  The age range of the children was 5-16 years (Mean 10·17, SD 3·4 years). Thirty were girls and 40 were boys. The total quality of life scores ranged from 21-100 (M = 65·5; SD = 17·6). The total scores of fatigue range from 12·5-100 (M = 65·79; SD = 22·20). Children with a high level of fatigue experienced lower quality of life.
  
  
  CONCLUSIONS
  Continuing education centres at hospitals may find the results of this study helpful to provide professional updates and training events to enhance nurses' understanding of psychosocial distress responses and ability to intervene effectively within the multiprofessional effort.
  
  
  CONCLUSIONS
  The outcomes of this study may enhance the development of guidelines for routine assessment by nurses and others of these factors among children with cancer. The nursing role in ensuring holistic care and attention to the problems of most concern to patients could be strengthened.
authors.affiliation: Psychiatric and Mental Health Nursing, Faculty of Nursing, The University of Jordan, Amman, Jordan. e.algamal@ju.edu.jo, gamale@ksau-hs.edu.sa.|Psychiatric and Mental Health Nursing, College of Nursing, Ministry of National Guard Health Affairs, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia. e.algamal@ju.edu.jo, gamale@ksau-hs.edu.sa.
authors.forename: Ekhlas
authors.initials: E
authors.lastname: Al-Gamal
authors.affiliation: Child and Family Health, School of Nursing, Midwifery & Social Work, University of Salford, Salford, UK.
authors.forename: Tony
authors.initials: T
authors.lastname: Long
mesh_terms: D000293:Adolescent; D002648:Child; D002662:Child Health Services; D002673:Child, Hospitalized / Q000523:psychology*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005221:Fatigue; D005260:Female; D006801:Humans; D007597:Jordan; D008297:Male; D009369:Neoplasms / Q000451:nursing / Q000523:psychology*; D010371:Pediatric Nursing; D011788:Quality of Life; D012649:Self Concept; D011795:Surveys and Questionnaires
keywords: Jordan; childhood cancer; nursing practice; quality of life; self-esteem