Fatigue in Children With Sickle Cell Disease: Association With Neurocognitive and Social-Emotional Functioning and Quality of Life
Fatigue in Children With Sickle Cell Disease: Association With Neurocognitive and Social-Emotional Functioning and Quality of Life
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DOI：
10.1097/mph.0000000000000431
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发表时间：
2015-11-01
影响因子：
1.2
通讯作者：
Bonner, Melanie J.
中科院分区：
文献类型：
--
作者：
Anderson, Lindsay M.;Allen, Taryn M.;Bonner, Melanie J.
患有镰状细胞病（SCD）的儿童除了急性和慢性疼痛外还报告疲劳，这可能会降低总体健康相关生活质量（HRQL）。本研究的主要目的是探讨疲劳和HRQL之间的关系。鉴于之前的研究有限，次要目标包括调查疲劳和功能结果之间的关系，包括儿童神经认知和社会情感功能。8至16岁的儿童（N=32）和一名照顾者完成了疲劳、HRQL、疼痛、神经认知和社会情感功能的测量。控制疼痛和scd相关住院次数，使用层次线性回归模型来确定儿童报告和父母报告的疲劳对儿童HRQL的影响。使用相关分析来探讨疲劳和其他儿童结局之间的关系。数据显示患有SCD的儿童会经历临床相关的疲劳水平，这独立地预测了较低的HRQL。疲劳还与较低的工作记忆、执行功能和较高水平的内化症状有关。鉴于观察到的对HRQL的影响以及与功能结果的关系，疲劳可能是临床、家庭或学校干预的重要目标。这种做法可以减轻这些患者的疲劳负担，反过来，有助于改善SCD患儿的生活质量。
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.