Research Reports - Prediction of fatigue after childhood brain injury

J Head Trauma Rehabil. 2016 Oct 7. [Epub ahead of print]

Crichton AJ(1), Babl F, Oakley E, Greenham M, Hearps S, Delzoppo C, Hutchison J,
Beauchamp M, Anderson VA.

OBJECTIVES: To determine (1) the presence of fatigue symptoms and predictors of
fatigue after childhood brain injury and examine (2) the feasibility,
reliability, and validity of a multidimensional fatigue measure (PedsQL
Multidimensional Fatigue Scale [MFS]) obtained from parent and child
perspectives.
SETTING: Emergency and intensive care units of a hospital in Melbourne,
Australia.
PARTICIPANTS: Thirty-five families (34 parent-proxies and 32 children) aged 8 to
18 years (mean child age = 13.29 years) with traumatic brain injury (TBI) of all
severities (27 mild, 5 moderate, and 3 severe) admitted to the Royal Children's
Hospital.
DESIGN: Longitudinal prospective study. Fatigue data collected at 6-week
follow-up (mean = 6.9 weeks).
MAIN OUTCOME MEASURES: Postinjury child- and parent-rated fatigue (PedsQL MFS),
mood, sleep, and pain based on questionnaire report: TBI severity (mild vs
moderate/severe TBI).
RESULTS: A score greater than 2 standard deviations below healthy control data
indicated the presence of abnormal fatigue, rates of which were higher compared
with normative data for both parent and child reports (47% and 29%). Fatigue was
predicted by postinjury depression and sleep disturbance for parent, but not
child ratings. Fatigue, as rated by children, was not significantly predicted by
TBI severity or other symptoms. The PedsQL MFS demonstrated acceptable
measurement properties in child TBI participants, evidenced by good feasibility
and reliability (Cronbach α values >0.90). Interrater reliability between parent
and child reports was poor to moderate.
CONCLUSIONS: Results underscore the need to assess fatigue and associated
sleep-wake disturbance and depression after child TBI from both parent and child
perspectives. 

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