Abstract
Background
As a complex multidimensional construct, fatigue may play an important role in the physical and psychosocial functioning of youth with chronic pain. Based on a model previously tested in adults, the current study similarly utilized Patient‐Reported Outcomes Measurement System (PROMIS) to examine how fatigue contributes to functional outcomes for youth with chronic pain. The model tested self‐reported ratings of pain intensity, depressive symptoms, and sleep disturbance as predictors of outcomes (mobility, pain‐related interference, and school functioning) as mediated by ratings of fatigue.
Methods
285 youth with chronic pain ages 8–17 years and their caregivers, completed surveys as part of their initial clinical evaluation at a tertiary pediatric pain clinic. Study measures included: pediatric PROMIS domains (mobility, pain interference, sleep disturbance, fatigue, and depressive symptoms), Pediatric Quality of Life (PedsQL) school functioning, and pain intensity. All mediated effects were calculated via a 1000‐draw bootstrap‐estimation method in Mplus.
Results
Fatigue was found to be a statistically significant mediator of the effects of pain intensity, sleep disturbance, and depressive symptoms on outcomes of pain interference, mobility, and school functioning. While pain intensity was found to independently contribute to mobility and pain interference, depressive symptoms did not show significant effects on any outcome beyond its association with fatigue. Sleep disturbance predicted pain interference while fatigue predicted school functioning.
Conclusions
Findings suggest that fatigue is an important intervening factor for functional outcomes among youth with chronic pain. Targeting fatigue may be effective in optimizing school functioning and reducing the deleterious effects of depressive symptoms.
This article is protected by copyright. All rights reserved.
from Wiley: European Journal of Pain: Table of Contents http://bit.ly/2woZ8LU
via IFTTT
No comments:
Post a Comment