The PedsQLTM Multidimensional Fatigue Scale in pediatric rheumatology: reliability and validity

Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, 3137 TAMU, College Station, TX 77843-3137, USA.
The Journal of Rheumatology (Impact Factor: 3.19). 01/2005; 31(12):2494-500.
Source: PubMed


OBJECTIVE:. The PedsQL (Pediatric Quality of Life Inventory) is a modular instrument designed to measure health related quality of life (HRQOL) in children and adolescents ages 2-18 years. The recently developed 18-item PedsQL Multidimensional Fatigue Scale was designed to measure fatigue in pediatric patients and comprises the General Fatigue Scale (6 items), Sleep/Rest Fatigue Scale (6 items), and Cognitive Fatigue Scale (6 items). The PedsQL 4.0 Generic Core Scales were developed as the generic core measure to be integrated with the PedsQL Disease-Specific Modules. The PedsQL 3.0 Rheumatology Module was designed to measure pediatric rheumatology-specific HRQOL. Methods. The PedsQL Multidimensional Fatigue Scale, Generic Core Scales, and Rheumatology Module were administered to 163 children and 154 parents (183 families accrued overall) recruited from a pediatric rheumatology clinic. Results. Internal consistency reliability for the PedsQL Multidimensional Fatigue Scale Total Score (a = 0.95 child, 0.95 parent report), General Fatigue Scale (a = 0.93 child, 0.92 parent), Sleep/Rest Fatigue Scale (a = 0.88 child, 0.90 parent), and Cognitive Fatigue Scale (a = 0.93 child, 0.96 parent) were excellent for group and individual comparisons. The validity of the PedsQL Multidimensional Fatigue Scale was confirmed through hypothesized intercorrelations with dimensions of generic and rheumatology-specific HRQOL. The PedsQL Multidimensional Fatigue Scale distinguished between healthy children and children with rheumatic diseases as a group, and was associated with greater disease severity. Children with fibromyalgia manifested greater fatigue than children with other rheumatic diseases. CONCLUSION: The results confirm the initial reliability and validity of the PedsQL Multidimensional Fatigue Scale in pediatric rheumatology.

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    • "Good reliability and validity have been demonstrated for the PedsQL TM MFS in healthy groups and children with chronic illness. [17] [20] [21] [32] [34] The PedsQL TM MFS has demonstrated internal consistency (α range 0.77–0.94) in a range of clinical populations.[20–22,35] Statistical analyses All data were analysed using SPSS version 22.[36] Continuous variables were summarised using descriptive statistics and categorical variables were summarised using frequency counts and percentages. "
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    ABSTRACT: The aim of this study was to investigate the psychometric properties of the Paediatric Quality of Life Inventory (PedsQLTM) in measuring health-related quality of life (HRQOL) and fatigue in adolescents with chronic fatigue syndrome (CFS), using both adolescent-reported and caregiver proxy ratings. Eighty-four participants (42 adolescents and 42 parent proxies) recruited consecutively through CFS specialist clinics at a tertiary paediatric hospital completed the PedsQLTM Core Generic Module (CGM) and Multidimensional Fatigue Scale (MFS). Overall, feasibility, floor/ceiling effects and internal consistency were found to be acceptable for the PedsQLTM CGM and the MFS according to predetermined criteria. For parent–adolescent agreement, intra-class correlations between adolescent and parent report on the PedsQLTM CGM and MFS were statistically significant and rated as ‘fair’ (range 0.45–0.68). At a group level, statistically significant discrepancies between mean adolescent and parent scores for the PedsQLTM CGM were noted on all scales (except school functioning). On the MFS, there were no significant differences between parent and adolescent mean scores. Bland–Altman plots revealed significant variability in the discrepancies between parent and adolescent reports on the PedsQLTM CGM and MFS. Based on the psychometric properties assessment, findings of this study suggest that the parent and adolescent PedsQLTM CGM and MFS are promising scales for use in adolescents with CFS. Parent and adolescent reports offer unique perspectives on HRQOL and fatigue in adolescents with CFS and ideally, reports should be sought from both parties.
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    • "A total fatigue score is also calculated based on the summation of the three subscale scores. Previous studies established the reliability and validity of the PedsQL Multidimensional Fatigue in children aged 2–18 years with JIA (Ringold et al., 2013; Varni, Burwinkle, & Szer, 2004). "
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    ABSTRACT: Objectives: (1) To compare sleep (nighttime sleep duration and sleep efficiency) and sleep fragmentation (movement and fragmentation index), as measured by actigraphy, and symptoms (pain and fatigue) in 8- to 14-year-old children with polyarticular and extended oligoarticular juvenile idiopathic arthritis (JIA) and (2) to examine the associations between sleep fragmentation (movement and fragmentation index) and the calcium-binding protein biomarkers S100A12 and myeloid-related protein (MRP8/14). Method: Participants included 40 children with extended oligoarticular (n = 15) or polyarticular (n = 25) JIA and their parents. Serum protein samples were obtained during routine rheumatology clinic visits. Children completed the PedsQL Multidimensional Fatigue Scale and daily pain and sleep diaries and wore actigraphy monitors for 9 consecutive days. Parents completed the Children's Sleep Habits Questionnaire (CSHQ). Results: Of the 40 children, 68% scored above the CSHQ clinical cutoff score for sleep disturbances. Mean nighttime sleep duration was 7.5 hr, and mean sleep efficiency was 85.3%. Group differences were not found for nighttime sleep duration, sleep efficiency, movement and fragmentation index, or S100A12 and MRP8/14 protein concentrations. In a stepwise regression, medications, joint count, and movement and fragmentation index explained 21% of the variance in MRP8/14 concentration. Conclusion: Decreased nighttime sleep duration, poor sleep efficiency, and fragmented sleep were observed in our sample, regardless of JIA category. Sleep fragmentation was a significant predictor of MRP8/14 protein concentration. Additional research is needed to understand the interrelations among sleep fragmentation, effects of medication, and S100A12 and MRP8/14 protein biomarkers in JIA.
    Full-text · Article · Jun 2015 · Annals of the Rheumatic Diseases
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    • "Recently, a Multidimensional Fatigue Scale has been proposed, entailing items from the Pediatric Quality of Life Inventory administered both to children and their parents.44 Goretti et al11 correlated the Pediatric Quality of Life Inventory-Multidimensional Fatigue Scale subjective reports of cognitive and other fatigue-related aspects with occurrence of neuropsychological impairments and psychiatric disorders. "
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    ABSTRACT: Cognitive and neuropsychological impairments are well documented in adult multiple sclerosis (MS). Research has only recently focused on cognitive disabilities in pediatric cases, highlighting some differences between pediatric and adult cases. Impairments in several functions have been reported in children, particularly in relation to attention, processing speed, visual-motor skills, and language. Language seems to be particularly vulnerable in pediatric MS, unlike in adults in whom it is usually preserved. Deficits in executive functions, which are considered MS-specific in adults, have been inconsistently reported in children. In children, as compared to adults, the relationship between cognitive dysfunctions and the two other main symptoms of MS, fatigue and psychiatric disorders, was poorly explored. Furthermore, data on the correlations of cognitive impairments with clinical and neuroimaging features are scarce in children, and the results are often incongruent; interestingly, involvement of corpus callosum and reduced thalamic volume differentiated patients identified as having a cognitive impairment from those without a cognitive impairment. Further studies about pediatric MS are needed in order to better understand the impact of the disease on brain development and the resulting effect on cognitive functions, particularly with respect to different therapeutic strategies.
    Full-text · Article · Jul 2014 · Neuropsychiatric Disease and Treatment
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