Fatigue mediates the relationship between emotional and cognitive functioning in children post-cancer treatment

Juliette E M Greidanus-Jongejan, Marloes van Gorp, Raphaele R L van Litsenburg, Femke K Aarsen, Merel M Nap- van der Vlist, Sanne Nijhof, Martha A Grootenhuis

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND/OBJECTIVES: Children treated for cancer are at risk to develop cognitive problems. Insight in underlying associations with emotional functioning and fatigue can be used to optimize interventions. We therefore aim to study emotional functioning, fatigue, and cognitive functioning in children postcancer treatment and investigate whether fatigue mediates the relationship between emotional and cognitive functioning.

DESIGN/METHODS: Emotional functioning, fatigue, and cognitive functioning were assessed in children post-cancer treatment using subscales of the Pediatric Quality of Life Inventory (PedsQL) Generic Core Scales, Multidimensional Fatigue Scale and Cognitive Functioning Scale. A one sample t-test was used to compare outcomes with general population peers and mediation analysis was used to address the effect of fatigue on the relationship between emotional and cognitive functioning.

RESULTS: A total of 137 children (mean age: 13.6, SD ± 3.3 years; mean time since end of treatment: 7.1 months, SD ± 5.9) participated. Lower scores on emotional functioning (Cohen's d [D]: 0.4), fatigue (D: 0.8) and cognitive functioning (D: 0.6) were found (p < .001) in children post-cancer treatment than in peers. A medium association was found between emotional and cognitive functioning (standardized regression coefficient [β]: 0.27, p < .001), which was mediated by fatigue (β = 0.16).

CONCLUSIONS: Outcomes on emotional and cognitive functioning are decreased and fatigue is increased in children postcancer treatment. Fatigue mediates the relationship between emotional and cognitive functioning. Our results show the importance to focus on fatigue amongst stress as a target for intervention to improve cognitive functioning.

Original languageEnglish
Pages (from-to)e30594
JournalPediatric blood & cancer
Volume70
Issue number10
Early online date4 Aug 2023
DOIs
Publication statusPublished - Oct 2023

Keywords

  • Adolescent
  • Child
  • Cognition
  • Emotions
  • Fatigue/etiology
  • Humans
  • Neoplasms/complications
  • Peer Group
  • Quality of Life/psychology

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