Examining the Impact of Fatigue, Age, Coping & Social Support on the Health-related Quality of Life of Pediatric Cancer Patients in Southeast Asia.

Abstract

AIMS: This study aims to compare the health-related quality of life (HRQOL) of pediatric cancer patients and healthy controls in Singapore. The study also aims to examine the risk and resilience factors of fatigue, coping, social support and age and their interactions with HRQOL following a modified version of Wallander & Varni?s Disease-Stress-Coping model.

METHODS: Participants included 54 pediatric cancer patients and their parents recruited from the National University Hospital (NUH) in Singapore. Child participants completed the Pediatric Quality of Life Inventory? (PedsQL?) 4.0 Generic Core Scales, PedsQL? Multidimensional Fatigue Scales (MFS), Kidcope and Multidimensional Scale of Perceived Social Support. Their parents completed a demographic questionnaire and the PedsQL? Generic Core Scales and PedsQL? MFS parent proxy reports. Both the child and their parents completed the questionnaires in the outpatient clinic of the Viva-University Children?s Cancer Centre at NUH.

RESULTS: The study findings indicated that pediatric cancer patients had significantly lower physical functioning than healthy controls as reported by both the parent and the child. Pediatric cancer patients also had significantly lower school functioning than their healthy counterparts as reported by their parents. When examining the impact of risk and resilience factors on HRQOL, fatigue was found to be negatively related to HRQOL. Both avoidance coping and approach coping were also found to be negatively related to HRQOL. The mediating effect of coping on the relationship between fatigue and HRQOL was also not established. Social support, on the other hand, seemed to be positively related to HRQOL. When the HRQOL of the younger and older children were compared, the younger children reported significantly higher physical functioning than older children. The results also suggested that the demographic and medical variables were not potential confounding variables, with the exception of phase of treatment.

CONCLUSION: The results of the present study showed that children with cancer did not differ significantly from healthy controls except in the sub-domains of physical and school functioning. Fatigue was found to be negatively related to HRQOL while both coping and social support was generally not significantly related to HRQOL. The HRQOL of younger children also generally did not differ from older children, with the exception of the sub-domain of physical functioning. This study had also provided insights into the relationships between the above study variables, which had not been previously examined in Singapore. The findings of this study also lent some support for Wallander & Varni?s (1998) theoretical framework of risk and resilience.