Fatigue in Young Survivors of Extracranial Childhood Cancer: A Finnish Nationwide Survey

Purpose/Objectives: To evaluate self-reports of fatigue by young cancer survivors (aged 11-18 years), to compare young survivors' fatigue scores with the scores of a healthy control group and of the parent proxy evaluation, and to analyze whether demographic or disease-related factors are associated with young survivors' fatigue.

Design: Cross-sectional quantitative study.

Setting: An urban hospital in southwestern Finland.

Sample: 384 survivors diagnosed with an extracranial malignancy at age 16 or younger, who have survived four or more years postdiagnosis, and who are free of cancer. General matched population controls were randomly selected from the Finnish Population Registry.

Methods: Demographic data and a self-report written fatigue questionnaire.

Main Research Variables: Total fatigue (TF), general fatigue (GF), sleep or rest fatigue (SF), and cognitive fatigue.

Findings: The control populations reported significantly more issues with TF, GF, and SF than did the survivor population. In survivors, older age, the need for remedial education at school, and a sarcoma diagnosis were associated with increasing fatigue, whereas female gender, better school grades, and greater health-related quality-of-life (HRQOL) scores were associated with lower fatigue. The study variables explained 49%-65% of the variation in fatigue scores.

Conclusions: Although survivors and their matched controls seem to have similar fatigue, subgroups of survivors do experience excessive fatigue, which may have an impact on their HRQOL.

Implications for Nursing: This study increases the knowledge about fatigue levels of young survivors of extracranial malignancies and identifies the need for instruments specifically designed to assess fatigue in this population. The healthcare team should pay attention to the fatigue level of young survivors, particularly SF.