Exploring Evidence of Fatigue in Survivors of Pediatric Brain Tumors

Abstract

Background: As the number of survivors of childhood brain tumor increase, fatigue is increasingly recognized as a long-term correlate of survivorship. Objective: To systematically evaluate the evidence for fatigue in pediatric brain tumor survivors. Method: A systematic search using EMBASE, Medline, and PsycINFO identified 20 papers meeting the inclusion criteria. Result: Nineteen of the 20 studies reviewed showed conclusive evidence of fatigue in survivors of pediatric brain tumor. This review found that the construct of fatigue was poorly defined throughout, with early onset fatigue associated with the physical effects of treatment and later emergent fatigue associated with long-term cognitive impairment not distinguished. Conclusion: Poor construct validity reduces the generalizability of the data and its utility in developing effective interventions. Current research does not provide a sound basis for developing effective management and rehabilitation plans and fails to support children who have survived brain tumor. Implications for Practice: The nebulous definition and imprecise measurement of posttumor fatigue leaves survivors without a clear diagnosis of impairment, and, in the case of some regions, access to treatment. Further research built on a well-defined construct offers the potential to improve the quality of life of pediatric brain tumor survivors. What is Foundational: Despite the significant impact of “fatigue” on cancer survivorship, much of the research available is based upon a poorly defined construct. This paper is the first to question the utility of this all-encompassing construct and to call for further research that identifies the fatigue experience in different subgroups of brain tumor survivors.