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Parent-Child Agreement on Fatigue in Pediatric Otolaryngology Patients
Amy E Ensing1, Amy L Zhang1, Rebecca Z Lin1
1Department of Otolaryngology, Head and Neck Surgery Washington University School of Medicine St. Louis Missouri USA.
Insights
Parent and child fatigue reports largely agree in pediatric otolaryngology patients. However, significant discrepancies in children with developmental delays highlight the need for direct patient self-reporting of fatigue.
Area of Science:
- Pediatric Otolaryngology
- Patient-Reported Outcomes
- Child Psychology
Background:
- Accurate fatigue assessment is crucial in pediatric otolaryngology for effective treatment.
- Parental proxy reports are often used, but their agreement with child self-reports needs investigation.
- Understanding factors influencing agreement can improve clinical care.
Purpose of the Study:
- To evaluate parent-child agreement on fatigue reporting in pediatric otolaryngology patients.
- To determine if agreement varies based on diagnosis (hearing loss, obstructive sleep apnea) and patient factors.
- To assess the clinical significance of score differences.
Main Methods:
- A cross-sectional survey design was employed.
- Children aged 5-18 years undergoing evaluation for hearing loss (HL) or obstructive sleep apnea (OSA) were recruited.
- The Pediatric Quality of Life Inventory Multidimensional Fatigue Scale (PedsQL MFS) was completed by both children and their parents.
Main Results:
- Strong correlations (Pearson r > 0.7) were observed between parent and child PedsQL MFS scores across most groups.
- Clinical significance was approached in specific subgroups, notably children with developmental/speech/language delays.
- Decreased parent-child score correlations were noted in children with reported developmental delays, particularly in the total, general, and cognitive domains.
Conclusions:
- The parent-proxy PedsQL MFS generally shows strong agreement with child self-reports in pediatric otolaryngology patients with HL and OSA.
- Discrepancies in specific groups, especially those with developmental delays, underscore the importance of prioritizing child self-reporting when feasible.
- Further research with wider confidence intervals is needed to confirm clinical significance in specific subgroups.
Objectives:
To investigate parent-child agreement on fatigue reporting in pediatric otolaryngology patients and whether agreement might vary by diagnosis and other patient factors.
Study Design:
Cross-sectional survey.
Methods:
Patients ages 5-18 years old being evaluated for hearing loss (HL) or obstructive sleep apnea (OSA) were recruited from a pediatric otolaryngology clinic and sleep center. Children and parents completed the Pediatric Quality of Life Inventory Multidimensional Fatigue Scale (PedsQL MFS).
Results:
Responses of 42 patients with HL, 49 with OSA, 10 with sleep-disordered breathing (SDB), and 34 controls were analyzed. Parent and child PedsQL MFS scores were strongly correlated (Pearson r > 0.7) across groups with few exceptions. Only the median child-parent score differences for general domain score in the SDB group (12.5; 95% CI 2.08 to 22.9), and total score (7.41; 95% CI -0.69 to 25.7) and general domain score (11.5; 95% CI 2.08 to 27.1) in the developmental delay group met clinical significance thresholds. Wide confidence intervals prevented definitive conclusions regarding clinical significance. A pattern of decreased parent-child score correlations was observed in children reported to have delays. Weak (±0.1 to ±0.4) to moderate (±0.4 to ±0.69) correlations were observed for total score, general domain score, and cognitive domain score for children with reported developmental/speech/language delay.
Conclusion:
Overall, the parent-proxy PedsQL MFS demonstrates strong agreement with self-reports for pediatric otolaryngology patients being evaluated for HL and OSA. However, parent-child score discrepancies within specific patient groups, especially children whose parents reported speech/developmental/language delays, emphasize the importance of administering self-reports when possible.
Level Of Evidence:
3.
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