No AccessAmerican Journal of AudiologyResearch Article12 Oct 2017

Subjective Fatigue in Children With Hearing Loss Assessed Using Self- and Parent-Proxy Report

    Purpose

    The primary purposes of this study were to examine the effects of hearing loss and respondent type (self- vs. parent-proxy report) on subjective fatigue in children. We also examined associations between child-specific factors and fatigue ratings.

    Method

    Subjective fatigue was assessed using the Pediatric Quality of Life Inventory Multidimensional Fatigue Scale (PedsQL-MFS; Varni, Burwinkle, Katz, Meeske, & Dickinson, 2002). We compared self- and parent-proxy ratings from 60 children with hearing loss (CHL) and 43 children with normal hearing (CNH). The children ranged in age from 6 to 12 years.

    Results

    School-age CHL experienced more overall and cognitive fatigue than CNH, although the differences were smaller than previously reported. Parent-proxy report was not strongly associated with child self-report, and parents tended to underestimate their child's fatigue, particularly sleep/rest fatigue. Language ability was also associated with subjective fatigue. For CHL and CNH, as language abilities increased, cognitive fatigue decreased.

    Conclusions

    School-age CHL experience more subjective fatigue than CNH. The poor association between parent-proxy and child reports suggests that the parent-proxy version of the PedsQL-MFS should not be used in isolation when assessing fatigue in school-age children. Future research should examine how language abilities may modulate fatigue and its potential academic consequences in CHL.

    References

    • Alhanbali, S., Dawes, P., Lloyd, S., & Munro, K. J. (2017). Self-reported listening-related effort and fatigue in hearing-impaired adults.Ear and Hearing, 38(1), e39–e48.
    • American National Standards Institute. (1997). American National Standard Methods for the calculation of the Speech Intelligibility Index (ANSI S3.5-1997). New York, NY: Author.
    • American National Standards Institute. (2010). American National Standard Specification for Audiometers (ANSI S3.6-2010). New York, NY: Author.
    • Bess, F. H., Dodd-Murphy, J., & Parker, R. A. (1998). Children with minimal sensorineural hearing loss: Prevalence, educational performance, and functional status.Ear and Hearing, 19(5), 339–354.
    • Bess, F. H., Gustafson, S. J., Corbett, B. A., Lambert, E. W., Camarata, S. M., & Hornsby, B. W. (2016). Salivary cortisol profiles of children with hearing loss.Ear and Hearing, 37(3), 334–344.
    • Bess, F. H., Gustafson, S. J., & Hornsby, B. W. (2014). How hard can it be to listen? Fatigue in school-age children with hearing loss.Journal of Educational Audiology, 20, 1–14.
    • Bess, F. H., & Hornsby, B. W. (2014a). Commentary: Listening can be exhausting—Fatigue in children and adults with hearing loss.Ear and Hearing, 35(6), 592–599.
    • Bess, F. H., & Hornsby, B. W. (2014b). The complexities of fatigue in children with hearing loss.SIG 9 Perspectives on Hearing and Hearing Disorders in Childhood, 24(2), 25–39.
    • Brown, L., Sherbenou, R. J., & Johnson, S. K. (2010). Test of Nonverbal Intelligence–Fourth Edition: TONI-4. Austin, TX: Pro-Ed.
    • Carhart, R., & Jerger, J. (1959). Preferred method for clinical determination of pure-tone thresholds.Journal of Speech and Hearing Disorders, 24(4), 330–345.
    • Christodoulou, C. (2005). The assessment and measurement of fatigue.In J. DeLuca (ed.), Fatigue as a Window to the Brain. (pp. 19–35). Cambridge, MA: MIT Press.
    • Daniel, L. C., Brumley, L. D., & Schwartz, L. A. (2013). Fatigue in adolescents with cancer compared to healthy adolescents.Pediatric Blood & Cancer, 60(11), 1902–1907.
    • De Los Reyes, A., & Kazdin, A. E. (2005). Informant discrepancies in the assessment of childhood psychopathology: A critical review, theoretical framework, and recommendations for further study.Psychological Bulletin, 131(4), 483–509.
    • De Vente, W., Olff, M., Van Amsterdam, J., Kamphuis, J., & Emmelkamp, P. (2003). Physiological differences between burnout patients and healthy controls: Blood pressure, heart rate, and cortisol responses.Occupational and Environmental Medicine, 60(Suppl. 1), i54–i61.
    • Dinges, D. F., Pack, F., Williams, K., Gillen, K. A., Powell, J. W., Ott, G. E., … Pack, A. I. (1997). Cumulative sleepiness, mood disturbance and psychomotor vigilance performance decrements during a week of sleep restricted to 4–5 hours per night.Sleep, 20(4), 267–277.
    • Dittner, A. J., Wessely, S. C., & Brown, R. G. (2004). The assessment of fatigue: A practical guide for clinicians and researchers.Journal of Psychosomatic Research, 56(2), 157–170.
    • Drotar, D. (2014). Measuring health-related quality of life in children and adolescents: Implications for research and practice. London, United Kingdom: Psychology Press.
    • Earle, F., Hockey, B., Earle, K., & Clough, P. (2015). Separating the effects of task load and task motivation on the effort–fatigue relationship.Motivation and Emotion, 39(4), 1–10.
    • Eddy, L., & Cruz, M. (2007). The relationship between fatigue and quality of life in children with chronic health problems: A systematic review.Journal for Specialists in Pediatric Nursing, 12(2), 105–114.
    • Eiser, C., & Varni, J. W. (2013). Health-related quality of life and symptom reporting: Similarities and differences between children and their parents.European Journal of Pediatrics, 172(10), 1299–1304.
    • Evans, E. J., & Wickstrom, B. (1999). Subjective fatigue and self-care in individuals with chronic illness.Medsurg Nursing, 8(6), 363–369.
    • Flechtner, H., & Bottomley, A. (2003). Fatigue and quality of life: Lessons from the real world.Oncologist, 8(Suppl. 1), 5–9.
    • Gaba, D. M., & Howard, S. K. (2002). Fatigue among clinicians and the safety of patients.New England Journal of Medicine, 347(16), 1249–1255.
    • Gamer, M., Lemon, J., Fellows, I., & Singh, P. (2012). irr: Various coefficients of interrater reliability and agreement. Retrieved from https://cran.r-project.org/package=irr
    • Gordijn, M. S., Cremers, E. M., Kaspers, G. J., & Gemke, R. J. (2011). Fatigue in children: Reliability and validity of the Dutch PedsQLTM Multidimensional Fatigue Scale.Quality of Life Research, 20(7), 1103–1108.
    • Goretti, B., Portaccio, E., Ghezzi, A., Lori, S., Moiola, L., Falautano, M., … Pozzilli, C. (2012). Fatigue and its relationships with cognitive functioning and depression in paediatric multiple sclerosis.Multiple Sclerosis Journal, 18(3), 329–334.
    • Grossi, G., Perski, A., Ekstedt, M., Johansson, T., Lindström, M., & Holm, K. (2005). The morning salivary cortisol response in burnout.Journal of Psychosomatic Research, 59(2), 103–111.
    • Hétu, R., Riverin, L., Lalande, N., Getty, L., & St-Cyr, C. (1988). Qualitative analysis of the handicap associated with occupational hearing loss.British Journal of Audiology, 22(4), 251–264.
    • Hicks, C. B., & Tharpe, A. M. (2002). Listening effort and fatigue in school-age children with and without hearing loss.Journal of Speech, Language, and Hearing Research, 45(3), 573–584.
    • Hockenberry, M. J., Hinds, P. S., Barrera, P., Bryant, R., Adams-McNeill, J., Hooke, C., … Manteuffel, B. (2003). Three instruments to assess fatigue in children with cancer: The child, parent and staff perspectives.Journal of Pain and Symptom Management, 25(4), 319–328.
    • Hockenberry-Eaton, M., Hinds, P., Howard, V., Gattuso, J., O'Neill, J. B., Alcoser, P., … Euell, K. (1999). Developing a conceptual model for fatigue in children.European Journal of Oncology Nursing, 3(1), 5–11.
    • Hockey, R. (2013). The psychology of fatigue: Work, effort and control. Cambridge, United Kingdom: Cambridge University Press.
    • Hornsby, B. W., & Kipp, A. M. (2016). Subjective ratings of fatigue and vigor in adults with hearing loss are driven by perceived hearing difficulties not degree of hearing loss.Ear and Hearing, 37(1), e1–e10.
    • Hornsby, B. W., Naylor, G., & Bess, F. H. (2016). A taxonomy of fatigue concepts and their relation to hearing loss.Ear and Hearing, 37, 136S–144S.
    • Hornsby, B. W., Werfel, K., Camarata, S., & Bess, F. H. (2014). Subjective fatigue in children with hearing loss: Some preliminary findings.American Journal of Audiology, 23(1), 129–134.
    • Jerjes, W. K., Cleare, A. J., Wessely, S., Wood, P. J., & Taylor, N. F. (2005). Diurnal patterns of salivary cortisol and cortisone output in chronic fatigue syndrome.Journal of Affective Disorders, 87(2), 299–304.
    • Koot, H., & Wallander, J. (2014). Quality of life in child and adolescent illness: Concepts, methods and findings. Abingdon, United Kingdom: Routledge.
    • Kramer, S. E., Kapteyn, T. S., & Houtgast, T. (2006). Occupational performance: Comparing normally-hearing and hearing-impaired employees using the Amsterdam Checklist for Hearing and Work.International Journal of Audiology, 45(9), 503–512.
    • Lieberman, H. R. (2007). Cognitive methods for assessing mental energy.Nutritional Neuroscience, 10(5–6), 229–242.
    • Marcus, S. B., Strople, J. A., Neighbors, K., Weissberg-Benchell, J., Nelson, S. P., Limbers, C., … Alonso, E. M. (2009). Fatigue and health-related quality of life in pediatric inflammatory bowel disease.Clinical Gastroenterology and Hepatology, 7(5), 554–561.
    • McCoy, S. L., Tun, P. A., Cox, L. C., Colangelo, M., Stewart, R. A., & Wingfield, A. (2005). Hearing loss and perceptual effort: Downstream effects on older adults' memory for speech.The Quarterly Journal of Experimental Psychology Section A, 58(1), 22–33.
    • McGarrigle, R., Munro, K. J., Dawes, P., Stewart, A. J., Moore, D. R., Barry, J. G., & Amitay, S. (2014). Listening effort and fatigue: What exactly are we measuring? A British Society of Audiology Cognition in Hearing Special Interest Group “white paper”.International Journal of Audiology, 53(7), 433–445.
    • McGraw, K. O., & Wong, S. P. (1996). Forming inferences about some intraclass correlation coefficients.Psychological Methods, 1(1), 30.
    • Meeske, K., Katz, E. R., Palmer, S. N., Burwinkle, T., & Varni, J. W. (2004). Parent proxy–reported health‐related quality of life and fatigue in pediatric patients diagnosed with brain tumors and acute lymphoblastic leukemia.Cancer, 101(9), 2116–2125.
    • Michielsen, H. J., De Vries, J., Van Heck, G. L., Van de Vijver, F. J., & Sijtsma, K. (2004). Examination of the dimensionality of fatigue: The construction of the Fatigue Assessment Scale (FAS).European Journal of Psychological Assessment, 20(1), 39–48.
    • Nelson, E. C., Wasson, J., Johnson, D., & Hays, R. D. (1996). Dartmouth COOP Functional Health Assessment Charts: Brief measures for clinical practice.In B. Spilker (Ed.), Quality of Life and Parmacoeconomics in Clinical Trials (2nd ed., pp. 161–168). Philadelphia, PA: Lippencott-Raven.
    • Nelson, E., Wasson, J., Kirk, J., Keller, A., Clark, D., Dietrich, A., … Zubkoff, M. (1987). Assessment of function in routine clinical practice: Description of the COOP Chart method and preliminary findings.Journal of Chronic Diseases, 40, 55S–63S.
    • Noguchi, K., Gel, Y. R., Brunner, E., & Konietschke, F. (2012). nparLD: An R software package for the nonparametric analysis of longitudinal data in factorial experiments.Journal of Statistical Software, 50(12), 1–23.
    • Semel, E., Wiig, E., & Secord, W. (2003). Clinical evaluation of language fundamentals-IV. Marickville: Harcourt Assessment.
    • Upton, P., Lawford, J., & Eiser, C. (2008). Parent–child agreement across child health-related quality of life instruments: A review of the literature.Quality of Life Research, 17(6), 895–913.
    • Van Dongen, H. P., & Dinges, D. F. (2000). Circadian rhythms in fatigue, alertness, and performance.Principles and Practice of Sleep Medicine, 20, 391–399.
    • Varni, J. W., Burwinkle, T. M., Berrin, S. J., Sherman, S. A., Artavia, K., Malcarne, V. L., & Chambers, H. G. (2006). The PedsQL in pediatric cerebral palsy: Reliability, validity, and sensitivity of the Generic Core Scales and Cerebral Palsy Module.Developmental Medicine and Child Neurology, 48(6), 442–449.
    • Varni, J. W., Burwinkle, T. M., Katz, E. R., Meeske, K., & Dickinson, P. (2002). The PedsQLTM in pediatric cancer.Cancer, 94(7), 2090–2106.
    • Varni, J. W., Burwinkle, T. M., Limbers, C. A., & Szer, I. S. (2007). The PedsQLTM as a patient-reported outcome in children and adolescents with fibromyalgia: An analysis of OMERACT domains.Health and Quality of Life Outcomes, 5, 9.
    • Varni, J. W., Burwinkle, T. M., & Szer, I. S. (2004). The PedsQL Multidimensional Fatigue Scale in pediatric rheumatology: Reliability and validity.The Journal of Rheumatology, 31(12), 2494–2500.
    • Varni, J. W., Katz, E. R., Colegrove, R., Jr., & Dolgin, M. J. (1996). Adjustment of children with newly diagnosed cancer: Cross-informant variance.Journal of Psychosocial Oncology, 13(4), 23–38.
    • Varni, J. W., & Limbers, C. A. (2008). The PedsQLTM Multidimensional Fatigue Scale in young adults: Feasibility, reliability and validity in a University student population.Quality of Life Research, 17(1), 105–114.
    • Varni, J. W., Limbers, C. A., Bryant, W. P., & Wilson, D. P. (2009). The PedsQLTM Multidimensional Fatigue Scale in type 1 diabetes: Feasibility, reliability, and validity.Pediatric Diabetes, 10(5), 321–328.
    • Varni, J. W., Limbers, C. A., Bryant, W. P., & Wilson, D. P. (2010). The PedsQLTM Multidimensional Fatigue Scale in pediatric obesity: Feasibility, reliability and validity.International Journal of Pediatric Obesity, 5(1), 34–42.
    • Varni, J. W., Limbers, C. A., Bryant, W. P., & Wilson, D. P. (2012). Assessment of fatigue in pediatric patients with short stature utilizing the PedsQLTM Multidimensional Fatigue Scale.Children's Health Care, 41(2), 162–181.
    • Verhulst, F. C., & Ende, J. (1992). Agreement between parents' reports and adolescents' self‐reports of problem behavior.Journal of Child Psychology and Psychiatry, 33(6), 1011–1023.
    • von Rueden, U., Gosch, A., Rajmil, L., Bisegger, C., & Ravens-Sieberer, U. (2006). Socioeconomic determinants of health related quality of life in childhood and adolescence: Results from a European study.Journal of Epidemiology and Community Health, 60(2), 130–135. https://doi.org/10.1136/jech.2005.039792
    • Werfel, K. L., & Hendricks, A. E. (2016). The relation between child versus parent report of chronic fatigue and language/literacy skills in school-age children with cochlear implants.Ear and Hearing, 37(2), 216–224.
    • Whitehead, L. (2009). The measurement of fatigue in chronic illness: A systematic review of unidimensional and multidimensional fatigue measures.Journal of Pain and Symptom Management, 37(1), 107–128.
    • Wilson, K. A., Dowling, A. J., Abdolell, M., & Tannock, I. F. (2000). Perception of quality of life by patients, partners and treating physicians.Quality of Life Research, 9(9), 1041–1052.
    • Zekveld, A. A., Kramer, S. E., & Festen, J. M. (2011). Cognitive load during speech perception in noise: The influence of age, hearing loss, and cognition on the pupil response.Ear and Hearing, 32(4), 498–510. https://doi.org/10.1097/AUD.0b013e31820512bb

    Additional Resources