Perceived Stress and the Fatigue Symptom Cluster in Childhood Brain Tumor Survivors.

OBJECTIVESTo explore and estimate relationships among the elements of the symptom cluster in survivors of brain tumors aged 8-12 years during early survivorship.SAMPLE & SETTINGChild participants completed treatment at least six months and less than six years prior to enrollment at Children's Hospital of Alabama in Birmingham or Cook Children's Medical Center in Fort Worth, Texas.METHODS & VARIABLESWith cross-sectional methods, the authors measured child-perceived stress, sleep-wake disturbance (SWD) (parent report), and fatigue. Children also provided saliva samples for cortisol measurement (stress response) and completed actigraphy sleep monitoring.RESULTSMild to moderate stress, SWD, and fatigue were reported, and a wide range of sleep times and cortisol levels were noted. Meaningful effect sizes in relationships between variables were found.IMPLICATIONS FOR NURSINGThe stress, SWD, and fatigue symptom cluster in survivorship necessitates routine nursing assessment.