All ETDs from UAB

Advisory Committee Chair

Marti Rice

Advisory Committee Members

Kristin Avis

Andres Azuero

Joan Haase

Anne Turner-Henson

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Nursing


Survivors of childhood cancer are a growing population, and knowledge of persistent cancer related fatigue (CRF) is integral to survivorship. CRF in central nervous system (CNS) cancer is multifactorial and may be unique based on treatment and stage of survival. There is a gap in evidence for school-age survivors, especially during early survivorship. Aims: The aim of this study was to examine factors that influence CRF in child CNS cancer survivors at least 6 months and less than 6 years post treatment. The purpose of this study was to examine relationships between select factors and CRF and to determine effect sizes. Methods: An exploratory, cross-sectional design was used to address the following research question: What are the effect sizes of the relationships among child perceived stress, sleep/wake disturbance (SWD), stress response (cortisol), and CRF? The convenience sample (N=21) was recruited from two southern United States pediatric cancer centers. Measures included child/parent questionnaires (perceived stress, subjective SWD, and CRF); timed a.m. and p.m. child salivary cortisol (stress response); and child actigraphy monitoring (objective SWD). Results: Analysis revealed relevant (r > 0.25) effect sizes between child perceived stress and CRF (r= -0.340), and between child perceived stress and objective SWD (r= -0.266; -0.546). There was evidence for alteration in child stress response (cortisol) patterns as well as scores reflecting child perceived stress, SWD, and CRF. Conclusions: This preliminary evidence adds to the body of knowledge of childhood CNS cancer survivors in early survivorship, a vulnerable time of transition for both the patient and family. Current findings will guide power analysis and sampling for future studies of CRF in this population and have implications for quality of life and comprehensive care of the child with CNS cancer.

Included in

Nursing Commons



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