What matters to children with CFS/ME? A conceptual model as the first stage in developing a PROM

Arch Dis Child. 2015 Dec;100(12):1141-7. doi: 10.1136/archdischild-2015-308831. Epub 2015 Oct 9.

Abstract

Background: Paediatric chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME) is relatively common and disabling. Research is hampered because current patient-reported outcome measures (PROMs) do not capture outcomes that are important to children with CFS/ME.

Aim: The aim of this study was to explore the aspects of life and health outcomes that matter to children with CFS/ME.

Methods: Twenty-five children with CFS/ME were interviewed (11 males, 14 females; mean age 12.9 years (SD 2.2), range 8-17). Twelve were trial participants interviewed during the trial and 13 were recruited as part of a follow-up qualitative study. Parents were present in 19 interviews with their children. Three mothers participated in a focus group. All the interviews and the focus group were audio-recorded and transcribed. Data were analysed thematically using techniques of constant comparison. NVivo was used to structure and categorise data in a systematic way.

Results: Children identified four key themes (health outcome domains): 'symptoms' that fluctuated, which caused an unpredictable reduction in both 'physical activity' and 'social participation' all of which impacted on 'emotional well-being'. These domains were influenced by both 'management' and 'contextual factors', which could be positive and negative. The relationship between healthcare and school was considered pivotal.

Conclusions: Children's descriptions helped to inform a conceptual model that is necessary to develop a new paediatric CFS/ME PROM. Doctors need to be aware of how children conceptualise CFS/ME; the relationship between healthcare and school is fundamental to ameliorate the impact of CFS/ME.

Trial registration number: ISRCTN81456207.

Keywords: Chronic Fatigue Syndrome; Myalgic Encephalomyelitis; Patient Reported Outcome; children; qualitative.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • England
  • Fatigue Syndrome, Chronic / psychology*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Motor Activity
  • Outcome Assessment, Health Care
  • Qualitative Research
  • Quality of Life
  • Social Participation

Associated data

  • ISRCTN/ISRCTN81456207