Asian Nurs Res.
2023 Feb;17(1):23-29. 10.1016/j.anr.2022.12.003.
The Moderated Mediating Effects of Nutrition and Physical Activity Between Fatigue and Quality of Life in Childhood Cancer Survivors
- Affiliations
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- 1School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
- 2Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
- 3Department of Social Work, National Taiwan University, Taipei, Taiwan
- 4Department of Pediatrics, National Taiwan University Children's Hospital, Taipei, Taiwan
- 5Department of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
- 6Department and Graduate Institute of Medical Education and Bioethics, College of Medicine, National Taiwan University, Taipei, Taiwan
- KMID: 2542727
- DOI: http://doi.org/10.1016/j.anr.2022.12.003
Abstract
- Purpose
The aim of this study was to investigate the associations between nutrition, physical activity, fatigue, and quality of life (QoL) among childhood cancer survivors. The specific purpose was to examine whether nutrition mediated and physical activity moderated the relationship between fatigue and QoL in this population.
Methods
A pooled sample of 120 childhood cancer survivors was recruited at pediatric oncology wards and ambulatory settings between August 2020 and May 2021. We collected data on participants’ demographic characteristics, fatigue, nutritional status, physical activity, and QoL. We then adapted Hayes Process Macro to examine the mediating and moderating effects of nutrition and physical activity on the relationship between fatigue and QoL.
Results
In models adjusted for age and sex, (1) the simple mediation analysis identified the mediating effect of nutrition on the relationship between fatigue and QoL; and (2) the mediation and moderation analysis identified that the direct effect of nutrition between fatigue and QoL was significant when adding (a) physical activity and (b) fatigue × physical activity. There were significantly decreasing trends in physical activity at 1 standard deviation below the mean and at the mean, but not at 1 standard deviation above the mean.
Conclusions
Our findings demonstrate that nutrition mediated and physical activity moderated the relationship between fatigue and QoL. This highlights an opportunity to enhance QoL among childhood cancer survivors through healthy lifestyle interventions. To ensure that future interventions address children's needs and promote the greatest impact, such interventions should include nutrition and physical activity components that involve nurses, pediatric oncology physicians, nutritionists, and physical therapists. Keyword
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