Pain, sleep, fatigue, and health-related quality of life in pediatric sickle cell disease: a serial multiple mediator analysis

The mechanisms of the predictive effects of SCD-specific pain on generic HRQOL in pediatric patients with SCD are explained in part by the serial multiple mediator effects of sleep disturbance and general fatigue. Recognizing the multiple mediators of SCD-specific pain on generic HRQOL from the perspective of pediatric patients with SCD may aid future clinical research and practice to address impaired daily functioning through more comprehensive treatment approaches that include targeted symptom-specific interventions for pain, sleep disturbance, and fatigue.