Fatigue Management Research Articles

The Influence of Fatigue, Recovery, and Environmental Factors on the Body Stability of Construction Workers.

In the construction industry, falls, slips, and trips (FST) account for 42.3% of all accidents. The primary cause of FST incidents is directly related to the deterioration of workers' body stability. To prevent FST-related accidents, it is crucial to understand the interaction between physical fatigue and body stability in construction workers. Therefore, this study investigates the impact of fatigue on body stability in various construction site environments using Dynamic Time Warping (DTW) analysis. We conducted experiments reflecting six different fatigue levels and four environmental conditions. The analysis process involves comparing changes in DTW values derived from acceleration data obtained through wearable sensors across varying fatigue levels and construction environments. The results reveal the following changes in DTW values across different environments and fatigue levels: for non-obstacle, obstacle, water, and oil conditions, DTW values tend to increase as fatigue levels rise. In our experiments, we observed a significant decrease in body stability against external environments starting from fatigue Levels 3 or 4 (30% and 40% of the maximum failure point). In the non-obstacle condition, the DTW values were 9.4 at Level 0, 12.8 at Level 3, and 23.1 at Level 5. In contrast, for the oil condition, which exhibited the highest DTW values, the values were 10.5 at Level 0, 19.1 at Level 3, and 34.5 at Level 5. These experimental results confirm that the body stability of construction workers is influenced by both fatigue levels and external environmental conditions. Further analysis of recovery time, defined as the time it takes for body stability to return to its original level, revealed an increasing trend in recovery time as fatigue levels increased. This study quantitatively demonstrates through wearable sensor data that, as fatigue levels increase, workers experience decreased body stability and longer recovery times. The findings of this study can inform individual worker fatigue management in the future.

A Narrative Review on Gut Microbiome Disturbances and Microbial Preparations in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Implications for Long COVID.

Myalgic encephalomyelitis, also known as chronic fatigue syndrome (ME/CFS), and long COVID are complex, multisystemic and long-term disabling conditions characterized by debilitating post-exertional malaise and other core symptoms related to immune dysregulation resultant from post-viral infection, including mitochondrial dysfunction, chronic neuroinflammation and gut dysbiosis. The reported associations between altered microbiota composition and cardinal symptoms of ME/CFS and long COVID suggest that the use of microbial preparations, such as probiotics, by restoring the homeostasis of the brain-immune-gut axis, may help in the management of symptoms in both conditions. Therefore, this review aims to investigate the implications of alerted gut microbiome and assess the evidence supporting use of microbial-based preparations, including probiotics, synbiotics, postbiotics alone and/or in combination with other nutraceuticals in the management of fatigue, inflammation and neuropsychiatric and gastrointestinal symptoms among patients with ME/CFS and long COVID.

Contributors to fatigue among nurses working in critical care units: A qualitative study.

Fatigue is a growing concern among nurses who provide care to unstable and critically ill patients in critical care wards. It has various negative consequences for both nurses and patients. To explore and describe contributors to fatigue among nurses working in critical care units. A qualitative content analysis. Participants were 21 nurses chosen using purposeful sampling. They were working in different critical care units at different hospitals in nine urban areas of Iran. Semi-structured interviews were used to collect data, and conventional content analysis was used to develop categories and subcategories. The analysis of data on the nurses' perspectives and experiences led to developing nine categories as contributors to fatigue: 'compassion fatigue', 'extensive network of interactions', 'sound and alarm fatigue', 'psychological tensions', 'managerial and organizational tensions', 'lack of motivation and incentives', 'individual characteristics of nurses', 'physical and mental pressure', and requirements of special care and situational complexity'. Understanding the factors that influence the experience of fatigue among nurses working in critical care units is essential for maintaining a reliable and high-quality health care environment within health care facilities. The experience of fatigue by critical care nurses can increase the possibility of practice errors, reduce patient safety and quality of care, and enhance staff burnout and turnover. Proactive policies should be formulated to assess nurses' fatigue levels and implement strategies for effective fatigue management. This approach aims to enhance both patient safety and job satisfaction in the workplace.

Management of Fatigue in Adult Survivors of Cancer: ASCO-Society for Integrative Oncology Guideline Update.

To update the ASCO guideline on the management of cancer-related fatigue (CRF) in adult survivors of cancer. A multidisciplinary panel of medical oncology, geriatric oncology, internal medicine, psychology, psychiatry, exercise oncology, integrative medicine, behavioral oncology, nursing, and advocacy experts was convened. Guideline development involved a systematic literature review of randomized controlled trials (RCTs) published in 2013-2023. The evidence base consisted of 113 RCTs. Exercise, cognitive behavioral therapy (CBT), and mindfulness-based programs led to improvements in CRF both during and after the completion of cancer treatment. Tai chi, qigong, and American ginseng showed benefits during treatment, whereas yoga, acupressure, and moxibustion helped to manage CRF after completion of treatment. Use of other dietary supplements did not improve CRF during or after cancer treatment. In patients at the end of life, CBT and corticosteroids showed benefits. Certainty and quality of evidence were low to moderate for CRF management interventions. Clinicians should recommend exercise, CBT, mindfulness-based programs, and tai chi or qigong to reduce the severity of fatigue during cancer treatment. Psychoeducation and American ginseng may be recommended in adults undergoing cancer treatment. For survivors after completion of treatment, clinicians should recommend exercise, CBT, and mindfulness-based programs; in particular, CBT and mindfulness-based programs have shown efficacy for managing moderate to severe fatigue after treatment. Yoga, acupressure, and moxibustion may also be recommended. Patients at the end of life may be offered CBT and corticosteroids. Clinicians should not recommend L-carnitine, antidepressants, wakefulness agents, or routinely recommend psychostimulants to manage symptoms of CRF. There is insufficient evidence to make recommendations for or against other psychosocial, integrative, or pharmacological interventions for the management of fatigue.Additional information is available at www.asco.org/survivorship-guidelines.

People with Inflammatory Bowel Disease Prefer Cognitive Behavioral Therapy for Fatigue Management: A Conjoint Analysis

BackgroundPsychological interventions are a promising area for fatigue management in patients with inflammatory bowel disease (IBD). However, most interventions trialled to date have been pilots with limited direct input from patients about the type of intervention they want. Thus, this study aimed to explore patient preferences for a psychological IBD fatigue intervention.MethodsAn international online cross-sectional survey was conducted with adults with self-reported IBD. A conjoint analysis was employed to elicit, through a series of forced-choice scenarios, patient preferences for a fatigue intervention. For this study, the attributes manipulated across these forced-choice scenarios were type of intervention, modality of delivery, and duration of intervention.ResultsOverall, 834 people with IBD were included in analysis. Respondents ranked the type of psychological intervention as most important for overall preference (with cognitive-behavioral therapy (CBT) preferred over the other approaches), followed by modality of delivery, but placed very little importance on how long the intervention runs for. Patients with IBD appear to most strongly preference a short online CBT intervention for managing their IBD-related fatigue.ConclusionThis study helps provide therapists and program developers clear direction on patient preferences when it comes to developing new psychological programs that address fatigue in IBD.

Investigating the causes and consequences of controlled rest on the flight deck

IntroductionFatigue is a known issue in aviation due to long and irregular working hours. In some regions, pilots are permitted to sleep during a controlled rest period on the flight deck to manage unexpected sleepiness. We aimed to determine: (1) the relative influence of pre-flight sleep-wake history and time of day on the likelihood to take controlled rest; (2) whether neurobehavioral measures taken pre-flight are predictive of controlled rest use in-flight; and (3) the impact of controlled rest on neurobehavioral measures at top-of-descent.MethodsData from 120 long (>6 h flight duration), unaugmented (two-pilot) flights were analyzed (n = 31 pilots). Pilots wore actiwatches and completed sleep logs before and during trips. At pre-flight and top-of-descent, pilots completed a 5-min psychomotor vigilance task (PVT) and Karolinska Sleepiness Scale (KSS). A series of mixed-effects models with relevant covariates were conducted to assess the likelihood of controlled rest based on several predictors and the impact of controlled rest on outcome measures at top-of-descent.ResultsPilots were more likely to take controlled rest on night flights [p = .01, η2p = .13, OR = 13.81, 95% CI: (1.99, 95.80)] and when pre-flight sleepiness ratings were higher [p = .01, η2p = .14, OR = 4.14, 95% CI: (1.48, 11.57)]. Pilots who took controlled rest had faster response speeds [1000/reaction time (ms)] [p = .03, η2p = 0.07; estimated marginal mean (EMM) = 4.19, standard error (SE) = 0.07, 95% CI: (4.08, 4.29)] than those who did not [EMM = 4.00, SE = 0.05, 95% CI: (3.86, 4.14)].DiscussionOur results suggest that taking controlled rest may improve vigilant attention at critical phases of flight and may be a useful fatigue management tool, particularly during unaugmented night flights. Further research is needed to determine the impact of psychological and cultural influences on controlled rest and to understand how the policy is applied in practice.

An Opportunity for Management of Fatigue, Physical Condition, and Quality of Life Through Asynchronous Telerehabilitation in Patients After Acute Coronavirus Disease 2019: A Randomized Controlled Pilot Study

ObjectiveTo compare the preliminary efficacy of asynchronous telerehabilitation in patients after acute coronavirus disease 2019 (COVID-19) on fatigue, physical condition, quality of life, and feasibility of this pilot study with that of a booklet format. DesignRandomized pilot study with 2 intervention arms: asynchronous telerehabilitation group and booklet-based rehabilitation group, with 2 follow-ups at 3 and 6 months. SettingHospital. ParticipantsPatients discharged after COVID-19 were recruited and evaluated (N=35). InterventionsThe intervention consisted of a 12-week multimodal rehabilitation program via telerehabilitation or by a booklet. Main Outcome MeasuresFatigue as the main outcome and functional status, quality of life, and feasibility as secondary outcomes were evaluated. ResultsAfter the intervention, there was no significant difference between groups in fatigue, but there were significant differences in favor of the asynchronous telerehabilitation group for the 6-Minute Walk Test (p=.008), the 30-Second Sit-to-Stand Test (p=.019), and physical quality of life (p=.035). These improvements were maintained throughout the 6-month follow-up. Telerehabilitation was shown to be a viable option, without incidents and with a higher adhesion (p=.028) than the booklet format. ConclusionsA multimodal rehabilitation program by means of asynchronous telerehabilitation appears as a more effective option than traditional formats in improving post–acute COVID-19 sequelae.

Night staff fatigue

Prior to the COVID-19 pandemic, burnout was reported to be prevalent among healthcare staff ( Lancet, 2019 ). Following the pandemic, there has been an increase in staff wellbeing awareness, and the emotional and physical strains felt by the healthcare workforce have been acknowledged and discussed. Associated fatigue risks increasing this burnout prevalence, especially among healthcare assistants that work at night, who are particularly susceptible to fatigue as a result of the opposing circadian rhythm demands (Geiger-Brown et al, 2019). Aim: This survey aimed to: identify what fatigue management strategies have been utilised among night staff in an acute NHS trust; examine the attitudes towards, and culture surrounding, power naps; identify the prevalence of associated risk for patients and staff wellbeing; and identify current barriers to fatigue management. This article aims to utilise the information gathered to make recommendations for optimising fatigue management among night staff within a hospital environment.

Fatigue Risk Management Preferences for Consumer Sleep Technologies and Data Sharing in Aviation.

INTRODUCTION: Employees from any type of aviation services industry were asked to give their opinions about the usefulness of consumer sleep technologies (CSTs) during operations and their willingness to share data from CSTs with their organizations for fatigue risk management purposes under a variety of circumstances.METHODS: Respondents provided information about position in aviation and use of CST devices. Respondents ranked sleep issues and feedback metrics by perceived level of importance to operational performance. Respondents rated their likelihood to share data with their organization under a series of hypothetical situations.RESULTS: Between January-July 2023, 149 (N = 149) aviation professionals responded. Pilots comprised 72% (N = 108) of respondents; 84% (N = 125) of all respondents worked short- or medium-haul operations. "Nighttime operations" and "inconsistent sleep routines" ranked as the most important issues affecting sleep. "Sleep quality history" and "projected alertness levels" ranked as most important feedback metrics for personal management of fatigue. Respondents were split between CST users (N = 64) and nonusers (N = 68). CST users did not indicate a strong preference for a specific device brand. The most-reported reason for not using a CST was due to not owning one or no perceived need. Respondents indicated greater likelihood of data sharing under conditions where the device was provided to them by their organization.DISCUSSION: These results suggest that aviation professionals are more concerned about schedule-related disturbances to sleep than they are about endogenous sleep problems. Organizations may be able to increase compliance to data collection for fatigue risk management by providing employees with company-owned CSTs of any brand.Devine JK, Choynowski J, Hursh SR. Fatigue risk management preferences for consumer sleep technologies and data sharing in aviation. Aerosp Med Hum Perform. 2024; 95(5):265-272.

ACUTE EFFECT OF INTERVAL TRAINING SET STRUCTURE ON PHYSIOLOGICAL AND PERCEPTUAL RESPONSES TO EXERCISE

INTRODUCTION & AIMS A novel method for prescribing maximal aerobic speed (MAS) interval sessions involves the use of rest redistribution (RR). This approach could reduce perceived exertion and fatigue, preventing a decline in performance. This study aimed to compare acute physiological and perceptual responses between traditional (TS) and RR MAS interval training in endurance athletes. METHODS Twenty-five endurance runners (19 males, 6 females; age=31.9±8.5 y; maximal oxygen consumption (V̇O2max)=54.6±5.7 ml·kg·min-1; height=1.77±0.10 m; body-mass=74.0±13.0 kg) who ran >5 hours/week participated. Participants completed two MAS interval sessions equal in duration (18 min total, 360 s exercise, TS=660 s rest/RR=680 s rest) in a randomised order; TS: 3 sets x 6 repetitions (1 rep=20 s running:20 s rest) at 110% MAS and RR: 18 sets x 1 repetition (20 s running:40 s rest) at 110% MAS. During both sessions V̇O2 and heart rate (HR) were measured after each repetition, and blood lactate (HLa-) measured pre-exercise and after repetitions 6, 12 and 18. Rating of perceived exertion (RPE) was measured after repetitions 6, 12, and 18, and overall session RPE 10 minutes post-session. RESULTS Linear mixed effects models showed that TS led to a faster increase in V̇O2 (β=.16, p=.04) and HLa- (β=.09, p<.01), with consistently higher HR than RR (β=5.35, p<.01). Additionally, RPE (β=1.35, p<.01) and session RPE were lower in RR than TS (β=1.13, p<.01). CONCLUSION Results indicate that when session time is similar, TS (1:1 work-to-rest ratio), produces a greater physiological stimulus with higher V̇O2, HR and HLa-. Conversely, RR (1:2 work-to-rest ratio) resulted in lower perceived exertion and metabolic stress. This makes RR an appropriate choice for training periods with lower physiological stress or during periods of fatigue management. The reduced physiological demands in RR can facilitate a more controlled and sustainable training experience while still providing valuable training benefits.

Changing practice to improve quality of life in glioma.

As treatment for glioma advances, with an attendant improvement in length of patient survival, the quality of that survival has rightly become an increasingly important patient-centered metric, and health-related quality of life (HRQOL) an important outcome measure. HRQOL is a self-assessed, multidimensional concept encompassing the physical, emotional, and social components of quality of life associated with illness and its treatment. Neurosurgeons caring for patients with gliomas should be aware of the latest research on HRQOL to understand mechanisms by which it can be improved. Neurosurgical outcomes related to surgical complications and neurological deficits can be important determinants of HRQOL and are well understood by neurosurgeons. However, an understanding of more general or global determinants of HRQOL not commonly addressed in the clinic, and implementation of the attendant evidence-based interventions to address them, would be transformative. The authors explore HRQOL determinants related to patient-, social-, tumor-, and treatment-related factors, with a particular emphasis on the strongest determinants, fatigue, sleep disturbance, anxiety, depression, neurocognitive dysfunction, caregiver distress, and end-of-life concerns. Evidence-based interventions are reviewed, including fatigue management, cognitive rehabilitation, insomnia interventions exercise, caregiver training, palliative care, and an overall multidisciplinary team approach. Lastly, features of a program are outlined that would embed HRQOL in neurosurgical care to the benefit of both patients and staff.

The Impact of Yoga on Cancer Survivorship: A Scoping Review

Background: As cancer survival rates improve, survivors face numerous physical and psychological challenges. Yoga, an ancient practice integrating physical, mental, and spiritual health, has shown potential in alleviating cancer treatment-related symptoms and enhancing overall health. Methods: This scoping review conducted a comprehensive literature search across multiple databases, focusing on randomized trials that assessed yoga’s effects on cancer survivors post-treatment. The review spanned studies published between 2018 and 2022, emphasizing physical and psychosocial benefits. Results: Eight randomized trials were identified, demonstrating yoga’s diverse benefits across physical and psychological dimensions. Significant findings include reductions in depression, improvements in shoulder mobility, pain, and anxiety, management of cancer-related fatigue, sleep quality, and modulation of inflammatory cytokine profiles, suggesting holistic benefits in managing cancer side effects. Conclusion: Yoga presents a holistic, low-risk intervention that significantly improves quality of life, manages fatigue, and supports psychological well-being in cancer survivors. Future research should investigate yoga’s therapeutic potential and develop personalized interventions for survivors’ recovery and long-term well-being.

Non-invasive Techniques for Muscle Fatigue Monitoring: A Comprehensive Survey

Muscle fatigue represents a complex physiological and psychological phenomenon that impairs physical performance and increases the risks of injury. It is important to continuously monitor fatigue levels for early detection and management of fatigue. The detection and classification of muscle fatigue also provide important information in human-computer interactions (HMI), sports injuries and performance, ergonomics, and prosthetic control. With this purpose in mind, this review first provides an overview of the mechanisms of muscle fatigue and its biomarkers and further enumerates various non-invasive techniques commonly used for muscle fatigue monitoring and detection in the literature, including electromyogram (EMG), which records the muscle electrical activity during muscle contractions, mechanomyogram (MMG), which records vibration signals of muscle fibers, near-infrared spectroscopy (NIRS), which measures the amount of oxygen in the muscle, ultrasound (US), which records signals of muscle deformation during muscle contractions. This review also introduces the principle and mechanism, parameters used for fatigue detection, application in fatigue detection, and advantages and disadvantages of each technology in detail. To conclude, the limitations/challenges that need to be addressed for future research in this area are presented.

P119 The effectiveness of drug-induced immunosuppression using biologics and Janus-kinase inhibitors in improving fatigue in adults with rheumatoid arthritis: a systematic review of randomised controlled trials

Abstract Background/Aims Fatigue is a prominent and debilitating symptom. Many clinicians indicate that they may not assess fatigue frequently because there are no guidelines for fatigue treatment; thus, they feel unskilled to appropriately manage it. Previous evidence from a 2016 Cochrane review supported the use of biologics for fatigue among people with rheumatoid arthritis (RA). As of yet, this evidence has not been incorporated into management guidelines. Further, it is outdated and lacks data on newer drugs such as biosimilars and Janus-Kinase inhibitors (JAKis). We aimed to update the evidence on the effectiveness of biologics and JAKis for RA-fatigue, with a view to informing future guidelines. Methods Five electronic databases (Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL and PubMed) were systematically searched, from 2014 to present, for randomised controlled trials (RCTs) evaluating pharmacological interventions in adults with RA. Two reviewers contributed to the screening and analysis of the included papers, and any dispute was resolved through a comprehensive discussion. One reviewer then extracted the data and assessed methodological quality using the Cochrane Risk of Bias Tool. The effectiveness of treatments was determined by extracting change from baseline (CFB) data and/or the proportion achieving the minimal clinically important difference (MCID) in fatigue. Where only CFB data were provided, reviewers compared absolute change values against the relevant MCID to evaluate intervention superiority. Owing to data heterogeneity, a narrative synthesis approach was undertaken. Results A total of 43 RCTs and post hoc analyses were included. No eligible studies were found regarding biosimilars. Drug classes investigated included JAKis (n = 27), interleukin-6 inhibitors (n = 9), anti-CD-20 monoclonal antibody (n = 1), selective so-stimulation modulators (n = 2) and TNF inhibitors (n = 4). Of these studies, four were inactive placebo comparator studies, 33 were active placebo comparator studies (i.e. csDMARDs), and six were head-to-head comparator studies. Studies had a low to unclear risk of bias, perhaps due to the high number of post hoc analyses (n = 28, 65%). In total, 37 studies (86%) determined an advantage to using biologics/JAKis; five (12%) determined that treatment with biologics/JAKis was not superior to csDMARDs. The final study showed no meaningful improvement in fatigue from treatment or control. Conclusion Most studies showed that biologics/JAKis hold the potential for fatigue management. However, fatigue reporting was poor, and few studies focussed on fatigue as a primary outcome in post hoc analyses. Therefore, it is not clear whether these treatments may, in fact, be more effective in certain subgroups of patients, for example, those for whom fatigue is a significant problem. Accordingly, the development of treatment guidelines involving these therapies is currently unlikely. We propose that future clinical trials designating fatigue as a primary endpoint will be crucial to improving the establishment of guidelines to support fatigue management. Disclosure H.J. Ghadanfari: None. J.H. Humphreys: None. K.L. Druce: None.

A Comparison of Sensorimotor Integration and Motor Fitness Components between Collegiate Athletes with and without Long COVID: A Cross-Sectional Study with Pair-Matched Controls.

Background: Long COVID presents a concern for collegiate athletes, potentially impacting sensorimotor processing and motor fitness. This study aimed to assess these effects. Methods: This cross-sectional study involved 60 athletes diagnosed with Long COVID and 60 controls. Sensorimotor processing and integration were evaluated using neurophysiological variables (N13, P14, N20, P27, and N30), while motor fitness was assessed through balance, agility, and vertical jump testing. T-tests compared groups, and Pearson's correlations explored relationships. Results: Significant differences (p < 0.001) were observed in neurophysiological variables and motor fitness between Long COVID and control groups. Fatigue correlated positively (p < 0.001) with neurophysiological variables in Long COVID cases but not with motor fitness (p = 0.08, p = 0.07, p = 0.09). Conclusions: Collegiate athletes with Long COVID exhibit abnormal sensorimotor processing, integration, and diminished motor fitness compared to uninfected peers. The fatigue severity of Long COVID correlates with neurophysiological changes, suggesting a link between sensorimotor deficits and fatigue. Targeted interventions for sensorimotor deficits and fatigue management are crucial for athletes recovering from Long COVID. This study underscores the importance of addressing these issues to optimize the recovery and performance of collegiate athletes affected by Long COVID.

0305 Can We Rely on Wearable Sleep-Tracker Devices for Fatigue Management?

0305 Can We Rely on Wearable Sleep-Tracker Devices for Fatigue Management?

Personalized Management of Fatigue in Individuals With Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Long COVID Using a Smart Digital mHealth Solution: Protocol for a Participatory Design Approach.

Fatigue is the most common symptom in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and long COVID, impacting patients' quality of life; however, there is currently a lack of evidence-based context-aware tools for fatigue self-management in these populations. This study aimed to (1) address fatigue in ME/CFS and long COVID through the development of digital mobile health solutions for self-management, (2) predict perceived fatigue severity using real-time data, and (3) assess the feasibility and potential benefits of personalized digital mobile health solutions. The MyFatigue project adopts a patient-centered approach within the participatory health informatics domain. Patient representatives will be actively involved in decision-making processes. This study combines inductive and deductive research approaches, using qualitative studies to generate new knowledge and quantitative methods to test hypotheses regarding the relationship between factors like physical activity, sleep behaviors, and perceived fatigue in ME/CFS and long COVID. Co-design methods will be used to develop a personalized digital solution for fatigue self-management based on the generated knowledge. Finally, a pilot study will evaluate the feasibility, acceptance, and potential benefits of the digital health solution. The MyFatigue project opened to enrollment in November 2023. Initial results are expected to be published by the end of 2024. This study protocol holds the potential to expand understanding, create personalized self-management approaches, engage stakeholders, and ultimately improve the well-being of individuals with ME/CFS and long COVID. PRR1-10.2196/50157.

Optimizing Nurse Workflow Efficiency: An Examination of Nurse Walking Behavior and Space Accessibility in Medical Surgical Units.

This study aimed to investigate the effect of spatial adjacencies on nurses' walking patterns and the subsequent impact on staff satisfaction with perceived accessibility and adjacency-related issues. Recognizing the crucial importance of spatial adjacencies in healthcare facilities is essential, as they significantly affect staff morale, fatigue management, operational efficiency, error reduction, and overall patient care excellence, highlighting the need for objective assessments to evaluate the impact of facility layout and space configuration on workflow patterns and staff satisfaction in patient care units. Integrating on-site observations with survey data, we explored how spatial adjacencies affect staff walking behavior and satisfaction in two med-surgical unit floors. The findings highlighted a significant frequency of movements between nurse stations, patient rooms, and medication areas. Regression analysis identified several contributing factors to staff satisfaction, including the proximity of supplies, team visibility, ease of access across departments, and the location of equipment rooms. Specifically, satisfaction with the proximity of supplies was positively associated with increased provider satisfaction with workflow, quality of care, and workplace. Additionally, valuable feedback from staff revealed concerns regarding break room placement, medication area functionality, and disparities in the availability of supplies. This study highlighted the critical need for carefully planned spatial adjacency strategies to enhance workflow efficiency and raise clinical staff satisfaction within healthcare facilities. The actionable insights gleaned from this research offer valuable direction to architects, healthcare administrators, and design professionals, enabling the creation of environments that positively resonate with healthcare providers and improve healthcare operations.

La préhabilitation, un nouveau parcours préopératoire pour améliorer la condition des patients

The maintenance and optimization of functional capacities before, during, and after treatment are major challenges for frailty persons as cancer's patients. It is now known that physical activity in prehabilitation plays a crucial role in limiting, among other things, post-operative complications. The benefits have already been demonstrated in various studies, including a decrease in hospitalization duration, an increase in cardiorespiratory endurance, improvement in quality of life, and better fatigue management. It is observed that patients who undergo prehabilitation are those who recover their preoperative capacities the fastest. However, it is estimated that only one-third of patients with access to prehabilitation improve their physical capacities.

The Mediating Role of Intrinsic Motivation in the Relationship Between Organizational Support and Quantitative Workload and Work-Related Fatigue

Increasingly tight job competition means that workers often ignore work-related fatigue conditions, which can negatively impact workers and organizations, resulting in decreased health and work effectiveness and even work accidents. In order to prevent this, proper work-related fatigue management is needed. This research examines the role of intrinsic motivation as a mediator in the relationship between organizational support and quantitative workload with work-related fatigue. This research is quantitative research with a survey method. The sampling technique used was stratified random sampling. The measuring instruments used are the Occupational Fatigue Exhaustion/Recovery Scale (OFER), the Quantitative Workload Inventory (QWI), the short version of the Survey of Perceived Organizational Support (SPOS), and the Situational Motivation Scale (SIMS). Data analysis used path analysis and bootstrapping in SmartPLS 3.0. The analysis results show no mediating role for intrinsic motivation in the relationship between organizational support and quantitative workload with work-related fatigue. A high quantitative workload triggers increased work-related fatigue, so it needs to be balanced with sufficient organizational support.