Higher Levels Of Fatigue Research Articles

Perceived Social Support as a Predictive Factor of Fatigue and Quality of Life Among Healthcare Professionals in Greece

The multitude of stressful factors in the work environment, combined with work burnout and the absence of social support, significantly degrades the quality of life of health professionals. And while studies focus individually on each variable, the purpose of the present research is to classify and simultaneously correlate them, in the case of healthcare professionals in the post-pandemic era. The quantitative method with a structured questionnaire was selected to conduct the research in 506 health workers, from 14 hospitals of the 6th HealthCare Region of Greece. A fairly high level of fatigue, a low level of social support and a moderate to high level of general health were found. Physical, mental, and overall fatigue were found to be significantly negatively correlated with family, friends, significant others, and overall social support. Their correlation was found to be significantly positive in terms of general health, as well as its individual subscales. Further investigation of the cumulative effects of fatigue and the low level of quality of life of health professionals on the efficiency and level of healthcare services provided, will contribute to the formation of new approaches to dealing with and preventing the phenomenon.

Stress Exposures Contribute to Worse Joint Morning and Evening Fatigue Profiles in Patients With Cancer During Chemotherapy.

To evaluate differences among stress, resilience, and coping strategies related to morning and evening fatigue profiles (both low, low morning and moderate evening, both moderate, and both high). Data were collected from 1,334 adult patients with cancer receiving chemotherapy. Morning and evening fatigue severity were rated over two cycles of chemotherapy using the Lee Fatigue Scale. Latent profile analysis was used to identify patient subgroups with distinct joint morning and evening profiles. Data were collected on global, cancer-specific, and cumulative life stress; resilience; and coping strategies. Differences among the latent classes were evaluated using parametric and nonparametric tests. Compared to the other three classes, the both high class reported the highest stress scores, highest occurrence of and effects from a variety of stressful life events, lowest resilience scores, and higher use of disengagement coping strategies. The both high class met the criteria for subsyndromal post-traumatic stress disorder. When patients report high levels of fatigue, detailed assessments of stress are warranted to provide tailored interventions.

Virtual Wellness Workshop for Medical Students: Effects on Healthy Lifestyle Behavior.

Medical students experience high levels of stress, burnout, depression, suicidal ideation, and compassion fatigue. Mindfulness interventions in this population have demonstrated improvement in psychological outcomes. However, it is unclear if these improvements are maintained. Evaluation of changes in lifestyle behaviors may provide insight into factors that sustain improvements. Specific aims of this study were to (1) assess feasibility and acceptability of an innovative, virtual program involving experiential learning, social support, and motivational interviewing; and (2) evaluate preliminary healthy lifestyle behaviors and psychological outcomes from preprogram to postprogram and 4-week follow-up. We used a mixed-methods approach to investigate feasibility, acceptability, and effects of the virtual program using validated measures and open-ended questions. Participants were 20 first- and second-year medical students at one Midwestern US medical college who participated between October 2020 and December 2020. Participants were enrolled in one of two groups for the 8-week program via Webex. Participants completed surveys at preprogram, postprogram, and 4-week follow-up. They also completed weekly home practice assessments. Nineteen of 20 participants completed the program (95% retention rate). All participants attended six or more sessions. Repeated measures analysis of variance revealed that participants had significant improvements in healthy lifestyle behaviors, burnout, self-compassion, and stress across time. Results were supported by qualitative themes of increased social support, wellness skills, and overall positive experiences. Findings suggest that the virtual program was feasible and acceptable to medical students, and improved healthy lifestyle behaviors and psychological outcomes that were maintained or increased at 4-week follow-up.

Efectos del entrenamiento cluster sobre la hipertrofia muscular: Una revisión sistemática

Objective: The aim of this systematic review was to determine the effects of cluster training on musclehypertrophy.Methodology: A literature search was performed in the electronic databases Pubmed, Scopus and Web of Science,using the following keywords: “cluster training”, “rest interval”, “rest pause”, “hypertrophy”, “resistance training”and “cross sectional area”. We included clinical trials that used cluster training as an intervention in people over 18years of age of both sexes.Results: The systematic review obtained during the search of the databases consulted yielded a total of 23 potentially eligible articles, of which a sample of 9 was taken from which results could be obtained that responded to the objective of this review. The number of participants from the 9 eligible articles was 172 subjects. Cluster workouts allow for increased training volume and intensity without causing high levels of fatigue, thus favoring the development of musclehypertrophy.Conclusions: The results of this systematic review suggest that cluster training can be an effective tool for the development of muscle hypertrophy.

Influence of Clinical and Demographic Variables 0n the Quality of Life in Patients with Cervical Cancer

Background: Cervical cancer remains a significant public health issue, particularly in low- and middle-income countries, where it disproportionately affects women's quality of life (QoL). Understanding the impact of clinical and demographic variables on the QoL of patients with cervical cancer is crucial for improving care and support strategies. Objective: This study aims to assess how clinical and demographic factors influence the QoL of Pakistani women diagnosed with cervical cancer, comparing these findings against established benchmarks for both healthy individuals and those with malignancies. Methods: Conducted at a leading cancer centre in Pakistan from April to September 2022, this cross-sectional study involved 186 women with histopathologically confirmed cervical cancer, identified through a population-based cancer database. QoL was evaluated using the Organization for Research and Treatment of Cancer QLQ-C30 (Version 3.0) questionnaire, encompassing functional scales, symptom scales, single-item scales, and a global health status score. Data analysis was performed using SPSS version 25, applying logistic regression to identify factors significantly associated with QoL outcomes. Results: The median global health status score for enrolled patients was 50.0 [interquartile range (IQR) 33.3 - 66.7], significantly lower than the reference values for healthy females (58.0 [IQR 41.3 - 82.7]) and those with any malignancy (71.0 at age 55). Functional scale scores indicated compromised physical (65.7 [IQR 60.0 - 75.0]) and social (67.7 [IQR 56.0 - 100]) functioning. Symptom scale scores revealed high levels of pain (84.3 [IQR 65.7 - 84.3]) and fatigue (78.8 [IQR 55.7 - 88.7]). Regression analysis highlighted age and education level as significant predictors of physical health outcomes. Conclusion: The study underscores the profound impact of cervical cancer on the QoL of Pakistani women, with age and education level emerging as key determinants. These findings call for tailored interventions to address the specific needs of this patient population, emphasizing the need for early detection and comprehensive support services.

Perceived Social Support as a Predictive Factor of Fatigue and Quality of Life Among Healthcare Professionals in Greece

The multitude of stressful factors in the work environment, combined with work burnout and the absence of social support, significantly degrades the quality of life of health professionals. And while studies focus individually on each variable, the purpose of the present research is to classify and simultaneously correlate them, in the case of healthcare professionals in the post-pandemic era. The quantitative method with a structured questionnaire was selected to conduct the research in 506 health workers, from 14 hospitals of the 6th HealthCare Region of Greece. A fairly high level of fatigue, an alarmingly low level of social support and a moderate to high level of general health were found. Physical, mental, and overall fatigue were found to be significantly negatively correlated with family, friends, significant others, and overall social support. Their correlation was found to be significantly positive in terms of general health, as well as its individual subscales. Further investigation of the cumulative effects of fatigue and the low level of quality of life of health professionals on the efficiency and level of healthcare services provided, will contribute to the formation of new approaches to dealing with and preventing the phenomenon.

Compassion Fatigue in Out of Home Care Workers: A Systematic Review

ABSTRACT Evidence suggests that providing out-of-home care to children is associated with high levels of compassion fatigue, possibly due to various work-related factors. This review examined the existing literature to determine the extent to which out of home care work results in compassion fatigue. To do so, it established which out of home care settings compassion fatigue has been measured in, how, and what factors contribute to developing compassion fatigue in this work. The study conducted a comprehensive search of five electronic databases (CINAHL, MEDLINE, PsycINFO, PubMED, and CENTRAL) for full-text articles examining compassion fatigue in out-of-home care workers caring for children aged 0–18 years. Out of the 2,759 articles initially identified, 14 articles were included. Studies were assessed against the Joanna Briggs Institute (JBI) Critical Appraisal Checklists for risk of bias. The findings suggest that compassion fatigue is prevalent in various out-of-home care settings and has been measured using validated quantitative and qualitative measures. Out of home care workers caring for children reported symptoms consistent with compassion fatigue, but a range of protective factors were also identified that may reduce its negative impact. This review highlights the need for further research in this area, using larger sample sizes and including a more comprehensive range of out-of-home care workers, settings, and countries.

Comparing Self-Report Fatigue Assessment Tools for Adults with Cerebral Palsy in a Danish Context

ABSTRACT Purpose: Many youth and adults with Cerebral Palsy (CP) experience high levels of fatigue. This study aimed to compare three fatigue self-report questionnaires to guide clinicians. Method: Thirty youth and adults (age range 17–64) with CP were assessed with Danish versions of the Fatigue Impact and Severity Self-Assessment questionnaire, the Modified Mental Fatigue Scale, and the Multidimensional Fatigue Inventory. Psychometric properties were investigated. Rank order and classification models were compared across questionnaires. Results: The Reduced Motivation and Physical Fatigue subscales of the Multidimensional Fatigue Inventory showed inadequate internal consistency. Participants were frequently ranked differently with the questionnaires. There were issues related to the conceptualization of physical fatigue. Conclusion: The choice of assessment tool should be based on assessment purpose as the questionnaires assess different aspects of fatigue severity, impact, and management. Also, test selection can have important implications on the conclusions that are made about fatigue type and severity.

Perceived Social Support as a Predictive Factor of Fatigue and Quality of Life Among Healthcare Professionals in Greece

The multitude of stressful factors in the work environment, combined with work burnout and the absence of social support, significantly degrades the quality of life of health professionals. And while studies focus individually on each variable, the purpose of the present research is to classify and simultaneously correlate them, in the case of healthcare professionals in the post-pandemic era. The quantitative method with a structured questionnaire was selected to conduct the research in 506 health workers, from 14 hospitals of the 6th HealthCare Region of Greece. A fairly high level of fatigue, an alarmingly low level of social support and a moderate to high level of general health were found. Physical, mental, and overall fatigue were found to be significantly negatively correlated with family, friends, significant others, and overall social support. Their correlation was found to be significantly positive in terms of general health, as well as its individual subscales. Further investigation of the cumulative effects of fatigue and the low level of quality of life of health professionals on the efficiency and level of healthcare services provided, will contribute to the formation of new approaches to dealing with and preventing the phenomenon.

Exploring humanistic burden of fatigue in adults with multiple sclerosis: an analysis of US National Health and Wellness Survey data

BackgroundThis retrospective study examined the humanistic burden of fatigue in patients with relapsing-remitting multiple sclerosis (RRMS), compared with adults without MS, using data from the 2017 and 2019 US National Health and Wellness Survey.MethodsThe 5-item Modified Fatigue Impact Scale (MFIS-5) was used to assess level of fatigue (MFIS-5 score <15: low fatigue [LF]; MFIS-5 score ≥15: high fatigue [HF]) in patients with RRMS. Health-related quality of life (HRQoL) measures (Short Form 36-Item Health Survey version 2, Euroqol-5 Dimensions-5 Levels [EQ-5D-5L], Patient Health Questionnaire-9 [PHQ-9], Generalized Anxiety Disorder-7 [GAD-7], Perceived Deficits Questionnaire-5) and treatment-related characteristics were assessed.ResultsIn total, 498 respondents were identified as RRMS (n=375 RRMS+LF, n=123 RRMS+HF) and compared with 1,494 matched non-MS controls. RRMS+LF and RRMS+HF had significantly lower Short Form 6 Dimensions health utility, Mental and Physical Component Summary, and EQ-5D-5L scores and higher PHQ-9 and GAD-7 scores, compared with matched non-MS controls (all p<0.001); scores were worse for RRMS+HF than RRMS+LF across all measures (all p<0.001). A higher proportion of RRMS+HF reported moderate-to-severe depression and moderate-to-severe anxiety, compared with RRMS+LF and matched non-MS controls (both p<0.001). Fatigue was a significant predictor of poor HRQoL across all measures (all p<0.001).ConclusionsPatients with RRMS experienced lower HRQoL with higher levels of fatigue, highlighting an unmet need. Results may help to inform physician-patient communication and shared decision-making to address fatigue and its associated impact on patients’ HRQoL.

Fatigue, sleep and physical activity in postoperative patients with pituitary adenomas: A survey.

The condition and correlation of fatigue, sleep and physical activity in postoperative patients with pituitary adenomas remain unclear. This survey aimed to evaluate the current status and influencing factors of fatigue, sleep and physical activity in postoperative patients with pituitary adenomas. Patients undergoing pituitary adenoma resection in two tertiary hospitals from November 2019 to November 2021 were included. The general data questionnaire, Multidimensional Fatigue Inventory (MFI-20), Pittsburgh Sleep Quality Index (PSQI) and international physical activity questionnaire were used for data analysis. In total, 184 patients with pituitary adenomas were included. The postoperative patients with pituitary adenomas had a high level of fatigue. In total, 34 (18.5%) patients had low level of physical activity, 76(41.3%) patients had medium level of physical activity and 74 (40.2%) had high level of physical activity. Postoperative time, PSQI, physical activity level and gender were the influencing factors of fatigue in patients with pituitary adenomas (all P < 0.05). Postoperative patients with pituitary adenomas have a higher level of fatigue, and it is related to reduced sleep quality and activity. Relevant nursing measures should be taken according to the influencing factors of fatigue to reduce the fatigue of postoperative patients with pituitary adenomas.

Higher Levels of Multiple Types of Stress Are Associated With Worse State Anxiety and Morning Fatigue Profiles in Patients Receiving Chemotherapy.

Anxiety and fatigue are common problems in patients receiving chemotherapy. Unrelieved stress is a potential cause for the co-occurrence of these symptoms. The aims of this study were to identify subgroups of patients with distinct state anxiety and morning fatigue profiles and evaluate for differences among these subgroups in demographic and clinical characteristics, as well as measures of global, cancer-specific, and cumulative life stress and resilience and coping. Patients (n = 1335) completed measures of state anxiety and morning fatigue 6 times over 2 cycles of chemotherapy. All of the other measures were completed prior to the second or third cycle of chemotherapy. Latent profile analysis was used to identify the state anxiety and morning fatigue profiles. Three distinct joint profiles were identified: Low Anxiety and Low Morning Fatigue (59%), Moderate Anxiety and Moderate Morning Fatigue (33.4%), and High Anxiety and High Morning Fatigue (7.6%). Patients in the 2 highest classes were younger, were less likely to be married/partnered, and had a higher comorbidity burden. All of the stress scores demonstrated a dose-response effect (ie, as anxiety and morning fatigue profiles worsened, stress increased). Patients in the 2 highest classes reported higher rates of emotional abuse, physical neglect, physical abuse, and sexual harassment. More than 40% of these patients experienced moderate to high levels of both anxiety and morning fatigue. Higher levels of all 3 types of stress were associated with the 2 highest profiles. Clinicians need to perform comprehensive evaluations of patients' levels of stress and recommend referrals to psychosocial services.

The comparison of functional status and health-related parameters in ovarian cancer survivors with healthy controls

PurposeThe primary purpose of this study was to evaluate functional status and health-related parameters in ovarian cancer (OC) survivors and to compare these parameters with healthy controls. The secondary purpose of this study was to compare these parameters in early and advanced OC survivors.MethodsThirty-two OC survivors (n = 15 early stage; n = 17 advanced stage) with no evidence/suspicion of cancer recurrence after completing adjuvant local and systemic treatments for at least 12 months and 32 healthy controls were recruited for functional- and health-related assessments. Participants were assessed using the following methods of measuring the following: 6-min walk test (6MWT) for functional exercise capacity, 30-s chair stand test (30 s-CST) for functional fitness and muscle endurance, a handheld dynamometer for peripheral muscle strength, and a handheld dynamometer for lower extremity strength, Medical Micro RPM for respiratory muscle strength, International Physical Activity Questionnaire-Short Form (IPAQ-SF) for physical activity level, and Eastern Cooperative Oncology Group Performance Scale (ECOG-PS) for performance status, Checklist Individual Strength (CIS) for fatigue, Treatment/Gynecological Oncology-Neurotoxicity (FACT/GOG-NTX) for neuropathy, the Hospital Anxiety and Depression Scale (HADS) for anxiety and depression level, and the World Health Organization-Five Well-Being Index (WHO-5) for generic quality of life.ResultsAll OC survivors underwent surgery and chemotherapy, and only 9.4% received radiotherapy in addition to chemotherapy. The median recurrence-free period post-completion of adjuvant treatments was 24.00 (12.00–75.00) months. OC survivors had lower 6MWT (m) (p < 0.001, r = 1.50), peripheral muscle strength (p = 0.005, r = 0.72), knee extension (p < 0.001, r = 1.54), and respiratory muscle strength (maximal inspiratory pressure) (p < 0.001, r = 1.90) (maximal expiratory pressure) (p < 0.001, r = 1.68) compared to healthy controls. HADS-A (p = 0.005, r = 0.75) and CIS scores (p = 0.025, r = 0.59) were also higher in the OC survivors. Early-stage OC survivors had better 6MWT (m) than advanced-stage OC survivors (p = 0.005, r = 1.83). Peripheral muscle strength was lower in advanced-stage OC survivors (p = 0.013, r = 0.92). FACT/GOG-NTX scores were higher in early-stage OC survivors (p < 0.001, r = 1.42). No significant differences were observed between early- and advanced-stage OC survivors in other measures (p < 0.05).ConclusionThe findings suggest functional status, and health-related parameters are negatively affected in OC survivors. Additionally, higher levels of fatigue, neuropathy anxiety, and depression were reported in advanced OC survivors.

Sleep quality and fatigue among nurses working in high-acuity clinical settings in Saudi Arabia: a cross-sectional study

BackgroundPoor sleep quality is prevalent among nurses worldwide. Around two-thirds of nurses doing shift work are known to experience sleep problems and fatigue. Fatigue and sleep problems are linked to poor performance, impaired alertness, injuries, chronic diseases, compromised healthcare quality, and medical errors, all of which detrimentally impact nurses and threaten patients’ safety. This area of research has received insufficient attention in Saudi Arabia; therefore, the purpose of this study was to examine the levels of sleep quality and perceived fatigue and their association among nurses working in acute care settings in comprehensive hospitals in Saudi Arabia.MethodsA descriptive cross-sectional study using the Pittsburgh Sleep Quality Index and Chalder Fatigue Scale. Data was obtained via an online questionnaire that was distributed to nurses using the QuestionPro platform through hospital administrators, social media (WhatsApp), and personal contact.ResultsA total of 173 nurses completed the online survey. Most participants reported poor sleep quality (n = 127, 73.4%) and severe perceived fatigue (n = 156, 90.2%). Furthermore, the study revealed a significant correlation between the overall sleep disturbance and fatigue global scores (r = 0.57, P < 0.001), indicating that poor sleep quality was significantly associated with higher fatigue levels among the study sample.ConclusionsThe current study found a significant association between sleep quality and severe fatigue in nurses working in high acute care settings in Saudi Arabia. It is very clear from the results that nurses are experiencing poor sleep and severe fatigue, which in turn, will negatively impact the nurse’s quality of life and patient safety.

Health-related quality of life across disease stages in patients with amyotrophic lateral sclerosis: results from a real-world survey.

Amyotrophic lateral sclerosis (ALS) is characterized by a rapid disease course, with disease severity being associated with declining health-related quality of life (HRQoL) in persons living with ALS (pALS). The main objective of this study was to assess the impact of disease progression on HRQoL across King's, Milano-Torino Staging (MiToS), and physician-judgement clinical staging. Additionally, we evaluated the impact of the disease on the HRQoL of care partners (cALS). Data were sourced from the Adelphi ALS Disease Specific Programme (DSP)™, a cross-sectional survey of neurologists, pALS and cALS presenting in a real-world clinical setting between July 2020 and March 2021 in Europe and the United States. Neurologists (n = 142) provided data for 880 pALS. There were significant negative correlations between all three clinical staging systems and EuroQol (European Quality of Life) Five Dimension Five Level Scale (EQ-5D-5L) utility scores and visual analogue scale (VAS) ratings. Although not all differences were significant, 5-item Amyotrophic Lateral Sclerosis Assessment Questionnaire (ALSAQ-5) scores showed a stepwise increase in HRQoL impairment at each stage of the disease regardless of the staging system. At later stages, high levels of fatigue and substantial activity impairment were reported. As pALS disease states progressed, cALS also experienced a decline inHRQoL and increased burden. Across outcomes, pALS and cALS generally reported worse outcomes at later stages of the disease, highlighting an unmet need in this population for strategies to maximise QoL despite disease progression. Recognition and treatment of symptoms such as pain and fatigue may lead to improved outcomes for pALS and cALS.

Managing the challenge of fatigue for pilots operating ultra-long range flights

IntroductionUltra-long range (ULR) flights are defined as exceeding regulatory limits: normally 16 h flight time. They pose challenges due to long duty periods that could result in extended wakefulness and sleep loss, increasing the risk of fatigue. This study describes the mitigations used to manage fatigue in these operations. Two data collection phases were conducted on the Auckland-Chicago ULR route: when the route commenced (Study 1) and when the flight crew complement was altered (Study 2). Seasonal differences were also investigated.MethodsStudy 1 involved 72 crew who completed diaries and wore an actigraph to record sleep pre-departure, throughout the trip, and on return. In-flight, fatigue, sleepiness and workload were reported, and reaction time performance was measured. Study 2 involved 75 crew and data collection in the northern summer and northern winter. Crew completed diaries throughout the trip.ResultsStudy 1 data found crew sleep longer than usual in the 24 h pre trip and post flights. On the shorter outbound flight in-flight sleep averaged 3.3 h and on the longer inbound flight, 3.3–3.8 h, with most crew taking 3 breaks. Ratings of sleepiness and fatigue increased, and reaction time performance declined across flights, with greater decrements on longer inbound flights. Pilots did not fully adjust their sleep patterns to local time during the layover and no seasonal differences were found. Comparisons between Study 1 and 2 showed no difference in ratings of fatigue and sleepiness or in-flight sleep duration with an altered crew complement. There was a trend for Captains to report greater workload and less in-flight sleep in Study 2.DiscussionMitigations that allow for preparation and recovery are well utilized by crew. In-flight sleep is relatively short and ways of increasing the amount of sleep obtained should be considered. The incomplete adaptation of sleep during the layover has implications for rest break strategies on the return flight. The altered crew complement did not result in higher levels of fatigue or sleepiness or less in-flight sleep on average, although findings suggest a need to understand the effects of changing the crew complement on workload and in-flight sleep for Captains.

The effect of total ankle arthroplasty on mechanical energy exchange

Total ankle arthroplasty (TAA) is a common surgical solution for patients with debilitating arthritis of the ankle. Prior to surgery patients experience high levels of pain and fatigue and low mechanical energy recovery. It is not known if TAA restores healthy levels of mechanical energy recovery in this patient population. This study was designed to determine whether mechanical energy recovery was restored following TAA. Ground reaction forces during self-selected speed walking were collected from patients with symptomatic, unilateral ankle arthritis (N = 29) before and one and two years after primary, unilateral TAA. The exchange of potential (PE) and kinetic (KE) energy was examined, and direction of change (%congruity) and energy exchange (%recovery) between the two curves was calculated, with those subjects with low congruity experiencing high energy recovery. Linear regressions were used to examine the impact of walking speed, congruity, and amplitude of the center of mass (COM) displacement on %recovery, while ANOVA and ANCOVA models were used to compare energy recovery and congruity across the three time points. Gender, BMI, and age at surgery had no effect in this study. TAA improved walking speed (p = 0.001), increased energy recovery (p = 0.020), and decreased congruity (p = 0.002), and these levels were maintained over at least two years. Differences in congruity were independent of walking speed. In some patients, especially those who are severely debilitated by ankle arthritis, TAA is effective in restoring mechanical energy recovery to levels similar to an asymptomatic population of a similar age recorded by other studies.

Pandemia de COVID-19: Sono e fadiga em profissionais da saúde mental

Abstract Objective To analyze the relationship between fatigue and sleep quality in mental health professionals during the COVID-19 pandemic. Method This cross-sectional and correlational study was carried out between October 2021 and July 2022 with professionals from mental health services in Rio Grande do Sul, Brazil. Socio-occupational and health questionnaires, the Pittsburgh Sleep Quality Index and the Fatigue Assessment Scale were used. The analysis was descriptive and analytical, and chi-square, Fischer’s exact, Spearman’s correlation and logistic binary regression analysis (5% significance level) were used. Results A total of 141 professionals took part, with a prevalence of poor sleep quality and high fatigue. Poor sleep quality was associated with sick leave in the last six months (p=0.023), tiredness at the end of the working day (p=0.011), health treatment (p=0.012) and fatigue (p=0.006). High fatigue was associated with feeling tired at the end of the working day (p=0.017). Multivariate models showed that professionals with high fatigue and frequent and/or constant tiredness were twice as likely to have poor sleep quality. Conclusion Fatigue and sleep quality are significantly associated, with a greater chance of poor sleep quality among those with high levels of fatigue. Strategies to reduce work overload, improve sleep quality and promote a healthy environment are recommended.

The Impact of Parental Stress among the Quality of Life of mothers of children with Autism Spectrum Disorder and Down Syndrome

For most parents, the birth of their child is a reason for joy because the child is the center of their Universe. He is light, hope, smile, change, and future. Raising a child with a disability can have a profound impact on the family. This causes great stress for parents, especially for the mother. Prolonged stress negatively influences their quality of life, causing health problems and having a high level of fatigue, anxiety, and depression. This research aimed to investigate the level of parental stress among mothers of children with autism spectrum disorder respectively, among mothers of children with Down syndrome. The results of this study demonstrated significant differences regarding the measured variables among mothers of children with ASD and Down syndrome. Regarding coping mechanisms, mothers of children with ASD use religious coping more frequently compared to mothers of children with Down syndrome, who use the following coping mechanisms: active coping, planning, seeking instrumental support, seeking emotional support, acceptance, mental disengagement, and venting. Additionally, the level of parental stress is higher among mothers of children with ASD, and their quality of life is lower; the tendency of social isolation is at a fairly high level.

Correlation of Work Fatigue and Mental Workload in Train Drivers: A Cross-sectional Study.

Evidence suggests that train drivers experience a high level of fatigue and mental workload. The present study aimed to assess overall, physical, and mental fatigue levels and their correlations with the mental workload in the metro train operation. Study Design: A cross-sectional study. This study was conducted on all 1194 train drivers in the Tehran Metro. The train drivers completed the Samn-Perelli Fatigue Scale and the Fatigue Assessment Scales at the beginning and end of the shift. In addition, they completed the National Aeronautics and Space Administration Task Load Index in the middle and at the end of the shift. Correlation and regression analyses were performed on the data to test the study hypothesis. Overall, physical, and mental fatigue levels increased significantly at the end of the shift compared to the onset of the shift (P<0.001). The mental workload and related dimensions were significantly increased at the end of the shift compared to the middle of the shift (P<0.001). Mental demand was the most important workload problem among the train drivers. The highest correlation was found between overall workload and time pressure (R=0.68, P<0.001). The mental workload had a significant correlation with work fatigue in the train drivers. Control measures should be focused on the mental workload and related dimensions, especially mental demand and time pressure.