Higher Levels Of Fatigue Research Articles

Lockdown fatigue among the university students at Nueva Ecija during the COVID-19 pandemic

One of the control measures to stop the transmission of COVID-19 was the implementation of a lockdown. However, after a few months of lockdown, previous research has found significant evidence of lockdown-related fatigue. Hence, the current study aimed to determine the lockdown fatigue of the students. A descriptive research design and total sampling were used. A questionnaire was developed to collect data about the sex and monthly income of the respondents and their level of lockdown fatigue and feelings after the lockdown. Permission to conduct and informed consent were obtained. Data were analyzed using various statistical tools. A total of 629 respondents participated in the study. Many of them were female and had a monthly income less than P11,690. Most of them had a moderate to high level of lockdown fatigue, and the difference in their profile was insignificant. After the lockdown period, they sometimes felt powerless, stressed, and angry, their problems were getting worse, and something unexpected would happen. Last, their feelings and lockdown fatigue level, after lockdown, had a significant positive relationship. Further studies regarding the efficacy and effectiveness of lockdowns, as well as any restriction that may jeopardize students’ health should be continually assessed by government authorities.

Factors influencing burnout among Korean nurses caring for patients with COVID-19: a cross-sectional study

Purpose: The purpose of this study was to investigate the levels of fatigue, social support, and burnout among nurses caring for coronavirus disease 2019 (COVID-19) patients, and to identify factors that affect burnout. Methods: Data were collected from 115 nurses who were caring for COVID-19 patients in Gyeonggi Province and Seoul from December 2021 to February 2022. Results: The mean scores for fatigue, social support, and burnout were 63.31 ± 11.48 (of 95), 48.34 ± 6.97 (of 60), and 81.90 ± 15.50 (of 132) points, respectively. The level of burnout of nurses caring for patients with COVID-19 was high. Fatigue (β = .49, p < .001) and social support (β = -.21, p = .012) were significantly associated with burnout. Conclusion: Higher levels of fatigue and lower levels of social support were associated with higher levels of burnout. Reducing fatigue among nurses and strengthening their social support can be a strategy to reduce nurse burnout.

Message Fatigue and COVID-19 Vaccine Booster Uptake in the United States

Dissemination of public health information plays an essential role in communicable disease control and prevention. However, widespread and repeated messaging could become counterproductive if it leads to avoidance and disengagement due to message fatigue. Americans have been inundated with accurate and inaccurate COVID-19 information from myriad sources since the start of the pandemic. Using the health belief model (HBM) as a guiding framework, this study examines COVID-19-related message fatigue among adults in the United States who have gotten at least one dose of a COVID-19 vaccine and the association between message fatigue and COVID-19 booster uptake and intentions. A special survey module of The COVID States Project was fielded between August and September 2022 (n = 16,546). Results showed moderately high levels of message fatigue among vaccinated individuals. Message fatigue was negatively associated with the likelihood of having gotten a COVID-19 booster and intentions to do so among those who had not yet received a booster, above and beyond variance explained by the HBM constructs. These findings underscore the importance of monitoring and mitigating COVID-19-related message fatigue in encouraging the public to stay up to date with COVID-19 vaccination.

Circulating Mitochondrial DNA Is Associated With High Levels of Fatigue in Two Independent Sarcoidosis Cohorts

Patients with sarcoidosis who develop severe clinical phenotypes of pulmonary fibrosis or multiorgan disease experience debilitating symptoms, with fatigue being a common chief complaint. Studies that have investigated this patient-related outcome measure (PROM) have used the Fatigue Assessment Scale (FAS), a self-reported questionnaire that reflects mental and physical domains. Despite extensive work, its cause is unknown and treatment options remain limited. Previously, we showed that the plasma of patients with sarcoidosis with extrapulmonary disease endorsing fatigue was enriched for mitochondrial DNA (mtDNA), a ligand for the innate immune receptor toll-like receptor 9 (TLR9). Through our cross-disciplinary platform, we investigated a relationship between sarcoidosis-induced fatigue and circulating mtDNA. Is there a psychobiologic mechanism that connects sarcoidosis-induced fatigue and mtDNA-mediated TLR9 activation? Using a local cohort of patients at Yale (discovery cohort) and the National Institutes of Health-sponsored Genomic Research in Alpha-1 Antitrypsin Deficiency and Sarcoidosis study (validation cohort), we scored the FAS and quantified in the plasma, mtDNA concentrations, TLR9 activation, and cytokine levels. Although FAS scores were independent of corticosteroid use and Scadding stage, we observed a robust association between FAS scores, which included mental and physical domains, and multiorgan sarcoidosis. Subsequently, we identified a significant correlation between plasma mtDNA concentrations and all domains of fatigue. Additionally, we found that TLR9 activation is associated with all aspects of the FAS and partially mediates this PROM through mtDNA. Last, we found that TLR9-associated soluble mediators in the plasma are independent of all facets of fatigue. Through our cross-disciplinary translational platform, we identified a previously unrecognized psychobiologic connection between sarcoidosis-induced fatigue and circulating mtDNA concentrations. Mechanistic work that investigates the contribution of mtDNA-mediated innate immune activation in this PROM and clinical studies with prospective cohorts has the potential to catalyze novel therapeutic strategies for this patient population and those with similar conditions.

Staff Turnover Intention at Long-Term Care Facilities: Implications of Resident Aggression, Burnout, and Fatigue

ObjectivesStaff shortages and the high turnover rate of nursing assistants pose great challenges to long-term care. This study examined the effects of aggression from residents of long-term care facilities, burnout, and fatigue on staff turnover intention. The findings will help managers to devise effective measures to retain their staff. DesignCross-sectional descriptive study design. Setting and ParticipantsA total of 800 nursing assistants were recruited from 70 long-term care facilities using convenience sampling. MethodsThe participants were individually interviewed and provided information about their turnover intention, resident aggression witnessed and experienced, self-efficacy, neuroticism, burnout, fatigue, and personal and facility characteristics. ResultsHierarchical multiple regression analysis revealed that the size and organizational practices of long-term care facilities were not associated with staff turnover intention. Staff who spent less time in the industry reported witnessing resident-to-resident aggression, experienced resident-to-staff aggression, reported high levels of burnout, had acute or chronic fatigue, and had low levels of inter-shift recovery were more likely than others to report a high turnover intention. Conclusions and ImplicationsStaff turnover poses great challenges to staff, residents, and organizations. This study identified important factors that may help support staff in long-term care facilities. Specific measures, such as person-centered care to diminish resident aggression by addressing residents’ unmet needs, work-directed programs to mitigate burnout and improve staff mental health, and flexible schedules to prevent fatigue should also be advocated to prevent staff turnover.

Impact of itch on quality of life in people with primary biliary cholangitis: A plain language summary

What is this summary about? This is a summary of an article about people with primary biliary cholangitis (PBC) who also suffer from itch. PBC is a disease that affects the liver; itching is common in PBC and can dramatically reduce a person's quality of life. People in a study called TARGET-PBC filled in surveys about their PBC symptoms, including itching, and the effects the symptoms had on their lives. Information was also collected on the medications people were taking for their PBC and itch. What were the results? Out of 211 people with PBC who filled in the surveys, 170 (81%) had itching. More than one-third of them (37%) had itch that was clinically significant. Clinically significant itch has been defined as an itch that sometimes affects a person's sleep, makes them scratch until their skin is raw, or causes embarrassment. These people would benefit from a discussion about treatment options. Clinically significant itch was linked with worse scores on the surveys, meaning poorer quality of life. This link was true for all areas looked at, but particularly for social aspects and cognition, such as memory and concentration. Sleep was affected in most people with clinically significant itch and there were high levels of fatigue. People with clinically significant itch were more likely to be taking anti-itch medication compared with those with mild itch, but onethird of them still had not received any treatment for itch. When itch medication was used, the stepwise guidelines suggested by specialty professional societies was not usually followed. What do the results mean? Itching is problematic for the people in this study. Those with clinically significant itch have a worse quality of life compared with those with mild itch and this affects all areas of their life measured. The study also shows that people do not always receive medication for their itch, and that treatment guidelines are not always followed.

Literature Review of Burnout Syndrome in Intensive Care Unit (ICU) Staffs During The COVID-19 Pandemic

Introductions: Burnout syndrome becomes a special concern for health workers during COVID-19 pandemic that has been exposed to increased workload and intense working hours with COVID-19 patients, stating having a high risk of getting infected with COVID-19 as well. Methods: This literature review paper reviewed scientific journals with prevalence and burnout syndrome profile data. The journals were obtained through the search engines GoogleScholar, the MEDLINE (PubMed) database and PsychINFO. From the search, there are 13 articles in total that meet the required data criteria. Results: Prevalence of burnout syndrome were found severely high in ICU settings, it reached more than 50% from most of the survey. Burnout syndrome rate can be influenced by working conditions, age and gender, time of work and working experience. Burnout syndrome can manifest as higher fatigue level and decrease of cognitive function that can increase the risk of medical mistake. Conclusions: High prevalence and severity of burnout syndrome oblige us to pay attention to symptoms that can affect professional intensive care unit staff and its service to patients. Further research should review prevention therapy and how to apply to health workers and also the prevalence of prevention that has been done in other studies.

Associations between patient reported fatigue and remotely monitored activity in patients with prostate cancer receiving androgen deprivation therapy.

593 Background: Androgen deprivation therapy (ADT) is commonly used for the management of prostate cancer (PCa). Despite its benefits, ADT can lead to a range of side effects that have prominent determents on patient quality of life, specifically fatigue. Fatigue is a multidimensional symptom that influences a patient’s psychological and physical well-being, including the inability to perform daily activities due to lack of energy. This analysis evaluates associations between patient-reported fatigue and remotely monitored objective activity in PCa patients. Methods: This is a secondary analysis ofa multi-site observational cohort study (DigiPRO) among men diagnosed with advanced PCa, initiating ADT within 6 months, conducted between 12/2020 and 4/2023. Eligible patients wore an activity monitor (Fitbit Charge HR 4) continuously for the 12-week study and completed NIH PROMIS fatigue surveys via REDCap, which included Likert-scale questions (8 items, range 1-5 (worse)) about fatigue severity and interference, at baseline, 4, 8, and 12 weeks. PROMIS scores were converted to standardized T-scores (mean 50: SD: 10). Pearson correlation coefficients were calculated, and multivariable logistic regression models were fit to evaluate associations between activity and fatigue T-scores. Results: 40 patients were included in the analysis (median age: 70 yrs, range 51-85; 37% Black or African American/63% White, 10% Hispanic/90% non-Hispanic White). 11 patients reported high levels of fatigue (T-Score>60) at least once over the course of the study and 20% of patients experienced an increase > 5 T-score points from baseline, indicating clinically meaningful deterioration. Higher fatigue T-scores were negatively correlated with higher daily step counts (r=-0.6, p=0.003) and calories expended (r=-0.5, p=0.002) and positively correlated with increased sedentary time (r=0.5, p=0.002) at baseline. Lower baseline step counts were significantly associated with any occurrence of worsening patient fatigue over the study period (OR: 2.08, 95% CI 1.12-3.8, per 1000 step decrease, p=0.02) after adjusting for age and race. Patients who reported worsening fatigue had a mean step count of 3,426 compared to 5,664 steps/day among those who reported stable or improving fatigue (p=0.02). Conclusions: Findings from this analysis suggest that objective measures of daily activityare correlated with patient-reported fatigue and predict worsening fatigue over time. Routine collection and monitoring of patient-reported fatigue and daily activity during ADT may help identify patients at increased risk for worsening fatigue. More research is needed to determine the role of wearable activity monitors as potential interventions and for real time monitoring to help manage fatigue and other symptoms during ADT. Clinical trial information: NCT04575402 .

Predictors of Dizziness and Hearing Disorders in People with Long COVID.

Background and Objectives: Individuals report persistent symptoms after becoming infected by SARS-CoV-2 (COVID-19) that last for >4 weeks (long-COVID syndrome). Dizziness and hearing loss have been reported among long-COVID symptoms. However, little is known about the potential predictors of dizziness and hearing loss in individuals with long COVID. This study aimed to explore the presence and correlates of dizziness and hearing loss in a sample of people with long-COVID syndrome. Materials and Methods: Individuals aged 18 years and older who were infected with COVID-19 at least 8 weeks prior to the start of the study were included if they were not diagnosed with dizziness or hearing loss before getting COVID-19. Demographics and COVID-19-related information were collected. Participants completed the Dizziness Handicap Inventory (DHI), Activities-Specific Balance Confidence (ABC) scale, Falls Efficacy Scale International (FES-I), Modified Fatigue Impact Scale (MFIS), and Medical Outcomes Study Short Form 12 (SF-12). Finally, hearing was assessed using pure-tone audiometry (PTA) in a subsample. Results: Two hundred and nine individuals (66% female) with a mean (SD) age of 27 (9) participated in the study. Perceived dizziness and hearing loss were reported in 26 and 15.3% of the sample, respectively. Logistic regression was conducted to identify potential predictors of dizziness and hearing loss separately. After controlling for age and severity of dizziness, female sex and high fatigue severity were associated with an increased likelihood of reporting dizziness (R2 = 31%). The severity of dizziness and neurological symptoms during the acute stage of COVID-19 were associated with an increased likelihood of reporting hearing loss (R2 = 10.4%) after controlling for age. Conclusions: Dizziness and hearing loss present in long COVID and can be disabling. Females with high levels of fatigue should be questioned about persistent dizziness. Hearing loss should be considered in individuals with neurological symptoms and severe dizziness as a consequence of long COVID.

Sleep quality assessment in emergency health professionals

Objective To assess emergency service professionals’ sleep quality and its association with the level of fatigue and quality of life. Methods A descriptive, cross-sectional and correlational study, carried out in the units of the Mobile Emergency Care Service (SAMU) and in the Emergency Care Unit (ECU), in 2021, with 108 participants. To assess sleep quality, the Pittsburgh Sleep Quality Index, Brazilian version (PSQI-BR), was used; to assess fatigue, the Chalder Fatigue Scale was used, together with the Need for Recovery Scale (NFR); and to assess quality of life, the World Health Organization Quality of Life Brief Version (WHOQOL-bref) was used, and the instruments used were adapted to Portuguese in previous studies. Association tests were applied for statistical analysis, using Pearson’s chi-square test, Mann-Whitney U test or Kruskal Wallis and Spearman’s correlation. P-values <0.05 were considered significant. Results It was identified that 72.2% of participants had poor sleep quality and 75.9% were fatigued. A significant association was observed between sleep quality and fatigue, the need for recovery and quality of life. Conclusion It was identified that health professionals working in emergency services have poor sleep quality and life, and high levels of fatigue and need for recovery, which can directly impact their personal and professional activities.

The Effects of Organizational Characteristics, Individual Nurse Characteristics, and Occupational Fatigue on Missed Care at Night.

Missed care is defined as the omission or delay of necessary patient care and is internationally reported by nurses as a significant safety risk. Nurses working at night also report high levels of occupational fatigue that, coupled with inadequate staffing and practice environment support, may impede a nurse's ability to carry out the nursing process and lead to more missed care. The study's objective was to examine the interrelationships among organizational and nurse characteristics, occupational fatigue, and missed care among nurses working at night. A cross-sectional design was used. Participants included registered nurses (RNs) who worked at night in New Jersey acute care hospitals. Multiple linear regression and simple moderation analyses were performed to examine the associations. Nurses reported missing necessary care at night. Unsupportive practice environments, high RN workloads, high patient-RN ratios, high chronic fatigue levels, and low intershift recovery were individually associated with missed care at night. High patient-to-RN ratios and chronic fatigue were independently associated with missed care. However, patient-to-registered-staffing levels had the most considerable effect on missed care at night. Nurses' years of experience and the number of hours of sleep between shifts were significant moderators of the relationship between occupational fatigue states and missed care. This study is the first to examine the interrelationship between occupational fatigue levels, organizational and nurse characteristics, and missed care at night. There is an urgent need to implement strategies in hospital organizations that foster work schedules and adequate staffing patterns that lessen nurses' occupational fatigue levels to ensure our workforce's and patients' safety.

A - 120 Fatigue Moderates the Relationship between Negative Attributional Style and Depression Symptoms in Multiple Sclerosis.

To investigate whether fatigue moderates the relationship between negative attributional style and depression symptoms in persons with Multiple Sclerosis (PwMS). Forty-seven PwMS (39 Female) completed a comprehensive neuropsychological test battery and psychosocial questionnaires. The Attributional Style Questionnaire was utilized to create internal, stable, and global attribution dimension scores, and an overall attributional style score combining the three dimensions. Overall, physical, psychosocial, and cognitive fatigue were measured using the Fatigue Impact Scale (FIS). The Beck Depression Inventory-Fast Screen was used to measure depression symptoms. Separate regressions with depression symptoms as the outcome were conducted with attributional style, each type of fatigue, and their interactions included as predictors. Regression analyses revealed that the interaction between attributional style and overall fatigue significantly predicted depression symptoms (p = 0.049). Simple effects tests showed that overall attributional style significantly predicted depression symptoms when overall fatigue was high (p = 0.008). The interactions between attributional style and both physical fatigue (p = 0.003) and psychosocial fatigue (p = 0.039) also significantly predicted depression symptoms. Simple effects tests showed that attributional style was associated with depression symptoms only in PwMS with high physical fatigue (p < 0.001) and high psychosocial fatigue (p = 0.018). Fatigue moderated the relationship between overall attributional style and depression symptoms in PwMS. Specifically, attributional style was only significantly associated with depression symptoms in PwMS reporting high levels of overall, physical, and psychosocial fatigue. Interventions aimed at targeting fatigue may reduce the risk that negative attributional style will lead to depressive symptoms in MS.

The cross-cutting edge: Medical selection and education viewed through the lens of emotional intelligence.

Evidence suggesting the benefits of compassionate, person-centred care, for both patients and physicians is accruing. Medical selection, for example, aims to choose future health professionals that possess the correct attitudes, beliefs and personal attributes to deliver such care. Moreover, once in training, these desirable personal qualities should be developed and maintained, sometimes in the face of adverse health care service conditions. However, advances in selecting for, and developing, these abilities and attributes in health care have been hindered by a lack of clarity regarding how the relevant skills and traits should be defined, measured, developed and maintained in clinicians. In this article, we demonstrate how developments in the emotional intelligence (EI) field can be applied to the challenge of selecting for, and developing, relevant interpersonal care skills in medical students and physicians. The concept of EI itself has been somewhat controversial. However, a more nuanced understanding of EI has evolved in the light of research findings that can be applied to medical selection and education. Specifically, we propose modifications to the existing 'cascading' model of EI. This model identifies, and relates, several key socioemotional skills and traits that could be considered as 'the elementary particles' of EI required to deliver compassionate, person-centred care. Our model of EI, which is relevant to care delivery, identifies putative targets for both medical selection and training. Selection for medical school and subsequent clinical education should focus on screening out those with low levels of the traits and abilities less amenable to training. Conversely, medical education should be concerned with developing and maintaining the socioemotional skills, attitudes and behaviours critical to the delivery of compassionate, person-centred care. This is especially important for specialties characterised by high levels of emotional labour and possible resultant compassion fatigue.

Correlation of fatigue with disability and accelerometer-measured daily physical activity in patients with relapsing-remitting MS.

Fatigue is one of the most common symptoms in patients with multiple sclerosis (MS). Furthermore, measuring its effects on patients in daily life is challenging. This study aimed to discover the association between relapsing-remitting MS (RRMS) patients' disability, fatigue, and accelerometer-measured physical activity. A total of 41 patients with RRMS with an Expanded Disability Status Scale (EDSS) level of 0-5.5 and 20 healthy controls completed the Modified Fatigue Impact Scale (MFIS) and the Fatigue Severity Scale (FSS) questionnaires. The EDSS was evaluated for all patients with RRMS, and all participants performed the MS Functional Composite (MSFC) test and six-min walk test and wore an accelerometer for seven days. Patients with an EDSS level of 0-2.5 were found to have higher fatigue levels (p < 0.001) than healthy controls but lower levels than patients with an EDSS level of 3-5.5 (p < 0.001). A significant correlation was found to exist between fatigue and disability level measured by the EDSS (EDSS/FSS, r=0.750/p=0.001; EDSS/MFIS, r=0.661/p=0.001) and with the MSFC test in the patient group (MSFC/FSS, r=-0.350 p=0.025; MSFC/MFIS, r=-0.423/p=0.007). Total daily activity correlated with fatigue as measured by the FSS (MVPS/FSS r=-0.357/p=0.028, step count/FSS r=-0.463/p=0.003), but no correlation was found between the EDSS or the MSFC. A lower disability rate, better physical condition, and higher daily-living activity were found to predict lower fatigue levels.

Prehabilitation in Radiation Therapy: A Scoping Review

Radiation therapy (RT) is a central component of cancer treatment with survival and long-term quality-of-life benefits across a spectrum of oncologic diagnoses. However, for certain cancers, RT has been associated with high levels of fatigue, pain, weight loss, and changes in mental health both during and post-treatment. Prehabilitation aims to optimize health prior to anti-neoplastic therapy in order to reduce complications, increase adherence to treatment, expedite posttreatment recovery, and improve long-term outcomes. Though prehabilitation has been studied in those undergoing cancer-related surgery, literature on prehabilitation in individuals undergoing RT has not been comprehensively explored. Thus, this scoping review aims to summarize the existing literature focused on prehabilitation interventions for patients receiving RT. The PRISMA-ScR checklist for conducting scoping reviews was adopted to identify and evaluate studies investigating the efficacy of prehabilitation before and during RT for cancer over the past 21 years (10/2002-10/2022). A search of prehabilitation and RT was performed to identify studies investigating prehabilitation interventions in adult cancer patients before or during RT. A total of 31 articles met inclusion criteria, yielding 4,031 total participants. Nineteen (61%) studies were randomized controlled trials with sample sizes ranging from 26-221. The most commonly studied populations were patients with head and neck cancer, followed by rectal, breast, and lung cancer. A majority (87%) of studies evaluated one prehabilitation intervention (i.e., unimodal). Targeted exercises were the most common intervention, followed by general exercises and technology/apps. Adherence/feasibility was the most common primary outcome, representing 23% of studies. All studies collected data on sex, and six (19%) studies collected data on race and/or ethnicity. Prehabilitation interventions have been successfully implemented in samples of patients with cancer undergoing surgical treatment. Studies demonstrating the efficacy of prehabilitation in RT are evolving. Though our review identified many RCTs, they were frequently small trials with primary outcomes focused on feasibility, rather than functional status. Thus, there is a need for adequately powered, randomized controlled intervention trials to investigate the efficacy of prehabilitation in RT.

Burnout and fatigue amongst internal medicine residents: A cross-sectional study on the impact of alternative scheduling models on resident wellness.

Fatigue and burnout are prevalent among resident physicians across Canada. Shifts exceeding 24 hours are commonly purported as detrimental to resident health and performance. Residency training programs have employed strategies towards understanding and intervening upon the complex issue of resident fatigue, where alternative resident scheduling models have been an area of active investigation. This study sought to characterize drivers and outcomes of fatigue and burnout amongst internal medicine residents across different scheduling models. We conducted cross-sectional surveys were among internal medicine resident physicians at the University of Alberta. We collected anonymized socioeconomic demographics and medical education background, and estimated associations between demographic or work characteristics and fatigue and burnout outcomes. Sixty-nine participants competed burnout questionnaires, and 165 fatigue questionnaires were completed (response rate of 48%). The overall prevalence of burnout was 58%. Lower burnout prevalence was noted among respondents with dependent(s) (p = 0.048), who identified as a racial minority (p = 0.018), or completed their medical degree internationally (p = 0.006). The 1-in-4 model was associated with the highest levels of fatigue, reported increased risk towards personal health (OR 4.98, 95%CI 1.77-13.99) and occupational or household harm (OR 5.69, 95%CI 1.87-17.3). Alternative scheduling models were not associated with these hazards. The 1-in-4 scheduling model was associated with high rates of resident physician fatigue, and alternative scheduling models were associated with less fatigue. Protective factors against fatigue are best characterized as strong social supports outside the workplace. Further studies are needed to characterize the impacts of alternative scheduling models on resident education and patient safety.

The Effects of Dialysis Modality and Emotional Distress on Fatigue in Patients Undergoing Dialysis

Introduction: Fatigue is a common but often overlooked symptom in dialysis patients. Factors affecting fatigue in dialysis patients are currently unclear. There are few studies on the effects of mental factors and dialysis modality on fatigue. This study aims to explore the potential relationship between fatigue and insomnia, as well as psychiatric disorders such as anxiety and depression among patients who undergo peritoneal dialysis (PD) or hemodialysis (HD). Methods: There were 96 HD patients and 160 PD patients at our hospital who voluntarily participated in the survey. A questionnaire survey was conducted to gather general characteristics of the patients and to evaluate fatigue, sleep quality, anxiety, and depression levels among PD and HD patients. Results: The overall fatigue score was 53.83 ± 14.22 for the PD group and 57.92 ± 16.35 for the HD group. Notably, the fatigue level was lower in the PD group compared to the HD group (p < 0.05). Univariate analysis indicated that fatigue was associated with occupational status and income in the PD group, as well as educational level and income in the HD group (p < 0.05). Correlation analysis revealed that patients in both groups who were older and had higher scores for insomnia, anxiety, and depression experienced more severe fatigue. Moreover, body mass index was positively correlated with fatigue status in the PD group, while duration of dialysis showed a positive association with fatigue in the HD group. Multivariate regression analysis identified income and depression as major factors influencing fatigue in the PD group, and duration of dialysis, income, and depression in the HD group. Conclusion: Patients who undergo dialysis exhibit high levels of fatigue, with the severity of fatigue being less pronounced in the PD group compared to the HD group. Fatigue in these patients is associated with the duration of dialysis, income level, and presence of depression.

The Assessment of Post-COVID Fatigue and Its Relationship to the Severity and Duration of Acute COVID Illness.

Emerging data suggests that COVID-19 is associated with fatigue well beyond the acute illness period. The present analysis aimed to: (1) characterize the prevalence and incidence of high fatigue at baseline and follow-up; (2) examine the impact of COVID-19 diagnosis on fatigue level following acute illness; and (3) examine the impact of acute COVID-19 symptom severity and duration on fatigue at follow-up. Subjects (n = 1417; 81.0% female; 83.3% White; X¯age = 43.6 years) completed the PROMIS-Fatigue during the initial wave of the pandemic at baseline (April-June 2020) and 9-month follow-up (January-March 2021). A generalized linear model (binomial distribution) was used to examine whether COVID-19 positivity, severity, and duration were associated with higher fatigue level at follow-up. Prevalence of high fatigue at baseline was 21.88% and 22.16% at follow-up, with 8.12% new cases at follow-up. Testing positive for COVID-19 was significantly associated with higher fatigue at follow-up. COVID-19 symptom duration and severity were significantly associated with increased fatigue at follow-up. COVID-19 symptom duration and severity during acute illness may precipitate longer-term fatigue, which could have implications for treatment planning and future research. Future studies should further evaluate the relationship between symptom severity, duration, and fatigue.

How much can we improve two-section watch bills? Sleepiness, Fatigue, and Psychomoter Vigilance Performance during naval operations in the 6/6 and 7-5-5-7 watch bills

A traditional two-section watch bill (6 hours on / 6 hours off, starting at midnight – “6/6”) and a two-section watch bill better adapted to the human circadian rhythm (watches of 7, 5, 5, and 7 hours duration, starting at 3 a.m. – “7-5-5-7”) were trialed on two vessels of the German Navy with 67 study participants in a crossover design. Questionnaires were used to assess subjective sleepiness (ESS, KSS) and subjective fatigue (FSS). The psychomotor vigilance task (PVT) was self-administered with wearable devices before and after each watch. Over the course of seven days at sea, PVT performance worsened significantly with the 6/6, but not with the 7-5-5-7 watch bill. In the 6/6 watch bill, number of participants with excessive sleepiness and high levels of fatigue was higher than in the 7-5-5-7 watch bill although not at a statistically significant level. Marked differences between watch bills in crew performance started to emerge after 6 days.

Patients with persistent symptoms after COVID-19 attending a multidisciplinary evaluation: Characteristics, medical conclusions, and satisfaction

ObjectiveAmong patients attending a multidisciplinary day-hospital program for persistent symptoms after COVID-19, we aimed i) to describe their characteristics ii) to present the medical conclusions (diagnoses and recommendations) and iii) to assess the patients' satisfaction and its correlates. MethodsFor this retrospective chart review study, frequent symptoms were systematically assessed. Standardized questionnaires explored fatigue (Pichot scale), physical activity (Ricci & Gagnon scale), health-related quality of life (Short-Form Health Survey), anxiety and depressive symptoms (Hospital Anxiety and Depression scale) and associated psychological burden (Somatic-Symptom-Disorder B criteria Scale). Medical record conclusions were collected and a satisfaction survey was performed at 3-months follow-up. ResultsAmong 286 consecutive patients (median age: 44 years; 70% women), the most frequent symptoms were fatigue (86%), breathlessness (65%), joint/muscular pain (61%) and cognitive dysfunction (58%), with a median duration of 429 days (Inter-quartile range (IqR): 216–624). Questionnaires revealed low levels of physical activity and quality of life, and high levels of fatigue, anxiety, depression, and psychological burden, with 32% and 23% meeting the diagnostic criteria for a depressive or anxiety disorder, respectively. Positive arguments for a functional somatic disorder were found in 76% of patients, including 96% with no abnormal clinical or test findings that may explain the symptoms. Physical activity rehabilitation was recommended for 91% of patients. Patients' median satisfaction was 8/10 (IqR: 6–9). ConclusionMost patients attending this program presented with long-lasting symptoms and severe quality of life impairment, received a diagnosis of functional somatic disorder, and reported high levels of satisfaction regarding the program.