Lower Levels Of Fatigue Research Articles

Understanding the interplay of compassion fatigue and moral resilience on moral distress in ICU nurses: a cross-sectional study

BackgroundIntensive Care Unit (ICU) nurses frequently confront significant psychological challenges, including compassion fatigue, moral distress, and diminished moral resilience. These issues not only affect their well-being but also impact the quality of care provided to patients. The interplay of these factors is complex and not fully understood, particularly how compassion fatigue influences the relationship between moral resilience and moral distress.ObjectivesTo explore the complex interplay between compassion fatigue and moral distress among ICU nurses, and to elucidate how compassion fatigue influences the protective role of moral resilience against moral distress.Research designA cross-sectional study was conducted using a nationwide random sample of ICU nurses in China. Latent profile analysis identified subgroups based on levels of compassion fatigue. Moderation analysis examined whether compassion fatigue moderated the association between moral resilience and moral distress.ResultsAmong 612 ICU nurses, latent profile analysis revealed three distinct groups with high, moderate, and low levels of compassion fatigue. Being female was protective against high compassion fatigue, while ages 30–49 yrs., lack of bachelor’s degree, and dissatisfaction with salary increased compassion fatigue risk. Moderation analysis showed compassion fatigue significantly moderated the relationship between moral resilience and moral distress. Nurses with higher compassion fatigue exhibited a stronger association between low moral resilience and high moral distress.ConclusionCompassion fatigue and moral distress are interconnected phenomena among ICU nurses. Demographic factors like gender, age, education, and income satisfaction impact compassion fatigue risk. High compassion fatigue impairs moral resilience, exacerbating moral distress. Comprehensive interventions targeting both compassion fatigue and moral resilience, tailored to nurses’ demographic profiles, are needed to support this workforce.

A - 82 Differences in Cognitive Effort-Based Decision Making between Younger and Older Adults

Abstract Objective Goal-directed decision-making relies on age-dependent reward processing. Current measures of motivation have yet to be validated for use among older adults (OA). This study aimed to compare the performance of younger adults (YA) and OAs on an objective effort-based decision-making behavioral task. Method Thirty-five YAs (21.9 ± 3.6 years of age) and thirty-five OAs (68.4 ± 8.5 years of age) completed a cognitive screening measure, self-report questionnaires assessing mood/motivation, and a computerized game in which individuals can choose to expend greater effort for larger reward that vary in magnitude and probability. Performance parameters were compared across groups. Results YAs displayed a greater willingness to exert effort for reward. YAs had faster decision-making time when compared to OAs, except conditions when the magnitude and probability for reward was lower. OA’s task difficulty selection was significantly influenced by the magnitude and probability for reward, as well as by previous trial outcomes. This behavior was not observed in YAs who were not sensitive to the magnitude of reward. Moreover, in OAs, lower levels of fatigue were correlated with expending greater effort in some reward probability conditions. Lower levels of apathy were also correlated with expending greater effort after following a small win. Conclusion(s) This study revealed preliminary evidence supporting the motivation task could recognize subtle motivational deficits and was well tolerated by YA and OAs. The measure was applicable in the context of age-related limitations. Our findings contribute to the existing body of research aimed at developing tools to accurately measure motivation levels among OAs.

Subjective, but not objective, language functions predict fatigue in patients with lower-grade gliomas during longitudinal follow-up

Purpose To investigate the course of fatigue, subjective and objective language functions in patients with lower-grade gliomas during the first year of disease. Further, to examine if subjective and objective language variables predicted ratings of fatigue. Methods Fatigue was assessed with the Fatigue Severity Scale, subjective language with self-reported word-finding, expression of thoughts, reading and writing from the Functional Assessment of Cancer Therapy – Brain, and objective language with standardized tests. Mixed models were used to investigate changes in variables over time and predictors of fatigue. Results Twenty-three patients with gliomas (WHO 1–3) were included. Average ratings of fatigue did not change significantly, but altering patterns were observed. Subjective concerns about word-finding and expression of thoughts increased significantly during follow-up. The regression analyses showed that concerns about abilities to read and write significantly predicted fatigue. The results indicated that less concerns about reading and writing were associated with lower levels of fatigue. Conclusions Patients with lower-grade gliomas report fatigue and language concerns throughout the first year. Concerns about reading and writing call for careful consideration as they seem to provoke fatigue. The findings underline the importance of the patients’ perspective in treatment and follow-up.

Evidence of aberrant anti-epstein-barr virus antibody response, though no viral reactivation, in people with post-stroke fatigue

BackgroundFatigue is a common complication of stroke that has a significant impact on quality of life. The biological mechanisms that underly post-stroke fatigue are currently unclear, however, reactivation of latent viruses and their impact on systemic immune function have been increasingly reported in other conditions where fatigue is a predominant symptom. Epstein-Barr virus (EBV) in particular has been associated with fatigue, including in long-COVID and myalgic encephalomyelitis/chronic fatigue syndrome, but has not yet been explored within the context of stroke.AimsWe performed an exploratory analysis to determine if there is evidence of a relationship between EBV reactivation and post-stroke fatigue.MethodsIn a chronic ischemic stroke cohort (> 5 months post-stroke), we assayed circulating EBV by qPCR and measured the titres of anti-EBV antibodies by ELISA in patients with high fatigue (FACIT-F < 40) and low fatigue (FACIT-F > 41). Statistical analysis between two-groups were performed by t-test when normally distributed according to the Shapiro-Wilk test, by Mann-Whitney test when the data was not normally distributed, and by Fisher’s exact test for categorical data.ResultsWe observed a similar incidence of viral reactivation between people with low versus high levels of post-stroke fatigue (5 of 22 participants (24%) versus 6 of 22 participants (27%)). Although the amount of circulating EBV was similar, we observed an altered circulating anti-EBV antibody profile in participants with high fatigue, with reduced IgM against the Viral Capsid Antigen (2.244 ± 0.926 vs. 3.334 ± 2.68; P = 0.031). Total IgM levels were not different between groups indicating this effect was specific to anti-EBV antibodies (3.23 × 105 ± 4.44 × 104 high fatigue versus 4.60 × 105 ± 9.28 × 104 low fatigue; P = 0.288).ConclusionsThese data indicate that EBV is not more prone to reactivation during chronic stroke recovery in those with post-stroke fatigue. However, the dysregulated antibody response to EBV may be suggestive of viral reactivation at an earlier stage after stroke.

Multidimensional perceived social support: A predictor of fatigue and quality of life in Greek social workers

The present study focuses on the investigation of fatigue, social support, and quality of life that characterizes social workers. A total of 400 social workers with an average age of 39.05 years took part in the research. Most of the recruited subjects were women, single, residents of cities with a population of more than 100,000, and health-care workers. The participants were asked to answer online questionnaires (Fatigue Assessment Scale for fatigue, Multidimensional Scale of Perceived Social Support for Social Support, and General Health Questionnaire 28 for quality of life). From the analysis of the data, it was found that the social workers suffered from low levels of fatigue. Meanwhile, the occurrence of negative symptoms among the subjects was not frequent, with physical symptoms appearing more often than the rest. The study also found that the participants received a high level of support from their environment and more so from their significant others. In conclusion, there is a strong relationship between perceived social support with fatigue level and the quality of life of social workers.

Abstract PO5-12-05: A Retrospective Study of the Rate of Cognitive Impairment and Influencing Factors during Postoperative Endocrine Therapy for Breast Cancer

Abstract Background Although cancer-related cognitive impairment (CRCI) has been gradually recognized, general cognitive function tests such as the MMSE are not sensitive enough to diagnose CRCI. There is also a lack of evidence on the incidence and its response. However, even mild cognitive impairment can have a significant impact on quality of life. In this study, we retrospectively analyzed the prevalence of cognitive impairment in patients undergoing endocrine therapy at our hospital and the factors influencing the symptoms. Subjects 349 patients who continued single-agent postoperative endocrine therapy for at least 6 months between January 1 and October 31, 2022, and who responded to the cognitive dysfunction questionnaire at least once. Data from the cognitive dysfunction items of the endocrine therapy questionnaire administered during the period were used to retrospectively examine the CRCI awareness rate and factors involved. Results and Discussion The patients who were aware of cognitive dysfunction was 170, or 49% of all patients, and univariate analysis showed that age was significantly higher in the group with CRCI, but there were no significant differences in type of endocrine therapy or history of chemotherapy between the groups with and without CRCI. Physical symptoms such as menopausal symptoms (hot flashes and sweats), arthralgia, myalgia, fatigue, depressed mood, and malaise were significantly more frequent in patients with CRCI, which could be considered side effects of endocrine therapy. Risk factors such as low cognitive reserve, low level of education, advanced age, race, depression, fatigue, and anxiety have been reported in the past, and in this study, fatigue, depressed mood, and malaise were found significantly more frequently in patients with cognitive dysfunction. However, the diagnosis of depression and dementia may also be important.Non-pharmacological interventions, especially cognitive rehabilitation and exercise, are expected to be effective in improving symptoms, but there is no certain opinion yet. The limitation of this study is that it was a single-center, retrospective analysis. In addition, it was difficult to evaluate the results over time, including before the start of oral medication, so we are considering conducting a prospective data collection study so that comparisons can be made in the future. Conclusion: This study was a simple screening, based only on subjective symptoms. In recent years, postoperative endocrine therapy has been prolonged to 10 years, and there is a possibility to improve the quality of life of patients by recognizing the possibility of cognitive dysfunction in both providers and patients, and by taking measures that include multiple factors. Citation Format: Akari Murakami, Mayuko Aono, Kaho Utsunomiya, Kumiko Okujima, Kana Takemoto, Megumi Takaoka, Erina Kusakabe, Kana Taguchi, Kanako Nishiyama, Yoshiaki Kamei, Yasutsugu Takada, Hitoshi Tanimukai. A Retrospective Study of the Rate of Cognitive Impairment and Influencing Factors during Postoperative Endocrine Therapy for Breast Cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-12-05.

Emotional Intelligence in Hemodialysis Patients: The Impact of an Intradialytic Exercise Training Program.

The current study aimed to investigate whether there is a relationship between emotional intelligence (EI), functional capacity, fatigue, cognitive function, and quality of life (QoL) in HD patients and to assess the effect of a 9-month intradialytic exercise training program on EI levels. Seventy-eight dialysis patients (50 M/28 F, 60.6 ± 17.2 years) participated in the cross-sectional study. Afterward, a subgroup of 18 patients (15 M/3 F, 56.7 ± 12.3 years) completed a 9-month supervised intradialytic exercise training program (three times weekly). EI was assessed by the Schutte Self Report Emotional Intelligence Test (SSEIT) and the Wong and Law Emotional Intelligence Scale (WLEIS). Functional capacity was assessed by a battery of tests. Sleep quality, depression levels, and daily sleepiness were assessed via validated questionnaires. All assessments were carried out before and after the intervention. A significant positive correlation was found between the WLEIS scores and the physical component summary of the QoL questionnaire. In contrast, the WLEIS scores were negatively associated with general and physical fatigue. The SSEIT scores were positively associated with cognitive function. After nine months of exercise training, only the group with low WLEIS scores improved their EI score significantly compared to the baseline values (98.7 ± 7.0 vs. 73.0 ± 4.0, p = 0.020), while no changes were observed in the medium or high EI groups. In conclusion, patients with higher levels of EI showed increased quality of life and lower levels of fatigue. Patients with low levels of EI are more likely to benefit from an exercise training program compared to their medium- and high-level counterparts.

Treatment fatigue among adult patients with chronic heart failure in a tertiary care hospital in Ethiopia: a mixed-methods study

Background/Aims Patients with heart failure must adhere to strict treatment regimens, including pharmacological treatments, medical appointments and lifestyle modifications. This study aimed to assess the extent of treatment regimen fatigue among patients with heart failure in Ethiopia and identify factors that may exacerbate this. The authors also aimed to gather insights from patients and health professionals about how to ameliorate the impact of treatment regimen fatigue. Methods An explanatory sequential mixed-methods study was conducted at a specialist cardiac clinic in Ethiopia from 1 August to 30 September 2021. In the quantitative stage, the Treatment Regimen Fatigue Scale was delivered via interview to 325 patients with heart failure to collect data on their level of treatment regimen fatigue and analyse this against their demographic, clinical and treatment-related characteristics. The influences of factors on treatment regimen fatigue were tested using the Mann–Whitney U, Kruskal–Wallis and Chi square tests, as appropriate. In the qualitative stage, interviews were conducted with 14 patients with heart failure and 10 specialist health professionals to identify possible interventions to reduce treatment regimen fatigue. Interviews were recorded, transcribed and subject to content analysis to identify themes. Results In the quantitative phase, participants' mean level of treatment regimen fatigue was −48.38±13.1, indicating low levels of fatigue. Several factors had a significant impact on level of treatment regimen fatigue, including living alone (U=7819.5; Z=−3.01; P=0.003); poor knowledge of heart failure (U=4379.0; Z=−4.24; P&lt;0.001); lack of family support (U=6152.5; Z=−4.09; P&lt;0.01); presence of two or more comorbidities (U=11273.5; Z=−2.28; P=0.023); adverse drug effects (U=6990.0; Z=−2.78; P=0.006); poor availability of medications (U=10215.0; Z=−3.43; P=0.001); and reliance on health insurance to obtain medication (X2=7.18; P=0.028). Qualitative results indicated that improving patients' self-care, making changes to the structure of the cardiac clinic (eg more regular follow up with the same clinician) and improving the general healthcare system could reduce treatment regimen fatigue. Conclusions Patients with heart failure seem to experience low levels of treatment regimen fatigue, but this can be influenced by a variety of demographic, clinical and treatment-related factors. Interventions on a local and systemic level could reduce the risk of treatment regimen fatigue, but there is no one-size-fits-all solution.

Association of Fatigue Level and Physical Activity among University Students: A Cross-Sectional Survey

Background: Fatigue is a common complaint among adults worldwide, with an estimated 20% experiencing persistent symptoms. Physical activity is recognized as a beneficial behavior with the potential to alleviate feelings of fatigue and enhance energy levels. However, the relationship between physical activity and fatigue among university students remains underexplored. Objective: This study aimed to assess the association between physical activity levels and fatigue among university students, providing insights into the potential of physical activity as a non-pharmacological intervention for fatigue mitigation. Methods: A descriptive cross-sectional study was conducted at the University of Lahore's Islamabad campus, involving 206 participants aged 17 to 25 years. After securing approval from the Institutional Review Committee (IRC)/Ethical Review Board (ERB), data were collected using the Fatigue Assessment Scale (FAS) and the International Physical Activity Questionnaire (IPAQ). The sample size was determined using the Slovin formula, with a confidence interval of 95% and a margin of error of 0.05. Non-probability convenience sampling was employed. Data analysis utilized SPSS version 25, employing Chi-square tests to examine the association between physical activity levels and fatigue. Results: The study comprised 41.3% male and 58.7% female participants. Results indicated that higher levels of physical activity were associated with lower levels of fatigue. Specifically, 38.8% of participants reported no fatigue, 54.9% reported mild to moderate fatigue, and 6.3% reported severe fatigue. Physical activity status revealed that 18.9% of participants had low, 48.1% had moderate, and 33% had high levels of physical activity. The Chi-square test demonstrated a significant association between physical activity levels and fatigue (X² = 23.13, P = 0.00). Conclusion: The findings underscore a significant inverse relationship between physical activity levels and fatigue among university students, suggesting that engaging in higher levels of physical activity may reduce fatigue levels. This study contributes to the understanding of physical activity as a viable approach to fatigue management in young adults.

Treatment burden and regimen fatigue among patients with HIV and diabetes attending clinics of Tikur Anbessa specialized hospital

Nascent studies showed that patients with chronic medical illnesses such as diabetes mellitus (DM) and HIV/AIDS are highly vulnerable to face both treatment burden and regimen fatigue. However, an attempt made so far in this sphere in sub-Saharan African health care context is dearth. Thus, this study aimed to determine the level of treatment burden and regimen fatigue of diabetic and HIV patients attending adult diabetic and ART clinics of TASH and explore patients’ and health care workers’ propositions to reduce treatment burden and regimen fatigue. An explanatory sequential mixed methods study was conducted at the adult HIV and DM clinics of TASH, Addis Ababa, Ethiopia from February 01-March 30, 2022. Simple random and purposive sampling techniques were employed to select participants for quantitative and qualitative studies, respectively. Descriptive analysis was done to summarize the quantitative data. Logistic and linear regression analyses were performed to identify predictors of treatment burden and regimen fatigue, respectively. P value < 0.05 was considered statistically significant. Qualitative data was analyzed by using a thematic analysis. A total of 300 patients (200 diabetes and 100 HIV) were included in the quantitative study. For the qualitative study, 14 patients and 10 health care workers (six nurses and four medical doctors) were included. Participants' mean global Treatment Burden Questionnaire (TBQ) and Treatment Regimen Fatigue Scale (TRFS) score were 28.86 ± 22.13 and − 42.82 ± 17.45, respectively. Roughly, 12% of patients experienced a high treatment burden. The presence of two or more comorbidities (adjusted odds ratio [AOR] = 7.95, 95% confidence interval [CI] 1.59–39.08), daily ingestion of more than five types of prescribed medications (AOR = 6.81, 95%CI 1.59–29.14), and good knowledge about DM and/or HIV (AOR = 0.33, 95%CI 0.12–0.92) were predictors of treatment burden. Poor availability of medications (β = 0.951, p < 0.001) was the only predictor of regimen fatigue. Patients and health care workers primarily proposed to foster self-care efficacy, advance administrative services of the clinic and hospital, and improve healthcare system provision. The findings of this study unveiled that a considerable proportion of patients experienced low levels of treatment burden and regimen fatigue. This study showed that boosting the patients’ self-care efficacy, upgrading administrative services of the clinic and hospital, and promoting the healthcare system provision had enormous significance in reducing treatment burden and regimen fatigue. Therefore, when designing patient-specific healthcare interventions for both HIV and diabetic patients’ various factors affecting both treatment burden and regimen fatigue should be considered to achieve the desired goals of therapy.

The Effect of Benson's Relaxation Technique on Fatigue and Quality of Life of Patients Diagnosed With Heart Failure.

Patients with heart failure (HF) reported poor quality of life (QOL) due to different reasons among which fatigue is the most important. Improving QOL is a crucial objective for patients with HF and their primary health care providers. Managing fatigue with medication is not enough. Benson's relaxation technique (BRT) is a complementary therapy used to manage fatigue among different populations with limited studies checking its effect among patients diagnosed with HF. The purpose of this quasi-experimental study was to check the effect of BRT on fatigue and QOL among 140 (68 intervention and 72 control) patients diagnosed with HF. Intervention group performed BRT for 20 minutes twice a day for 2 months. Control group received regular care from their health care providers. At baseline, there were no differences between intervention and control groups regarding fatigue, physical component summary, and mental component summary. At follow-up, intervention group had higher scores in physical and mental component summaries than control group (45.48 ± 10.52 vs 37.97 ± 14.78) and (46.22 ± 8.39 vs 41.01 ± 10.36), respectively. Also, intervention group had lower levels of fatigue than control group (2.54 ± 0.87 vs 6.33 ± 0.61). In conclusion, the use of BRT as a complementary therapy for patients with HF might decrease fatigue level and improve QOL.

Predictors of adherence in Austrian employees during the COVID-19 pandemic: results of an online survey.

Since the beginning of the pandemic in December 2019, Coronavirus disease 2019 (COVID-19) has been a significant challenge to health care systems throughout the world. The introduction of measures to reduce the incidence of infection had a significant impact on the workplace. Overall, companies played a key and adaptive role in coping with the pandemic. Cross-sectional data from an online-survey of 1,183 employees conducted during the COVID-19 pandemic in spring 2021 in Austria were used in the analyses. The influence of health beliefs (e.g., perceived severity), modifying factors (e.g., age) and time-dependent factors (e.g., corona fatigue) on individual adherence were evaluated. The conception of the questionnaire was based on the health belief model. The majority of respondents were female (58.3%), worked in companies with more than 250 employees (56.6%) and had been to an academic secondary school or had a university degree (58.3%). Overall, employees were adherent to most of the measures at their company (>80%), except for wearing FFP-2 masks when they were travelling in a car with coworkers (59.3, 95%CI 51.3-66.7%). Overall adherence was associated with high ratings for the meaningfulness of testing (OR: 2.06 95%CI: 1.00-4.22; p = 0.049), the extent to which social norms govern behavior (OR: 6.61 95%CI: 4.66-9.36; p < 0.001), lower perceived difficulties associated with the adoption of health-promoting measures (OR: 0.37 95%CI: 0.16-0.82; p = 0.015) and lower corona fatigue (OR: 0.23 95%CI: 0.10-0.52; p < 0.001). Adherence to four single measures was influenced by different predictors. The most important predictors (important for the adherence to three out of four single measures) were social norms and corona fatigue. The importance attached to testing and social norms, as well as lower perceived barriers to health-promoting measures and low levels of corona fatigue all increase overall adherence to Covid-19 protective measures in companies. Strategies to improve adherence should be adapted depending on the aim (to raise overall adherence or adherence to individual measures) and on the group of persons that is being targeted.

Pressurizing or encouraging: Health behaviors among long-distance couples.

Couples in long-distance relationships face unique challenges that affect their health outcomes and relationship dynamics in ways that are different from couples in close proximal relationships (PR). The results of previous literature analyzing health outcomes for long-distance relationship (LDR) couples have been mixed, and factors such as couple satisfaction and gender of the individuals contribute to the variance. This study examined the good health practices of couples in LDRs, the ways in which partners influence each other's health, and the health outcomes of these couples as compared to couples in PRs. Multilevel multivariate analysis showed that couples in LDRs had better health practices than those in PRs, and men overall had poorer health practices than women. There was no main effect seen for LDRs when we examined strategies used for influencing health. There was a main effect for gender, though, and we found that women tend to use more collaborative and pressurizing strategies for influencing their partner's health. On health indices, we found that LDR couples tended to have lower levels of fatigue and sleep disturbance as compared to PR couples. In the adjusted model with covariates, which included age, income, couple satisfaction, and married or unmarried couples, we found that lower couple satisfaction and lower income significantly predicted poorer health on all health indices. These results are discussed in light of unequal gender roles, social control, and positive aspects of LDRs on health in an attempt to understand LDRs better and destigmatize the narrative of these relationships as 'less than' PRs. Implications for health and mental health practitioners are also discussed.

Factors influencing fatigue among patients undergoing hemodialysis: a multi-center cross-sectional study

ABSTRACT Fatigue has been reported to be the most common symptom experienced by patients receiving hemodialysis (HD) therapy. Fatigue can lead to a reduction in their ability to engage in both routine and self-care activities, which can negatively affect their self-confidence and quality of life. This study aimed to determine the level of fatigue and the factors that affecting its level among patients receiving uHD. Methods: A cross-sectional design was utilized to explore the level of fatigue among patients receiving maintenance HD using the Mul-tidimensional Assessment of Fatigue (MAF) scale. Data were collected from four dialysis centers in two Saudi Arabia cities, Hail and Al-Qassim, between January 2022 and October 2022. Results: The questionnaire was completed by 236 patients. Older patients, male patients, and retired pa-tients reported significantly higher levels of fatigue (p < 0.001). In contrast, marital status, educational level, and financial status did not significantly affect the level of fatigue among patients (p = 0.193, 0.285, and 0.126, respectively). Patients who had seven or more dependents reported more fatigue than those who had lower levels of fatigue or who did not have dependents (p = 0.004). In addition, patients who had a regular exercise regimen reported significantly lower fatigue than those who did not have an exercise regimen (p = 0.011). Multiple linear regression demonstrated that employment status (student), comorbidity condition (one chronic disease), dialysis duration, satisfaction with dialysis time, and dialysis time were found to affect the fatigue scores (R2 = 0.302, p ˂ 0.001). Conclusion: The findings of this study gives a broader understanding of factors influencing fatigue among patients with HD that will help to develop strategies of more focused interventions to reduce fatigue among patients with HD.

Cancer-related fatigue trajectories up to 5 years after curative treatment for oesophageal cancer

BackgroundWhether cancer-related fatigue develops differently after curative-intended oesophageal cancer treatment and the related modifiable factors are unclear.MethodsThis population-based and longitudinal cohort included 409 oesophageal cancer patients who underwent curative oesophagectomy in 2013–2020 in Sweden. The main outcome was cancer-related fatigue trajectories with measurements at 1, 1.5, 2, 2.5, 3, 4 and 5 years postoperatively by validated EORTC QLQ-FA12 questionnaire, and analysed using growth mixture models. Weighted logistic regressions provided odds ratios (OR) with 95% confidence intervals (95% CI) for underlying sociodemographic, clinical, and patient-reported outcome factors in relation to the identified trajectories.ResultsTwo distinct overall cancer-related fatigue trajectories were identified: low level of persistent fatigue and high level of increasing fatigue, with 64% and 36% of patients, respectively. The odds of having high level of fatigue trajectory were increased by Charlson comorbidity index (≥ 2 versus 0: OR = 2.52, 95% CI 1.07–5.94), pathological tumour Stage (III–IV versus 0-I: OR = 2.52, 95% CI 1.33–4.77), anxiety (OR = 7.58, 95% CI 2.20–26.17), depression (OR = 15.90, 95% CI 4.44–56.93) and pain (continuous score: OR = 1.02, 95% CI 1.01–1.04).ConclusionsLong-term trajectories with high level of increasing cancer-related fatigue and the associated modifiable factors were identified after oesophageal cancer treatment. The results may facilitate early identification and targeted intervention for such high-risk patients.

The influence of social support on sleep and fatigue level among patients receiving hemodialysis in Saudi Arabia: a cross-sectional correlational design.

Patients on hemodialysis (HD) are more likely to experience sleep problems and fatigue that may affect their health outcomes. Management of these patients with social support may improve their sleep quality and fatigue as well as their health. This study aimed to assess the influence of social support on sleep quality and fatigue levels among HD patients. A cross-correlational study was conducted among 260 conveniently sampled HD patients from four dialysis centers in Hail and Al-Qassim cities of Saudi Arabia from Jun 2022 to January 2023. Besides sociodemographic data, the Pittsburgh Sleep Quality Index (PSQI), the Multidimensional Assessment of Fatigue (MAF) and the Oslo Social Support Scale (OSSS-3) were used to assess sleep quality, fatigue levels and social support, respectively. Chi-square test was used to determine the association between categorical variables, while Pearson's correlation coefficient was used to test the correlation between sleep quality, fatigue, and social support. Poor sleep and high fatigue were significantly higher in older patients compared to younger patients (p <0.001), while strong social support was significantly lower in older patients than younger and middle-aged ones (p = 0.001). On the other hand, poor sleep and high fatigue were significantly higher in males than females (p = 0.022 and p <0.001, respectively), while strong social support was significantly higher in females than males (p <0.001). Married patients showed significantly poorer sleep than single ones (p = 0.019), but single patients received significantly stronger social support. Retired patients showed significantly poorer sleep, higher fatigue and weaker social support than other groups (p <0.001). There was a significant negative correlation between fatigue and sleep quality among HD patients, where patients with more fatigue had poorer sleep (r = -0.510, p <0.001). A significant positive correlation was found between social support and sleep quality, where patients with stronger social support had more normal sleep (r = 0.415, p <0.001). However, a significant negative correlation was found between social support and fatigue, where patients with stronger social support had lower levels of fatigue (r = -0.479, p <0.001). Saudi patients on HD who have stronger social support have better sleep quality and reduced fatigue levels than those with less social support. There is a need to design and implement intervention studies with structured social support programs, and to evaluate their effectiveness on improving sleep and reducing fatigue among HD patients.

Structural Factors Contributing to Compassion Fatigue, Burnout, and Secondary Traumatic Stress Among Hospital-Based Healthcare Professionals During the COVID-19 Pandemic.

High levels of burnout among healthcare providers (HCPs) have been a widely documented phenomenon, which have been exacerbated during the COVID-19 pandemic. In the United States, qualitative studies that are inclusive of HCPs in diverse professional roles have been limited. Therefore, we utilized a qualitative-quantitative design to examine professional quality of life in terms of compassion fatigue, burnout, and secondary traumatic stress among hospital-based HCPs, including social workers, hospitalists, residents, and palliative care team members during COVID-19. HCPs (n = 26) participated in virtual semi-structured focus groups or individual interviews and online surveys (n = 30) including the Professional Quality of Life (ProQOL) Scale. While ProQOL scores indicated low levels of compassion fatigue, burnout, and secondary traumatic stress, thematic analysis of our qualitative data included rich descriptions of compassion fatigue, burnout, and secondary traumatic stress. Safety concerns and value misalignment characterized structural stressors perceived to contribute to HCP compassion fatigue, burnout, and secondary traumatic stress. The discrepancy between our qualitative and quantitative findings may be indication that modifications to current screenings are warranted. These findings also suggest a need to identify and implement structural and policy changes that increase HCPs' physical and emotional safety and promote better alignment of institutional interests with HCP values.

Associations between modifiable lifestyle factors and health-related quality of life among endometrial carcinoma survivors - A cross-sectional study

ObjectiveTo explore possible associations between modifiable lifestyle factors and health-related quality of life (HRQoL) in endometrial carcinoma survivors by assessing differences in HRQoL between survivors meeting and not meeting the World Health Organization's (WHO) recommendations regarding physical activity, BMI, and smoking. MethodsThis was a cross-sectional population-based study in women having undergone surgery for assumed early-stage endometrial carcinoma. Thresholds for clinical importance based on the EORTC QoL working group were used to interpret scores. Effect size (ES) was interpreted as small (d = 0.2–0.49), medium (d = 0.5–0.8), and large (d > 0.8). ResultsIn total, 1200 evaluable women were included. Meeting physical activity recommendations and BMI <25 kg/m2 was associated with significantly better global health status, (ES) = 0.18 and ES = −0.11, respectively. On multivariate analysis, women meeting physical activity recommendations had significantly higher scores on physical- (ES = 0.31), role- (ES = 0.15), and social functioning (ES = 0.15), and lower levels of fatigue (ES = −0.16), pain (ES = −0.10), and appetite loss (ES = −0.15) (all p < 0.05) compared to non-meeting survivors. Participants with BMI ≥25 kg/m2 had lower scores for social functioning (ES = −0.10), and higher levels of pain (ES = 0.13) and dyspnea (ES = 0.12) (all p < 0.05) compared to those with BMI <25 kg/m2. Smokers had lower scores for emotional functioning (ES = −0.09) and higher levels of diarrhea (ES = 0.10) (all p < 0.05) compared to non-smokers. ConclusionMeeting WHO recommendations for modifiable life-style factors is associated with better HRQoL among endometrial carcinoma survivors: Being sufficiently physical active and having a BMI <25 kg/m2 are significantly associated with better self-reported global health status. All modifiable factors are associated with better functioning, and reduced symptom-burden.

17 Grit Predicts Lower Cognitive Fatigue in Persons with Parkinson’s Disease Independent of Cognitive Status

Objective:Fatigue, which can be classified into physical and cognitive subtypes (Schiehser et al., 2012), is a common non-motor symptom in persons with Parkinson’s disease (PD) that has no clear treatment. Cognitive changes, also common in PD (Litvan et al., 2012), may impact how patients perceive fatigue (Kukla et al., 2021). Grit is a personality trait defined as perseverance and passion towards a long-term goal, and is associated with multiple positive outcomes such as lower fatigue levels in healthy individuals (Martinez-Moreno et al., 2021). However, scarce research has examined the relationship between grit and fatigue in persons with PD. Therefore, we aimed to investigate the relationship between fatigue (cognitive and physical) and grit, as well as the impact of cognitive status (i.e., cognitive normal vs. mild cognitive impairment [MCI]) on this relationship in non-demented individuals with PD.Participants and Methods:Participants were 70 non-demented individuals with PD who were diagnosed as either cognitively normal (n=20) or MCI (n=50) based on Level II of the Movement Disorder Society PD-MCI criteria. Participants completed the Modified Fatigue Impact Scale (MFIS), which consists of two subscales (cognitive and physical fatigue) that are combined for a total overall fatigue score. Participants also completed the Grit Scale, which consists of items such as ambition, perseverance, and consistency. ANOVAs were conducted to determine differences in grit between PD-cognitively normal vs PD-MCI groups. Correlations and multiple hierarchical regressions controlling for significant demographics (i.e., age, education, sex), mood (i.e., depression, anxiety) and disease variables (i.e., disease duration, Levodopa equivalent dosage) with backwards elimination were conducted to evaluate the relationship between grit and fatigue (MFIS total score and MFIS cognitive and physical fatigue subscales).Results:There was no significant difference in grit total scores between PD patients who were cognitively normal or MCI (p = .336). Higher grit total scores predicted lower MFIS total (ß = -.290, p = .005) and lower cognitive fatigue (ß = -.336, p &lt; .001) scores in the total sample, above and beyond relevant covariates as well as cognitive status. Grit scores were not significantly associated with physical fatigue (ß = -.206, p = .066). Furthermore, cognitive status was not a significant predictor of fatigue scores in any of the models (all p’s &gt; .28).Conclusions:Findings indicate that higher levels of grit are associated with lower levels of fatigue, specifically cognitive fatigue, in individuals with PD. These results held true for those who were cognitively normal or with MCI, suggesting that grit may impact fatigue in non-demented PD patients regardless of cognitive status. These findings underscore the importance of considering grit when assessing or treating fatigue, particularly cognitive fatigue, in persons with PD.

The role of self-compassion and compassion toward others in burnout syndrome in a sample of medical students.

Burnout produces negative effects on academic performance, and, in turn, feelings of inefficiency that are detrimental to students' psychosocial well-being. The aim of this research is to determine the effects that self-compassion and compassion toward others have on various burnout dimensions in a sample of medical students. A total of 235 medical students (61.7% women) aged between 16 and 32 years old (M = 19.82; SD = 2.37) belonging to a Colombian university participated. A cluster analysis to segment the population according to burnout was carried out along with nonparametric contrasts to identify differences in the levels of self-compassion and compassion toward others between each profile. A series of regression analyses was designed to find out how each type of compassion was associated with burnout on each profile. The cluster analysis allowed us to identify three profiles. The low-involvement profile (n = 51) is characterized by low depersonalization, intermediate levels of emotional exhaustion and personal accomplishment and exhibits low levels of self-compassion and compassion fatigue compared with the other profiles. The positive-adaptation profile (n = 104) is characterized by low depersonalization levels, intermediate degrees of emotional exhaustion and high levels of personal accomplishment and exhibits the highest levels of self-compassion and compassion fatigue compared with the other profiles. The high-demand profile (n = 104) is characterized by intermediate depersonalization levels, medium-high levels of emotional exhaustion and high levels of personal accomplishment and exhibits intermediate levels of self-compassion and low levels of compassion fatigue. Establishing profiles based on burnout allows students to be segmented and for precise knowledge to be acquired about the effects that both types of compassion have on the dimensions of burnout.