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Background: Kinesiophobia, an irrational fear-avoidance behaviour, can significantly impact the quality of life and prognosis of peritoneal dialysis patients. This study aimed to assess the prevalence of kinesiophobia in patients undergoing peritoneal dialysis and to analyse its influencing factors., Methods: A total of 291 patients who visited the outpatient and ward of peritoneal dialysis in 7 tertiary hospitals in Jiangsu Province from December 2023 to March 2024 were selected as research subjects via the convenience sampling method. A cross-sectional survey was conducted using a general data questionnaire, the Tampa Kinesiophobia-11 Scale, the Chinese Version of the Multidimensional Fatigue Symptom Scale, and the Simplified Coping Style Questionnaire., Results: The score obtained using the Tampa Scale for kinesiophobia in patients with peritoneal dialysis was 22.44 ± 7.46, with a prevalence rate of 69.1%. Binary logistic regression analysis revealed that no complications, daily exercise before illness, and positive coping styles were protective factors (p < 0.05), whereas fatigue and negative coping styles were risk factors for kinesiophobia in patients receiving peritoneal dialysis (p < 0.05)., Conclusions: The prevalence of kinesiophobia in patients receiving peritoneal dialysis was high but at a mild level. Medical staff should combine influencing factors to identify high-risk groups as early as possible, formulate targeted interventions to reduce the occurrence of kinesiophobia and mitigate adverse effects on peritoneal dialysis patients., Competing Interests: Declarations Ethics approval and consent to participate The study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Committee of the Affiliated Hospital of Nanjing University of Traditional Chinese Medicine (2023NL-277-02). Informed consent was obtained from all the subjects involved in the study. Consent for publication Not applicable. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Background: Many patients with enterostomy and their family caregivers experience severe anxiety and fatigue, which affects their participation in normal social activities and family life, resulting in impaired social function. The purpose of this study was to understand the status of social function of patients with enterostomy and their family caregivers;at the same time to analyze the subjective and objective effects of anxiety and fatigue on their social functions., Methods: The self-made general information questionnaire, WHO Social Disability rating Scale, Miao Yu's Multidimensional Fatigue Scale-20 and Zung et al. 's Self-rating Anxiety Scale were used to investigate the general situation, social function, fatigue and anxiety of enterostomy patients and their family caregivers who came to the hospital for treatment from March 28, 2023 to November 30, 2023. SPSS27.0 was used to complete the statistical analysis of the data, and AMOS26.0 was used to establish the structural equation model to complete the subject and object effect analysis., Results: A total of 260 pairs of enterostomy patients and their family caregivers were included in this study. The social function scores of enterostomy patients and their family caregivers were (8.80±3.44) and (6.44±3.60). The anxiety scores were (37.81±7.60) and (34.73±7.50). The fatigue scores were (63.35±12.80) and (51.21±12.38).The results of the subject-object effect analysis reported the subject effect: the anxiety of patients with enterostomy had a significant positive impact on the degree of social dysfunction (β = 0.154, P = 0.015); The fatigue of patients with enterostomy had a significant positive effect on the degree of social dysfunction (β = 0.132, P = 0.034). The anxiety of family caregivers had a significant positive effect on the degree of social dysfunction (β = 0.161, P = 0.023). The fatigue of family caregivers had a significant positive effect on the degree of social dysfunction (β = 0.201, P = 0.005). In terms of object effects: only the fatigue of family caregivers had a significant positive impact on the degree of social dysfunction of enterostomy patients (β = 0.224, P < 0.001), and other ways had no object effects., Conclusion: Patients with enterostomy and their family caregivers have serious social function defects. Clinical medical staff should take care of them as a whole in order to better return to family and society after surgery., Competing Interests: NO authors have competing interests., (Copyright: © 2024 Fan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Mindfulness-based stress reduction (MBSR) intervention has been widely used to reduce the burden of symptoms in cancer patients, and its effectiveness has been proven. However, the effectiveness of MBSR on depression, anxiety, fatigue, quality of life (QOL), posttraumatic growth (PTG), fear of cancer recurrence (FCR), pain, and sleep in breast cancer patients has not yet been determined. This study aims to determine the role of mindfulness-based stress reduction therapy in patients with breast cancer., Objectives: The objective was to systematically review the literature to explore the effect of MBSR on anxiety, depression, QOL, PTG, fatigue, FCR, pain, stress and sleep in breast cancer patients. To explore the effect of 8-week versus 6-week MBSR on the 9 indicators. Data were extracted from the original RCT study at the end of the intervention and three months after baseline to explore whether the effects of the intervention were sustained., Methods: We conducted searches on PubMed, Web of Science, Embase, and China National Knowledge Infrastructure from inception to November 2023. Eligible studies included randomized controlled trials of breast cancer patients who received mindfulness stress reduction intervention, reporting outcomes for anxiety, depression, fatigue, QOL, PTG, FCR, pain, stress, and sleep. Two researchers conducted separate reviews of the abstract and full text, extracted data, and independently evaluated the risk of bias using the Cochrane 'Bias Risk Assessment tool'. The meta-analysis utilized Review Manager 5.4 to conduct the study, and the effect size was determined using the standardized mean difference and its corresponding 95% confidence interval., Results: The final analysis included 15 studies with a total of 1937 patients. At the end of the intervention, the interventions with a duration of eight weeks led to a significant reduction in anxiety [SMD=-0.60, 95% CI (-0.78, -0.43), P < 0.00001, I 2  = 31%], depression [SMD=-0.39, 95% CI (-0.59, -0.19), P = 0.0001, I 2  = 55%], and QOL [542 participants, SMD = 0.54, 95% CI (0.30, 0.79), P < 0.0001, I 2  = 49%], whereas no statistically significant effects were found in the intervention with a duration of six weeks. Similarly, in 3 months after baseline, the interventions with a duration of eight weeks led to a significant reduction in depression and QOL, however, no statistically significant effects were found at the 6-week intervention. MBSR led to a significant improvement in PTG at end of intervention [MD = 6.25, 95% CI (4.26, 8.25), P < 0.00001, I 2  = 0%] and PTG 3 months after baseline. We found that MBSR reduced the fatigue status at end of intervention, but had no significant effect on fatigue status 3 months after baseline. There was no significant difference in improving pain, stress, and FCR compared to usual care., Conclusions: In terms of effects on QOL, anxiety, depression, and fatigue, the 8-week MBSR intervention showed better results than the 6-week MBSR intervention. The intervention of MBSR on PTG was effective, and the effect lasted until 3 months after baseline. Future studies could further identify the most effective intervention components in MBSR., Trial Registration: PROSPERO registration number: CRD42023483980., (© 2024. The Author(s).)

Burnout and fatigue have overlaps in their symptoms. The common denominator is exhaustion. Physical activity has been shown to be a risk-reducing factor for the development or manifestation of symptoms. There is also evidence of an effect of physical activity in the acute phase, rehabilitation, and aftercare of burnout as well as in diseases that are associated with the occurrence of fatigue and their treatments.In burnout research, physical activity is considered a risk-reducing factor and coping strategy, but there are no specific exercise recommendations with regard to symptom severity. In the area of tiredness/fatigue, the overall picture is inconsistent: there are already targeted recommendations for exercise therapy in a multimodal approach for individual clinical pictures. For example, there is high evidence for the use of appropriately dosed physical activity in cancer patients in adjuvant therapy and aftercare. Other diseases associated with the occurrence of fatigue, such as long- and post-COVID, have not yet been sufficiently researched to make clear statements about a dose-response relationship. For some diseases, there are already targeted recommendations for exercise therapy in a multimodal approach.This paper aims to provide an overview of the current state of exercise research in burnout and fatigue and thus, on the one hand, make therapy recommendations for practitioners and patients, and on the other hand, shed light on the evidence in those areas in which there are (still) no general and individualized exercise recommendations and guidelines., (© 2024. The Author(s).)

Background: There is a lack of qualitative data on the negative effects of workplace stressors on the well-being of healthcare professionals in hospitals in Africa. It is unclear how well research methods developed for high-income country contexts apply to different cultural, social, and economic contexts in the global south., Methods: We conducted a qualitative interview-based study including 64 perioperative healthcare professionals across all provinces of Rwanda. We used an iterative thematic analysis and aimed to explore the lived experience of Rwandan healthcare professionals and to consider to what extent the Maslach model aligns with these experiences., Results: We found mixed responses of the effects on individuals, including the denial of burnout and fatigue to the points of physical exhaustion. Responses aligned with Maslach's three-factor model of emotional exhaustion, decreased personal accomplishment, and depersonalisation, with downstream effects on the healthcare system. Other factors included strongly patriotic culture, goals framed by narratives of Rwanda's recovery after the genocide, and personal and collective investment in developing the Rwandan healthcare system., Conclusions: The Rwandan healthcare system presents many challenges which can become profoundly stressful for the workforce. Consideration of reduced personal and collective accomplishment, of moral injury, and its diverse downstream effects on the whole healthcare system may better represent the costs of burnout Rwanda. It is likely that improving the causes of work-based stress will require a significant investment in improving staffing and working conditions., (Copyright © 2024 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.)

Introduction: Long-COVID is a multisystem disease characterized by a varied presentation of symptoms. According to most recent research, the most common symptom of long-COVID is fatigue, which up to this date lacks a universally accepted definition. This study aimed to investigate neurocognitive and physical manifestations of neurological long-COVID, particularly fatigue and its relation with autonomic disfunction, cognitive impairment (known as, brain fog), and depressive symptoms. Furthermore, the study provided insights into predictors of fatigue in long-COVID., Methods: The included patients (n=141) were referred to the neuro-long-COVID ambulatory service of Trieste from 30 September 2021-02 March 2022. Patients were given self-reporting questionnaires to screen for fatigue, autonomic dysfunction, cognitive impairment and depressive symptoms. The questionnaires adopted for these conditions to be assessed were Fatigue Severity Scale (FSS), COMPASS-31, Prospective-Retrospective Memory Questionnaire (PRMQ), and Beck Depression Inventory (BDI). Participants were divided into two groups, fatigued and non-fatigued patients, based on FSS scoring (scores > 4.67 indicate fatigued patients). The questionnaire scores of the two groups were then compared., Results: Fatigued patients had significantly higher scores in COMPASS (p<0.001, Cohen's d=1.077), BDI (p<0.001, Cohen's d=0.862), and PRMQ ( p<0.001, Cohen's d=1.159). Furthermore, the multivariate regression analysis showed that predictors of fatigue in long-COVID were symptomatological burden in acute infection (OR=1.38, 95 % CI 1.020-1.887, p=0.037) and in long-COVID (OR=1.78, 95 % CI 1.133-2.2824, p=0.013), COMPASS-31>16 (OR=3.44, 95 % CI 1240-9.560, p=0.018) and BDI>15 (OR=5.1, 95 % CI 1.715-15.164, p=0.003)., Conclusion: This study showed associations between fatigue, dysautonomia and depression, as well as with symptom burden in acute and long-COVID., (Copyright © 2024. Published by Elsevier B.V.)

Objective: The number of perimenopausal women in China is rising, but the population's concept of menopausal hormone therapy (MHT) is still relatively outdated., Methods: In this study, we used the Knowledge-Attitude-Practice (KAP) theory and collected online questionnaires from 1,100 women aged 40 to 60 years nationwide to find out their menopausal symptom profiles; to learn about their perceptions, attitudes, and behaviors toward menopause and MHT; to explore the factors influencing the acceptance of hormone treatments; and to look for better ways to promote the dissemination of menopausal knowledge., Results: The results revealed that among women aged 40 to 60 years, 82.36% experienced possible menopausal symptoms, with hot flushes/sweating, sleep disorders, mood disorders, and fatigue being the most prevalent; 55.90% reported moderate to severe symptoms, but only 46.99% of them sought healthcare services. Among those who sought medical care, 16.00% had their first visit to climacteric clinics/gynecological endocrinology, and 5.66% accepted MHT. Furthermore, 77.82% of participants never heard of MHT or were unaware of its existence. The healthcare-seeking behavior of menopausal women in response to symptoms and their willingness to accept MHT were found to be closely associated with their level of self-care., Conclusions: The prevalence of menopausal symptoms is higher in China than previous research findings, but due to a lack of relevant knowledge, the rate of seeking treatment from the appropriate medical department and accepting MHT is relatively low. Enhancing physicians' knowledge of the menopausal transition and using Internet tools might help improve Chinese women's knowledge of menopause and help them pass through this period smoothly., Competing Interests: Financial disclosure/conflicts of interest: None reported., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The Menopause Society.)

Introduction: The COVID-19 pandemic, caused by SARS-CoV-2, has led to long-term health issues known as post-COVID-19 condition, including fatigue and cognitive disruptions. Despite its recognition as a public health concern, the efficacy of therapeutic interventions, especially in neurological rehabilitation, remains unclear. This study examines how treatment expectations are associated with psychological and physical outcomes in post-COVID-19 condition neurological rehabilitation., Methods: In an observational cohort study 61 patients with confirmed post-COVID-19 condition were included. Baseline (T0) data on treatment and side effect expectations were collected, before participants underwent a 4-6 week multidisciplinary rehabilitation program. Primary outcome was illness-related disability (Pain Disability Index). Secondary outcomes included depressive symptoms (PHQ-9), anxiety levels (GAD-7), functional status (PCFS), fatigue (CFS), and physical fitness (6MWT). Regression models analyzed the associations of baseline expectations with outcomes at the end of rehabilitation (T1) and three months post-rehabilitation (T2)., Results: After adjusting for multiple testing, higher baseline side-effect expectations were associated with greater illness-related disability (β = 0.42, p = 0.007), reduced physical fitness (β = - 0.24, p = 0.04), and more somatic symptoms (β = 0.33, p = 0.006) at follow-up (T2). Positive treatment expectations were associated with poorer functional status (β = 0.35, p = 0.011) at T2., Conclusion: This study highlights the associations of side-effect expectations with post-COVID-19 condition rehabilitation outcomes. Higher side-effect expectations were associated to poorer outcomes, indicating a nocebo effect. Surprisingly, positive expectations were linked to worse outcomes, possibly due to unrealistic optimism. Managing patient expectations realistically and addressing side-effect concerns seems crucial for optimizing rehabilitation outcomes., Competing Interests: Declaration of competing interest SS reports research funding (no personal honoraria) from the German Research Foundation and the German Heart Foundation/German Foundation of Heart Research. WR declares to have received honoraria from Boehringer Ingelheim for workshops on Post Covid, and royalties from book publishers. All other authors report to have no conflicts of interest to declare., (Copyright © 2024. Published by Elsevier Inc.)

There is widespread empirical evidence that the COVID-19 pandemic contributed to elevated risk of mental and physical health symptoms and decreased quality of life. The present investigation sought to examine if individual differences in anxiety sensitivity was associated with mental health, psychosomatic, and well-being among a sample of US adults during a 6-month period early in the COVID-19 pandemic. Employing longitudinal research methodology, we tested the hypothesis that the anxiety sensitivity global factor would be related to increased risk of anxiety, depression, fatigue, and lower well-being. Secondary analyses evaluated the lower order anxiety sensitivity factors for the same criterion variables. The sample consisted of 778 participants with an average age of 37.96 (SD = 11.81; range 18-73). Results indicated that, as hypothesized, anxiety sensitivity was associated with increased risk for more severe anxiety, depression, fatigue, and lesser well-being; the observed effects of anxiety sensitivity were relatively robust and evident in adjusted models that controlled for numerous theoretically and clinically relevant factors (e.g. perceived health status). Overall, these results suggest that pandemic functioning could likely be improved via interventions that target elevated anxiety sensitivity as a vulnerability factor for a broad range of aversive psychosomatic symptoms and personal well-being.

Background: Depression is a pervasive symptom in patients with gynecological cancer undergoing chemotherapy., Objectives: Purposes were to identify subgroups of patients with distinct depression profiles and evaluate for differences in demographic and clinical characteristics, severity of common symptoms, and quality of life (QOL) outcomes among these subgroups., Methods: Patients with gynecological cancer (n = 231) completed the Center for Epidemiologic Studies-Depression Scale 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 done to identify the distinct depression profiles. Differences were evaluated using parametric and nonparametric tests., Results: Three distinct profiles were identified: low (60.1%), high (35.1%), and very high (4.8%). Compared with low class, the other 2 classes had lower functional status and were more likely to self-report a diagnosis of depression. Patients in the 2 worse profiles reported a higher comorbidity burden, higher levels of trait and state anxiety, sleep disturbance, and fatigue, as well as lower levels of cognitive function and poorer QOL. State and trait anxiety, evening fatigue, and sleep disturbance scores exhibit a "dose-response effect" (ie, as the depression profile worsened, the severity of these symptoms increased)., Conclusions: Almost 40% of our sample experienced high or very high levels of depression across 2 cycles of chemotherapy., Implications for Practice: Clinicians can use the identified risk factors to identify high patients risk and provide tailored psychological interventions aimed to decrease symptom burden and prevent decrements in QOL., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Glioma ‎(GL)‎, a primary brain tumor, presents significant challenges in patient care due to its complex disease trajectory and psychological impact. Phased nursing interventions, grounded in the Chronic Illness Trajectory Model (CITM), offer a holistic approach to addressing these multifaceted needs., Objective: The objective of this study was to assess the impact of phased nursing within the CITM on the psychological well-being, quality of life, and cancer-related fatigue (CRF) of glioma patients., Methods: A total of 100 GL patients undergoing treatment at our hospital between February 2020 and February 2021 were enrolled in this randomized controlled trial. Patients were randomly assigned to either the control group, which received standard routine care, or the observation group, which received phased nursing interventions based on the CITM framework. The mental state, quality of life, and CRF scores of the patients were assessed using validated measures at baseline and following the intervention period. Statistical analyses were conducted to compare the outcomes between the two groups., Results: The findings revealed that patients in the observation group exhibited significantly higher scores in mental state and quality of life domains compared to those in the control group (P < .05). Additionally, patients receiving phased nursing showed a significant reduction in CRF scores post-intervention. These results indicate that phased nursing within the CITM framework has a beneficial effect on the psychological well-being and overall quality of life of GL patients while also mitigating CRF., Conclusions: Our findings suggest that incorporating phased nursing interventions into the care of GL patients can lead to improvements in psychological outcomes, CRF, and quality of life. These findings underscore the importance of adopting holistic approaches to patient care, particularly in chronic disease management.

Purpose: Delaying high school start times prolongs weekday sleep. However, it is not clear if longer sleep reduces depression symptoms and if the impact of such policy change is the same across groups of adolescents., Methods: We examined how gains in weekday sleep impact depression symptoms in 2,134 high school students (mean age 15.16 ± 0.35 years) from the Minneapolis metropolitan area. Leveraging a natural experiment design, we used the policy change to delay school start times as an instrument to estimate the effect of a sustained gain in weekday sleep on repeatedly measured Kandel-Davies depression symptoms. We also evaluated whether allocating the policy change to subgroups with expected benefit could improve the impact of the policy., Results: Over 2 years, a sustained half-hour gain in weekday sleep expected as a result of the policy change to delay start times decreased depression symptoms by 0.78 points, 95%CI (-1.32,-0.28), or 15.6% of a standard deviation. The benefit was driven by a decrease in fatigue and sleep-related symptoms. While symptoms of low mood, hopelessness, and worry were not affected by the policy on average, older students with greater daily screen use and higher BMI experienced greater improvements in mood symptoms than would be expected on average, signaling heterogeneity. Nevertheless, universal implementation outperformed prescriptive strategies., Conclusion: High school start time delays are likely to universally decrease fatigue and overall depression symptoms in adolescents. Students who benefit most with respect to mood are older, spend more time on screens and have higher BMI., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

Background: Mental fatigue, elicited by cognitive demands, can impair sport and exercise performance. The effects of isolated mental fatigue on performance are well documented but few studies have explored the effects of combined mental and physical fatigue on skilled motor and endurance exercise performance., Objective: This study explored the effects of isolated mental, isolated physical, and combined (mental plus physical) fatigue on skill and exercise task performance., Method: 164 athletes were randomly assigned to 1 of 4 groups: mental fatigue, physical fatigue, combined fatigue, control (no fatigue). Mental fatigue was induced by a 15-min time-load dual-back cognitive task. Physical fatigue was induced by a 90-s burpee exercise task. Next, all participants completed a throwing skill task and performed burpee exercises to failure. Objective (brief Psychomotor Vigilance Task, PVT-B) and subjective (self-report) measures of mental fatigue and Ratings of Perceived Exertion were obtained throughout., Results: The mental fatigue and combined fatigue groups performed the worst on both the throwing and burpee tasks compared with the physical fatigue and control groups. The former reported higher mental fatigue throughout and had worse response accuracy and variation on the end-of-session PVT-B task. The combined fatigue group performed better than the mental fatigue group on the throwing and burpee tasks., Conclusion: A demanding cognitive task induced a state of mental fatigue and impaired skill and endurance performance. Mental fatigue alone was more detrimental than combined fatigue to skill and endurance performance, suggesting that the physical activity manipulation reduced the negative effects of mental fatigue on performance., Competing Interests: Declaration of competing interest We have no conflicts of interest to declare., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objectives: The objective is to assess the interconnectedness of a network of health-related quality of life (HRQoL) variables among people with HIV (PHIV) to identify key areas for which clinical interventions could improve HRQoL for this population., Methods: Between 2021 and 2023, we carried out a cross-sectional study within the Spanish CoRIS cohort. We conducted a weighted and undirected network analysis, which examines complex patterns of relationships and interconnections between variables, to assess a network of eight HRQoL dimensions from the validated Clinic Screening Tool for HIV (CST-HIV): anticipated stigma, psychological distress, sexuality, social support, material deprivation, sleep and fatigue, cognitive problems and physical symptoms., Results: A total of 347 participants, predominantly male (93.1%), currently working (79.0%), self-reported homosexual (72.6%) and college-educated (53.9%), were included in the study. Psychological distress showed the highest centrality in the network, indicating its strong connections with sleep and fatigue, cognitive problems and social support within the HRQoL network., Conclusions: Psychological distress, sleep and fatigue, cognitive issues and social support were identified as key factors in an HRQoL network, indicating that interventions focused on these areas could significantly enhance overall well-being., (© 2024 British HIV Association.)

Background: While speech analysis holds promise for mental health assessment, research often focuses on single symptoms, despite symptom co-occurrences and interactions. In addition, predictive models in mental health do not properly assess the limitations of speech-based systems, such as uncertainty, or fairness for a safe clinical deployment., Objective: We investigated the predictive potential of mobile-collected speech data for detecting and estimating depression, anxiety, fatigue, and insomnia, focusing on other factors than mere accuracy, in the general population., Methods: We included 865 healthy adults and recorded their answers regarding their perceived mental and sleep states. We asked how they felt and if they had slept well lately. Clinically validated questionnaires measuring depression, anxiety, insomnia, and fatigue severity were also used. We developed a novel speech and machine learning pipeline involving voice activity detection, feature extraction, and model training. We automatically modeled speech with pretrained deep learning models that were pretrained on a large, open, and free database, and we selected the best one on the validation set. Based on the best speech modeling approach, clinical threshold detection, individual score prediction, model uncertainty estimation, and performance fairness across demographics (age, sex, and education) were evaluated. We used a train-validation-test split for all evaluations: to develop our models, select the best ones, and assess the generalizability of held-out data., Results: The best model was Whisper M with a max pooling and oversampling method. Our methods achieved good detection performance for all symptoms, depression (Patient Health Questionnaire-9: area under the curve [AUC]=0.76; F 1 -score=0.49 and Beck Depression Inventory: AUC=0.78; F 1 -score=0.65), anxiety (Generalized Anxiety Disorder 7-item scale: AUC=0.77; F 1 -score=0.50), insomnia (Athens Insomnia Scale: AUC=0.73; F 1 -score=0.62), and fatigue (Multidimensional Fatigue Inventory total score: AUC=0.68; F 1 -score=0.88). The system performed well when it needed to abstain from making predictions, as demonstrated by low abstention rates in depression detection with the Beck Depression Inventory and fatigue, with risk-coverage AUCs below 0.4. Individual symptom scores were accurately predicted (correlations were all significant with Pearson strengths between 0.31 and 0.49). Fairness analysis revealed that models were consistent for sex (average disparity ratio [DR] 0.86, SD 0.13), to a lesser extent for education level (average DR 0.47, SD 0.30), and worse for age groups (average DR 0.33, SD 0.30)., Conclusions: This study demonstrates the potential of speech-based systems for multifaceted mental health assessment in the general population, not only for detecting clinical thresholds but also for estimating their severity. Addressing fairness and incorporating uncertainty estimation with selective classification are key contributions that can enhance the clinical utility and responsible implementation of such systems., (©Rachid Riad, Martin Denais, Marc de Gennes, Adrien Lesage, Vincent Oustric, Xuan Nga Cao, Stéphane Mouchabac, Alexis Bourla. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 31.10.2024.)

Objective: The purpose of this study is to examine the national impact of workplace factors during the SARS-CoV-2 pandemic on mental health experienced by non-physician healthcare workers (HCWs)., Methods: This study consisted of an online sample of non-physician HCWs across the United States, including nurses, medical assistants, and physician assistants. The survey consisted of 93 questions, which included the Perceived Stress Scale, the Center for Epidemiological Studies-Depression (CESD-10) scale, questions about COVID-19 vaccination, sources of trusted information, and questions about work environment and training during the COVID-19 pandemic. Descriptive statistics were used to evaluate associations., Results: In the final sample ( N = 220), (81.8%) reported receiving at least one dose of a COVID vaccine. Most respondents trusted the CDC's information on the SARS-CoV-2 virus and COVID-19 disease. Several workplace-related factors that occurred during the pandemic were associated with moderate to high levels of perceived stress, fatigue, and higher risk of developing depression. In particular, concerns about exposing others, experiencing discrimination related to their jobs, and caring for patients who died from COVID-19 were associated with increased perceived stress, depression, and fatigue., Conclusions: The importance of planning by healthcare facilities should include planning for workplace factors associated with poor mental health among all HCWs.

Objectives: Following the declaration of the pandemic, students' education has to be done at a distance due to the COVID-19 pandemic. This study evaluated the association of university students' COVID-19 phobia, pain severity, sleep quality, physical activity, fatigue levels, and quality of life on students' achievement., Methods: This cross-sectional survey was conducted by including 353 students from the university faculty of health sciences. The Pain Quality Assessment Scale was used to assess pain, the Fatigue Severity Scale to evaluate fatigue, the COVID-19 Phobia Scale to assess fear of disease, the International Physical Activity Questionnaire Short Form to evaluate physical activity level, and the Jenkins Sleep Scale to assess sleep quality, The Short Form-36 to determine the quality of life, and Online Learning Systems Acceptance Scale to evaluate satisfaction with distance education. Multiple linear regression and path analysis were conducted to identify factors associated with academic achievement., Results: It was found that age ( B = 0.045; P = 0.040), BMI ( B = -0.200; P = 0.004), and physical ( B = 0.128; P = 0.008), psychological ( B = 0.057; P = 0.012) and social ( B = 0.189; P = 0.018) domains of quality of life were associated with the level of achievement., Conclusions: Precautions must be taken to improve students' academic achievement and quality of life in preparing for the future against infectious and epidemic diseases.

Background: Heart failure is a serious chronic medical condition that negatively impacts daily living. Living with heart failure can be challenging due to the physical symptoms, unpredictable nature of the disease, and lifestyle changes required. The objective of this study was to explore and describe the experiences of people living with heart failure and how it affects their health-related quality of life in Ethiopia., Methods: A qualitative descriptive design was employed to explore the experience of people living with heart failure, guided by the Theory of Symptom Management. A purposive sample of 14 participants was recruited from the cardiac outpatient clinics at two tertiary-level public hospitals in Ethiopia. Data were collected using a semi-structured interview. The recorded interviews were transcribed verbatim in Amharic, translated into English, and entered NVivo statistical software for analysis. An inductive-deductive hybrid thematic analysis method was used to analyse the data., Results: Three themes were identified deductively, while an additional three themes emerged inductively:-"Journey from diagnosis to daily life with heart failure"; "Symptom experience"; "Impact of heart failure on health-related quality of life"; "Perception of health-related quality of life and influencing factors"; "Symptom management and coping strategies"; and "Challenges faced in the journey of living with heart failure". Fatigue, and depression were the most frequently reported symptoms. Participants described how their condition affected their overall physical functioning. Participants utilized consistent follow up-care, adhered to their medications, ensured adequate rest, made dietary modifications, sought social support and engaged in spiritual activities to manage their symptoms and cope with their condition. Challenges they faced included financial difficulties, unavailability of medications, and a lack of continuity of care., Conclusion: People living with heart failure in Ethiopia experience various symptoms. The impact of heart failure on various aspects of their lives, combined with the challenges they face while living with heart failure, significantly affect their health-related quality of life. Health care providers caring for these people need to understand their experiences and the impact on their daily life. Effective multimodal interventions are needed to reduce the impact of heart failure and improve health-related quality of life in this population., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Mulugeta et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Endoscopy nurses in China face significant work-family conflicts, where the clash between high work demands and family responsibilities markedly increases the risk of occupational fatigue. This not only affects the nurses' physical and mental health and overall well-being, but also poses a threat to the quality of care and patient safety. This study, grounded in the Conservation of Resources theory, constructs a moderated mediation model to examine the mediating role of positive coping style in the relationship between work-family conflict and occupational fatigue among endoscopy nurses in China, as well as the moderating effect of perceived social support., Methods: A convenience sampling method was employed to select 315 endoscopy nurses from 25 tertiary hospitals across 14 provinces in China. A questionnaire survey was conducted using the Fatigue Assessment Instrument, the Work-Family Conflict Scale, the Simplified Coping Style Questionnaire, and the Perceived Social Support Scale. The moderated mediation model was validated using Stata16.0., Results: Our findings reveal that work-family conflict is a significant predictor of occupational fatigue, with a negative impact on positive coping style. Positive coping style, in turn, is negatively associated with occupational fatigue. Furthermore, positive coping style partially mediates the relationship between work-family conflict and occupational fatigue, accounting for 35.52% of the total effect. Additionally, perceived social support mitigates the negative effects of work-family conflict on positive coping style and occupational fatigue., Conclusion: There exists a moderated mediation effect between work-family conflict and occupational fatigue among endoscopy nurses in China, wherein positive coping style serve as a mediating variable. Perceived social support mitigates the negative impact of work-family conflict on positive coping style, while enhancing the alleviating effect of positive coping style on occupational fatigue. Therefore, improving endoscopy nurses' levels of perceived social support and coping strategies may help to prevent and alleviate the occurrence of occupational fatigue., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Zeng, Zhou, Liu, Xie, He and Zhang.)

Background: Primary healthcare, the first line of care in many countries, treats patients with diverse health problems. High workload, time pressure, poor job control and negative interpersonal experiences with supervisors have been documented in primary healthcare. The work environment in primary healthcare is also affected by several types of changes., Aim: We aimed to explore the levels of job satisfaction, turnover intention, social support, leadership climate and change fatigue according to physicians in Swedish primary healthcare. We also aimed to identify and characterize physicians exhibiting both high turnover intention and low job satisfaction, i.e., "discontent with current job"., Methods: A cross-sectional survey based on a random sample of physicians working in Swedish primary healthcare., Results: Approximately one-quarter of the respondents were discontented with their current job. Discontent was negatively associated with poor general health and change fatigue among the respondents; social support from colleagues and a favorable leadership climate showed positive associations in terms of reducing the levels of discontent with current job., Conclusions: The findings of this study highlight the association between low levels of job satisfaction and high levels of turnover intention (i.e., discontent with current job) among physicians in primary healthcare. Moreover, these variables exhibited a strong association with physicians' general health; poor health significantly increased the likelihood of discontent with current job. Our findings also show that experiencing change fatigue is associated with discontent with current job among physicians in primary healthcare. This knowledge can help identify and improve shortcomings within the psychosocial work environment in Swedish primary healthcare., (© 2024. The Author(s).)

Background: Working in accident management centers and medical emergencies makes employees face psychological tensions and leads to a decrease in their work quality and endangering the lives of patients. Therefore, any solution to reduce their tension will be valuable. This study was conducted to investigate the effect of acceptance and commitment-based therapy (ACT) on work-related rumination and job fatigue among the employees of the Emergency and Medical Accident Management Center of Alborz Province, Iran., Methods: This study is an experimental research with intervention and control groups conducted between January 16, 2019, and July 8, 2019. Sixty-four employees were selected based on the entry criteria and randomly assigned to two groups. People in the intervention group participated in 8 sessions of 2-hour therapy based on acceptance and commitment. Questionnaires for demographic information, work-related rumination, and occupational recovery/exhaustion were used to collect data. The intervention was conducted with univariate and multivariate covariance analysis., Results: The findings showed that the average job fatigue reached 16.78[Formula: see text] 11.44 from 37.06 ± 16.70 in the pre-test with a decrease of 20.28 points. Also, the average of all rumination dimensions related to work decreased in the post-test. The findings showed that the effectiveness of treatment based on acceptance and commitment therapy was confirmed on job fatigue and all its components and all dimensions of work-related rumination (p < 0.05). The partial eta square index was greater than 0.14 in all cases and showed the significant effectiveness of the intervention on all components of work-related rumination and job fatigue., Conclusion: Treatment based on acceptance and commitment reduced rumination and job fatigue. It is recommended to practice this intervention to improve personnel's mental health and the quality of services provided to patients., Clinical Trial Number: Not applicable., (© 2024. The Author(s).)

Aim: This study examines the moderating role of specific job resources in the association between job demands, vigour, sustainable performance and fatigue in nursing home staff., Design: A multi-location cross-sectional survey study in line with the STROBE guidelines., Methods: Online self-completion questionnaires were distributed in the Summer of 2022. A total of 667 healthcare employees from 24 nursing home locations in the Netherlands participated in this study. Data were analysed using hierarchical multiple regression analysis., Results: Job resources were able to moderate the relation between job demands on the one hand, and vigour, sustainable performance and fatigue on the other. Regression analyses revealed that high cognitive job resources moderated (i.e., strengthened) the positive association between cognitive job demands and successively cognitive liveliness, physical strength and sustainable performance. Furthermore, high emotional job resources moderated (i.e., buffered) the positive relation between emotional job demands and emotional and cognitive fatigue, respectively., Conclusions: It can be concluded that job resources are crucial for nursing home staff to deal with their high job demands. Maintaining a healthy balance between job demands and sufficient, matching, job resources to promote vigour and sustainable performance, as well as to prevent fatigue of staff, seems to be important., Implications for the Profession: There is an urgent need to train nursing home staff to cope better with increasing job demands. Because job demands cannot be reduced in many situations, this study revealed that the idea of boosting job resources instead is appealing to both staff and managers., Patient or Public Contribution: Dutch healthcare staff from 24 nursing home locations were involved in this study by responding to the online survey., (© 2024 The Author(s). Nursing Open published by John Wiley & Sons Ltd.)

Background: Understanding cancer symptom cluster through network analyses is a new approach in oncology, revealing interconnected and influential relationships among reported symptoms. We aimed to assess these relationships using network analysis in posttreatment breast cancer patients, focusing on the five dimensions of cancer-related fatigue (CRF), and on other common difficulties encountered by oncological patients (i.e., pain, anxiety, depression, sleep difficulties, cognitive impairments, and emotion regulation and mental adaptation difficulties)., Method: This study involved a complementary analysis of data from two interventional studies. Participants completed questionnaires before and after the intervention, with baseline scores being used in this article. Partial correlation network analysis modeled the relationships between symptoms in five distinct networks, each of them including one specific dimension of CRF. The core symptom in each network was identified based on the highest centrality indices., Results: Depression emerged as the core symptom in all networks, strongly associated with all fatigue dimensions (partial correlations ranging from 0.183 to 0.269) except mental fatigue. These findings indicate robust connections between symptoms, as variations in depression scores directly or indirectly influence fatigue and other symptoms within the cluster., Conclusion: Our results support the multidimensional aspect of CRF, and its links with other common symptoms. To effectively reduce patient CRF, interventions should address not only fatigue but also the closely related symptoms from the cluster, such as depression, given its centrality in the cluster., Trial Registration: ClinicalTrials.gov (NCT03144154 and NCT04873661). Retrospectively registered on May 1, 2017 and April 29, 2021, respectively., (© 2024 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd.)

Objectives: To explore the quality of life (QoL) of patients with systemic lupus erythematosus (SLE) and the factors affecting it., Methods: In this cross-sectional study, 269 patients diagnosed with SLE from multiple centers across different regions of Saudi Arabia were included. We used the LupusPRO1.8 QoL assessment tool. Additionally, comprehensive data regarding patient demographics, disease features, and associated comorbidities were collected for analysis., Results: The overall mean QoL score was 57.71±11.97, with the median value (interquartile range [IQR]) of 56.82 (48.62-66.65). The mean health-related QoL (HRQoL) score was 57.09±18.81, with the median (IQR) of 55.63 (44.04-70.19). Among HRQoL domains, the emotional health domain had the lowest score (44.67±30.00, median: 41.7 [16.7-66.7]). The second and third lowest scores were for fatigue (46.24±29.18, median: 43.8 [25-68.8]) and pain (48.65±30.38, median: 50 [25-71.9]). Regarding non-HRQoL, the mean score was 58.32±15.52 and median (IQR) score was 58.85 (48.18-70.83). The desires-goals domain had the lowest score (45.79±31.41), with the median value of 43.8 (21.9-68.8). The presence of comorbidities was the only factor affecting the QoL of patients with SLE., Conclusion: Our findings indicate that patients with SLE have worse overall QoL, which includes both HRQoL and non-HRQoL domains. Furthermore, the presence of comorbidities was the only factor that influenced the QoL of lupus patients., (Copyright: © Saudi Medical Journal.)

Purpose: The purpose of this study was to identify the factors influencing pediatric nurses' job stress, including their level of fatigue and partnerships with the parents of patients. This investigation aimed to findings of this study may lead to the development of strategies to reduce pediatric nurse's job stress., Design and Methods: Participants were recruited from pediatric, pediatric intensive care, and neonatal intensive care units across seven general hospitals. Eligibility requires a minimum of 6 months of experience in pediatric nursing. The sample size was determined using the G*power program, considering various variables, including age, marital status, presence of children, and work-related characteristics, leading to a final sample size of 135, adjusted for a 10% dropout rate. Data collection was conducted through self-report questionnaires, and analysis involved frequency, percentage, mean, standard deviation, t-tests, ANOVA, and stepwise multiple regression, using SPSS Statistics 27.0., Results: This study confirmed a significant correlation between pediatric nurses' fatigue and job stress, with higher levels of fatigue associated with increased job stress. Stepwise regression analysis showed that fatigue and age were significant predictors of job stress among pediatric nurses, explaining 23% of the variance. However, detailed analysis showed that younger nurses had lower job stress scores compared to older nurses. This result suggests that more experienced nurses may experience higher job stress due to increased responsibilities and emotional burdens., Practice Implications: This study identified the need for effective strategies to manage fatigue and reduce job stress among pediatric nurses during the COVID-19 pandemic. Younger nurses, particularly those under 25 and between 26 and 30 years old, experience lower job stress compared to older nurses. Comprehensive support systems should be developed, including workload management, emotional support, and programs to enhance partnerships between nurses and parents. These strategies can improve job satisfaction and the quality of care provided to young patients. Additionally, they ensure a more resilient and effective healthcare workforce during pandemics and similar crises., (© 2024 Wiley Periodicals LLC.)

Fatigue is common, but under-recognized in Parkinson's disease (PD), with limited treatment options. The aim of this study is to explore the experience of people with PD (PwPD) regarding content and delivery of the individual Packer Managing Fatigue program. This mixed-method study ( n = 12) was conducted concurrently with a pilot randomized controlled trial. Data were collected using questionnaires, interviews, and focus groups. Five themes emerged: the program is helpful; the program has strengths; areas for improvement; individual online delivery is feasible; and more support from occupational therapist would be helpful. Quantitative findings confirmed feasibility with high ratings on questionnaires and confidence to use learned strategies. The findings inform future implementation of the Packer Managing Fatigue program and contribute to understanding the needs of PwPD. Future studies might explore program's effectiveness as stand-alone treatment or in combination with other approaches. Tailoring fatigue programs to PwPD's unique needs and characteristics of PD fatigue is suggested., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Packer is co-founder, with no financial interest, of Think Self-Management Inc. Think Self-Management provides health care professionals with the tools and resources to empower people living with chronic conditions to cultivate the self-management skills they need to live happier, healthier lives. The Packer Managing Fatigue Program is distributed by Think Self-Management. None of the other authors declares real or potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objectives: This study, which uses a randomized controlled design, aimed to determine the effect of foot reflexology on stress, fatigue, and low back pain (LBP) in intensive care unit (ICU) nurses., Methods: The study was conducted with intensive care unit nurses at two hospitals in a city between September 2022 and April 2023. The study sample consisted of 42 nurses, 21 of whom had low back pain for at least 3 months and 21 of whom were controls. In the study, foot reflexology was applied to the intervention group for 20 minutes (10 minutes on each foot) once a week for 4 weeks. There was no intervention applied to the control group. Data were collected using the Personal Information Form, the Perceived Stress Scale (PSS), the Fatigue Severity Scale (FSS), and the Visual Analog Scale (VAS)., Findings: Based on the change in the mean scores of the scale in the intervention and control groups over time, a statistically significant decrease was found between the pre-test (before foot reflexology) and post-test mean scores of the LBP-VAS (from 6.33 to 2.24, respectively) and the Fatigue Severity Scale (from 4.81 to 3.60, respectively) in the intervention group. Although there was no statistically significant difference between the perceived stress scale pre-test and post-test scores, it was found that there was a decrease in favor of the intervention group., Conclusion: Foot reflexology appears to offer promise as an effective method for ICU nurses to reduce lower back pain and fatigue., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Inc.)

Depression is a major health problem in Chile. Evidence suggests that physical symptoms of depression (PSD) negatively impact self-perceived health and life satisfaction. The aim of this study was to determine the between-person and within-person associations of PSD with self-perceived health and life satisfaction in Chilean adults. The sample consisted of 1424 participants (64.54% female; M age = 46.77, SD = 14.88) with data in five waves of the Social Longitudinal Study of Chile. Variables were measured through self-report questionnaires. Hypotheses were tested using multilevel analysis. At the within-person level, physical slowing, fatigue, and sleep problems were associated with poorer self-perceived health and lower life satisfaction. At the between-person level, physical slowing and fatigue were associated with poorer perceived health and lower life satisfaction. PSD are associated with self-perceived health and life satisfaction in Chilean adults longitudinally. The study highlights the importance of monitoring PSD changes in Chilean adults., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Fatigue is prevalent amongst people with long COVID, but is poorly understood. The sensory attenuation framework proposes that impairments in sensory processing lead to heightened perception of effort, driving fatigue. This study aims to investigate the role of somatosensory processing impairments in long COVID fatigue and quantify how sensory processing relates to other prominent symptoms of long COVID including autonomic dysfunction, mood and illness beliefs in driving the experience of fatigue. We will recruit 44 individuals with long COVID fatigue and 44 individuals with neither long COVID nor fatigue (controls). Our primary objective is to compare baseline somatosensory processing between individuals with long COVID fatigue and controls. Additionally, we will explore the associations between somatosensory processing, fatigability and the level of fatigue induced by cognitive and physical exertion. Due to the complex nature of fatigue, we will also investigate how long COVID, state fatigue, perceived effort, mood, illness beliefs, autonomic symptoms and autonomic nervous system function interact to predict trait fatigue. This comprehensive investigation aims to elucidate how sensory processing and other prominent symptoms interact to impact the experience of fatigue., (© 2024 The Author(s). Experimental Physiology published by John Wiley & Sons Ltd on behalf of The Physiological Society.)

Objectives: To examine differences in psychological detachment from work during nonwork time by nurses' personal and work-related characteristics, and to examine the moderating and mediating effects of psychological detachment on the relationships between nursing workload and fatigue and sleep., Methods: This study employed a cross-sectional design with a self-administered online survey. Survey data from 827 hospital nurses providing direct patient care in the United States were used. Moderating and mediating effects of psychological detachment between workload and fatigue/sleep relationships were assessed using Hayes' PROCESS macro in SPSS., Results: There were significant differences in psychological detachment from work based on age, highest nursing degree, work experience, shift length, weekly work hours, and frequency of providing care to patients with COVID-19. The associations of workload with physical fatigue, mental fatigue, and sleep quality were weakened when psychological detachment was high. Psychological detachment statistically mediated the associations between workload and fatigue and sleep problems., Conclusion: Healthcare organizations are encouraged to facilitate nurses' psychological detachment during time-off to protect them from fatigue and sleep problems., Competing Interests: Declaration of conflicts of interest The authors declare no conflicts of interest., (Copyright © 2024 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.)

Objectives: Middle-aged women (i.e., aged 40-65 years) who live with, through and beyond breast cancer (survivors) are an under-researched population, particularly within an Australian context. The unmet needs reported within this population include fatigue, psychological distress, body image concerns, early-onset menopause, and a lack of information on these issues. This study explores how the experiences of breast cancer survivorship impact the lives of Australian middle-aged women., Study Design: Qualitative analysis of written comments in an open text field of a survey completed by 644 women reporting breast cancer in the middle-aged cohort of the Australian Longitudinal Study of Women's Health gathered between 1996 and 2013. Data was collected from any participants who reported breast cancer in any survey. Researchers conducted a thematic analysis using consensus coding on data and identified key themes., Main Outcome Measures: Any data where participants described their experiences of breast cancer survivorship., Results: This cohort reported a unique experience of breast cancer survivorship due to their age group. Analysis developed the following themes: the middle-aged context of breast cancer; care and support, body changes, overcoming fears and maintaining balance; and finding a 'new normal'., Conclusions: Breast cancer survivorship is a diverse experience. For many it involves chronic limitations and challenges. Investigation and application of survivorship care plans in Australia could benefit breast cancer survivors by including multidisciplinary health professionals in their care. Unmet needs and psychological distress were described by participants rather than biomedical concerns. Further recommendations include development of online support groups providing access to rehabilitation professionals, especially for otherwise isolated rural women., Competing Interests: Declaration of competing interest The authors declare that they have no competing interest., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Objective: Numerous studies have uncovered a correlation between menopausal, anxiety, and depressive symptoms. How these symptoms interrelate and influence each other, however, remains unclear. This study aimed to identify the associations between menopausal, anxiety, and depressive symptoms using network analysis., Methods: The participants comprised 423 women ( Mage = 49.21 ± 4.01 y; range, 40-60 y) recruited from a menopause clinic at a tertiary hospital in Beijing, China. Demographic characteristics and menopausal, anxiety, and depressive symptoms were obtained through self-report questionnaires. Two networks were established: a partial correlation network and a Bayesian network., Results: The menopausal symptom of nervousness exhibited a robust association with anxiety symptoms in both networks. Within the partial correlation network, the depressive symptom of tiredness emerged as a pivotal symptom, facilitating the co-occurrence of menopausal and depressive symptoms. Bayesian network analysis exhibited that the depressive symptom of a loss of interest was related to certain menopausal symptoms through depressive symptoms of tiredness and motor problems, both serving as critical links between menopausal symptoms and depression. Notably, four menopausal symptoms-arthralgia/myalgia, formication, sexual complaints, and urinary tract infection-appeared independent of other menopausal, anxiety, and depressive symptoms., Conclusions: Both psychological (eg, fatigue) and somatic (eg, hot flashes, headaches, and dizziness) menopausal symptoms demonstrate strong associations with depression. In providing optimal support for women's health during menopause, psychological interventions aimed at depression, particularly among those experiencing a loss of interest or pleasure in activities, should complement conventional therapies., Competing Interests: Financial disclosure/conflicts of interest: None reported., (Copyright © 2024 by The Menopause Society.)

Background: Fatigue is commonly reported in population surveys and has been identified in patients with health conditions as a key co-morbidity which makes remaining in work challenging. Such patients, however, rarely have access to programmes to help them manage their fatigue., Aims: To quantify the relationship between fatigue, work impairment and health-related job loss., Methods: We use data from the Health and Employment After Fifty study, a longitudinal study of people aged 50-64 years when recruited through general practices in England in 2013-14. During follow-up, fatigue was measured using the Fatigue Assessment Scale, work impairment was assessed using the Work Productivity and Activity Impairment scale, and changes in employment status were recorded., Results: A total of 2743 participants were eligible for the current analysis; 23% satisfied criteria for being fatigued. People who were fatigued were less likely to have a partner, university degree, be physically active and were more likely to be obese. Their job was more likely to involve shifts, be perceived as insecure, have reported difficulties coping with job demands, and be unsatisfying. After adjustment for socio-economic, lifestyle and work-related factors, they were almost twice as likely to report both work impairment (relative risk 1.8; 95% confidence interval [CI] 1.6, 2.1) and future health-related job loss, although the latter effect was only in those with other morbidities (incidence rate ratio 1.96; 95% CI 1.03-3.72)., Conclusions: Providing evidence-based support for workers with health conditions who experience fatigue may have an important impact at a population level in terms of extending working lives., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Society of Occupational Medicine.)

Background: The persistent destructive power of cancer-related fatigue (CRF) has been regarded as the biggest influencing factor affecting the postoperative physical and mental health of patients with cervical cancer. During this process, patients might also experience different feelings of disease-related psychological. Therefore, this study aimed to adopt mindfulness-based stress reduction (MBSR) to intervene in patients with cervical cancer, and conducted follow-up for 3 and 6 months to observe the effects of changes in CRF, uncertainty in illness, coping styles, sense of coherence (SOC), and perceived social support (PSS)., Methods: A randomized controlled trial was conducted in ShengJing Hospital of China Medical University. A total of 102 patients were selected, and 78 patients completed the whole process, including 40 in the experimental group and 38 in the control group. Data were collected according to Cancer Fatigue Scale, Medical Coping Modes Questionnaire, Multidimensional Scale of Perceived Social Support, and Sense of Coherence-13. The change trend and difference of the two groups of research data were compared by repeated measurement analysis of variance. Bonferroni test was used for multiple tests between groups., Results: The CRF, SOC, and coping styles of the MBSR group showed a decreasing trend (P < 0.001) at after MBSR, 3 months follow-up, and 6 months follow-up compared to the before MBSR. However, the uncertainty in illness of the MBSR group showed a decreasing trend (P < 0.001) at after MBSR compared to the before MBSR, and it rose in 3 months follow-up and 6 months follow-up., Conclusion: MBSR can effectively alleviate the fatigue of CRF after treatment, while improving their psychological environment. Medical workers can consider implementing online MBSR for patients with cervical cancer in their daily rehabilitation nursing, which is beneficial for their recovery., Trial Registration: China Clinical Trial Registration Center ChiCTR2000040122 (https//www.chictr.org.cn/). Registered on November 21, 2020., (© 2024. The Author(s).)

Purpose: Treatment fatigue is a complex, multidimensional, multicausal, and subjective phenomenon that is not yet well explored and understood in the area of speech therapy. The purpose of this study was to investigate speech-related treatment fatigue and speech treatment dropout in parents and children with a cleft (lip and) palate receiving or having received speech treatment for cleft-related articulation disorders., Method: Thirteen participants were included in this study ( n = seven parents with a median age of 40 years and n = six children with a median age of 10 years). Qualitative semistructured interviews were conducted separately with parents and children to investigate their experiences with cleft speech treatment. An inductive thematic approach was used to analyze the data and construct different themes. Rigor of the data was verified by conducting an investigator triangulation and by performing member checks., Results and Conclusions: The analyses of the interviews yielded three major themes of importance to the children and their parents: (a) physical symptoms of treatment fatigue, (b) psychological symptoms of treatment fatigue, and (c) from treatment fatigue to treatment dropout. Physical symptoms of treatment fatigue were mainly related to transportation burden. On a psychological level, speech treatment may potentially lead to a cognitive-emotional overload. These feelings are primarily related to the practical issue of scheduling required treatment sessions in the family agenda. The decision to discontinue speech treatment was reported to be multifactorial. In this decision-making process, data suggested that the child's perspective must be heard more.

Purpose: A breast cancer (BC) diagnosis may negatively affect health-related quality of life (HRQoL). However, there are few comparisons of HRQoL at several time points for women with BC, and particular when subdivided into invasive and in situ tumors. The purpose of this study was to investigate various aspects of HRQoL in women recently diagnosed with invasive BC or ductal carcinoma in situ (in situ) compared to age-matched BC free controls in a population-wide sample recruited through the Cancer Registry of Norway., Methods: This cross-sectional study utilized HRQoL data collected in 2020-2022 from a digital survey including 4117 cases (3867 women with invasive BC and 430 with in situ) and 2911 controls. HRQoL was assessed ≥ 21 days after diagnosis, using EORTC QLQ-C30. This includes scores assessing global quality of life (gHRQoL) and HRQoL functions and symptoms. Multivariable regression analyses were used to compare HRQoL between cases and controls and to identify factors associated with gHRQoL and fatigue. Additionally, HRQoL 14 months after diagnosis was analyzed in 1989 of the included cases and in 1212 of the controls. Score differences of ≥ 10 points were considered clinically relevant and thus presented in the results., Results: Invasive BC cases had lower gHRQoL, role- and social functioning in addition to more fatigue than controls. In situ cases had lower role-and social functioning than controls. Invasive BC cases scored worse than in situ on all domains, but the differences were not considered clinically relevant. Physical activity was associated with better gHRQoL and less fatigue in invasive BC, in situ and controls. Both invasive BC and in situ cases improved their role- and social functioning scores from diagnosis to 14 months follow-up, however no improvement was seen for fatigue., Conclusion: Women with invasive BC and in situ reported lower role- and social functioning scores than controls right after diagnosis with improvements 14 months after diagnosis. Physical activity was associated with better gHRQoL and less fatigue and should, whenever possible, play a key role in the care for BC patients., (© 2024. The Author(s).)

The popularity of online shopping in China has increased significantly, creating new development opportunities for the express delivery industry. However, the rapid expansion of the express industry has also created challenges in the parcel sorting process. The demanding nature of parcel sorting work, which is characterized by intense and prolonged repetitive tasks, makes individuals particularly vulnerable to the effects of fatigue. Fatigue is a complex condition that encompasses both physiological and psychological exhaustion. It often results in reduced energy levels and diminished functionality, significantly impacting an individual's performance at work and their overall well-being. This study aimed to investigate how physiological and psychological fatigue affects sorting efficiency and to identify appropriate rest periods that will allow employees to maintain their performance levels. The research involved fifteen participants who took part in a 60 min continuous sorting experiment and a similar experiment with scheduled breaks. During both trials, we collected data on participants' electromyography (EMG) and electrodermal activity (EDA), as well as subjective fatigue ratings (RPE). Signal features such as the median frequency ( MF ) of EMG and the skin conductance level ( SCL ) were analyzed to assess physiological and psychological fatigue, respectively. The results show that physiological fatigue mainly affects sorting efficiency in the first 30 min, while psychological fatigue becomes more influential in the following half-hour period. In addition, subjective fatigue levels during the first 30 min are primarily determined by psychological factors, while beyond that point, both physiological and psychological fatigue contribute to subjective fatigue. Rest periods of 415-460 s, based on EDA recovery times, effectively support sorting efficiency and participants' recovery. This study highlights the complex ways in which fatigue affects parcel sorting performance and provides valuable theoretical and practical insights for establishing labor quotas and optimizing work schedules in the parcel sorting industry.

Purpose: Listening effort is a broad construct, and there is no consensus on how to subdivide listening effort into dimensions. This project focuses on the subjective experience of effortful listening and tests if cognitive workload, mental fatigue, and mood are interrelated dimensions., Method: Two online studies tested young adults ( n = 74 and n = 195) and measured subjective workload, fatigue (subscales of fatigue and energy), and mood (subscales of positive and negative mood) before and after a challenging listening task. In the listening effort task, participants responded to intermittent 1-kHz target tones in continuous white noise for approximately 12 min., Results: Correlations and principal component analysis showed that fatigue and mood were distinct but interrelated constructs that weakly correlated with workload. Effortful listening provoked increased fatigue and decreased energy and positive mood yet did not influence negative mood or workload., Conclusions: The findings suggest that self-reported listening effort has multiple dimensions that can have different responses to the same effortful listening episode. The results can help guide evidence-based development of clinical listening effort tests and may reveal mechanisms for how listening effort relates to quality of life in those with hearing impairment., Supplemental Material: https://doi.org/10.23641/asha.26418976.

Objectives: Exploring the effect of resilience and self-efficacy in mediating the chain between fatigue and quality of life(QOL) in patients with rheumatoid arthritis (RA)., Methods: From June 2022 to November 2022, 423 RA patients were chosen by a convenience sample method from two tertiary care facilities in Chengdu, Sichuan Province. General Information Questionnaire, Bristol Multidimensional Scale of Fatigue in Patients with Rheumatoid Arthritis, SF-12 Health Survey Short Form, Chinese version of the ten-item psychological Resilience Scale, and Chinese-language Arthritis Self-Efficacy Scale, an 8-element version, were among the questionnaires used., Results: In the physical component summary( PCS), self-efficacy, psychological resilience, and self-efficacy were all significantly mediated by fatigue (total effect mediated 8.88%). In the mental component summary (MCS), fatigue (total effect mediated 10.79%), self-efficacy (total effect mediated 8.99%), psychological resilience, and self-efficacy (total effect mediated 2.01%) were all significantly mediated by fatigue., Conclusion: Fatigue in RA patients can affect the quality of life both directly and indirectly through the mediating effects of psychological resilience, self-efficacy, and the chain mediating effect of psychological resilience-self-efficacy., (© 2024. The Author(s).)

Purpose: This study aimed to explore the levels of postpartum fatigue, parenting stress, family support, and postpartum depression (PPD) experienced by first-time Chinese mothers and to investigate their impact on PPD., Methods: This cross-sectional survey involved 150 primigravida women attending postnatal checkups in Hebi City, Henan Province, China. Demographic data and information on environmental variables (living conditions, family relationships), postpartum fatigue, parenting stress, family support (expected vs. actual level), and PPD were collected., Results: The average age of the women was 26.25 years (SD, ±3.90), with 78.7% at risk for PPD (score ≥10). Significant correlations were found between PPD and postpartum fatigue (r=.63, p<.001), parenting stress (r=.59, p<.001), and family support (r=.40, p<.001). In model 1, which examined the influence of women's demographic variables on PPD, significant factors included a poor relationship with parents (β=.24, p=.001), a poor relationship with parents-in-law (β=.18, p=.029), and a poor relationship with the husband (β=.20, p=.013). When the three research variables were incorporated into model 2, the factors contributing to a higher level of PPD included a poor relationship with parents-in-law (β=.14, p=.033), increased postpartum fatigue (β=.37, p<.001), increased parenting stress (β=.33, p<.001), and less family support than expected (β=.12, p=.048)., Conclusion: The most critical factors influencing PPD include postpartum fatigue, parenting stress, poor relationships with parents-in-law, and low family support among Chinese primiparas. To mitigate PPD levels, healthcare professionals should screen mothers for depression in outpatient clinics and offer education and counseling to both mothers and their families or companions regarding PPD.

Background: While advancements in cancer treatments have improved survival rates, they also lead to adverse effects such as insomnia, which significantly impacts survivors' sleep quality., Objective: This study explores the influence of cancer-related fatigue (CRF), Fear of Cancer Recurrence (FCR), and psychological distress, with rumination serving as a mediating factor, on the insomnia experienced by cancer survivors., Methods: The study involved 220 cancer survivors attending Shohada-e-Tajrish Hospital's oncology center in Tehran, Iran. Participants were selected through convenience sampling and completed several questionnaires: the Insomnia Severity Index, Fear of Cancer Recurrence Inventory, Cancer Fatigue Scale, Kessler Psychological Distress Scale, and Rumination Response Scale., Results: The results showed that the tested model had a good fit, and the correlation matrix demonstrated significant positive correlations between CRF (0.46), FCR (0.15), psychological distress (0.55), and rumination (0.42) with insomnia in cancer survivors (p < 0.05). Notably, CRF (B = 0.356, p < 0.001) and psychological distress (B = 0.339, p < 0.001) affect insomnia both directly and indirectly through mediation by rumination, while the impact of FCR on insomnia was indirectly significant (B = 0.73, p < 0.05)., Conclusion: The findings suggest that interventions focused on managing rumination could be potential targets to alleviate insomnia and improve the sleep quality of cancer survivors., (© 2024 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd.)

The present study investigated burnout among esports players and its association with mental toughness and resilience. Esports players ( N  = 453; M age  = 23.0, SD = 4.18; in the top 40% of in-game rank) from seven team-based esports completed the Athlete Burnout Scale (ABO-S), Mental Toughness Questionnaire 18 (MTQ-18), and the Connor-Davidson Resilience Scale (CD-RISC-10). Latent profile analysis identified three distinct burnout profiles: "low burnout risk" (LBR; 33.8%), "medium burnout risk" (MBR; 28.0%), and "high burnout risk" (HBR; 38.3%). Low burnout profiles were associated with higher mental toughness and resilience. The LBR profile was characterized by low levels of reduced accomplishment (RA), physical exhaustion (PE), and negative feelings (NF), while [MBR and HBR reported similar PE and NF scores but] differed in RA, with HBR showing the highest RA and total burnout. This study is the first to show distinct burnout profiles among esports players, indicating a significant prevalence of burnout symptoms. This should be monitored by both players and support staff (e.g. club managers, programme managers, and high-performance support staff). Additionally, mental toughness and resilience appear to play a protective role against burnout.

Background: Cancer-related fatigue is a common and distressing late effect of cancer that can persist for decades after treatment completion. Although negatively affecting survivors' quality of life, few, if any, efficacious interventions for persistent, or chronic, fatigue exist., Aims: To inform future interventions, we explored how long-term, young adult cancer survivors (YACSs) with chronic fatigue live with, and manage their fatigue over time, including their experiences with nonpharmacological interventions (NPIs) for chronic fatigue., Methods and Results: We conducted a qualitative focus group study with 15 YACSs (13 women) with chronic fatigue, on average 7.3 years post-diagnosis. The YACS were identified and recruited through a nationwide health survey of cancer survivors (the NOR-CAYACS study). Systematic content analysis was used to identify recurrent themes. Analysis revealed five themes: (1) manifestation of fatigue, detailing chronic fatigue experiences; (2) impact on daily life, highlighting the necessity to balance rest and activity, affecting relationships; (3) NPIs, where walks in nature were notably beneficial; (4) barriers to fatigue management, including energy deficits, treatment-related bodily changes, and self-care prioritization challenges; (5) facilitators to fatigue management, emphasizing the need for regular breaks, self-care practices, and the importance of fatigue management education., Conclusion: This study offers novel insights into the lived experiences of YACSs with chronic fatigue, a subject scarcely examined in prior research. Our findings highlight the significant impact of chronic fatigue and the individualized strategies YACSs use to cope. The research emphasizes the need for personalized interventions to support chronic fatigue management, marking a critical step forward in addressing this often-overlooked issue in survivorship care. Future research should focus on tailored approaches to improve YACSs' quality of life., (© 2024 The Author(s). Cancer Reports published by Wiley Periodicals LLC.)

Purpose: To develop a PRO assessment of multidimensional cancer-related fatigue based on the PROMIS fatigue assessments., Method: Cancer patients reporting fatigue were recruited from a comprehensive cancer care center and completed a survey including 39 items from the PROMIS Cancer Item Bank-Fatigue. Component and factor structures of the fatigue items were explored with Monte Carlo parallel factor and Mokken analyses, respectively. Psychometric properties were determined using item response theory, ensuring unidimensionality, scalability, and item independence., Results: Fatigue scores from a sample of 333 fatigued cancer patients (mean age = 59.50, SD = 11.62, 67% women) were used in all scale development analyses. Psychometric analyses yielded 3 dimensions: motivational fatigue (15 items), cognitive fatigue (9 items), and physical fatigue (9 items). The subscales showed strong unidimensionality, were scalable, and were free of differential item function. Confirmatory factor analyses in a new sample of 182 patients confirmed the findings., Conclusion: The resulting 33-item PROMIS multidimensional cancer-related fatigue (mCRF) form provides a novel measure for the assessment of the different dimensions of cancer-related fatigue. It is the only multidimensional scale specific for cancer patients that has been developed using modern psychometric approaches. With its 3 dimensions (motivational, cognitive, and physical fatigue), this scale accurately captures the fatigue experienced by cancer patients, allowing clinicians to optimize fatigue management and improve patient care. The scale could also advance research on the nature and experience of cancer-related fatigue., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background: Constant availability, overtime and feeling overwhelmed by work can impact employees' wellbeing and their biological stress responses. Especially working parents often struggle to balance the demands of their work and family life and were found to be distracted from their work due to family responsibilities. The Family-to-Work Conflict (FWC) indicates the extent to which participating in work is made difficult by family demands. Recent studies have found associations between FWC and biological outcomes such as the Cortisol Awakening Response (CAR), a measure of an individual's Hypothalamic-Pituitary-Adrenal (HPA)-axis activity. This diary study investigates the effect of parental work demands on next day's cortisol response as well as the moderating role of FWC and the mediating role of fatigue., Methods: Over the course of five consecutive days (from Monday to Friday), 168 observations were made on a total of 42 parents. Participants had at least one child and worked a minimum of 20 hours per week. Salivary cortisol samples were obtained immediately, 15 and 30 minutes after awakening each day. Work demands, FWC and fatigue were assessed using standardized questionnaires. Within-person effects were examined using multilevel modeling and mediation analyses., Results: Our results indicate that there are no main effects of work demands on next day's cortisol response. The multilevel analysis revealed that FWC predicts lower wakening cortisol levels and confirmed FWC as an increasing moderator between work demands and next day's HPA-axis activity. Further, work overload was found to increase fatigue, which in turn leads to higher CAR on the following day. This indicates that fatigue mediates the relationship between work demands and CAR. Our findings add to a growing body of research demonstrating further predictors for HPA-axis activity and emphasise the importance of considering family related demands when investigating biological outcomes for working parents., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Introduction: Primary biliary cholangitis (PBC) is a chronic liver disease, leading to cirrhosis and impairment of patient-reported outcomes. We aimed to develop a PBC-specific version of the Chronic Liver Disease Questionnaire (CLDQ) instrument to assess health-related quality of life of patients with PBC., Methods: From our Liver Database, we included patients with PBC who had CLDQ, clinicolaboratory data, and completed Short Form-36 and The Functional Assessment of Chronic Illness Therapy-Fatigue. The 29 items of CLDQ were subjected to item reduction, exploratory factor analysis, and fed into a standard instrument validation pipeline., Results: Data were available for 108 patients with PBC: 57 ± 11 years, 7% male, 58% cirrhosis, and 24% decompensated cirrhosis (Child B and C). Of 29 CLDQ items, none met the exclusion criteria. Exploratory factor analysis (95% of variance) returned 7 factors. Based on evaluation of factor loadings and face validity, those factors yielded 7 domains (Diet, Emotion, Fatigue, Itch, Symptoms, Sleep, and Worry). Good to excellent internal consistency (Cronbach's α 0.85-0.93) was observed for 5/7 domains. For the remaining 2 domains (Diet and Itch), additional items obtained from patients, experts, and review of the literature were included. For 5 domains, known-group validity tests discriminated between patients with PBC with and without cirrhosis, advanced cirrhosis, and depression ( P < 0.05 for 3-5 domains). The CLDQ-PBC domains were correlated with relevant domains of Short Form-36, CLDQ-PBC Fatigue correlated with Fatigue Scale of Functional Assessment of Chronic Illness Therapy-Fatigue (rho = +0.85), and CLDQ-PBC Worry domain negatively correlated with alkaline phosphatase (rho = -0.38, P = 0.0082)., Discussion: The CLDQ-PBC has been developed based on the original CLDQ. The new instrument has evidence for internal consistency and validity and is being fully validated using an external cohort., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.)

Introduction: Prolonged progress can occur in the first and second stages of labour and may contribute to a negative birth experience. However, previous studies have mainly focused on quantitative aspects or overall birth experience, and little is known about women's experiences of a prolonged passive second stage., Objective: To describe the lived experiences of a prolonged passive second stage of labour in nulliparous women., Methods: A qualitative study was conducted with 15 nulliparous women with a passive second stage lasting three hours or more. Data were analysed using thematic analysis based on descriptive phenomenology., Results: The analysis resulted in four themes: "An unknown phase" that entailed remaining in a phase that the women lacked an awareness of. "Trust and mistrust in the body's ability" represents the mindset for vaginal birth as well as feelings of powerlessness and self-guilt. The theme "Loss of control" included experiences of frustration, fatigue, and having to deny bodily instincts. "Support through presence and involvement" signifies support through the midwife's presence in the birthing room, although there were also descriptions of emotional or physical absence., Conclusions: The findings contribute to the understanding of prolonged labour based on women's lived experiences and add to the body of knowledge about the prolonged passive second stage. This study highlights that women need support through information, presence, and encouragement to remain in control. It can be beneficial during birth preparation to include knowledge about the passive second stage together with unexpected or complicated situations during birth, such as prolonged labour., (Copyright © 2024. Published by Elsevier B.V.)

Purpose: This study identifies potential predictors of unemployment and describes specific work difficulties and their determinants in a subgroup of employed people with multiple sclerosis (PwMS). The specific work difficulties were evaluated using a validated tool that measures the impact of respondents' symptoms and of workplace features., Methods: A cross-sectional study was carried out in Italy during 2021-2022. The subjects included were adults (18-65 years) with a diagnosis of MS, currently employed or unemployed. Logistic regression models were used to determine the association between each potential determinant and employment status, while linear regression models were used to determine the association between determinants and specific work difficulties., Results: The main risk factors associated with a higher risk of being unemployed were being older, living in the South of Italy/islands, and having a higher disability level, while protective factors against unemployment were having a high level of education and 'stable' employment (an open-ended contract). Fatigue was found to be associated with all work difficulties analyzed; mood disorders emerged as the main predictors of mental health-related work difficulties; level of disability and comorbidity significantly impacted physical health-related ones, and a good quality of life was found to improve both workplace-related and mental health-related difficulties at work., Conclusion: Identifying the most significant difficulties is a crucial step in the development of vocational rehabilitation interventions tailored to maximize the ability of PwMS to handle their job-related duties and demands., (© 2023. The Author(s).)