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Knobbe TJ, Kremer D, Abma FI, Annema C, Berger SP, Navis GJ, van der Mei SF, Bültmann U, Visser A, Bakker SJ. Employment Status and Work Functioning among Kidney Transplant Recipients. Clin J Am Soc Nephrol 2022; 17:1506-1514. [PMID: 36162849 PMCID: PMC9528259 DOI: 10.2215/cjn.05560522] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/18/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND AND OBJECTIVES To date, employment figures of kidney transplant recipients in Europe are inconsistent. Additionally, little is known about work functioning of employed kidney transplant recipients and work functioning trajectories before and after transplantation. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Data from the ongoing TransplantLines Biobank and Cohort study and from community-dwelling employed adults were used. Health-related work functioning of kidney transplant recipients was assessed with the Work Role Functioning Questionnaire 2.0 and compared with potential kidney donors and community-dwelling employed adults. RESULTS We included 668 kidney transplant recipients of working age (59% men, age 51±11 years) at median 3 (interquartile range, 2-10) years after transplantation, 246 potential kidney donors of working age (43% men, age 53±9 years), and 553 community-dwelling employed adults (70% men, age 45±11 years). The proportion of employed kidney transplant recipients was lower compared with potential kidney donors (56% versus 79%). If employed, the work functioning score of kidney transplant recipients was slightly lower compared with employed potential kidney donors yet higher compared with community-dwelling employed adults (medians 91 [interquartile range, 76-98], 94 [interquartile range, 85-99], and 88 [interquartile range, 79-95], respectively). Backward linear regression analyses revealed that lower educational level, having a kidney from a deceased donor, presence of tingling or numbness of hands or feet, presence of concentration/memory problems, presence of anxiety, and presence of severe fatigue were independently associated with lower work functioning among kidney transplant recipients. Additional subgroup analyses showed that work functioning scores were lower before transplantation than at 12 months after transplantation (83 [interquartile range, 66-93] versus 92 [interquartile range, 88-98], respectively; P=0.002). CONCLUSIONS Stable employed kidney transplant recipients report to function well at work. In addition, this study shows that self-reported work functioning is higher after successful kidney transplantation compared with before transplantation. CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER TransplantLines Biobank and Cohort study, NCT03272841 PODCAST: This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2022_09_26_CJN05560522.mp3.
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Affiliation(s)
- Tim J. Knobbe
- Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Daan Kremer
- Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Femke I. Abma
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Coby Annema
- Department of Health Sciences, Section of Nursing Science, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Stefan P. Berger
- Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Gerjan J. Navis
- Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Sijrike F. van der Mei
- Department of Health Sciences, Applied Health Research, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Ute Bültmann
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Annemieke Visser
- Department of Health Sciences, Applied Health Research, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Stephan J.L. Bakker
- Department of Internal Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- University Medical Center Groningen Transplant Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Ingman T, Smakowski A, Goldsmith K, Chalder T. A systematic literature review of randomized controlled trials evaluating prognosis following treatment for adults with chronic fatigue syndrome. Psychol Med 2022; 52:2917-2929. [PMID: 36059125 PMCID: PMC9693680 DOI: 10.1017/s0033291722002471] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 06/20/2022] [Accepted: 07/18/2022] [Indexed: 01/05/2023]
Abstract
This systematic review investigated randomized controlled trials evaluating cognitive behavioral therapy (CBT) and graded exercise therapy (GET) for adults with chronic fatigue syndrome (CFS). The objective was to determine prognosis following treatment. Studies were eligible if they were peer-reviewed and investigated treatment at least 12 weeks in duration. Studies were excluded if they used co-morbid diagnoses as entry criteria or if they did not measure fatigue, disability, or functioning. Literature published between 1988 and 2021 was searched using MEDLINE, EMBASE, PsycINFO, and Web of Science. Study quality was assessed using the Effective Public Health Practice Project assessment tool. Outcomes were synthesized when three or more studies reported outcomes obtained from the same validated measurement tool. The review included 15 publications comprising 1990 participants. Following CBT, and at short-term to medium-term follow-up, 44% considered themselves better and 11% considered themselves worse. Following GET, and at post-treatment to short-term follow-up, 43% considered themselves better and 14% considered themselves worse. These outcomes were 8-26% more favorable compared to control conditions. Two-thirds of studies were of moderate quality and the remainder were of weak quality. Limitations of this review relate to the clinical heterogeneity of studies and that most outcomes were self-reported. Results suggest some support for the positive effects of CBT and GET at short-term to medium-term follow-up although this requires further investigation given the inconsistent findings of previous reviews. Findings may not be generalizable to severe CFS. This review was registered with PROSPERO (CRD42018086002).
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Affiliation(s)
- Tom Ingman
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, Addiction Sciences Building, King's College London, London, UK
| | - Abigail Smakowski
- Persistent Physical Symptoms Clinical Research and Treatment Unit, South London and Maudsley NHS Foundation Trust, London, UK
| | - Kimberley Goldsmith
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Trudie Chalder
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Jegal KH, Yoon J, Kim S, Jang S, Jin YH, Lee JH, Choi SM, Kim TH, Kwon S. Herbal Medicines for Post-Acute Sequelae (Fatigue or Cognitive Dysfunction) of SARS-CoV-2 Infection: A Phase 2 Pilot Clinical Study Protocol. Healthcare (Basel) 2022; 10:healthcare10101839. [PMID: 36292286 PMCID: PMC9601660 DOI: 10.3390/healthcare10101839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/13/2022] [Accepted: 09/18/2022] [Indexed: 11/19/2022] Open
Abstract
Long-term sequelae refer to persistent symptoms or signs for >6 months after SARS-CoV-2 infection. The most common symptoms of sequelae are fatigue and neuropsychiatric symptoms (concentration difficulty, amnesia, cognitive dysfunction, anxiety, and depression). However, approved treatments have not been fully established. Herbal medicines are administered for 12 weeks to patients who continuously complain of fatigue or cognitive dysfunction for >4 weeks that only occurred after COVID-19 diagnoses. Based on the Korean Medicine syndrome differentiation diagnosis, patients with fatigue will be administered Bojungikgi-tang or Kyungok-go, whereas those with cognitive dysfunction will be administered Cheonwangbosim-dan. Results could support evidence that herbal medicines may mitigate fatigue and cognitive dysfunction caused by COVID-19. Furthermore, by investigating the effects of herbal medicines on changes in metabolite and immune response due to COVID-19, which may be responsible for sequelae, the potential of herbal medicines as one of the therapeutic interventions for post-acute sequelae of SARS-CoV-2 infection can be evaluated. Therefore, the effects of herbal medicine on fatigue and cognitive dysfunction sequelae due to COVID-19 will be elucidated in this study to provide an insight into the preparation of medical management for the post-acute sequelae of SARS-CoV-2 infection.
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Affiliation(s)
- Kyung Hwan Jegal
- Digital Health Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Korea
- College of Korean Medicine, Daegu Haany University, Gyeongsan 38610, Korea
| | - Jiwon Yoon
- Korean Medicine Data Division, Korea Institute of Oriental Medicine, Daejeon 34054, Korea
| | - Sanghyun Kim
- Korean Medicine Data Division, Korea Institute of Oriental Medicine, Daejeon 34054, Korea
| | - Soobin Jang
- College of Korean Medicine, Daegu Haany University, Gyeongsan 38610, Korea
| | - Young-Hee Jin
- Korean Medicine Application Center, Korea Institute of Oriental Medicine, Daegu 41062, Korea
| | - Jun-Hwan Lee
- Korean Medicine Science Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Korea
- UST KIOM School, University of Science and Technology (UST), Daejeon 34113, Korea
| | - Sun-Mi Choi
- Korean Medicine Data Division, Korea Institute of Oriental Medicine, Daejeon 34054, Korea
- UST KIOM School, University of Science and Technology (UST), Daejeon 34113, Korea
| | - Tae Hun Kim
- Korean Medicine Clinical Trial Center, Korean Medicine Hospital, Kyung Hee University, Seoul 02447, Korea
- Correspondence: (T.H.K.); (S.K.); Tel.: +82-2-958-9088 (T.H.K.); +82-42-868-9675 (S.K.)
| | - Sunoh Kwon
- UST KIOM School, University of Science and Technology (UST), Daejeon 34113, Korea
- Korean Medicine Convergence Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Korea
- Correspondence: (T.H.K.); (S.K.); Tel.: +82-2-958-9088 (T.H.K.); +82-42-868-9675 (S.K.)
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Using smartphone-based ecological momentary assessment and personalized feedback for patients with chronic cancer-related fatigue: A proof-of-concept study. Internet Interv 2022; 30:100568. [PMID: 36072334 PMCID: PMC9441302 DOI: 10.1016/j.invent.2022.100568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 06/25/2022] [Accepted: 08/22/2022] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Chronic cancer-related fatigue (CCRF) is a complex multidimensional problem warranting person-centered care. Providing patients and therapists personalized feedback based on network analysis applied to ecological momentary assessment (EMA) data could facilitate case conceptualization in psycho-oncological care. The aim was to explore patients' and therapists' experiences of using an EMA app and personalized feedback based on network theory to aid case conceptualization in psycho-oncological care. METHODS A n = 5 proof-of-concept study was implemented in routine psycho-oncological care. We purposively selected adult cancer patients suffering from severe CCRF who were on the waitlist for psycho-oncological care. During a 3-week period participants filled out the EMA app Energy InSight (fatigue, mood, activity, responding, and context) five times a day. Participants received a descriptive and network feedback report, which they reflected upon during the first therapy sessions. Thematic analysis was used to analyze user experiences. RESULTS Patients experienced that filling out the Energy InSight app, as well as receiving descriptive and network-based personalized feedback provided them with insight into their CCRF. Although therapists experienced the discussion of network feedback as challenging, it facilitated the case conceptualization. DISCUSSION Using EMA during waitlist for psychological care seemed feasible. Patients experienced beneficial effects from filling out the EMA app and talking over the personalized feedback reports, which in turn aided case conceptualization and personalized care. Based on this evaluation, an improved version of the Energy InSight app and a therapist training for providing network feedback is developed for implementation in psycho-oncological care.
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Vroegindeweij A, Swart JF, Houtveen J, Eijkelkamp N, van de Putte EM, Wulffraat NM, Nijhof SL. Identifying disrupted biological factors and patient-tailored interventions for chronic fatigue in adolescents and young adults with Q-Fever Fatigue Syndrome, Chronic Fatigue Syndrome and Juvenile Idiopathic Arthritis (QFS-study): study protocol for a randomized controlled trial with single-subject experimental case series design. Trials 2022; 23:683. [PMID: 35986408 PMCID: PMC9389501 DOI: 10.1186/s13063-022-06620-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/02/2022] [Indexed: 11/10/2022] Open
Abstract
Background Chronic fatigue with a debilitating effect on daily life is a frequently reported symptom among adolescents and young adults with a history of Q-fever infection (QFS). Persisting fatigue after infection may have a biological origin with psychological and social factors contributing to the disease phenotype. This is consistent with the biopsychosocial framework, which considers fatigue to be the result of a complex interaction between biological, psychological, and social factors. In line, similar manifestations of chronic fatigue are observed in chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) and juvenile idiopathic arthritis (JIA). Cognitive behavioral therapy is often recommended as treatment for chronic fatigue, considering its effectiveness on the group level. However, not everybody benefits on the individual level. More treatment success at the individual level might be achieved with patient-tailored treatments that incorporate the biopsychosocial framework. Methods In addition to biological assessments of blood, stool, saliva, and hair, the QFS-study consists of a randomized controlled trial (RCT) in which a single-subject experimental case series (N=1) design will be implemented using Experience Sampling Methodology in fatigued adolescents and young adults with QFS, CFS/ME, and JIA (aged 12–29). With the RCT design, the effectiveness of patient-tailored PROfeel lifestyle advices will be compared against generic dietary advices in reducing fatigue severity at the group level. Pre-post analyses will be conducted to determine relevance of intervention order. By means of the N=1 design, effectiveness of both advices will be measured at the individual level. Discussion The QFS-study is a comprehensive study exploring disrupted biological factors and patient-tailored lifestyle advices as intervention in adolescent and young adults with QFS and similar manifestations of chronic fatigue. Practical or operational issues are expected during the study, but can be overcome through innovative study design, statistical approaches, and recruitment strategies. Ultimately, the study aims to contribute to biological research and (personalized) treatment in QFS and similar manifestations of chronic fatigue. Trial registration Trial NL8789. Registered July 21, 2020. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06620-2.
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106
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Declercq I, Van Den Eede F, Roelant E, Verbraecken J. SHIFTPLAN: a randomized controlled trial investigating the effects of a multimodal shift-work intervention on drivers' fatigue, sleep, health, and performance parameters. Trials 2022; 23:662. [PMID: 35978435 PMCID: PMC9382013 DOI: 10.1186/s13063-022-06573-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 07/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Shift work is commonly associated with health problems resulting from circadian misalignment and sleep restriction. About one in three shift workers is affected by insomnia and up to 90% report regular fatigue and/or sleepiness at the workplace. Epidemiological data shows that shift workers are at increased risk of cardiovascular disease, diabetes, obesity, breast cancer, mental-health problems, and shift-work disorder, which conditions typically lead to reduced work performance, processing errors, accidents at work, absenteeism, and reduced quality of life. Given these widespread and debilitating consequences, there is an urgent need for treatments that help improve the sleep, health, and functional performance of the shift-working population. The most common non-pharmacological recommendations are improved scheduling, bright-light exposure, napping, psychoeducation promoting sleep hygiene, and cognitive-behavioral techniques. The objectives of the present study are to investigate the effects of a multimodal shift-work intervention on perceived fatigue, sleepiness, physical and mental health, sleep parameters, and absenteeism. METHODS A randomized controlled interventional study comparing the two groups each comprising at least 80 drivers of a public transport company, using self-report questionnaires and health checks completed at intake and after 3 and 6 months following the start of the intervention or waiting-list period. The intervention consists of (a) healthy scheduling taking into account shift-rotation direction and speed, chronotype, resting time, and napping; (b) an education program specifically developed for shift workers; and (c) a dedicated information campaign for shift planners. The primary outcome is symptomatic burden in terms of sleepiness, and the key secondary outcome is symptomatic burden in terms of fatigue. Supplementary secondary outcomes are sleep parameters, absenteeism, general and clinical health, changes in mood, and anxiety. DISCUSSION Expected outcomes are significant improvements on all primary and secondary outcome parameters in the intervention group. To our knowledge, ours is the first randomized controlled study to systematically investigate the effects of a multimodal program on multiple health, sleep, and performance parameters in shift workers. Our research also aims at providing evidence-based practice guidelines for healthy scheduling in general and thus contribute to diminishing the serious health and economic burdens associated with shift work overall. TRIAL REGISTRATION EDGE registration number: 000339. CLINICALTRIALS gov NCT05452096.
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Affiliation(s)
- Inge Declercq
- Multidisciplinary Sleep Disorders Center, Antwerp University Hospital (UZA), Drie Eikenstraat 655 - 2650, Edegem, Belgium.
| | - Filip Van Den Eede
- Department of Psychiatry, Antwerp University Hospital (UZA), Drie Eikenstraat 655 - 2650, Edegem, Belgium.,Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp (UA), Universiteitsplein 1, 2610, Antwerp, Belgium
| | - Ella Roelant
- Clinical Trial Center (CTC), CRC Antwerp, Antwerp University Hospital (UZA), University of Antwerp, Edegem, Belgium
| | - Johan Verbraecken
- Multidisciplinary Sleep Disorders Center, Antwerp University Hospital (UZA), Drie Eikenstraat 655 - 2650, Edegem, Belgium.,Medical Coordinator Multidisciplinary Sleep Disorders Center (UZA), LEMP FGGW UA, Antwerp University Hospital (UZA), Drie Eikenstraat 655 - 2650, Edegem, Belgium
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107
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Adamowicz JL, Vélez-Bermúdez M, Thomas EB. Fatigue severity and avoidance among individuals with chronic disease: A meta-analysis. J Psychosom Res 2022; 159:110951. [PMID: 35665612 PMCID: PMC9629285 DOI: 10.1016/j.jpsychores.2022.110951] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 05/23/2022] [Accepted: 05/23/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Fatigue is a common, debilitating symptom experienced by individuals with chronic disease. Avoidance, or the act of evading unwanted experiences, is associated with fatigue across chronic disease samples. The current study sought to determine the strength of association between fatigue severity and avoidance in individuals with chronic disease. METHODS PubMed, PsycINFO, CINAHL, and ProQuest Dissertations and Theses databases were searched. Eligible studies measured fatigue and avoidance in chronic disease samples. Sixty-six studies were included. Data analyses were conducted in Rstudio. A random effects model was employed, and a weighted mean effect size was computed for fatigue severity and avoidance. Mixed-effects meta-regression analyses were conducted to examine moderating variables, including patient, clinical, and measurement characteristics. Publication bias was examined using funnel plot, trim-and-fill, and p-curve. RESULTS The meta-analysis comprised of 71 unique patient samples from 66 studies. The total number of included participants was 13,024. A small, positive association was found between fatigue severity and avoidance, r(71) = 0.22, p < .001, 95% CI [0.18-0.27], SE = 0.02. There was also significant heterogeneity, Q(70) = 349.96, p < .001. Moderator analyses examining age, sex, illness duration, avoidance type, and disease sample were all non-significant. Regarding publication bias, trim-and-fill resulted in a modified weighted mean effect size (r(83) = 0.18, p < .001) and a p-curve analysis supported the evidential value of the current analysis. CONCLUSION Findings support that among individuals with chronic disease, fatigue severity and avoidance are positively associated, which has implications for behavioral interventions in this population.
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Affiliation(s)
| | - Miriam Vélez-Bermúdez
- University of Iowa, Department of Psychological and Brain Sciences, United States of America.
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van Voorthuizen EL, van Helvoort HAC, Peters JB, van den Heuvel MM, van den Borst B. Persistent Exertional Dyspnea and Perceived Exercise Intolerance After Mild COVID-19: A Critical Role for Breathing Dysregulation? Phys Ther 2022; 102:6651031. [PMID: 35900016 PMCID: PMC9384552 DOI: 10.1093/ptj/pzac105] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 04/19/2022] [Accepted: 06/03/2022] [Indexed: 11/14/2022]
Abstract
OBJECTIVE After mild COVID-19, a subgroup of patients reported post-acute-phase sequelae of COVID-19 (PASC) in which exertional dyspnea and perceived exercise intolerance were common. Underlying pathophysiological mechanisms remain incompletely understood. The purpose of this study was to examine outcomes from cardiopulmonary exercise testing (CPET) in these patients. METHODS In this observational study, participants were patients who were referred for the analysis of PASC after mild COVID-19 and in whom CPET was performed after standard clinical workup turned out unremarkable. Cardiocirculatory, ventilatory, and metabolic responses to and breathing patterns during exercise at physiological limits were analyzed. RESULTS Twenty-one patients (76% women; mean age = 40 years) who reported severe disability in physical functioning underwent CPET at 32 weeks (interquartile range = 22-52) after COVID-19. Mean peak O2 uptake was 99% of predicted with normal anaerobic thresholds. No cardiovascular or gas exchange abnormalities were detected. Twenty of the 21 patients (95%) demonstrated breathing dysregulation (ventilatory inefficiency [29%], abnormal course of breathing frequency and tidal volume [57%], absent increase of end-tidal Pco2 [57%], and abnormal resting blood gases [67%]). CONCLUSION Breathing dysregulation may explain exertional dyspnea and perceived exercise intolerance in patients with PASC after mild COVID-19 and can be present in the absence of deconditioning. This finding warrants further study on the levels of neural control of breathing and muscle function, and simultaneously provides a potential treatment opportunity. IMPACT This study contributes to the understanding of persistent exertional dyspnea and perceived exercise intolerance following mild COVID-19, which is vital for the development of effective rehabilitation strategies.
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Affiliation(s)
| | | | - Jeanette B Peters
- Department of Pulmonary Diseases, Radboud University Medical Center Nijmegen, the Netherlands
| | - Michel M van den Heuvel
- Department of Pulmonary Diseases, Radboud University Medical Center Nijmegen, the Netherlands
| | - Bram van den Borst
- Department of Pulmonary Diseases, Radboud University Medical Center Nijmegen, the Netherlands
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Müller F, Verdam MGE, Oort FJ, Riper H, van Straten A, Verdonck-de Leeuw IM, Sprangers MAG, Knoop H. Response Shift After Cognitive Behavioral Therapy Targeting Severe Fatigue: Explorative Analysis of Three Randomized Controlled Trials. Int J Behav Med 2022:10.1007/s12529-022-10111-8. [DOI: 10.1007/s12529-022-10111-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2022] [Indexed: 11/28/2022]
Abstract
Abstract
Background
Cognitive behavioral therapy (CBT) is an evidence-based intervention for severe fatigue. Changes in patients’ fatigue scores following CBT might reflect not only the intended relief in fatigue but also response shift, a change in the meaning of patients’ self-evaluation. Objectives were to (1) identify the occurrence of response shift in patients undergoing CBT, (2) determine the impact of response shift on the intervention effect, and (3) investigate whether changes in fatigue-related cognitions and perceptions, targeted during CBT, are associated with response shift.
Methods
Data of three randomized controlled trials testing the efficacy of CBT in individuals with chronic fatigue syndrome (CFS, n = 222), cancer (n = 123), and diabetes (n = 107) were re-analyzed. Fatigue severity was measured with 8 items from the Checklist Individual Strength, a valid and widely used self-report questionnaire. Structural equation modelling was applied to assess lack of longitudinal measurement invariance, as indication of response shift.
Results
As expected, in all three trials, response shift was indicated in the CBT groups, not the control groups. Response shift through reprioritization was indicated for the items “Physically, I feel exhausted” (CFS) and “I tire easily” (cancer, diabetes), which became less vs. more important to the measurement of fatigue, respectively. However, this did not affect the intervention effects. Some changes in cognitions and perceptions were associated with the response shifts.
Conclusions
CBT seems to induce response shift through reprioritization across patient groups, but its occurrence does not affect the intervention effect. Future research should corroborate these findings and investigate whether patients indeed change their understanding of fatigue.
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van de Geest-Buit WA, Rasing NB, Mul K, Deenen JCW, Vincenten SCC, Siemann I, Lanser A, Groothuis JT, van Engelen BG, Custers JAE, Voermans NC. Facing facial weakness: psychosocial outcomes of facial weakness and reduced facial function in facioscapulohumeral muscular dystrophy. Disabil Rehabil 2022:1-10. [DOI: 10.1080/09638288.2022.2092779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- W. A. van de Geest-Buit
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - N. B. Rasing
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - K. Mul
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J. C. W. Deenen
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - S. C. C. Vincenten
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - I. Siemann
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - A. Lanser
- Patient Representative and Chairman FSHD Advocacy Group, Patient Organization for Muscular Diseases Spierziekten Nederland, Baarn, The Netherlands
| | - J. T. Groothuis
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - B. G. van Engelen
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J. A. E. Custers
- Department of Medical Psychology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - N. C. Voermans
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
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Post A, Kremer D, Groothof D, van der Veen Y, de Blaauw P, van der Krogt J, Kema IP, Westerhuis R, Heiner-Fokkema MR, Bakker SJL, Franssen CFM. Amino Acid Homeostasis and Fatigue in Chronic Hemodialysis Patients. Nutrients 2022; 14:nu14142810. [PMID: 35889768 PMCID: PMC9318329 DOI: 10.3390/nu14142810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/04/2022] [Accepted: 07/05/2022] [Indexed: 12/04/2022] Open
Abstract
Patients dependent on chronic hemodialysis treatment are prone to malnutrition, at least in part due to insufficient nutrient intake, metabolic derangements, and chronic inflammation. Losses of amino acids during hemodialysis may be an important additional contributor. In this study, we assessed changes in plasma amino acid concentrations during hemodialysis, quantified intradialytic amino acid losses, and investigated whether plasma amino acid concentrations and amino acid losses by hemodialysis and urinary excretion are associated with fatigue. The study included a total of 59 hemodialysis patients (65 ± 15 years, 63% male) and 33 healthy kidney donors as controls (54 ± 10 years, 45% male). Total plasma essential amino acid concentration before hemodialysis was lower in hemodialysis patients compared with controls (p = 0.006), while total non-essential amino acid concentration did not differ. Daily amino acid losses were 4.0 ± 1.3 g/24 h for hemodialysis patients and 0.6 ± 0.3 g/24 h for controls. Expressed as proportion of protein intake, daily amino acid losses of hemodialysis patients were 6.7 ± 2.4% of the total protein intake, compared to 0.7 ± 0.3% for controls (p < 0.001). Multivariable regression analyses demonstrated that hemodialysis efficacy (Kt/V) was the primary determinant of amino acid losses (Std. β = 0.51; p < 0.001). In logistic regression analyses, higher plasma proline concentrations were associated with higher odds of severe fatigue (OR (95% CI) per SD increment: 3.0 (1.3; 9.3); p = 0.03), while higher taurine concentrations were associated with lower odds of severe fatigue (OR (95% CI) per log2 increment: 0.3 (0.1; 0.7); p = 0.01). Similarly, higher daily taurine losses were also associated with lower odds of severe fatigue (OR (95% CI) per log2 increment: 0.64 (0.42; 0.93); p = 0.03). Lastly, a higher protein intake was associated with lower odds of severe fatigue (OR (95% CI) per SD increment: 0.2 (0.04; 0.5); p = 0.007). Future studies are warranted to investigate the mechanisms underlying these associations and investigate the potential of taurine supplementation.
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Affiliation(s)
- Adrian Post
- Department of Internal Medicine, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (D.K.); (D.G.); (Y.v.d.V.); (S.J.L.B.); (C.F.M.F.)
- Correspondence: ; Tel.: +31-649-653-442
| | - Daan Kremer
- Department of Internal Medicine, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (D.K.); (D.G.); (Y.v.d.V.); (S.J.L.B.); (C.F.M.F.)
| | - Dion Groothof
- Department of Internal Medicine, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (D.K.); (D.G.); (Y.v.d.V.); (S.J.L.B.); (C.F.M.F.)
| | - Yvonne van der Veen
- Department of Internal Medicine, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (D.K.); (D.G.); (Y.v.d.V.); (S.J.L.B.); (C.F.M.F.)
| | - Pim de Blaauw
- Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (P.d.B.); (J.v.d.K.); (I.P.K.); (M.R.H.-F.)
| | - Jennifer van der Krogt
- Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (P.d.B.); (J.v.d.K.); (I.P.K.); (M.R.H.-F.)
| | - Ido P. Kema
- Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (P.d.B.); (J.v.d.K.); (I.P.K.); (M.R.H.-F.)
| | - Ralf Westerhuis
- Dialysis Center Groningen, 9713 GZ Groningen, The Netherlands;
| | - M. Rebecca Heiner-Fokkema
- Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (P.d.B.); (J.v.d.K.); (I.P.K.); (M.R.H.-F.)
| | - Stephan J. L. Bakker
- Department of Internal Medicine, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (D.K.); (D.G.); (Y.v.d.V.); (S.J.L.B.); (C.F.M.F.)
| | - Casper F. M. Franssen
- Department of Internal Medicine, University of Groningen, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands; (D.K.); (D.G.); (Y.v.d.V.); (S.J.L.B.); (C.F.M.F.)
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Mutubuki EN, van der Maaden T, Leung KY, Wong A, Tulen AD, de Bruijn S, Haverman L, Knoop H, Franz E, van Hoek AJ, van den Wijngaard CC. Prevalence and determinants of persistent symptoms after infection with SARS-CoV-2: protocol for an observational cohort study (LongCOVID-study). BMJ Open 2022; 12:e062439. [PMID: 35777877 PMCID: PMC9251892 DOI: 10.1136/bmjopen-2022-062439] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION A substantial proportion of individuals infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), report persisting symptoms weeks and months following acute infection. Estimates on prevalence vary due to differences in study designs, populations, heterogeneity of symptoms and the way symptoms are measured. Common symptoms include fatigue, cognitive impairment and dyspnoea. However, knowledge regarding the nature and risk factors for developing persisting symptoms is still limited. Hence, in this study, we aim to determine the prevalence, severity, risk factors and impact on quality of life of persisting symptoms in the first year following acute SARS-CoV-2 infection. METHODS AND ANALYSIS The LongCOVID-study is both a prospective and retrospective cohort study being conducted in the Netherlands, with a one year follow-up. Participants aged 5 years and above, with self-reported positive or negative tests for SARS-CoV-2 will be included in the study. The primary outcome is the prevalence and severity of persistent symptoms in participants that tested positive for SARS-CoV-2 compared with controls. Symptom severity will be assessed for fatigue (Checklist Individual Strength (CIS subscale fatigue severity)), pain (Rand-36/SF-36 subscale bodily pain), dyspnoea (Medical Research Council (mMRC)) and cognitive impairment (Cognitive Failure Questionnaire (CFQ)). Secondary outcomes include effect of vaccination prior to infection on persistent symptoms, loss of health-related quality of life (HRQoL) and risk factors for persisting symptoms following infection with SARS-CoV-2. ETHICS AND DISSEMINATION The Utrecht Medical Ethics Committee (METC) declared in February 2021 that the Medical Research Involving Human Subjects Act (WMO) does not apply to this study (METC protocol number 21-124/C). Informed consent is required prior to participation in the study. Results of this study will be submitted for publication in a peer-reviewed journal.
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Affiliation(s)
- Elizabeth N Mutubuki
- National Institute for Public Health and the Environment (RIVM), Center for Infectious Disease Control, Bilthoven, The Netherlands
| | - Tessa van der Maaden
- National Institute for Public Health and the Environment (RIVM), Center for Infectious Disease Control, Bilthoven, The Netherlands
| | - Ka Yin Leung
- National Institute for Public Health and the Environment (RIVM), Center for Infectious Disease Control, Bilthoven, The Netherlands
| | - Albert Wong
- National Institute for Public Health and the Environment (RIVM), Center for Infectious Disease Control, Bilthoven, The Netherlands
| | - Anna D Tulen
- National Institute for Public Health and the Environment (RIVM), Center for Infectious Disease Control, Bilthoven, The Netherlands
| | - Siméon de Bruijn
- National Institute for Public Health and the Environment (RIVM), Center for Infectious Disease Control, Bilthoven, The Netherlands
| | - Lotte Haverman
- Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam Public Health, Amsterdam, the Netherlands
| | - Hans Knoop
- Department of Medical Psychology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Eelco Franz
- National Institute for Public Health and the Environment (RIVM), Center for Infectious Disease Control, Bilthoven, The Netherlands
| | - Albert Jan van Hoek
- National Institute for Public Health and the Environment (RIVM), Center for Infectious Disease Control, Bilthoven, The Netherlands
| | - Cees C van den Wijngaard
- National Institute for Public Health and the Environment (RIVM), Center for Infectious Disease Control, Bilthoven, The Netherlands
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113
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Prouskas SE, Schoonheim MM, Huiskamp M, Steenwijk MD, Gehring K, Barkhof F, de Jong BA, Sitskoorn MM, Geurts JJG, Hulst HE. A randomized trial predicting response to cognitive rehabilitation in multiple sclerosis: Is there a window of opportunity? Mult Scler 2022; 28:2124-2136. [PMID: 35765748 PMCID: PMC9574229 DOI: 10.1177/13524585221103134] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background: Cognitive training elicits mild-to-moderate improvements in cognitive functioning in people with multiple sclerosis (PwMS), although response heterogeneity limits overall effectiveness. Objective: To identify patient characteristics associated with response and non-response to cognitive training. Methods: Eighty-two PwMS were randomized into a 7-week attention training (n = 58, age = 48.4 ± 10.2 years) or a waiting-list control group (n = 24, age = 48.5 ± 9.4 years). Structural and functional magnetic resonance imaging (MRI) was obtained at baseline and post-intervention. Twenty-one healthy controls (HCs, age = 50.27 ± 10.15 years) were included at baseline. Responders were defined with a reliable change index of 1.64 on at least 2/6 cognitive domains. General linear models and logistic regression were applied. Results: Responders (n = 36) and non-responders (n = 22) did not differ on demographics, clinical variables and baseline cognition and structural MRI. However, non-responders exhibited a higher baseline functional connectivity (FC) between the default-mode network (DMN) and the ventral attention network (VAN), compared with responders (p = 0.018) and HCs (p = 0.001). Conversely, responders exhibited no significant baseline differences in FC compared with HCs. Response to cognitive training was predicted by lower DMN-VAN FC (p = 0.004) and DMN-frontoparietal FC (p = 0.029) (Nagelkerke R2 = 0.25). Conclusion: An intact pre-intervention FC is associated with cognitive training responsivity in pwMS, suggesting a window of opportunity for successful cognitive interventions.
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Affiliation(s)
- Stefanos E Prouskas
- SE Prouskas Department of Anatomy and Neurosciences, MS Centre Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Location VUmc, O2 building, 13W01, PO Box 7700, 1000 SN Amsterdam, The Netherlands. ; Twitter handle:@StefProuskas
| | - Menno M Schoonheim
- Department of Anatomy and Neurosciences, MS Centre Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marijn Huiskamp
- Department of Anatomy and Neurosciences, MS Centre Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Martijn D Steenwijk
- Department of Anatomy and Neurosciences, MS Centre Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Karin Gehring
- Department of Cognitive Neuropsychology, Tilburg University, Tilburg, The Netherlands/Department of Neurosurgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands/Institutes of Neurology and Healthcare Engineering, UCL, London, UK
| | - Brigit A de Jong
- Department of Neurology, MS Centre Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Margriet M Sitskoorn
- Department of Cognitive Neuropsychology, Tilburg University, Tilburg, The Netherlands
| | - Jeroen JG Geurts
- Department of Anatomy and Neurosciences, MS Centre Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Hanneke E Hulst
- Department of Anatomy and Neurosciences, MS Centre Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Schellekens MPJ, Bruggeman-Everts FZ, Wolvers MDJ, Vollenbroek-Hutten MMR, van der Lee ML. What web-based intervention for chronic cancer-related fatigue works best for whom? Explorative moderation analyses of a randomized controlled trial. Support Care Cancer 2022; 30:7885-7892. [PMID: 35726109 PMCID: PMC9512869 DOI: 10.1007/s00520-022-07223-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 06/11/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE Approximately 25% of cancer patients suffer from chronic cancer-related fatigue (CCRF), which is a complex, multifactorial condition. While there are evidence-based interventions, it remains unclear what treatment works best for the individual patient. This study explored whether baseline characteristics moderated the effect of web-based mindfulness-based cognitive therapy (eMBCT) versus ambulant activity feedback (AAF) and a psycho-education control group (PE) on fatigue in patients suffering from CCRF. METHODS In a randomized controlled trial, participant suffering from CCRF participated in either eMBCT, AAF, or PE. Complete data of the treatment-adherent sample (≥ 6 sessions) was used to explore whether sociodemographic, clinical, and psychological characteristics at baseline moderated the intervention effect on fatigue severity at 6 months. RESULTS A trend showed that baseline fatigue severity and fatigue catastrophizing moderated the intervention effect. That is, at low levels of fatigue severity and catastrophizing, patients benefited more from AAF than from eMBCT and at high levels of fatigue severity and catastrophizing, patients benefited more from eMBCT than from PE. CONCLUSIONS This study found some preliminary evidence on what treatment works best for the individual suffering from CCRF. These findings emphasize the potential gain in effectiveness of personalizing treatment. An alternative approach that might help us further in answering the question "what treatment works best for whom?" is discussed.
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Affiliation(s)
- Melanie P J Schellekens
- Scientific Research Department, Helen Dowling Institute, Centre for Psycho-Oncology, Bilthoven, The Netherlands.
- Department of Medical and Clinical Psychology, Tilburg University School of Social and Behavioral Sciences, Tilburg, The Netherlands.
| | - Fieke Z Bruggeman-Everts
- Scientific Research Department, Helen Dowling Institute, Centre for Psycho-Oncology, Bilthoven, The Netherlands
- Telemedicine Group, Faculty of Electrical Engineering, Mathematics, and Computer Science, University of Twente, Enschede, The Netherlands
| | - Marije D J Wolvers
- Telemedicine Group, Faculty of Electrical Engineering, Mathematics, and Computer Science, University of Twente, Enschede, The Netherlands
| | - Miriam M R Vollenbroek-Hutten
- Telemedicine Group, Faculty of Electrical Engineering, Mathematics, and Computer Science, University of Twente, Enschede, The Netherlands
- ZGT Academy, ZiekenhuisGroep Twente, Almelo, The Netherlands
| | - Marije L van der Lee
- Scientific Research Department, Helen Dowling Institute, Centre for Psycho-Oncology, Bilthoven, The Netherlands
- Department of Medical and Clinical Psychology, Tilburg University School of Social and Behavioral Sciences, Tilburg, The Netherlands
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115
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Penson A, Walraven I, Bronkhorst E, Maurice-Stam H, Grootenhuis MA, Van der Heiden-van der Loo M, Tissing WJE, Van der Pal HJH, De Vries ACH, Bresters D, Ronckers C, Van den Heuvel MM, Neggers SJCMM, Versluys BAB, Louwerens M, Pluijm SMF, Kremer LCM, Blijlevens N, Van Dulmen-den Broeder E, Knoop H, Loonen J. The Impact of Cancer-Related Fatigue on HRQOL in Survivors of Childhood Cancer: A DCCSS LATER Study. Cancers (Basel) 2022; 14:cancers14122851. [PMID: 35740518 PMCID: PMC9221067 DOI: 10.3390/cancers14122851] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/31/2022] [Accepted: 06/03/2022] [Indexed: 02/05/2023] Open
Abstract
Simple Summary Survivors of childhood cancer have an increased risk to experience symptoms of severe and persistent fatigue. We studied how fatigue might affect the health-related quality of life of these survivors. Questionnaire items asking about a broad range of daily life aspects were compared between fatigued survivors, survivors without fatigue and the general Dutch population. A total of eleven aspects were studied which were all negatively affected by fatigue, with the largest impact seen for Vitality (how much energy does a person have), General Health (perception of current and future health) and Role Limitations (work-related activities). Results show the negative impact fatigue can have on the daily lives of survivors and why it is important to treat fatigue adequately. Abstract Background: Early detection and management of late effects of treatment and their impact on health-related quality of life (HRQOL) has become a key goal of childhood cancer survivorship care. One of the most prevalent late effects is chronic fatigue (CF). The current study aimed to investigate the association between CF and HRQOL in a nationwide cohort of CCS. Methods: Participants were included from the Dutch Childhood Cancer Survivor Study (DCCSS) LATER cohort, a nationwide cohort of CCS. Participants completed the Checklist Individual Strength (CIS) to indicate CF (CIS fatigue severity subscale ≥ 35 and duration of symptoms ≥6 months) and the Short Form-36 (SF-36) and TNO (Netherlands Organization for Applied Scientific Research) and AZL (Leiden University Medical Centre) Adult’s Health-Related Quality of Life questionnaire (TAAQOL) as measures for HRQOL. Differences in mean HRQOL domain scores between CF and non-CF participants were investigated using independent samples t-tests and ANCOVA to adjust for age and sex. The association between CF and impaired HRQOL (scoring ≥ 2 SD below the population norm) was investigated using logistic regression analyses, adjusting for confounders. Results: A total of 1695 participants were included in the study. Mean HRQOL domain scores were significantly lower in participants with CF. In addition, CF was associated with impaired HRQOL on all of the domains (except physical functioning) with adjusted odds ratios ranging from 2.1 (95% CI 1.3–3.4; sexuality domain) to 30.4 (95% CI 16.4–56.2; vitality domain). Conclusions: CF is associated with impaired HRQOL, urging for the screening and regular monitoring of fatigue, and developing possible preventative programs and interventions.
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Affiliation(s)
- Adriaan Penson
- Department of Hematology, Radboud University Medical Center, Geert-Grooteplein Zuid 8, 6500 HB Nijmegen, The Netherlands;
- Correspondence:
| | - Iris Walraven
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Geert-Grooteplein 21, 6500 HB Nijmegen, The Netherlands; (I.W.); (E.B.); (N.B.)
| | - Ewald Bronkhorst
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Geert-Grooteplein 21, 6500 HB Nijmegen, The Netherlands; (I.W.); (E.B.); (N.B.)
| | - Heleen Maurice-Stam
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (H.M.-S.); (M.V.d.H.-v.d.L.); (W.J.E.T.); (H.J.H.V.d.P.); (D.B.); (C.R.); (M.M.V.d.H.); (S.J.C.M.M.N.); (B.A.B.V.); (S.M.F.P.); (L.C.M.K.)
| | - Martha A. Grootenhuis
- Department of Psychology, Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands;
| | - Margriet Van der Heiden-van der Loo
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (H.M.-S.); (M.V.d.H.-v.d.L.); (W.J.E.T.); (H.J.H.V.d.P.); (D.B.); (C.R.); (M.M.V.d.H.); (S.J.C.M.M.N.); (B.A.B.V.); (S.M.F.P.); (L.C.M.K.)
| | - Wim J. E. Tissing
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (H.M.-S.); (M.V.d.H.-v.d.L.); (W.J.E.T.); (H.J.H.V.d.P.); (D.B.); (C.R.); (M.M.V.d.H.); (S.J.C.M.M.N.); (B.A.B.V.); (S.M.F.P.); (L.C.M.K.)
- Department of Pediatric Oncology/Hematology, University of Groningen/University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Helena J. H. Van der Pal
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (H.M.-S.); (M.V.d.H.-v.d.L.); (W.J.E.T.); (H.J.H.V.d.P.); (D.B.); (C.R.); (M.M.V.d.H.); (S.J.C.M.M.N.); (B.A.B.V.); (S.M.F.P.); (L.C.M.K.)
| | - Andrica C. H. De Vries
- Department of Pediatric Oncology, Erasmus Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands;
| | - Dorine Bresters
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (H.M.-S.); (M.V.d.H.-v.d.L.); (W.J.E.T.); (H.J.H.V.d.P.); (D.B.); (C.R.); (M.M.V.d.H.); (S.J.C.M.M.N.); (B.A.B.V.); (S.M.F.P.); (L.C.M.K.)
- Willem-Alexander Children’s Hospital, Department of Pediatrics, Leiden University Medical Center, Einthovenweg 20, 2333 ZC Leiden, The Netherlands
| | - Cécile Ronckers
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (H.M.-S.); (M.V.d.H.-v.d.L.); (W.J.E.T.); (H.J.H.V.d.P.); (D.B.); (C.R.); (M.M.V.d.H.); (S.J.C.M.M.N.); (B.A.B.V.); (S.M.F.P.); (L.C.M.K.)
- Department of Health Services Research, Carl von Ossietzky University of Oldenburg, Ammerländer Heerstraβe 114, 26129 Oldenburg, Germany
| | - Marry M. Van den Heuvel
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (H.M.-S.); (M.V.d.H.-v.d.L.); (W.J.E.T.); (H.J.H.V.d.P.); (D.B.); (C.R.); (M.M.V.d.H.); (S.J.C.M.M.N.); (B.A.B.V.); (S.M.F.P.); (L.C.M.K.)
- Department of Pediatric Oncology, Erasmus Medical Center—Sophia Children’s Hospital, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
| | - Sebastian J. C. M. M. Neggers
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (H.M.-S.); (M.V.d.H.-v.d.L.); (W.J.E.T.); (H.J.H.V.d.P.); (D.B.); (C.R.); (M.M.V.d.H.); (S.J.C.M.M.N.); (B.A.B.V.); (S.M.F.P.); (L.C.M.K.)
- Department of Medicine, Section Endocrinology, Erasmus Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
| | - Birgitta A. B. Versluys
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (H.M.-S.); (M.V.d.H.-v.d.L.); (W.J.E.T.); (H.J.H.V.d.P.); (D.B.); (C.R.); (M.M.V.d.H.); (S.J.C.M.M.N.); (B.A.B.V.); (S.M.F.P.); (L.C.M.K.)
| | - Marloes Louwerens
- Leiden University Medical Center, Department of Internal Medicine, Albinusdreef 2, 2333 ZA Leiden, The Netherlands;
| | - Saskia M. F. Pluijm
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (H.M.-S.); (M.V.d.H.-v.d.L.); (W.J.E.T.); (H.J.H.V.d.P.); (D.B.); (C.R.); (M.M.V.d.H.); (S.J.C.M.M.N.); (B.A.B.V.); (S.M.F.P.); (L.C.M.K.)
| | - Leontien C. M. Kremer
- Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584 CS Utrecht, The Netherlands; (H.M.-S.); (M.V.d.H.-v.d.L.); (W.J.E.T.); (H.J.H.V.d.P.); (D.B.); (C.R.); (M.M.V.d.H.); (S.J.C.M.M.N.); (B.A.B.V.); (S.M.F.P.); (L.C.M.K.)
- University Medical Center Utrecht, Wilhelmina’s Children’s Hospital, Lundlaan 6, 3584 EA Utrecht, The Netherlands
- Department Pediatric Oncology, Emma Children’s Hospital, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Nicole Blijlevens
- Department for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Geert-Grooteplein 21, 6500 HB Nijmegen, The Netherlands; (I.W.); (E.B.); (N.B.)
| | - Eline Van Dulmen-den Broeder
- Department of Pediatric Oncology/Hematology, Amsterdam University Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands;
| | - Hans Knoop
- Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands;
| | - Jacqueline Loonen
- Department of Hematology, Radboud University Medical Center, Geert-Grooteplein Zuid 8, 6500 HB Nijmegen, The Netherlands;
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Tommel J, Evers AWM, van Hamersvelt HW, van Dijk S, Chavannes NH, Wirken L, Hilbrands LB, van Middendorp H. E-HEalth treatment in Long-term Dialysis (E-HELD): study protocol for a multicenter randomized controlled trial evaluating personalized Internet-based cognitive-behavioral therapy in dialysis patients. Trials 2022; 23:477. [PMID: 35672832 PMCID: PMC9172166 DOI: 10.1186/s13063-022-06392-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 05/10/2022] [Indexed: 11/23/2022] Open
Abstract
Background Kidney failure and dialysis treatment have a large impact on a patient’s life. Patients experience numerous, complex symptoms and usually have multiple comorbid conditions. Despite the multitude of problems, patients often have priorities for improvement of specific aspects of their functioning, which would be helpful for clinicians to become informed of. This highlights a clear need for patient-centered care in this particular patient group, with routine screening as a vital element to timely recognize symptoms and tailored treatment to match individual patients’ needs and priorities. By also providing feedback on patient’s screening results to the patient itself, the patient is empowered to actively take control in one’s mostly uncontrollable disease process. The current paper describes the study design of a multicenter randomized controlled trial evaluating the effectiveness of the “E-HEealth treatment in Long-term Dialysis” (E-HELD) intervention. This therapist-guided Internet-based cognitive-behavioral therapy (ICBT) intervention is focused on and personalized to the myriad of problems that dialysis patients experience and prioritize. Methods After a screening procedure on adjustment problems, 130 eligible dialysis patients will be randomized to care as usual or the E-HELD intervention. Patients will complete questionnaires on distress (primary outcome measure), several domains of functioning (e.g., physical, psychological, social), potential predictors and mediators of treatment success, and the cost-effectiveness of the intervention, at baseline, 6-month follow-up, and 12-month follow-up. In addition, to take account of the personalized character of the intervention, the Personalized Priority and Progress Questionnaire (PPPQ) will be administered which is a personalized instrument to identify, prioritize, and monitor individual problems over time. Discussion The present study design will provide insight in the effectiveness of tailored ICBT in patients with kidney failure who are treated with dialysis. When proven effective, the screening procedure and the subsequent ICBT intervention could be implemented in routine care to detect, support, and treat patients struggling with adjustment problems. Trial registration NL63422.058.17 [Registry ID: METC-LDD] NL7160 [Netherlands Trial Register; registered on 16 July 2018]
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Sakai R, Tanaka E, Inoue E, Sato M, Tanaka M, Ikari K, Yamanaka H, Harigai M. Subjective Symptoms Contributing to the Quality of Life of Rheumatoid Arthritis Patients with Clinical Remission from the IORRA Database. Mod Rheumatol 2022; 33:496-502. [PMID: 35652691 DOI: 10.1093/mr/roac053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 05/11/2022] [Accepted: 06/01/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To explore patient-reported outcomes (PROs) related to quality of life (QOL) in patients with rheumatoid arthritis (RA) who achieved clinical remission. METHODS In the Institute of Rheumatology, Rheumatoid Arthritis (IORRA) dataset, RA patients over 18 years old who met the simplified disease activity index (SDAI) remission criteria in April 2017 were enrolled in this analysis. Pain-visual analogue scale (pain-VAS) (0-100 mm), Patient's Global Assessment of Disease Activity (0-100 mm), Japanese version of Health Assessment Questionnaire, duration of morning joint stiffness, and fatigue (Checklist Individual Strength 8R [CIS]) were the tools used to evaluate PROs. To assess the contribution of each PRO to the European QOL-5 Dimensions-5 Level (EQ-5D-5L) score, analysis of variance was conducted. RESULTS Among the 2,443 patients with remission, the mean EQ-5D-5L was 0.9. The mean pain VAS and patients' global assessment of disease activity (Pt-GA) were 7.2 and 7.4, respectively. Factors that significantly contributed to the EQ-5D-5L were pain-VAS (48.8%), CIS score (18.1%), and Pt-GA (15.6%). Around 82.5% of the variance in EQ-5D-5L were explained by the three PROs. CONCLUSION This study demonstrated that pain-VAS, CIS, and Pt-GA were significant contributors to the EQ-5D-5L score in patients with RA who achieved SDAI remission.
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Affiliation(s)
- Ryoko Sakai
- Department of Rheumatology, Institute of Rheumatology, Tokyo Women's Medial University Hospital, Tokyo, Japan.,Division of Rheumatology, Department of Internal Medicine, Tokyo Women's Medial University School of Medicine, Tokyo, Japan.,Division of Multidisciplinary Management of Rheumatic Diseases, Tokyo Women's Medial University School of Medicine, Tokyo, Japan
| | - Eiichi Tanaka
- Department of Rheumatology, Institute of Rheumatology, Tokyo Women's Medial University Hospital, Tokyo, Japan.,Division of Rheumatology, Department of Internal Medicine, Tokyo Women's Medial University School of Medicine, Tokyo, Japan
| | - Eisuke Inoue
- Department of Medical Informatics, Medical Education and Culture, St Marianna University School of Medicine, Kanagawa, Japan
| | | | | | - Katsunori Ikari
- Department of Rheumatology, Institute of Rheumatology, Tokyo Women's Medial University Hospital, Tokyo, Japan.,Division of Multidisciplinary Management of Rheumatic Diseases, Tokyo Women's Medial University School of Medicine, Tokyo, Japan.,Department of orthopedics, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Hisashi Yamanaka
- Division of Rheumatology, Department of Internal Medicine, Tokyo Women's Medial University School of Medicine, Tokyo, Japan.,Rheumatology, Sanno Medical Center, Tokyo, Japan
| | - Masayoshi Harigai
- Department of Rheumatology, Institute of Rheumatology, Tokyo Women's Medial University Hospital, Tokyo, Japan.,Division of Rheumatology, Department of Internal Medicine, Tokyo Women's Medial University School of Medicine, Tokyo, Japan
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Querido NR, Kenkhuis MF, van Roekel EH, Breukink SO, van Duijnhoven FJB, Janssen-Heijnen ML, Keulen ET, Ueland PM, Vogelaar FJ, Wesselink E, Bours MJ, Weijenberg MP. Longitudinal associations between inflammatory markers and fatigue up to two years after colorectal cancer treatment. Cancer Epidemiol Biomarkers Prev 2022; 31:1638-1649. [PMID: 35654354 DOI: 10.1158/1055-9965.epi-22-0077] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/14/2022] [Accepted: 05/20/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Fatigue is often reported by colorectal cancer survivors (CRC) and largely impacts their quality of life. Inflammation has been linked to fatigue mainly in breast cancer patients. Therefore, we investigated how inflammation is longitudinally associated with fatigue in CRC survivors, up to 2 years post-treatment. METHODS A total of 257 patients from the ongoing Energy for life after ColoRectal cancer (EnCoRe) cohort study were included in the analysis. Plasma levels of IL6, IL8, IL10, TNFα, hsCRP, and fatigue were measured at 6 weeks, 6, 12, and 24 months post-treatment. Fatigue was measured through the validated Checklist Individual Strength (CIS total, 20-140), consisting of four subscales - subjective fatigue (8-56), motivation (4-28), physical activity (3-21), and concentration (5-35), and the EORTC QLQ-C30 fatigue subscale (0-100). Linear mixed-models were used to assess the confounder-adjusted longitudinal associations between inflammatory markers and overall fatigue along with the subscales. RESULTS Mean levels of CIS fatigue decreased from 62.9 at 6 weeks to 53.0 at 24 months. In general, levels of inflammatory markers also decreased over time. No statistically significant longitudinal associations were found between IL6, IL8, IL10, TNFα, and fatigue. Higher levels of hsCRP were associated with more CIS fatigue (β per SD 3.21, 95% CI 1.42; 5.01) and EORTC fatigue (β 2.41, 95% CI 0.72; 4.10). CONCLUSION Increased levels of hsCRP are longitudinally associated with more post-treatment fatigue in CRC survivors. IMPACT These findings suggest that low-grade inflammation may play a role in fatigue reported by CRC survivors up to 2 years post-treatment.
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A Combination of Nicotinamide and D-Ribose (RiaGev) Is Safe and Effective to Increase NAD + Metabolome in Healthy Middle-Aged Adults: A Randomized, Triple-Blind, Placebo-Controlled, Cross-Over Pilot Clinical Trial. Nutrients 2022; 14:nu14112219. [PMID: 35684021 PMCID: PMC9183138 DOI: 10.3390/nu14112219] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/21/2022] [Accepted: 05/25/2022] [Indexed: 12/26/2022] Open
Abstract
Nicotinamide adenine dinucleotide (NAD+) is an essential cofactor required for proper functioning of all cells and its decline is correlated with advancing age and disease. This randomized, triple-blind, placebo-controlled, crossover pilot study assessed the efficacy and safety of a combination of nicotinamide with D-ribose (RiaGev) for NAD metabolome enhancement and related benefits in healthy middle-aged adults. Supplementing with 1520 mg RiaGev twice daily for 7 days significantly increased the NAD+ metabolome in blood, especially NADP+ by 27% compared to the placebo group (p = 0.033) and over the baseline (p = 0.007). Increases in glutathione and high energy phosphates were also observed in the blood. Seven-day supplementation with RiaGev significantly (p = 0.013) reduced overall blood glucose without significant changes in insulin secretion (p = 0.796), suggesting an improved insulin sensitivity and glucose tolerance. The waking salivary cortisol of the subjects steadily and significantly decreased (p = 0.026) in the RiaGev group in contrast to the placebo. Subjects in the RiaGev group showed less fatigue, improved mental concentration and motivation over the baseline (p = 0.015, 0.018, and 0.012, respectively) as observed through the Checklist Individual Strength (CIS) questionnaire. There were no clinically relevant adverse events, or alterations in hematology, electrolytes, liver, and kidney markers pre- and post-supplementation. RiaGev appears to be safe and efficacious in increasing NAD+ metabolome in healthy middle-aged adults, as shown by this study.
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Boelhouwer IG, Vermeer W, van Vuuren T. Work ability among employees 2–10 years beyond breast cancer diagnosis: Late treatment effects and job resources - A longitudinal study. Work 2022; 74:1061-1076. [PMID: 35527613 DOI: 10.3233/wor-211288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: The number of workers who have previously undergone a cancer treatment is increasing, and possible late treatment effects (fatigue, physical and cognitive complaints) may affect work ability. OBJECTIVE: The aim of the study was to investigate the impact of late treatment effects and of job resources (autonomy, supportive leadership style, and colleagues’ social support) on the future work ability of employees living 2–10 years beyond a breast cancer diagnosis. METHODS: Data at T1 (baseline questionnaire) and at T2 (9 months later) were collected in 2018 and 2019 (N = 287) among Dutch-speaking workers with a breast cancer diagnosis 2–10 years ago. Longitudinal regression analyses, controlling for years since diagnosis, living with cancer (recurrence or metastasis), other chronic or severe diseases, and work ability at baseline were executed. RESULTS: Higher levels of fatigue and cognitive complaints at baseline predicted lower future work ability. The three job resources did not predict higher future work ability, but did relate cross-sectionally with higher work ability at baseline. Autonomy negatively moderated the association between physical complaints and future work ability. CONCLUSIONS: Fatigue and cognitive complaints among employees 2–10 years past breast cancer diagnosis need awareness and interventions to prevent lower future work ability. Among participants with average or high levels of physical complaints, there was no difference in future work ability between medium and high autonomy. However, future work ability was remarkably lower when autonomy was low.
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Affiliation(s)
- Ingrid G. Boelhouwer
- Department of Applied Psychology, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Willemijn Vermeer
- Department of Applied Psychology, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Tinka van Vuuren
- Department Organisation, Faculty of Management, Open Universiteit, Heerlen, The Netherlands
- Loyalis Knowledge & Consult, Heerlen, The Netherlands
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Verveen A, Wynberg E, van Willigen HDG, Boyd A, de Jong MD, de Bree G, Davidovich U, Lok A, Moll van Charante EP, Knoop H, Prins M, Nieuwkerk P. Severe Fatigue in the First Year Following SARS-CoV-2 Infection: A Prospective Cohort Study. Open Forum Infect Dis 2022; 9:ofac127. [PMID: 35415196 PMCID: PMC8995073 DOI: 10.1093/ofid/ofac127] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 03/10/2022] [Indexed: 12/16/2022] Open
Abstract
Background Severe fatigue can persist for months after coronavirus disease 2019 (COVID-19) onset. This longitudinal study describes fatigue severity and its determinants up to 12 months after illness onset across the full spectrum of COVID-19 severity. Methods RECoVERED, a prospective cohort study in Amsterdam, the Netherlands, enrolled participants aged ≥16 years after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diagnosis. Fatigue was measured using the validated Short Fatigue Questionnaire (SFQ; range 4–28) at months 1, 3, 6, 9, and 12 of follow-up. Fatigue severity was modeled over time using mixed-effects linear regression. Determinants of severe fatigue (SFQ ≥18) at 6 months since illness onset (ie, persistent fatigue) were identified using logistic regression. Results Between May 2020 and July 2021, 303 participants completed at least 1 fatigue questionnaire. Twelve months after illness onset, 17.4% (95% CI, 6.7% to 38.3%), 21.6% (95% CI, 11.2% to 37.7%), and 44.8% (95% CI, 28.0% to 62.9%) of participants with mild, moderate, and severe/critical COVID-19 (World Health Organization definition), respectively, experienced severe fatigue. When adjusting for age and sex, having ≥3 comorbidities (P = .007), severe/critical COVID-19 (P = .002), low mood (P < .001), and dyspnea in the first 2 weeks of illness (P = .001) were associated with more severe fatigue over time. Severe/critical COVID-19 (adjusted odds ratio [aOR], 3.37; 95% CI, 1.28 to 8.93) and low mood at enrollment (aOR, 2.43; 95% CI, 1.11 to 5.29) were associated with persistent fatigue. Recovery rarely occurred beyond 6 months after illness onset, regardless of COVID-19 severity. Conclusions The occurrence of severe fatigue in our cohort was high, especially among those with initially severe/critical COVID-19, with little recovery beyond 6 months after illness onset. Our findings highlight an urgent need for improved understanding of persistent severe fatigue following COVID-19 to help inform prevention and intervention.
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Affiliation(s)
- Anouk Verveen
- Department of Medical Psychology, Amsterdam UMC, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, the Netherlands
| | - Elke Wynberg
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands.,Department of Infectious Diseases, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
| | - Hugo D G van Willigen
- Department of Infectious Diseases, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands.,Department of Medical Microbiology & Infection Prevention, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
| | - Anders Boyd
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands.,Stichting HIV Monitoring, Amsterdam, the Netherlands
| | - Menno D de Jong
- Department of Medical Microbiology & Infection Prevention, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
| | - Godelieve de Bree
- Department of Infectious Diseases, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
| | - Udi Davidovich
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands.,Department of Social Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - Anja Lok
- Department of Psychiatry, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Eric P Moll van Charante
- Department of Public & Occupational Health, Amsterdam UMC, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, the Netherlands.,Department of General Practice, Amsterdam UMC, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, the Netherlands
| | - Hans Knoop
- Department of Medical Psychology, Amsterdam UMC, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, the Netherlands
| | - Maria Prins
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands.,Department of Infectious Diseases, Amsterdam UMC, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands
| | - Pythia Nieuwkerk
- Department of Medical Psychology, Amsterdam UMC, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, the Netherlands
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Boot EM, van de Camp SAJH, Maaijwee NA, Arntz RM, Kessels RPC, de Leeuw FE, Tuladhar AM. Neuroimaging Parameters Are Not Associated With Chronic Post-stroke Fatigue in Young Stroke Patients. Front Neurol 2022; 13:831357. [PMID: 35572922 PMCID: PMC9096084 DOI: 10.3389/fneur.2022.831357] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 04/04/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction Post-stroke fatigue is frequently present in young adults, but its underlying mechanism is still unclear. The aim of the study was to investigate the association between lesion location, network efficiency and chronic post-stroke fatigue based on voxel-based lesion-symptom mapping and structural network connectivity analysis. Patients and Methods One hundred and thirty five young patients, aged 18–50 years, with a first-ever transient ischemic attack or cerebral infarction from the Follow-Up of Transient ischemic attack and stroke patients and Unelucidated Risk factor Evaluation (FUTURE) study, underwent 1.5T MRI and were assessed for fatigue using the self-report Checklist Individual Strength. Stroke lesions were manually segmented, and structural network efficiency was calculated using the diffusion MRI-based brain networks and graph theory for each patient. Univariate and multivariate analyses was performed to study the associations between MRI parameters and chronic post-stroke fatigue. In addition, we used voxel-based lesion-symptom mapping to analyze the relationship between the lesion location and chronic post-stroke fatigue. Results Mean age at index event was 39.0 years (SD ± 8.2), and mean follow-up duration was 11.0 years (SD ± 8.0). 50 patients (37%) had post-stroke fatigue. Voxel-based lesion-symptom mapping showed no significant relation between stroke lesions and the presence of chronic post-stroke fatigue. Furthermore, there were no significant associations between the lesion size or network efficiency, and the presence of chronic post-stroke fatigue. Discussion We did not find any association between stroke characteristics (lesion location and size) and chronic post-stroke fatigue (CIS20-R), nor associations between structural brain network connectivity and post-stroke fatigue on the long term in young stroke patients.
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Affiliation(s)
- Esther M. Boot
- Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Sanne A. J. H. van de Camp
- Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Noortje A. Maaijwee
- Department of Neurology and Neurorehabilitation, Luzerner Kantonsspital Neurocentre, Luzern, Switzerland
| | - Renate M. Arntz
- Department of Neurology, Medisch Spectrum Twente, Enschede, Netherlands
| | - Roy P. C. Kessels
- Department of Psychology, Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, Netherlands
- Department of Medical Psychology and Radboudumc Alzheimer's Centre, Radboud University Medical Centre, Nijmegen, Netherlands
- Vincent van Gogh Institute for Psychiatry, Venray, Netherlands
| | - Frank-Erik de Leeuw
- Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Anil M. Tuladhar
- Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Centre, Nijmegen, Netherlands
- *Correspondence: Anil M. Tuladhar
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van Elk F, Robroek SJW, Smits-de Boer S, Kouwenhoven-Pasmooij TA, Burdorf A, Oude Hengel KM. Study design of PerfectFit@Night, a workplace health promotion program to improve sleep, fatigue, and recovery of night shift workers in the healthcare sector. BMC Public Health 2022; 22:779. [PMID: 35436871 PMCID: PMC9014783 DOI: 10.1186/s12889-022-13206-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 04/08/2022] [Indexed: 11/10/2022] Open
Abstract
Background Healthcare workers need to be at work 24 h a day to ensure continuity of care in hospitals. However, shift work - particularly night shifts - can have negative acute and long-term effects on health and productivity due to disturbances in the circadian rhythm. Shift work is also associated with unhealthy lifestyle behaviors such as poor sleep hygiene and diet. The PerfectFit@Night intervention aims to improve sleep and recovery, and reduce fatigue, and therewith contribute to sustainable employability of healthcare workers. The current study describes the intervention and the evaluation and implementation. Methods The study population will consist of healthcare workers, nurses and physicians, with night shifts in a large Dutch academic hospital. The intervention consists of individual and environmental intervention elements: i) an e-learning for healthcare workers to increase knowledge and awareness on a healthy lifestyle during night shifts, ii) a powernap bed to take powernaps during night shifts, iii) the availability of healthy food at the department during night shifts, iv) a workshop on healthy rostering at the level of the department, and v) individual sleep coaching among the high risk group. In a longitudinal prospective study, data will be collected 1 month before the start of the intervention, in the week before the start of the intervention, and three and 6 months after the start of the intervention. The primary outcomes are sleep, fatigue, and need for recovery. The implementation process will be evaluated using the framework of Steckler and Linnan. Cost-benefit analyses from the employers perspective will be conducted to understand the possible financial consequences or benefits of the implementation of PerfectFit@Night. Discussion The feasibility and effectiveness of this workplace health promotion program will be investigated by means of an effect, process and economic evaluation. If proven effective, PerfectFit@Night can be implemented on a larger scale within the healthcare sector. Trial registration Netherlands Trial Register trial number NL9224. Registered 17 January 2021.
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Affiliation(s)
- Fleur van Elk
- Department of Public Health, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
| | - Suzan J W Robroek
- Department of Public Health, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Sonja Smits-de Boer
- Occupational Health Service, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - Alex Burdorf
- Department of Public Health, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Karen M Oude Hengel
- Department of Public Health, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Work Health Technology, Netherlands Organisation for Applied Scientific Research TNO, Leiden, The Netherlands
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van de Wal D, Elie M, Le Cesne A, Fumagalli E, den Hollander D, Jones RL, Marquina G, Steeghs N, van der Graaf WTA, Husson O. Health-Related Quality of Life and Side Effects in Gastrointestinal Stromal Tumor (GIST) Patients Treated with Tyrosine Kinase Inhibitors: A Systematic Review of the Literature. Cancers (Basel) 2022; 14:cancers14071832. [PMID: 35406604 PMCID: PMC8997462 DOI: 10.3390/cancers14071832] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/30/2022] [Accepted: 04/01/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The introduction of tyrosine kinase inhibitors (TKIs) has revolutionized the treatment of gastrointestinal stromal tumors (GISTs), resulting in a substantial gain in median overall survival. Subsequently, health-related quality of life (HRQoL) has become more relevant. Here, we systematically review the available literature on HRQoL issues and side effects of different TKIs registered for the treatment of GIST. METHODS A search through five databases was performed. Full reports in English describing HRQoL outcomes and/or side effects in GIST patients on TKI therapy were included. RESULTS A total of 104 papers were included; 13 studies addressed HRQoL, and 96 studies investigated adverse events. HRQoL in patients treated with imatinib, regorafenib, and ripretinib remained stable, whereas most sunitinib-treated patients reported a decrease in HRQoL. Severe fatigue and fear of recurrence or progression were specifically assessed as HRQoL issues and had a negative impact on overall HRQoL as well as psychological and physical well-being. The majority of studies focused on physician-reported side effects. Nearly all GIST patients treated with a TKI experienced at least one adverse event, mostly mild to moderate. CONCLUSIONS Despite the fact that almost all patients treated with a TKI experienced side effects, this did not seem to affect overall HRQoL during TKI therapy. In daily practice, it are the side effects that hamper a patient's HRQoL resulting in treatment adjustments, suggesting that the reported side effects were underestimated by physicians, or the measures used to assess HRQoL do not capture all relevant issues that determine a GIST patient's HRQoL.
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Affiliation(s)
- Deborah van de Wal
- Department of Medical Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, 1066 CX Amsterdam, The Netherlands; (D.v.d.W.); (N.S.); (W.T.A.v.d.G.)
| | - Mai Elie
- Department of Medical Oncology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands; (M.E.); (D.d.H.)
| | - Axel Le Cesne
- Department of Medical Oncology, Gustave Roussy, 94805 Villejuif, France;
| | - Elena Fumagalli
- Department of Medical Oncology, IRCCS Foundation National Cancer Institute, 20133 Milan, Italy;
| | - Dide den Hollander
- Department of Medical Oncology, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands; (M.E.); (D.d.H.)
| | - Robin L. Jones
- Department of Clinical Oncology, The Royal Marsden Hospital and Institute of Cancer Research, London SM2 5 NG, UK;
| | - Gloria Marquina
- Department of Medical Oncology, Hospital Clinico San Carlos, 28040 Madrid, Spain;
| | - Neeltje Steeghs
- Department of Medical Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, 1066 CX Amsterdam, The Netherlands; (D.v.d.W.); (N.S.); (W.T.A.v.d.G.)
- Department of Clinical Pharmacology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, 1066 CX Amsterdam, The Netherlands
| | - Winette T. A. van der Graaf
- Department of Medical Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, 1066 CX Amsterdam, The Netherlands; (D.v.d.W.); (N.S.); (W.T.A.v.d.G.)
- Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
| | - Olga Husson
- Department of Medical Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, 1066 CX Amsterdam, The Netherlands; (D.v.d.W.); (N.S.); (W.T.A.v.d.G.)
- Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
- Division of Clinical Studies, Institute of Cancer Research, London SM2 5NG, UK
- Correspondence: ; Tel.: +31-614-549-755
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Alghamdi I, Ariti C, Williams A, Wood E, Hewitt J. Prevalence of fatigue after stroke: A systematic review and meta-analysis. Eur Stroke J 2022; 6:319-332. [PMID: 35342803 PMCID: PMC8948505 DOI: 10.1177/23969873211047681] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 09/01/2021] [Indexed: 11/16/2022] Open
Abstract
Background and Purpose Post-stroke fatigue is a debilitating and long-lasting condition. However, there are uncertainties regarding its prevalence and variability between studies. This review aims to estimate the prevalence of fatigue and determine the factors responsible for its variation in the literature. Methods A systematic review was conducted for all published studies (search to November 2020) using AMED, CINAHL, EMBASE, MEDLINE, PsycINFO, SCOPUS and Web of Science. Papers were included if they recruited participants with stroke, used a validated scale to measure fatigue and were in English. Two reviewers screened and assessed the relevant studies for eligibility (n = 96). The included papers were appraised using the Joanna Briggs Institute (JBI) tool for prevalence studies, and data were extracted by one reviewer. To understand the variation in PSF prevalence between papers, data were pooled and analysed based on relevant methodological (e.g. time of assessment) or clinical factors (e.g. depression) using Review Manager 5.4 software. Results While 48 studies were included and summarised (N = 9004), only 35 were appropriate for the meta-analysis (N = 6851). The most frequently used tool to measure fatigue was the Fatigue Severity Scale (FSS) (n = 31). The prevalence was calculated with a cut-off point of four or more using FSS and resulted in an estimate of 48% (95% CI 42-53%). Time of assessment (<6 vs ≥6 months), stroke type (ischaemic vs haemorrhagic/subarachnoid haemorrhage) and geographical location (East Asia vs Europe) could explain the prevalence variation between studies. Conclusions Fatigue is prevalent among stroke survivors. This condition varies in terms of occurrence between studies; however, time of assessment, stroke type and geographical location might explain this variation. As this review estimates the overall burden of fatigue after stroke, it provides a useful indicator to inform policy, planning and healthcare professionals. Further efforts are required to investigate the mechanisms that lead to PSF, particularly in the groups that show high prevalence, in order to prevent or alleviate it.
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Affiliation(s)
- Ibraheem Alghamdi
- Department of Family and Community Medicine, School of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Cono Ariti
- Centre for Trials Research, School of Medicine, Cardiff University, Cardiff, UK
| | - Adam Williams
- Centre for Trials Research, School of Medicine, Cardiff University, Cardiff, UK
| | - Emma Wood
- School of Medicine, Cardiff University, Cardiff, UK
| | - Jonathan Hewitt
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, UK
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Wolters F, van Middendorp H, van den Bergh O, Biermasz NR, Meijer OC, Evers AWM. Conditioning of the Cortisol Awakening Response in Healthy Males: Study Protocol for a Randomized, Controlled Trial (Preprint). JMIR Res Protoc 2022. [DOI: 10.2196/38087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
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Legg M, Meertens RM, van Roekel E, Breukink SO, Janssen ML, Keulen ETP, Steindorf K, Weijenberg MP, Bours M. The Association between Sleep Quality and Fatigue in Colorectal Cancer Survivors up until Two Years after Treatment: A Cross-Sectional and Longitudinal Analysis. Cancers (Basel) 2022; 14:cancers14061527. [PMID: 35326678 PMCID: PMC8945971 DOI: 10.3390/cancers14061527] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/02/2022] [Accepted: 03/11/2022] [Indexed: 02/01/2023] Open
Abstract
Simple Summary Fatigue is a distressing complaint with high detriment to quality of life that persists in one third of colorectal cancer survivors after cancer treatment. Surprisingly, the contribution of poor sleep quality to fatigue in colorectal cancer survivors is underinvestigated. We aimed to investigate the association between sleep quality and fatigue in colorectal cancer survivors up until two years post-treatment. Results showed worse sleep quality in colorectal cancer patients was associated with higher levels of fatigue during the first two years post-treatment. The results of this study suggest that more attention for sleep quality in colorectal cancer survivors and offering sleep health interventions may lead to less fatigue and better quality of life in this group. Abstract Fatigue is a distressing complaint with high detriment to quality of life that persists in one-third of colorectal cancer survivors after cancer treatment. Previous studies in mixed groups of cancer patients have suggested sleep quality is associated with fatigue. We aimed to investigate this association in colorectal cancer survivors up until two years post-treatment. Data on n = 388 stage I–III colorectal cancer patients were utilized from the EnCoRe study. Sleep quality and fatigue were measured at 6 weeks and 6, 12, and 24 months post-treatment. Sleep quality was measured using the Pittsburgh Sleep Quality Index (cross-sectional analysis only) and the single-item insomnia scale from the EORTC QLQ-C30. Fatigue was measured by the Checklist Individual Strength. Linear and mixed-model regression analyses analysed associations between sleep quality and fatigue cross-sectionally and longitudinally. Longitudinal analysis revealed worsening sleep quality over time was significantly associated with increased levels of fatigue over time (β per 0.5 SD increase in the EORTC-insomnia score = 2.56, 95% Cl: 1.91, 3.22). Significant cross-sectional associations were observed between worse sleep quality and higher levels of fatigue at all time points. Worse sleep quality in colorectal cancer patients was associated with higher levels of fatigue during the first two years post-treatment.
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Affiliation(s)
- Meera Legg
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, 6200 MD Maastricht, The Netherlands;
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, 6200 MD Maastricht, The Netherlands; (E.v.R.); (M.P.W.); (M.B.)
| | - Ree M. Meertens
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, 6200 MD Maastricht, The Netherlands;
- Correspondence:
| | - Eline van Roekel
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, 6200 MD Maastricht, The Netherlands; (E.v.R.); (M.P.W.); (M.B.)
| | - Stéphanie O. Breukink
- Department of Surgery, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center+, 6202 AZ Maastricht, The Netherlands;
| | - Maryska L. Janssen
- Department of Clinical Epidemiology, VieCuri Medical Centre, Tegelseweg 210, 5912 BL Venlo, The Netherlands;
| | - Eric T. P. Keulen
- Department of Internal Medicine and Gastroenterology, Zuyderland Medical Centre, Dr. H. van der Hoffplein 1, 6162 BG Sittard-Geleen, The Netherlands;
| | - Karen Steindorf
- Division of Physical Activity, Prevention and Cancer, National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany;
| | - Matty P. Weijenberg
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, 6200 MD Maastricht, The Netherlands; (E.v.R.); (M.P.W.); (M.B.)
| | - Martijn Bours
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, 6200 MD Maastricht, The Netherlands; (E.v.R.); (M.P.W.); (M.B.)
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Beijers RJ, van Iersel LEJ, Schuurman LT, Hageman RJJ, Simons SO, van Helvoort A, Gosker HR, Schols AM. Effect of targeted nutrient supplementation on physical activity and health-related quality of life in COPD: study protocol for the randomised controlled NUTRECOVER trial. BMJ Open 2022; 12:e059252. [PMID: 35296491 PMCID: PMC8928317 DOI: 10.1136/bmjopen-2021-059252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Physical and mental health are often affected in chronic obstructive pulmonary disease (COPD) adversely affecting disease course and quality of life. Abnormalities in whole body and cellular energy metabolism, dietary and plasma nutrient status and intestinal permeability have been well established in these patients as systemic determinants of functional decline and underexplored treatable traits. The aim of this study is to investigate the efficacy of 1 year targeted nutrient supplementation on physical activity level and health-related quality of life in patients with COPD. METHODS AND ANALYSIS This study is a single-centre randomised, placebo-controlled, double-blind trial in 166 patients with COPD recruited from multiple hospitals in the Netherlands. The intervention group will receive a multinutrient supplement, including vitamin D, tryptophan, long-chain polyunsaturated fatty acids and prebiotic dietary fibres as main components (94 kCal per daily dose). The control group will receive an isocaloric isonitrogenous placebo. Both groups will ingest one portion per day for at least 12 months and will additionally receive counselling on healthy lifestyle and medical adherence over the course of the study. Coprimary outcomes are physical activity assessed by triaxial accelerometry and health-related quality of life measured by the EuroQol-5 dimensions questionnaire. Secondary outcomes are cognitive function, psychological well-being, physical performance, patient-reported outcomes and the metabolic profile assessed by body composition, systemic inflammation, plasma nutrient levels, intestinal integrity and microbiome composition. Outcomes will be measured at baseline and after 12 months of supplementation. In case patients are hospitalised for a COPD exacerbation, a subset outcome panel will be measured during a 4-week recovery period after hospitalisation. ETHICS AND DISSEMINATION This study was approved by the local Ethics Committee of Maastricht University. Subjects will be included after written informed consent is provided. Study outcomes will be disseminated through presentations at (inter)national conferences and through peer-reviewed journals. TRIAL REGISTRATION NCT03807310.
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Affiliation(s)
- Rosanne Jhcg Beijers
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Lieke E J van Iersel
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Lisanne T Schuurman
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | | | - Sami O Simons
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Ardy van Helvoort
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, the Netherlands
- Danone Nutricia Research, Utrecht, the Netherlands
| | - Harry R Gosker
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Annemie Mwj Schols
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, the Netherlands
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Montoro L, Cendales B, Alonso F, Gonzalez-Marin A, Lijarcio I, Llamazares J, Useche SA. Essential…but also vulnerable? Work intensification, effort/reward imbalance, fatigue and psychological health of Spanish cargo drivers during the COVID-19 pandemic. PeerJ 2022; 10:e13050. [PMID: 35282283 PMCID: PMC8916026 DOI: 10.7717/peerj.13050] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 02/11/2022] [Indexed: 01/11/2023] Open
Abstract
Objective This study investigates the combined effect of the Effort/Reward Imbalance (ERI) model of stress and work intensification within the context of the COVID-19 pandemic on the psychological health (general and work-related fatigue, and psychological strain) of cargo drivers, one of the most demanded workforces during the first year of this pandemic. Methods For this cross-sectional research, the data provided by n = 1,013 professional drivers from the different 17 autonomous communities (regions) of Spain were analyzed. Participants answered a questionnaire composed of the short version of the Effort Reward Imbalance (ERI) questionnaire, a Work Intensification Scale (WIS) designed for this study, the fatigue subscale of the Checklist Individual Strength (CIS), the Need for Recovery after Work Scale (NFR), and the General Health Questionnaire (GHQ). Results Hierarchical regression analyses show that both (ERI and work intensification) models significantly predict driver's fatigue and psychological strain. The effect of work intensification exists above and beyond the effect of effort/reward imbalance, which has been previously related to the safety performance of cargo drivers. Conclusions These findings suggest that the ERI and work intensification models can be complementarily used, especially in scenarios introducing substantial changes in the work environment, such as the COVID-19 crisis. Also, the results of this study support the need to intervene in the working conditions of professional drivers in order to improve their psychological health and well-being during both pandemic and post-pandemic times, as crisis-related management interventions are necessary to promote health and safety in professional drivers in potentially similar contexts in the future.
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Affiliation(s)
- Luis Montoro
- Research Institute on Traffic and Road Safety (INTRAS), Universidad de Valencia, Valencia, Spain
| | - Boris Cendales
- Faculty of Economic and Administrative Sciences, El Bosque University, Bogotá, Colombia
| | - Francisco Alonso
- Research Institute on Traffic and Road Safety (INTRAS), Universidad de Valencia, Valencia, Spain
| | - Adela Gonzalez-Marin
- Department of Economic and Legal Sciences, University Center of Defense, Santiago del la Ribera, Spain
| | - Ignacio Lijarcio
- Research Institute on Traffic and Road Safety (INTRAS), Universidad de Valencia, Valencia, Spain
| | - Javier Llamazares
- Department of Technology, ESIC Business and Marketing School, Pozuelo de Alarcón, Community of Madrid, Spain
| | - Sergio A. Useche
- Research Institute on Traffic and Road Safety (INTRAS), Universidad de Valencia, Valencia, Spain,Spanish Foundation for Road Safety, Madrid, Community of Madrid, Spain
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Pruijssen JT, Wenmakers A, Kessels RPC, Piai V, Meijer FJA, Pegge SAH, Loonen JJ, Tuladhar AM, Hansen HHG, Kaanders JHAM, Wilbers J. Long-term cognitive, psychosocial, and neurovascular complications of unilateral head and neck irradiation in young to middle-aged adults. BMC Cancer 2022; 22:244. [PMID: 35248013 PMCID: PMC8897732 DOI: 10.1186/s12885-022-09295-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 02/10/2022] [Indexed: 11/16/2022] Open
Abstract
Background With a growing, younger population of head and neck cancer survivors, attention to long-term side-effects of prior, often radiotherapeutic, treatment is warranted. Therefore, we studied the long-term cognitive effects in young adult patients irradiated for head and neck neoplasms (HNN). Methods Young to middle-aged adults with HNN (aged 18-40 years) and treated with unilateral neck irradiation ≥ 5 years before inclusion underwent cardiovascular risk and neuropsychological assessments and answered validated questionnaires regarding subjective cognitive complaints, fatigue, depression, quality of life, and cancer-specific distress. Additionally, magnetic resonance imaging (MRI) of the brain was performed to assess white matter hyperintensities (WMH), infarctions, and atrophy. Results Twenty-nine patients (aged 24–61, 13 men) median 9.2 [7.3–12.9] years post-treatment were included. HNN patients performed worse in episodic memory (Z-score = -1.16 [-1.58–0.34], p < 0.001) and reported more fatigue symptoms (Z-score = 1.75 [1.21–2.00], p < 0.001) compared to normative data. Furthermore, patients had a high level of fear of tumor recurrence (13 patients [44.8%]) and a heightened speech handicap index (13 patients [44.8%]). Only a small number of neurovascular lesions were found (3 infarctions in 2 patients and 0.11 [0.00–0.40] mL WMH), unrelated to the irradiated side. Cognitive impairment was not associated with WMH, brain atrophy, fatigue, or subjective speech problems. Conclusions HNN patients showed impairments in episodic memory and an increased level of fatigue ≥ 5 years after radiotherapy compared to normative data. Cognitive impairments could not be explained by WMH or brain atrophy on brain MRI or psychological factors. Trial registration Clinicaltrials.gov (https://clinicaltrials.gov/ct2/show/NCT04257968). Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-09295-9.
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131
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Wirken L, van Middendorp H, Hooghof CW, Sanders JS, Dam R, van der Pant KAMI, Wierdsma J, Wellink H, Ulrichts P, Hoitsma AJ, Hilbrands LB, Evers AW. Combining transplant professional's psychosocial donor evaluation and donor self-report measures to optimise the prediction of HRQoL after kidney donation: an observational prospective multicentre study. BMJ Open 2022; 12:e045249. [PMID: 35236728 PMCID: PMC8895930 DOI: 10.1136/bmjopen-2020-045249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Living donor kidney transplantation is currently the preferred treatment for patients with end-stage renal disease. The psychosocial evaluation of kidney donor candidates relies mostly on the clinical viewpoint of transplant professionals because evidence-based guidelines for psychosocial donor eligibility are currently lacking. However, the accuracy of these clinical risk judgements and the potential added value of a systematic self-reported screening procedure are as yet unknown. The current study examined the effectiveness of the psychosocial evaluation by transplant professionals and the potential value of donor self-report measures in optimising the donor evaluation. Based on the stress-vulnerability model, the predictive value of predonation, intradonation and postdonation factors to impaired longer term health-related quality of life (HRQoL) of kidney donors was studied. DESIGN An observational prospective multicentre study. SETTING Seven Dutch transplantation centres. PARTICIPANTS 588 potential donors participated, of whom 361 donated. Complete prospective data of 230 donors were available. Also, 1048 risk estimation questionnaires were completed by healthcare professionals. METHODS Transplant professionals (nephrologists, coordinating nurses, social workers and psychologists) filled in risk estimation questionnaires on kidney donor candidates. Furthermore, 230 kidney donors completed questionnaires (eg, on HRQoL) before and 6 and 12 months after donation. PRIMARY AND SECONDARY OUTCOME MEASURES HRQoL, demographic and preoperative, intraoperative and postoperative health characteristics, perceived support, donor cognitions, recipient functioning and professionals risk estimation questionnaires. RESULTS On top of other predictors, such as the transplant professionals' risk assessments, donor self-report measures significantly predicted impaired longer term HRQoL after donation, particularly by poorer predonation physical (17%-28% explained variance) and psychological functioning (23%). CONCLUSIONS The current study endorses the effectiveness of the psychosocial donor evaluation by professionals and the additional value of donor self-report measures in optimising the psychosocial evaluation. Consequently, systematic screening of donors based on the most prominent risk factors provide ground for tailored interventions for donors at risk.
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Affiliation(s)
- Lieke Wirken
- Health, Medical and Neuropsychology Unit, Leiden University, Leiden, The Netherlands
- Department of Medical Psychology, Radboudumc, Nijmegen, The Netherlands
| | - Henriët van Middendorp
- Health, Medical and Neuropsychology Unit, Leiden University, Leiden, The Netherlands
- Department of Medical Psychology, Radboudumc, Nijmegen, The Netherlands
| | | | - Jan-Stephan Sanders
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, Groningen, The Netherlands
| | - Ruth Dam
- Department of Nephrology, Leiden University Medical Center, Leiden, The Netherlands
| | - Karlijn A M I van der Pant
- Department of Internal Medicine/Nephrology, Renal Transplant Unit, Amsterdam UMC, Amsterdam, The Netherlands
| | - Judith Wierdsma
- Department of Nephrology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Hiske Wellink
- Department of Nephrology, Amsterdam UMC VUMC Site, Amsterdam, The Netherlands
| | - Philip Ulrichts
- Department of Internal Medicine/Nephrology, Maastricht University Medical Center, Maastricht, The Netherlands
| | | | | | - Andrea W Evers
- Health, Medical and Neuropsychology Unit, Leiden University, Leiden, The Netherlands
- Department of Medical Psychology, Radboudumc, Nijmegen, The Netherlands
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Verveen A, Müller F, Lloyd A, Moss-Morris R, Omland T, Penninx B, Raijmakers RPH, van der Schaaf M, Sandler CX, Stavem K, Wessely S, Wyller VBB, Nieuwkerk P, Knoop H. A research agenda for post-COVID-19 fatigue. J Psychosom Res 2022; 154:110726. [PMID: 35086054 PMCID: PMC8786369 DOI: 10.1016/j.jpsychores.2022.110726] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/10/2022] [Accepted: 01/15/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Anouk Verveen
- Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Fabiola Müller
- Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Andrew Lloyd
- The Kirby Institute, UNSW Sydney, NSW, Australia
| | - Rona Moss-Morris
- Health Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Torbjørn Omland
- Department of Cardiology, Akershus University Hospital, Norway and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Brenda Penninx
- Department of Psychiatry, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam Public Health, Amsterdam, the Netherlands
| | - Ruud P H Raijmakers
- Department of Primary Care, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, the Netherlands
| | - Marike van der Schaaf
- Amsterdam UMC, University of Amsterdam, Department of Rehabilitation, Amsterdam Movement Sciences, Amsterdam, the Netherlands; Faculty of Health, Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands
| | - Carolina X Sandler
- The Kirby Institute, UNSW Sydney, NSW, Australia; School of Health Sciences, Western Sydney University, NSW, Australia
| | - Knut Stavem
- Department of Pulmonary Medicine, Akershus University Hospital, Norway and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Simon Wessely
- Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, United Kingdom
| | - Vegard B B Wyller
- Department of Pediatrics and Adolescent Medicine, Akershus University Hospital, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Pythia Nieuwkerk
- Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Hans Knoop
- Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
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Upper cervical cord atrophy is independent of cervical cord lesion volume in early multiple sclerosis: A two-year longitudinal study. Mult Scler Relat Disord 2022; 60:103713. [PMID: 35272146 DOI: 10.1016/j.msard.2022.103713] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/10/2022] [Accepted: 02/24/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Upper cervical cord atrophy and lesions have been shown to be associated with disease and disability progression already in early relapsing-remitting multiple sclerosis (RRMS). However, their longitudinal relationship remains unclear. OBJECTIVE To investigate the cross-sectional and longitudinal relation between focal T2 cervical cord lesion volume (CCLV) and regional and global mean upper cervical cord area (UCCA), and their relations with disability. METHODS Over a two-year interval, subjects with RRMS (n = 36) and healthy controls (HC, n = 16) underwent annual clinical and MRI examinations. UCCA and CCLV were obtained from C1 through C4 level. Linear mixed model analysis was performed to investigate the relation between UCCA, CCLV, and disability over time. RESULTS UCCA at baseline was significantly lower in RRMS subjects compared to HCs (p = 0.003), but did not decrease faster over time (p ≥ 0.144). UCCA and CCLV were independent of each other at any of the time points or cervical levels, and over time. Lower baseline UCCA, but not CCLV, was related to worsening of both upper and lower extremities function over time. CONCLUSION UCCA and CCLV are independent from each other, both cross-sectionally and longitudinally, in early MS. Lower UCCA, but not CCLV, was related to increasing disability over time.
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134
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Heesakkers H, van der Hoeven JG, Corsten S, Janssen I, Ewalds E, Simons KS, Westerhof B, Rettig TCD, Jacobs C, van Santen S, Slooter AJC, van der Woude MCE, van den Boogaard M, Zegers M. Clinical Outcomes Among Patients With 1-Year Survival Following Intensive Care Unit Treatment for COVID-19. JAMA 2022; 327:559-565. [PMID: 35072716 PMCID: PMC8787680 DOI: 10.1001/jama.2022.0040] [Citation(s) in RCA: 147] [Impact Index Per Article: 73.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
IMPORTANCE One-year outcomes in patients who have had COVID-19 and who received treatment in the intensive care unit (ICU) are unknown. OBJECTIVE To assess the occurrence of physical, mental, and cognitive symptoms among patients with COVID-19 at 1 year after ICU treatment. DESIGN, SETTING, AND PARTICIPANTS An exploratory prospective multicenter cohort study conducted in ICUs of 11 Dutch hospitals. Patients (N = 452) with COVID-19, aged 16 years and older, and alive after hospital discharge following admission to 1 of the 11 ICUs during the first COVID-19 surge (March 1, 2020, until July 1, 2020) were eligible for inclusion. Patients were followed up for 1 year, and the date of final follow-up was June 16, 2021. EXPOSURES Patients with COVID-19 who received ICU treatment and survived 1 year after ICU admission. MAIN OUTCOMES AND MEASURES The main outcomes were self-reported occurrence of physical symptoms (frailty [Clinical Frailty Scale score ≥5], fatigue [Checklist Individual Strength-fatigue subscale score ≥27], physical problems), mental symptoms (anxiety [Hospital Anxiety and Depression {HADS} subscale score ≥8], depression [HADS subscale score ≥8], posttraumatic stress disorder [mean Impact of Event Scale score ≥1.75]), and cognitive symptoms (Cognitive Failure Questionnaire-14 score ≥43) 1 year after ICU treatment and measured with validated questionnaires. RESULTS Of the 452 eligible patients, 301 (66.8%) patients could be included, and 246 (81.5%) patients (mean [SD] age, 61.2 [9.3] years; 176 men [71.5%]; median ICU stay, 18 days [IQR, 11 to 32]) completed the 1-year follow-up questionnaires. At 1 year after ICU treatment for COVID-19, physical symptoms were reported by 182 of 245 patients (74.3% [95% CI, 68.3% to 79.6%]), mental symptoms were reported by 64 of 244 patients (26.2% [95% CI, 20.8% to 32.2%]), and cognitive symptoms were reported by 39 of 241 patients (16.2% [95% CI, 11.8% to 21.5%]). The most frequently reported new physical problems were weakened condition (95/244 patients [38.9%]), joint stiffness (64/243 patients [26.3%]) joint pain (62/243 patients [25.5%]), muscle weakness (60/242 patients [24.8%]) and myalgia (52/244 patients [21.3%]). CONCLUSIONS AND RELEVANCE In this exploratory study of patients in 11 Dutch hospitals who survived 1 year following ICU treatment for COVID-19, physical, mental, or cognitive symptoms were frequently reported.
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Affiliation(s)
- Hidde Heesakkers
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department Intensive Care, Nijmegen, the Netherlands
| | - Johannes G. van der Hoeven
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department Intensive Care, Nijmegen, the Netherlands
| | - Stijn Corsten
- Department of Intensive Care Medicine, Canisius Wilhelmina Hospital, Nijmegen, the Netherlands
| | - Inge Janssen
- Department of Intensive Care Medicine, Maasziekenhuis Pantein, Beugen, the Netherlands
| | - Esther Ewalds
- Department of Intensive Care Medicine, Bernhoven Hospital, Uden, the Netherlands
| | - Koen S. Simons
- Department of Intensive Care Medicine, Jeroen Bosch Hospital, ’s-Hertogenbosch, the Netherlands
| | - Brigitte Westerhof
- Department of Intensive Care Medicine, Rijnstate Hospital, Arnhem, the Netherlands
| | - Thijs C. D. Rettig
- Department of Anesthesiology, Intensive Care and Pain Medicine, Amphia Hospital, Breda, the Netherlands
| | - Crétien Jacobs
- Department of Intensive Care Medicine, Elkerliek Hospital, Helmond, the Netherlands
| | - Susanne van Santen
- Department of Intensive Care Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Arjen J. C. Slooter
- Department of Intensive Care Medicine and UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
- Department of Neurology, UZ Brussel and Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Mark van den Boogaard
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department Intensive Care, Nijmegen, the Netherlands
| | - Marieke Zegers
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department Intensive Care, Nijmegen, the Netherlands
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Reukers DFM, van Jaarsveld CHM, Akkermans RP, Keijmel SP, Morroy G, van Dam ASG, Wever PC, Wielders CCH, van der Velden K, van Loenhout JAF, Hautvast JLA. Impact of Q-fever on physical and psychosocial functioning until 8 years after Coxiella burnetii infection: An integrative data analysis. PLoS One 2022; 17:e0263239. [PMID: 35108330 PMCID: PMC8809529 DOI: 10.1371/journal.pone.0263239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 01/17/2022] [Indexed: 11/19/2022] Open
Abstract
Background This study aimed to determine short- and long-term physical and psychosocial impact of Coxiella burnetii infection in three distinct entities: Q-fever fatigue syndrome (QFS), chronic Q-fever, and patients with past acute Q-fever without QFS or chronic Q-fever. Methods Integrative data analysis was performed, combining original data from eight studies measuring quality of life (QoL), fatigue, physical and social functioning with identical validated questionnaires, from three months to eight years after onset infection. Linear trends in each outcome were compared between Q-fever groups using multilevel linear regression analyses to account for repeated measures within patients. Results Data included 3947 observations of 2313 individual patients (228 QFS, 135 chronic Q-fever and 1950 patients with past acute Q-fever). In the first years following infection, physical and psychosocial impact was highest among QFS patients, and remained high without significant improvements over time. In chronic Q-fever patients, QoL and physical functioning worsened significantly over time. Levels of fatigue and social participation in patients with past acute Q-fever improved significantly over time. Conclusion The impact differs greatly between the three Q-fever groups. It is important that physicians are aware of these differences, in order to provide relevant care for each patient group.
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Affiliation(s)
- Daphne F. M. Reukers
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
- * E-mail:
| | - Cornelia H. M. van Jaarsveld
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Reinier P. Akkermans
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
- Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Institute for Quality of Care, Nijmegen, The Netherlands
| | - Stephan P. Keijmel
- Division of Infectious Diseases, Department of Internal Medicine, Radboud Expert Centre for Q-fever, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Gabriella Morroy
- Department of Infectious Disease Control, Municipal Health Service Hart voor Brabant, ’s-Hertogenbosch, The Netherlands’s
| | - Adriana S. G. van Dam
- Department of Infectious Disease Control, Municipal Health Service Hart voor Brabant, ’s-Hertogenbosch, The Netherlands’s
| | - Peter C. Wever
- Department of Medical Microbiology and Infection Control, Jeroen Bosch Hospital, ‘s-Hertogenbosch, The Netherlands
| | - Cornelia C. H. Wielders
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Koos van der Velden
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Joris A. F. van Loenhout
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
- Center for Research on the Epidemiology of Disasters (CRED), Institute of Health and Society, Université catholique de Louvain, Brussels, Belgium
| | - Jeannine L. A. Hautvast
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
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Bickton FM, Mankhokwe T, Nightingale R, Fombe C, Mitengo M, Mwahimba L, Lipita W, Wilde L, Pina I, Yusuf ZK, Ahmed Z, Kamponda M, Limbani F, Shannon H, Chisati E, Barton A, Free RC, Steiner M, Matheson JA, Manise A, Singh SJ, Rylance J, Orme M. Protocol for a single-centre mixed-method pre-post single-arm feasibility trial of a culturally appropriate 6-week pulmonary rehabilitation programme among adults with functionally limiting chronic respiratory diseases in Malawi. BMJ Open 2022; 12:e057538. [PMID: 35105655 PMCID: PMC8804676 DOI: 10.1136/bmjopen-2021-057538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 12/13/2021] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Malawi has a substantial burden of chronic respiratory diseases (CRDs) which cause significant morbidity and loss of economic productivity, affecting patients, families and health systems. Pulmonary rehabilitation (PR) is a highly recommended non-pharmacological intervention in the clinical management of people with CRDs. However, Malawi lacks published evidence on the implementation of PR for people with CRDs. This trial will test the feasibility and acceptability of implementing a culturally appropriate hospital-based PR programme among adults with functionally limiting CRDs at Queen Elizabeth Central Hospital in Blantyre, Malawi. METHODS AND ANALYSIS This is a single-centre mixed-methods pre-post single-arm feasibility trial. Ten patients aged ≥18 years, with a spirometry confirmed diagnosis of a CRD and breathlessness of ≥2 on the modified Medical Research Council dyspnoea scale, will be consecutively recruited. Their baseline lung function, exercise tolerance and health status will be assessed; including spirometry, Incremental Shuttle Walk Test and Chronic Obstructive Pulmonary Disease Assessment Test, respectively. Pretrial semistructured in-depth interviews will explore their experiences of living with CRD and potential enablers and barriers to their PR uptake. Along with international PR guidelines, these data will inform culturally appropriate delivery of PR. We initially propose a 6-week, twice-weekly, supervised centre-based PR programme, with an additional weekly home-based non-supervised session. Using combination of researcher observation, interaction with the participants, field notes and informal interviews with the participants, we will assess the feasibility of running the programme in the following areas: participants' recruitment, retention, engagement and protocol adherence. Following programme completion (after 6 weeks), repeat assessments of lung function, exercise tolerance and health status will be conducted. Quantitative changes in clinical outcomes will be described in relation to published minimal clinically important differences. Post-trial semistructured interviews will capture participants' perceived impact of the PR programme on their quality of life, enablers, and barriers to fully engaging with the programme, and allow iteration of its design. ETHICS AND DISSEMINATION Ethical approval for this trial was obtained from University of Malawi College of Medicine Research and Ethics Committee (COMREC), Blantyre, Malawi (protocol number: P.07/19/2752) and University of Leicester Research Ethics Committee, Leicester, UK (ethics reference: 31574). The results of the trial will be disseminated through oral presentations at local and international scientific conferences or seminars and publication in a peer-reviewed journal. We will also engage the participants who complete the PR trial and the Science Communication Department at Malawi-Liverpool-Wellcome Trust Clinical Research Programme to organise community outreach activities within Blantyre to educate communities about CRDs and PR. We will also broadcast our trial results through national radio station programmes such as the weekly "Thanzi la Onse" (Health of All) programme by Times Radio Malawi. We will formally present our trial results to Blantyre District Health Office and Malawi Ministry of Health. TRIAL REGISTRATION NUMBER ISRCTN13836793.
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Affiliation(s)
- Fanuel Meckson Bickton
- Lung Health Research Group, Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
- UCL GOS Institute of Child Health, University College London, London, UK
| | - Talumba Mankhokwe
- Physiotherapy Department, Queen Elizabeth Central Hospital, Blantyre, Southern Region, Malawi
| | - Rebecca Nightingale
- Lung Health Research Group, Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
- Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Cashon Fombe
- Physiotherapy Department, Queen Elizabeth Central Hospital, Blantyre, Southern Region, Malawi
| | - Martha Mitengo
- Physiotherapy Department, Queen Elizabeth Central Hospital, Blantyre, Southern Region, Malawi
| | - Langsfield Mwahimba
- Physiotherapy Department, Queen Elizabeth Central Hospital, Blantyre, Southern Region, Malawi
| | - Wilfred Lipita
- Physiotherapy Department, Queen Elizabeth Central Hospital, Blantyre, Southern Region, Malawi
| | - Laura Wilde
- Department of Respiratory Sciences, University of Leicester, Leicester, Leicestershire, UK
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre Respiratory Diseases, Leicester, East Midlands, UK
| | - Ilaria Pina
- Department of Respiratory Sciences, University of Leicester, Leicester, Leicestershire, UK
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre Respiratory Diseases, Leicester, East Midlands, UK
| | - Zainab K Yusuf
- Department of Respiratory Sciences, University of Leicester, Leicester, Leicestershire, UK
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre Respiratory Diseases, Leicester, East Midlands, UK
| | - Zahira Ahmed
- Department of Respiratory Sciences, University of Leicester, Leicester, Leicestershire, UK
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre Respiratory Diseases, Leicester, East Midlands, UK
| | - Martin Kamponda
- Medicine Department, Queen Elizabeth Central Hospital, Blantyre, Southern Region, Malawi
| | - Felix Limbani
- Lung Health Research Group, Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
| | - Harriet Shannon
- UCL GOS Institute of Child Health, University College London, London, UK
| | - Enock Chisati
- Department of Rehabilitation Sciences, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Andy Barton
- Department of Respiratory Sciences, University of Leicester, Leicester, Leicestershire, UK
| | - Robert C Free
- Department of Respiratory Sciences, University of Leicester, Leicester, Leicestershire, UK
| | - Michael Steiner
- Department of Respiratory Sciences, University of Leicester, Leicester, Leicestershire, UK
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre Respiratory Diseases, Leicester, East Midlands, UK
| | | | - Adrian Manise
- NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Sally J Singh
- Department of Respiratory Sciences, University of Leicester, Leicester, Leicestershire, UK
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre Respiratory Diseases, Leicester, East Midlands, UK
| | - Jamie Rylance
- Lung Health Research Group, Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
- Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Mark Orme
- Department of Respiratory Sciences, University of Leicester, Leicester, Leicestershire, UK
- Centre for Exercise and Rehabilitation Science, NIHR Leicester Biomedical Research Centre Respiratory Diseases, Leicester, East Midlands, UK
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Boelhouwer IG, Vermeer W, van Vuuren T. Late Effects of Cancer Treatment, Job Resources, and Burnout Complaints Among Employees With a Breast Cancer Diagnosis 2–10 Years Ago: A Longitudinal Study. Front Psychol 2022; 12:793138. [PMID: 35153917 PMCID: PMC8832114 DOI: 10.3389/fpsyg.2021.793138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 12/21/2021] [Indexed: 12/02/2022] Open
Abstract
Purpose The aim of this study was to investigate the effect of possible late effects of cancer treatment (physical complaints, fatigue, and cognitive complaints) and of two job resources (autonomy and supportive leadership style) on future burnout complaints, among employees living 2–10 years beyond breast cancer diagnosis. Methods Data at T1 (baseline questionnaire) and at T2 (9 months later) were collected in 2018 and 2019 (N = 287). These data were part of a longitudinal study among Dutch speaking workers with a cancer diagnosis 2–10 years ago. All complaints and job resources were self-reported. Longitudinal multivariate regression analyses were executed, controlling for years since diagnosis, living with cancer (recurrence or metastasis), and other chronic or severe diseases. Mediation by baseline burnout complaints was considered. Results A higher level of fatigue and cognitive complaints at baseline (T1) resulted in higher future burnout complaints (at T2), with partial mediation by baseline burnout complaints. No effect of physical complaints at T1 was observed. Higher levels of autonomy or a supportive leadership style resulted in lower burnout complaints, with full mediation by baseline burnout complaints. Buffering was observed by autonomy in the relationship of cognitive complaints with future burnout complaints. No moderation was observed by supportive leadership. Conclusion The level of burnout complaints among employees 2–10 years beyond breast cancer diagnosis may be an effect of fatigue or cognitive complaints, and awareness of this effect is necessary. Interventions to stimulate supportive leadership and autonomy are advisable, the latter especially in the case of cognitive complaints.
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Affiliation(s)
- Ingrid G. Boelhouwer
- Department of Organisation, Faculty of Management, Open Universiteit, Heerlen, Netherlands
- Department of Applied Psychology, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
- *Correspondence: Ingrid G. Boelhouwer,
| | - Willemijn Vermeer
- Department of Applied Psychology, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Tinka van Vuuren
- Department of Organisation, Faculty of Management, Open Universiteit, Heerlen, Netherlands
- Loyalis Knowledge & Consult, Heerlen, Netherlands
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Developing a Personalized Integrative Obesity-Coaching Program: A Systems Health Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020882. [PMID: 35055703 PMCID: PMC8775850 DOI: 10.3390/ijerph19020882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/30/2021] [Accepted: 01/05/2022] [Indexed: 02/05/2023]
Abstract
Current obesity management strategies are failing to achieve sustainable and favorable long-term results. We propose a more personalized, dynamic, and systemic perspective on the interactions of key determinants and coaching advice on obesity. The aim of this study was to use a systems view on overweight, complexity science, and a transdisciplinary process to develop a five-year personalized integrative obesity-coaching and research program. Managers, medical specialists, clinical psychologists, dieticians, physical- and psychomotor therapists, and lifestyle coaches aligned their perspectives and objectives with experts in systems thinking and systems biology. A systems health model of obesity was used to identify the causal relations of variables with the most influence on obesity. The model helped to align and design a personalized integrative obesity-coaching program and to identify the key variables to monitor the progress and to adjust the personalized program, depending on the goals and needs of the participant. It was decided to use subtyping of participants by a systems biologist, based on traditional Chinese medicine symptoms, as a novel method to personalize the intervention. The collaborative transdisciplinary approach based upon a systems view on obesity was successful in developing a personalized and adaptive five-year obesity-coaching and research program.
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139
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Lim EJ, Son CG. Comparison of assessment scores for fatigue between multidimensional fatigue inventory (MFI-K) and modified chalder fatigue scale (mKCFQ). J Transl Med 2022; 20:8. [PMID: 34980164 PMCID: PMC8722196 DOI: 10.1186/s12967-021-03219-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 12/24/2021] [Indexed: 11/10/2022] Open
Abstract
Background Because of the absence of biological parameters for fatigue, appropriate instruments for assessing the degree of fatigue are important in the diagnosis and management of people complaining of fatigue-like symptoms. This study statistically analyzed the fatigue scores from two typical questionnaire-based instruments: the Korean version of the Multidimensional Fatigue Inventory (MFI-K) and the modified Chalder Fatigue Scale (mKCFQ). Methods Seventy participants (males n = 40, females n = 30, median age 48 years old, range of 25–67) were grouped into three groups (‘mild’ = 20, ‘moderate’ = 42, and ‘severe’ = 8) according to self-reported fatigue levels using a 7-point Likert scale. The similarities and differences between two instrument-derived scores were analyzed using correlations (r) and multidimensional scaling (MDS). Results The total scores of the two assessments were significantly correlated (r = 75%, p < 0.001), as were the subscores (‘Total Physical fatigue’: r = 76%, p < 0.001, ‘Total Mental fatigue’: r = 56%, p < 0.001). Relative overestimation of the MFI-K (45.8 ± 11.3) compared to the mKCFQ (36.1 ± 16.2) was observed, which was especially prominent in the ‘mild’ group. The scores of the three groups were more easily distinguished by the mKCFQ than by the MFI-K. In terms of the five dimension scores, we found a higher correlation of the two assessments for ‘general fatigue’ (r = 79%, p < 0.001) and ‘physical fatigue’ (r = 66%, p < 0.001) than for the reductions in ‘motivation’ (r = 41%, p < 0.01) and ‘activity’ (r = 26%, p > 0.05). Conclusions Our results may indicate the usefulness of the two instruments, especially for the physical symptoms of fatigue (‘general’ and ‘physical’ fatigue). Furthermore, the MFI-K may be useful for conditions of moderate-to-severe fatigue, such as chronic fatigue syndrome, but the mKCFQ may be useful for all spectra of fatigue, including in subhealthy people. Supplementary Information The online version contains supplementary material available at 10.1186/s12967-021-03219-0.
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Affiliation(s)
- Eun-Jin Lim
- Department of Integrative Medicine, Graduate School of Integrative Medicine, CHA University, 335 Pangyo-ro, Sungnam-si, Bundang-gu, 13488, Gyeonggi-do, Korea
| | - Chang-Gue Son
- Department of Korean Medicine, Institute of Bioscience and Integrative Medicine, Daejeon University, 62 Daehak-ro, Dong-gu, Daejeon, 300-716, Republic of Korea.
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Raijmakers R, Roerink M, Keijmel S, Joosten L, Netea M, van der Meer J, Knoop H, Klein H, Bleeker-Rovers C, Doorduin J. No Signs of Neuroinflammation in Women With Chronic Fatigue Syndrome or Q Fever Fatigue Syndrome Using the TSPO Ligand [ 11C]-PK11195. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2022; 9:9/1/e1113. [PMID: 34815320 PMCID: PMC8611501 DOI: 10.1212/nxi.0000000000001113] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 09/15/2021] [Indexed: 12/20/2022]
Abstract
Background and Objectives The pathophysiology of chronic fatigue syndrome (CFS) and Q fever fatigue syndrome (QFS) remains elusive. Recent data suggest a role for neuroinflammation as defined by increased expression of translocator protein (TSPO). In the present study, we investigated whether there are signs of neuroinflammation in female patients with CFS and QFS compared with healthy women, using PET with the TSPO ligand 11C-(R)-(2-chlorophenyl)-N-methyl-N-(1-methylpropyl)-3-isoquinoline-carbox-amide ([11C]-PK11195). Methods The study population consisted of patients with CFS (n = 9), patients with QFS (n = 10), and healthy subjects (HSs) (n = 9). All subjects were women, matched for age (±5 years) and neighborhood, aged between 18 and 59 years, who did not use any medication other than paracetamol or oral contraceptives, and were not vaccinated in the last 6 months. None of the subjects reported substance abuse in the past 3 months or reported signs of underlying psychiatric disease on the Mini-International Neuropsychiatric Interview. All subjects underwent a [11C]-PK11195 PET scan, and the [11C]-PK11195 binding potential (BPND) was calculated. Results No statistically significant differences in BPND were found for patients with CFS or patients with QFS compared with HSs. BPND of [11C]-PK11195 correlated with symptom severity scores in patients with QFS, but a negative correlation was found in patients with CFS. Discussion In contrast to what was previously reported for CFS, we found no significant difference in BPND of [11C]-PK11195 when comparing patients with CFS or QFS with healthy neighborhood controls. In this small series, we were unable to find signs of neuroinflammation in patients with CFS and QFS. Trial Registration Information EudraCT number 2014-004448-37.
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Affiliation(s)
- Ruud Raijmakers
- From the Radboud Expertise Center for Q Fever (R.R., S.K., L.J., M.N., J.M., C.B.-R.), Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center; Department of Internal Medicine (R.R., M.R., S.K., L.J., M.N., J.M., C.B.-R.), Radboud University Medical Center, Nijmegen; Department of Medical Psychology (H. Knoop), Amsterdam University Medical Centers, Amsterdam Public Health Research Institute, University of Amsterdam; Department of Psychiatry (H. Klein), University of Groningen, University Medical Center Groningen; and Department of Nuclear Medicine and Molecular Imaging (J.D.), University of Groningen, University Medical Center Groningen, the Netherlands.
| | - Megan Roerink
- From the Radboud Expertise Center for Q Fever (R.R., S.K., L.J., M.N., J.M., C.B.-R.), Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center; Department of Internal Medicine (R.R., M.R., S.K., L.J., M.N., J.M., C.B.-R.), Radboud University Medical Center, Nijmegen; Department of Medical Psychology (H. Knoop), Amsterdam University Medical Centers, Amsterdam Public Health Research Institute, University of Amsterdam; Department of Psychiatry (H. Klein), University of Groningen, University Medical Center Groningen; and Department of Nuclear Medicine and Molecular Imaging (J.D.), University of Groningen, University Medical Center Groningen, the Netherlands
| | - Stephan Keijmel
- From the Radboud Expertise Center for Q Fever (R.R., S.K., L.J., M.N., J.M., C.B.-R.), Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center; Department of Internal Medicine (R.R., M.R., S.K., L.J., M.N., J.M., C.B.-R.), Radboud University Medical Center, Nijmegen; Department of Medical Psychology (H. Knoop), Amsterdam University Medical Centers, Amsterdam Public Health Research Institute, University of Amsterdam; Department of Psychiatry (H. Klein), University of Groningen, University Medical Center Groningen; and Department of Nuclear Medicine and Molecular Imaging (J.D.), University of Groningen, University Medical Center Groningen, the Netherlands
| | - Leo Joosten
- From the Radboud Expertise Center for Q Fever (R.R., S.K., L.J., M.N., J.M., C.B.-R.), Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center; Department of Internal Medicine (R.R., M.R., S.K., L.J., M.N., J.M., C.B.-R.), Radboud University Medical Center, Nijmegen; Department of Medical Psychology (H. Knoop), Amsterdam University Medical Centers, Amsterdam Public Health Research Institute, University of Amsterdam; Department of Psychiatry (H. Klein), University of Groningen, University Medical Center Groningen; and Department of Nuclear Medicine and Molecular Imaging (J.D.), University of Groningen, University Medical Center Groningen, the Netherlands
| | - Mihai Netea
- From the Radboud Expertise Center for Q Fever (R.R., S.K., L.J., M.N., J.M., C.B.-R.), Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center; Department of Internal Medicine (R.R., M.R., S.K., L.J., M.N., J.M., C.B.-R.), Radboud University Medical Center, Nijmegen; Department of Medical Psychology (H. Knoop), Amsterdam University Medical Centers, Amsterdam Public Health Research Institute, University of Amsterdam; Department of Psychiatry (H. Klein), University of Groningen, University Medical Center Groningen; and Department of Nuclear Medicine and Molecular Imaging (J.D.), University of Groningen, University Medical Center Groningen, the Netherlands
| | - Jos van der Meer
- From the Radboud Expertise Center for Q Fever (R.R., S.K., L.J., M.N., J.M., C.B.-R.), Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center; Department of Internal Medicine (R.R., M.R., S.K., L.J., M.N., J.M., C.B.-R.), Radboud University Medical Center, Nijmegen; Department of Medical Psychology (H. Knoop), Amsterdam University Medical Centers, Amsterdam Public Health Research Institute, University of Amsterdam; Department of Psychiatry (H. Klein), University of Groningen, University Medical Center Groningen; and Department of Nuclear Medicine and Molecular Imaging (J.D.), University of Groningen, University Medical Center Groningen, the Netherlands
| | - Hans Knoop
- From the Radboud Expertise Center for Q Fever (R.R., S.K., L.J., M.N., J.M., C.B.-R.), Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center; Department of Internal Medicine (R.R., M.R., S.K., L.J., M.N., J.M., C.B.-R.), Radboud University Medical Center, Nijmegen; Department of Medical Psychology (H. Knoop), Amsterdam University Medical Centers, Amsterdam Public Health Research Institute, University of Amsterdam; Department of Psychiatry (H. Klein), University of Groningen, University Medical Center Groningen; and Department of Nuclear Medicine and Molecular Imaging (J.D.), University of Groningen, University Medical Center Groningen, the Netherlands
| | - Hans Klein
- From the Radboud Expertise Center for Q Fever (R.R., S.K., L.J., M.N., J.M., C.B.-R.), Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center; Department of Internal Medicine (R.R., M.R., S.K., L.J., M.N., J.M., C.B.-R.), Radboud University Medical Center, Nijmegen; Department of Medical Psychology (H. Knoop), Amsterdam University Medical Centers, Amsterdam Public Health Research Institute, University of Amsterdam; Department of Psychiatry (H. Klein), University of Groningen, University Medical Center Groningen; and Department of Nuclear Medicine and Molecular Imaging (J.D.), University of Groningen, University Medical Center Groningen, the Netherlands
| | - Chantal Bleeker-Rovers
- From the Radboud Expertise Center for Q Fever (R.R., S.K., L.J., M.N., J.M., C.B.-R.), Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center; Department of Internal Medicine (R.R., M.R., S.K., L.J., M.N., J.M., C.B.-R.), Radboud University Medical Center, Nijmegen; Department of Medical Psychology (H. Knoop), Amsterdam University Medical Centers, Amsterdam Public Health Research Institute, University of Amsterdam; Department of Psychiatry (H. Klein), University of Groningen, University Medical Center Groningen; and Department of Nuclear Medicine and Molecular Imaging (J.D.), University of Groningen, University Medical Center Groningen, the Netherlands
| | - Janine Doorduin
- From the Radboud Expertise Center for Q Fever (R.R., S.K., L.J., M.N., J.M., C.B.-R.), Department of Internal Medicine and Radboud Center for Infectious Diseases, Radboud University Medical Center; Department of Internal Medicine (R.R., M.R., S.K., L.J., M.N., J.M., C.B.-R.), Radboud University Medical Center, Nijmegen; Department of Medical Psychology (H. Knoop), Amsterdam University Medical Centers, Amsterdam Public Health Research Institute, University of Amsterdam; Department of Psychiatry (H. Klein), University of Groningen, University Medical Center Groningen; and Department of Nuclear Medicine and Molecular Imaging (J.D.), University of Groningen, University Medical Center Groningen, the Netherlands
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Chang WP, Wang CH. Influence of sleep fragmentation and fatigue on turnover of female nurses working rotating shifts. J Clin Nurs 2021; 31:3573-3583. [PMID: 34957611 DOI: 10.1111/jocn.16184] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/24/2021] [Accepted: 12/10/2021] [Indexed: 01/19/2023]
Abstract
AIMS AND OBJECTIVES To investigate whether the sleep quality and fatigue of female nurses working rotating shifts could be used to predict future turnover status. BACKGROUND Female nurses working rotating shifts often suffer from sleep problems and fatigue, and the turnover rates of nurses are generally higher than those of other hospital personnel. DESIGN A prospective study. METHODS We recruited a total of 198 female nurses working rotating shifts from December 2017 to March 2019. The nurses completed the Checklist Individual Strength (CIS) scale and wore an actigraph for seven consecutive days in order to collect their sleep parameters. Their turnover status was tracked until 31 May 2021 at which time 55 participants (27.8%) had resigned. The Cox proportional hazard model was used to analyse the factors influencing turnover. In addition, the study adhered to the STROBE checklist. RESULTS The results revealed significant differences between the nurses in the still-working group and the resigned group in terms of the sleep quality parameters sleep efficiency (SE) and wake after sleep onset (WASO) as well as CIS scores. WASO was significantly correlated with intensity of fatigue, and fatigue was common among all of the nurses working rotating shifts. As time progressed, the sleep quality parameter WASO and CIS scores could be used to predict turnover status after 2.4 years. CONCLUSION The results of this study indicated more sleep fragmentation and poor sleep efficiency in the resigned group. Sleep fragmentation was highly correlated with fatigue, and sleep fragmentation and fatigue could be used to predict turnover status. RELEVANCE TO CLINICAL PRACTICE We suggest that relevant hospital management pay more attention to the sleep conditions and fatigue of female nurses working rotating shifts when arranging personnel and schedules and offer them more understanding.
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Affiliation(s)
- Wen-Pei Chang
- Department of Nursing, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.,School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Chia-Hui Wang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
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142
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Penson A, Walraven I, Bronkhorst E, Grootenhuis MA, Tissing WJE, van der Pal HJH, de Vries ACH, van den Heuvel-Eibrink MM, Neggers S, Versluys BAB, Louwerens M, Pluijm SMF, Blijlevens N, van der Heiden-van der Loo M, Kremer LCM, van Dulmen-den Broeder E, Knoop H, Loonen J. Assessing fatigue in childhood cancer survivors: Psychometric properties of the Checklist Individual Strength and the Short Fatigue Questionnaire--a DCCSS LATER study. Cancer Med 2021; 11:1172-1180. [PMID: 34953059 PMCID: PMC8855897 DOI: 10.1002/cam4.4490] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 11/30/2021] [Indexed: 01/18/2023] Open
Abstract
Background Fatigue is often reported by patients with childhood cancer both during and after cancer treatment. Several instruments to measure fatigue exist, although none are specifically validated for use in childhood cancer survivors (CCS). The aim of the current study was to present norm values and psychometric properties of the Checklist Individual Strength (CIS) and Short Fatigue Questionnaire (SFQ) in a nationwide cohort of CCS. Methods In total, 2073 participants were included from the Dutch Childhood Cancer Survivor Study (DCCSS) LATER cohort. Normative data, construct validity, structural validity, and internal consistency were calculated for the CIS and SFQ. In addition, reliability and a cutoff score to indicate severe fatigue were determined for the SFQ. Results Correlations between CIS/SFQ and vitality measures asking about fatigue were high (>0.8). Correlations between CIS/SFQ and measures of different constructs (sleep, depressive emotions, and role functioning emotional) were moderate (0.4–0.6). Confirmatory factor analysis resulted in a four‐factor solution for the CIS and a one‐factor solution for the SFQ with Cronbach's alpha for each (sub)scale showing good to excellent values (>0.8). Test–retest reliability of the SFQ was adequate (Pearson's correlation = 0.88; ICC = 0.946; weighted Cohen's kappa item scores ranged 0.31–0.50) and a cut‐off score of 18 showed good sensitivity and specificity scores (92.6% and 91.3%, respectively). Conclusion The current study shows that the SFQ is a good instrument to screen for severe fatigue in CCS. The CIS can be used as a tool to assess the multiple fatigue dimensions in CCS.
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Affiliation(s)
- Adriaan Penson
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Iris Walraven
- Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ewald Bronkhorst
- Department of Dentistry, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Martha A Grootenhuis
- Department of Psychology, Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Wim J E Tissing
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.,Department of Pediatric Oncology/Hematology, Beatrix Children's Hospital/University of Groningen/University Medical Center Groningen, Groningen, The Netherlands
| | | | - Andrica C H de Vries
- Department of Pediatric Oncology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Marry M van den Heuvel-Eibrink
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.,Department of Pediatric Oncology, Erasmus Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Sebastian Neggers
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.,Department of Medicine, section Endocrinology, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Marloes Louwerens
- Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Saskia M F Pluijm
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Nicole Blijlevens
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Leontien C M Kremer
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.,Department Pediatric Oncology, Emma Children's Hospital, University of Amsterdam, The Netherlands
| | | | - Hans Knoop
- Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Public health research institute, Amsterdam, Netherlands
| | - Jacqueline Loonen
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
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143
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Chang WP, Li HB. Influence of shift work on rest-activity rhythms, sleep quality, and fatigue of female nurses. Chronobiol Int 2021; 39:557-568. [PMID: 34906006 DOI: 10.1080/07420528.2021.2005082] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Female nurses working rotating shifts must change their daily routines often, which affects their biological circadian rhythms and could cause sleep disorders and fatigue. The objective of this study was to compare the sleep-wake rhythms, sleep quality, and fatigue of female nurses working rotating shifts and fixed day shifts and to analyze the factors that influence their fatigue. Participants comprised a shift worker group of 101 nurses and a day worker group of 76 nurses. Following the collection of basic information of the nurses and their scores in the various constructs of the Pittsburg Sleep Quality Index (PSQI) and the Checklist Individual Strength (CIS) questionnaire, each nurse wore an actigraph for seven consecutive days to collect for analysis the sleep-wake rhythm parameter dichotomy index (I < O) and durations of continuous sleep and wake. Multivariable linear regression was then used to determine whether the influence of various variables on fatigue differed between the two groups. Results revealed that the sleep-wake rhythm parameter I < O of the day worker group was significantly higher than that of the shift worker group (t = 5.08, p < .001). The shift worker group exhibited significantly higher PSQI global scores (t = -2.00, p = .047), longer total sleep time (t = 2.07, p = .040), poorer habitual sleep efficiency (t = -3.06, p = .003), and greater use of sleeping medication (t = -2.90, p = .004) than did the day worker group. Multivariable linear regression was performed to analyze the important predictors of the CIS score in the two groups with body mass index, age, work experience, marital status, educational background, department of employment, shift type at the time of recruitment, sleep-wake rhythm parameter I < O, and quality of sleep as independent variables. Results indicated that in the shift worker group, the overall explanatory power (R2) of the multivariable linear regression model was 22.9% (F = 3.01, p = .003), and only the PSQI global score (β = 0.33, p = .003) influenced the CIS score. In the day worker group, the various variables did not influence the CIS score in the multivariable linear regression model. Although the female nurses working rotating shifts spent more time in bed, their sleep-wake rhythms and sleep quality were poorer than those of the day worker group. Furthermore, the sleep quality of female nurses in the shift worker group had a significant impact on their fatigue. In other words, for female nurses who must work rotating shifts, sleep quality determines whether fatigue can be reduced. The shift-working nurses themselves should implement sleep management, such as avoiding disruptions to their sleep-wake rhythm and improving sleep quality, which should be effective strategies to reduce fatigue.
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Affiliation(s)
- Wen-Pei Chang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Department of Nursing, Taipei Medical University-Shuang Ho Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan
| | - Hau-Bin Li
- Institute of Physics, Academia Sinica, Taipei, Taiwan
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144
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Alshutwi S, Miligi E, Alhumidan L, Almutairi AF. The influence of the disclosure of diabetes on the cognitive, physical ability and diabetes self-management in diabetic employed adults in Saudi Arabia. Nurs Open 2021; 9:978-985. [PMID: 34894099 PMCID: PMC8859031 DOI: 10.1002/nop2.1133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 09/02/2021] [Accepted: 10/31/2021] [Indexed: 11/24/2022] Open
Abstract
Background Diabetes is a serious medical condition that may cause blindness, renal failure and amputation of the lower limbs, stroke and myocardial infarction. The global incidence of diabetes increases continuously. The self‐management of diabetes can be problematic and burdensome, especially if employed individuals choose not to reveal their illness. The workplace has been highlighted as an important element that may impact how employed individuals, diagnosed with diabetes and managed their illness. Aim To describe the influence of diabetes disclosure on the cognitive, physical ability and diabetes self‐management of employed adults with diabetes in Saudi Arabia. Design A descriptive correlational study. Methods This study used a self‐administered questionnaire, including the Checklist Individual Strength and Perceived Diabetes Self‐Management Scale, for data collection. The sample size was 250 employed adults with diabetes. The data were analysed using descriptive statistics, Spearman's correlation coefficient and bivariate analysis. Results A significant correlation was found between diabetes self‐management and support from co‐workers (r = .55, p < .05), and the employees who received more support from their co‐workers were able to perform diabetes self‐management. The results also indicate that employees who received support at their workplace reported improved concentration, motivation and activity (r = .41, p < .05). Conclusion It is essential for top management and policymakers to implement supportive programmes in the workplace, and considering a constant, not rotating, work schedule.
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Affiliation(s)
- Sitah Alshutwi
- College of Nursing-Riyadh, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Eman Miligi
- College of Nursing-Riyadh, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia.,Nursing Administration Department, Faculty of Nursing, Cario University, Egypt
| | - Lujain Alhumidan
- Science and Technology Unit, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Adel F Almutairi
- Science and Technology Unit, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
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145
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Kuut TA, Müller F, Aldenkamp A, Assmann-Schuilwerve E, Braamse A, Geerlings SE, Gibney KB, Kanaan RAA, Nieuwkerk P, Olde Hartman TC, Pauëlsen D, Prins M, Slieker K, Van Vugt M, Bleeker-Rovers CP, Keijmel SP, Knoop H. A randomised controlled trial testing the efficacy of Fit after COVID, a cognitive behavioural therapy targeting severe post-infectious fatigue following COVID-19 (ReCOVer): study protocol. Trials 2021; 22:867. [PMID: 34857010 PMCID: PMC8637041 DOI: 10.1186/s13063-021-05569-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 08/26/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) results in debilitating long-term symptoms, often referred to as Post-Acute Sequelae of SARS-CoV-2 Infection (PASC), in a substantial subgroup of patients. One of the most prevalent symptoms following COVID-19 is severe fatigue. Prompt delivery of cognitive behavioural therapy (CBT), an evidence-based treatment that has shown benefit in reducing severe fatigue in other conditions, may reduce post-COVID-19 fatigue. Based on an existing CBT protocol, a blended intervention of 17 weeks, Fit after COVID, was developed to treat severe fatigue after the acute phase of infection with SARS-CoV-2. METHOD The ReCOVer study is a multicentre 2-arm randomised controlled trial (RCT) to test the efficacy of Fit after COVID on severe post-infectious fatigue. Participants are eligible if they report severe fatigue 3 up to and including 12 months following COVID-19. One hundred and fourteen participants will be randomised to either Fit after COVID or care as usual (ratio 1:1). The primary outcome, the fatigue severity subscale of the Checklist Individual Strength (CIS-fatigue), is assessed in both groups before randomisation (T0), directly post CBT or following care as usual (T1), and at follow-up 6 months after the second assessment (T2). In addition, a long-term follow-up (T3), 12 months after the second assessment, is performed in the CBT group only. The primary objective is to investigate whether CBT will lead to a significantly lower mean fatigue severity score measured with the CIS-fatigue across the first two follow-up assessments (T1 and T2) as compared to care as usual. Secondary objectives are to determine the proportion of participants no longer being severely fatigued (operationalised in different ways) at T1 and T2 and to investigate changes in physical and social functioning, in the number and severity of somatic symptoms and in problems concentrating across T1 and T2. DISCUSSION This is the first trial testing a cognitive behavioural intervention targeting severe fatigue after COVID-19. If Fit after COVID is effective in reducing fatigue severity following COVID-19, this intervention could contribute to alleviating the long-term health consequences of COVID-19 by relieving one of its most prevalent and distressing long-term symptoms. TRIAL REGISTRATION Netherlands Trial Register NL8947 . Registered on 14 October 2020.
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Affiliation(s)
- T A Kuut
- Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
- Amsterdam University Medical Centers, Expert Center for Chronic Fatigue, Department of Medical Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
| | - F Müller
- Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - A Aldenkamp
- Department of Lung Medicine, Catharina Hospital, Eindhoven, The Netherlands
| | | | - A Braamse
- Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - S E Geerlings
- Department of Internal Medicine, Division Infectious Diseases, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - K B Gibney
- Victorian Infectious Diseases Service, Royal Melbourne Hospital, and Department of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia
| | - R A A Kanaan
- Department of Psychiatry, University of Melbourne, Austin Health, Heidelberg, Australia
| | - P Nieuwkerk
- Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - T C Olde Hartman
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - D Pauëlsen
- Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - M Prins
- Department of Internal Medicine, Division Infectious Diseases, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands
| | - K Slieker
- Department of Internal Medicine, Bernhoven, Uden, The Netherlands
| | - M Van Vugt
- Division of Internal Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Institute for Infection and Immunity, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - C P Bleeker-Rovers
- Department of Internal Medicine, Radboud university medical center, Nijmegen, The Netherlands
| | - S P Keijmel
- Department of Internal Medicine, Radboud university medical center, Nijmegen, The Netherlands
| | - H Knoop
- Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Amsterdam University Medical Centers, Expert Center for Chronic Fatigue, Department of Medical Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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146
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Pimenta S, Silva CG, Flora S, Hipólito N, Burtin C, Oliveira A, Morais N, Brites-Pereira M, Carreira BP, Januário F, Andrade L, Martins V, Rodrigues F, Brooks D, Marques A, Cruz J. What Motivates Patients with COPD to Be Physically Active? A Cross-Sectional Study. J Clin Med 2021; 10:5631. [PMID: 34884333 PMCID: PMC8658241 DOI: 10.3390/jcm10235631] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 11/26/2021] [Accepted: 11/27/2021] [Indexed: 01/03/2023] Open
Abstract
Motivation can be broadly defined as what moves people to act. Low motivation is a frequently reported factor for the reduced physical activity (PA) levels observed in patients with chronic obstructive pulmonary disease (COPD). This study assessed patients' motives to be physically active, according to three pulmonary rehabilitation (PR) participation groups (Never PR, Previous PR and Current PR) and explored whether these motives were related to the PA levels and clinical characteristics. The motives to be physically active were assessed with the Exercise Motivation Inventory-2 (EMI-2, 14 motivational factors, five dimensions) and PA with accelerometry (PA groups: <5000 steps/day vs. ≥5000 steps/day). The clinical variables included symptoms, impact of the disease, exercise capacity and comorbidities. Ninety-two patients (67.4 ± 8.1 years, 82.6% male, forced expiratory volume in 1s (FEV1) 48.3 ± 18.9% predicted; 30.4% Never PR, 51% Previous PR and 18.5% Current PR) participated. The motivational dimensions related to health/fitness presented the highest scores (3.8 ± 1.1; 3.4 ± 1.3). The motives to be active were not significantly different between PA groups (p > 0.05) but having less symptoms and ≥two comorbidities were associated with higher scores in psychological/health and body-related motives, respectively (p < 0.05). The findings may encourage health professionals to actively explore with patients their motives to be physically active to individualise PA promotion.
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Affiliation(s)
- Sara Pimenta
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, 2410-541 Leiria, Portugal; (S.P.); (C.G.S.); (S.F.); (N.H.); (N.M.); (M.B.-P.); (B.P.C.)
- School of Health Sciences (ESSLei), Polytechnic of Leiria, 2411-901 Leiria, Portugal
| | - Cândida G. Silva
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, 2410-541 Leiria, Portugal; (S.P.); (C.G.S.); (S.F.); (N.H.); (N.M.); (M.B.-P.); (B.P.C.)
- School of Health Sciences (ESSLei), Polytechnic of Leiria, 2411-901 Leiria, Portugal
- Coimbra Chemistry Centre, Department of Chemistry, University of Coimbra, 3004-535 Coimbra, Portugal
| | - Sofia Flora
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, 2410-541 Leiria, Portugal; (S.P.); (C.G.S.); (S.F.); (N.H.); (N.M.); (M.B.-P.); (B.P.C.)
| | - Nádia Hipólito
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, 2410-541 Leiria, Portugal; (S.P.); (C.G.S.); (S.F.); (N.H.); (N.M.); (M.B.-P.); (B.P.C.)
| | - Chris Burtin
- REVAL—Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, B-3590 Diepenbeek, Belgium;
- BIOMED—Biomedical Research Institute, Hasselt University, B-3590 Diepenbeek, Belgium
| | - Ana Oliveira
- School of Rehabilitation Science, McMaster University, Hamilton, ON L8S 1C7, Canada; (A.O.); (D.B.)
- Respiratory Medicine, West Park Healthcare Centre, Toronto, ON M6M 2J5, Canada
- Lab 3R—Respiratory Research and Rehabilitation Laboratory, School of Health Sciences (ESSUA), University of Aveiro, 3810-193 Aveiro, Portugal;
| | - Nuno Morais
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, 2410-541 Leiria, Portugal; (S.P.); (C.G.S.); (S.F.); (N.H.); (N.M.); (M.B.-P.); (B.P.C.)
- School of Health Sciences (ESSLei), Polytechnic of Leiria, 2411-901 Leiria, Portugal
- Centre for Rapid and Sustainable Product Development (CDRSP), Polytechnic of Leiria, 2430-028 Leiria, Portugal
| | - Marcelo Brites-Pereira
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, 2410-541 Leiria, Portugal; (S.P.); (C.G.S.); (S.F.); (N.H.); (N.M.); (M.B.-P.); (B.P.C.)
| | - Bruno P. Carreira
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, 2410-541 Leiria, Portugal; (S.P.); (C.G.S.); (S.F.); (N.H.); (N.M.); (M.B.-P.); (B.P.C.)
- School of Health Sciences (ESSLei), Polytechnic of Leiria, 2411-901 Leiria, Portugal
- Unidade de Saúde Familiar Pedro e Inês, ACeS Oeste Norte, 2460-492 Alcobaça, Portugal
| | - Filipa Januário
- Physical Medicine and Rehabilitation Department, Leiria Hospital Center, 2410-197 Leiria, Portugal;
| | - Lília Andrade
- Pulmonology Department, Baixo Vouga Hospital Center, 3810-501 Aveiro, Portugal;
| | - Vitória Martins
- Pulmonology Department, District Hospital of Figueira da Foz, 3094-001 Figueira da Foz, Portugal;
| | - Fátima Rodrigues
- Pulmonology Department, Northern Lisbon University Hospital Centre (CHULN), 1769-001 Lisboa, Portugal;
- Environmental Health Behaviour Lab, Faculty of Medicine, University of Lisbon (ISAMB/FMUL), 1649-028 Lisboa, Portugal
| | - Dina Brooks
- School of Rehabilitation Science, McMaster University, Hamilton, ON L8S 1C7, Canada; (A.O.); (D.B.)
- Respiratory Medicine, West Park Healthcare Centre, Toronto, ON M6M 2J5, Canada
| | - Alda Marques
- Lab 3R—Respiratory Research and Rehabilitation Laboratory, School of Health Sciences (ESSUA), University of Aveiro, 3810-193 Aveiro, Portugal;
- Institute of Biomedicine (iBiMED), University of Aveiro, 3810-193 Aveiro, Portugal
| | - Joana Cruz
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, 2410-541 Leiria, Portugal; (S.P.); (C.G.S.); (S.F.); (N.H.); (N.M.); (M.B.-P.); (B.P.C.)
- School of Health Sciences (ESSLei), Polytechnic of Leiria, 2411-901 Leiria, Portugal
- Lab 3R—Respiratory Research and Rehabilitation Laboratory, School of Health Sciences (ESSUA), University of Aveiro, 3810-193 Aveiro, Portugal;
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147
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Köse E, Aydin M, Köse O, Aksu MG, Sekban G. The efficiency of a mixed exercise program on quality of life and fatigue levels in patients with breast cancer. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2021; 67:1279-1285. [PMID: 34816921 DOI: 10.1590/1806-9282.20210539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 08/03/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Exercise is a nonpharmacological supportive therapy which has been specifically identified to reduce postoperative complications or adverse events of cancer or treatments. Although there are few studies combining resistance and aerobic exercise in cancer survivors, exercise programs are very rare in different places in the literature. This study aims to investigate the effects of mixed-type exercise in different venues on weight, body mass index, fatigue, and quality of life in cancer survivors. METHODS This is a descriptive, intervention study. Participants were included in the study, and the exercise process was between January and November 2019. The exercise group consisted of 32 patients who had just completed their breast cancer treatment and did not have distant metastases, and they applied a mixed exercise program including resistance at home and aerobic exercise in the fitness center for 12 weeks. The patients with breast cancer in the control group (30 patients) did not receive any exercise program. RESULTS Subjective feelings of fatigue and decrease in concentration, motivation, and physical activity significantly decreased after exercise (p<0.001, p<0.001, p=0.006, p=0.008, and p<0.001, respectively) in the study group. The results also showed that physical health, general health status, and emotional and social health status significantly increased with the exercise program (p<0.001, p<0.001, p=0.004, and p=0.003, respectively). CONCLUSION Our results show that a mixed (fitness center and home) 12-week exercise program provides an improvement in general health and reduces the side effects of the treatments and fatigue in patients with breast cancer. For a good prognostic process after medical treatment, exercise can be recommended in every accessible area.
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Affiliation(s)
- Elif Köse
- Sakarya University, Faculty of Medicine, Department of Public Health - Sakarya, Turkey
| | - Menşure Aydin
- Halic University, Department of Physical Education and Sports Education - Istanbul, Turkey
| | - Osman Köse
- Sakarya University, Faculty of Medicine, Gynecological Oncology clinic - Sakarya, Turkey
| | - Maksut Görkem Aksu
- Kocaeli University, Faculty of Medicine, Department of Radiation Oncology - Kocaeli, Turkey
| | - Gülşah Sekban
- Kocaeli University, Department of Physical Education and Sports Education - Kocaeli, Turkey
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148
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Knobbe TJ, Kremer D, Eisenga MF, van Londen M, Gomes-Neto AW, Douwes RM, Gan CT, Corpeleijn E, Annema C, Navis G, Berger SP, Bakker SJ. Airflow Limitation, Fatigue, and Health-Related Quality of Life in Kidney Transplant Recipients. Clin J Am Soc Nephrol 2021; 16:1686-1694. [PMID: 34750161 PMCID: PMC8729428 DOI: 10.2215/cjn.06600521] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 09/07/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Many kidney transplant recipients suffer from fatigue and poor health-related quality of life. Airflow limitation may be an underappreciated comorbidity among kidney transplant recipients, which could contribute to fatigue and lower health-related quality of life in this population. In this study, we compared the prevalence of airflow limitation between kidney transplant recipients and healthy controls and investigated associations of airflow limitation with fatigue and health-related quality of life in kidney transplant recipients. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Data from the ongoing TransplantLines Biobank and Cohort study were used. Airflow limitation was defined as forced exhaled volume in 1 second less than the fifth percentile of the general population. Fatigue and health-related quality of life were assessed using checklist individual strength 20 revised (CIS20-R) and Short Form-36 (SF-36) questionnaires. RESULTS A total of 539 kidney transplant recipients (58% men; mean age 56±13 years) and 244 healthy controls (45% men; mean age 57±10 years) were included. Prevalence of airflow limitation was higher in kidney transplant recipients than in healthy controls (133 [25%] versus 25 [10%]). In multinomial regression models, airflow limitation was independently associated with fatigue severity (odds ratio moderate fatigue, 1.68; 95% confidence interval, 0.92 to 3.09 and odds ratio severe fatigue, 2.51; 95% confidence interval, 1.39 to 4.55; P=0.007) and lower physical health-related quality of life (-0.11 SDs; 95% confidence interval, -0.19 to -0.02; P=0.01) in kidney transplant recipients. In exploratory mediation analyses, fatigue accounted for 79% of the association of airflow limitation with physical health-related quality of life. CONCLUSIONS Airflow limitation is common among kidney transplant recipients. Its occurrence is associated with more than two times higher risk of severe fatigue, and it is associated with lower physical health-related quality of life. Mediation analyses suggest that airflow limitation causes fatigue, which in turn, decreases physical health-related quality of life. CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER TransplantLines: The Transplantation Biobank, NCT03272841 PODCAST: This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2021_11_08_CJN06600521.mp3.
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Affiliation(s)
- Tim J. Knobbe
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Daan Kremer
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Michele F. Eisenga
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Marco van Londen
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - António W. Gomes-Neto
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Rianne M. Douwes
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - C. Tji Gan
- Department of Pulmonary Diseases and Tuberculosis, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Eva Corpeleijn
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Coby Annema
- Department of Health Sciences, Section of Nursing Research, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Gerjan Navis
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Stefan P. Berger
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Stephan J.L. Bakker
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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149
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Fatigue in patients with chronic disease: results from the population-based Lifelines Cohort Study. Sci Rep 2021; 11:20977. [PMID: 34697347 PMCID: PMC8546086 DOI: 10.1038/s41598-021-00337-z] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 10/07/2021] [Indexed: 12/21/2022] Open
Abstract
(1) To evaluate the prevalence of severe and chronic fatigue in subjects with and without chronic disease; (2) to assess to which extent multi-morbidity contributes to severe and chronic fatigue; and (3) to identify predisposing and associated factors for severe and chronic fatigue and whether these are disease-specific, trans-diagnostic, or generic. The Dutch Lifelines cohort was used, including 78,363 subjects with (n = 31,039, 53 ± 12 years, 33% male) and without (n = 47,324, 48 ± 12 years, 46% male) ≥ 1 of 23 chronic diseases. Fatigue was assessed with the Checklist Individual Strength-Fatigue. Compared to participants without a chronic disease, a higher proportion of participants with ≥ 1 chronic disease were severely (23% versus 15%, p < 0.001) and chronically (17% versus 10%, p < 0.001) fatigued. The odds of having severe fatigue (OR [95% CI]) increased from 1.6 [1.5–1.7] with one chronic disease to 5.5 [4.5–6.7] with four chronic diseases; for chronic fatigue from 1.5 [1.5–1.6] to 4.9 [3.9–6.1]. Multiple trans-diagnostic predisposing and associated factors of fatigue were found, explaining 26% of variance in fatigue in chronic disease. Severe and chronic fatigue are highly prevalent in chronic diseases. Multi-morbidity increases the odds of having severe and chronic fatigue. Several trans-diagnostic factors were associated with fatigue, providing a rationale for a trans-diagnostic approach.
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150
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Shi Y, Xie J, Zhou ZE, Ma H, Tang Y. How parents' psychological detachment from work affects their children via fatigue: The moderating role of gender. Stress Health 2021; 38:463-476. [PMID: 34679228 DOI: 10.1002/smi.3107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 10/06/2021] [Accepted: 10/15/2021] [Indexed: 11/10/2022]
Abstract
Previous studies demonstrated that psychological detachment from work can impact employees' work and family lives. Based on conservation of resources theory and social role theory, the present study examined the process through which working parents' psychological detachment from work influences their children's perception of neglectful parenting (emotional warmth and rejection). Specifically, we examined the mediating role of parents' fatigue and the moderating role of parent gender in this process. Data were collected from working parents (n = 371) and their children in junior high school (n = 371, 10-13 years old) at two time points with a three-month interval. Our results showed that working parents' psychological detachment from work at Time 1 significantly predicted children's perception of parent emotional warmth and rejection at Time 2, and parents' fatigue at Time 2 mediated this relationship. Besides, parent gender moderated this mediated process such that the positive indirect effect of parent psychological detachment from work on emotional warmth via fatigue was stronger for working mothers than for working fathers. These findings contribute to the limited research on the effects of psychological detachment from work on family members and highlight the importance of parent gender in children's perceptions of working parents' behaviours.
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Affiliation(s)
- Yanwei Shi
- Department of Human Resource Management, Shanghai Normal University, Shanghai, China
| | - Julan Xie
- School of Business, Central South University, Changsha, China
| | - Zhiqing E Zhou
- Baruch College and The Graduate Center, City University of New York, New York City, New York, USA
| | - Hongyu Ma
- School of Psychology, Central China Normal University, Wuhan, China
| | - Yan Tang
- Bureau of Education of Huanggang, Huanggang, China
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