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van Elk F, Lammers-van der Holst HM, Robroek SJW, Burdorf A, Oude Hengel KM. Effects and implementation of an intervention to improve sleep, fatigue and recovery among healthcare workers with night shifts: A pre- and post-test study. Int J Nurs Stud 2024; 160:104881. [PMID: 39255526 DOI: 10.1016/j.ijnurstu.2024.104881] [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: 03/06/2024] [Revised: 08/02/2024] [Accepted: 08/19/2024] [Indexed: 09/12/2024]
Abstract
BACKGROUND Previous intervention studies among night workers mainly focused on single interventions and found inconclusive evidence for effectiveness. A comprehensive intervention approach that includes individual and environmental components has been argued as important. Gaining insight into contributing factors for the implementation of interventions for night workers and effectiveness is important to distinguish between theory and programme failure. OBJECTIVES To evaluate the effects and implementation of the PerfectFit@Night intervention to improve sleep, fatigue and recovery of night workers in healthcare, using the RE-AIM framework, which assesses reach, effectiveness, adoption, implementation and maintenance of interventions. DESIGN A prospective pre-post study design, with two measurements before and three and six months after the intervention. SETTING Twelve different departments of a university hospital in the Netherlands. PARTICIPANTS Healthcare workers working night shifts (n = 210). METHODS PerfectFit@Night consisted of environmental (provision of a powernap bed and healthy food, and workshop healthy rostering) and individual elements (e-learning and sleep coaching) and was implemented for three months in a phased manner. Questionnaires, logbooks and interview data were used. Effects of the intervention on sleep, fatigue and recovery were evaluated with mixed-effects models, and implementation factors of reach, adoption, implementation and maintenance were evaluated. RESULTS Night shift-related insomnia (-11 %-points, 95 % CI: -19 %, -4 % at three months), need for recovery (β: -2.45, 95 % CI: -4.86, -0.03 at six months) and fatigue (OR: 0.46, 95 % CI: 0.25, 0.86 at six months) decreased significantly after the intervention. No changes were found for subjective sleep quality and sleep duration. Barriers and facilitators for implementation were identified for each intervention element at individual (e.g., dietary preferences), organisational (e.g., responsibilities at work) and workplace levels (e.g., location of power nap bed), and for the intervention itself (e.g., useful information in e-learning). Although satisfaction was high and continuation was preferred, embedding of the intervention in the daily routine was limited. Facilitators for future implementation include a positive attitude towards the intervention, clear guidelines regarding intervention elements, appointment of night workers as ambassadors, and suitable conditions in terms of work demands and for the intervention elements. CONCLUSIONS The multi-faceted PerfectFit@Night intervention reduced insomnia, fatigue and need for recovery in night workers in healthcare. The most important facilitators to improve the implementation of PerfectFit@Night exist at the organisational level (e.g., positive attitude within the culture and suitable work demands). Combining effect and implementation evaluation is crucial to identify barriers and facilitators that hamper or enhance intervention effects. TRIAL REGISTRATION The study was registered in the Netherlands Trial Register on 17 January 2021 (trial number NL9224).
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Affiliation(s)
- Fleur van Elk
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
| | | | - Suzan J W Robroek
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Alex Burdorf
- Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Karen M Oude Hengel
- Department of Work Health Technology, Netherlands Organisation for Applied Scientific Research TNO, Leiden, the Netherlands.
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2
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Müller F, van Dongen S, van Woezik R, Tibosch M, Tuinman MA, Schellekens MPJ, Laurenceau JP, van der Lee M, Hagedoorn M. A Web-Based Mindfulness-Based Cognitive Therapy for Couples Dealing With Chronic Cancer-Related Fatigue: Protocol for a Single-Arm Pilot Trial. JMIR Res Protoc 2023; 12:e48329. [PMID: 37930767 PMCID: PMC10660231 DOI: 10.2196/48329] [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: 04/26/2023] [Revised: 08/04/2023] [Accepted: 08/29/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND Chronic fatigue is a common symptom among patients who have been treated for cancer. Current psychosocial interventions typically target the patient alone, despite growing evidence suggesting that a couples' approach can increase and broaden the efficacy of an intervention. Therefore, based on an existing web-based mindfulness-based cognitive therapy for patients, the couple intervention COMPANION was developed. OBJECTIVE The primary objectives of this study are to determine the acceptability of COMPANION and its potential efficacy in reducing fatigue in patients with cancer. Our secondary objectives are to examine the feasibility of the trial procedures and the potential working mechanisms of the couple intervention. METHODS We will conduct a single-arm pilot trial for couples (ie, patients with cancer with chronic fatigue and their partners). All couples are allocated to the web-based couple intervention that consists of psychoeducation, mindfulness, and cognitive-behavioral exercises. The 9 sessions of the intervention are supervised remotely by a trained therapist. Patients and partners will complete questionnaires before starting the intervention (T0), 2 weeks after completing the intervention (T1), and 1 month after T1 (T2). They will also fill out weekly diaries during the intervention period. A subsample of patients (n≈5) and partners (n≈5) as well as all the therapists providing COMPANION will participate in the final focus groups. Benchmark values have been defined to determine the acceptability (ie, ≥60% of couples complete the intervention and/or ≥70% of the participants are satisfied with the intervention) and potential efficacy (ie, a significant improvement in fatigue and/or a clinically relevant improvement in fatigue in 45% of the patients between T0 and T1) of the intervention. The trial procedures are deemed feasible if an average of at least three couples are included per recruiting month and/or adherence to the assessments is at least 65% for T1 and the diaries and 60% for T2. To establish potential working mechanisms, changes in affect, sleep, catastrophizing, partner communication and interactions, self-efficacy, mindfulness, and closeness will be examined. Quantitative outcomes will be interpreted along with the results from the focus groups. RESULTS Data collection is expected to be completed by March 2024. CONCLUSIONS This pilot trial will test the first web-based mindfulness-based cognitive therapy for couples targeting chronic cancer-related fatigue. Findings will indicate whether proceeding with a randomized controlled trial is warranted. TRIAL REGISTRATION ClinicalTrials.gov NCT05636696; https://clinicaltrials.gov/study/NCT05636696. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/48329.
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Affiliation(s)
- Fabiola Müller
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Sophie van Dongen
- Scientific Research Department, Helen Dowling Institute, Bilthoven, Netherlands
| | - Rosalie van Woezik
- Scientific Research Department, Helen Dowling Institute, Bilthoven, Netherlands
| | - Marijke Tibosch
- Scientific Research Department, Helen Dowling Institute, Bilthoven, Netherlands
| | - Marrit A Tuinman
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Melanie P J Schellekens
- Scientific Research Department, Helen Dowling Institute, Bilthoven, Netherlands
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands
| | - Jean-Philippe Laurenceau
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, United States
| | - Marije van der Lee
- Scientific Research Department, Helen Dowling Institute, Bilthoven, Netherlands
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands
| | - Mariët Hagedoorn
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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3
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Close J, Vandercappellen J, King M, Hobart J. Measuring Fatigue in Multiple Sclerosis: There may be Trouble Ahead. Neurol Ther 2023; 12:1649-1668. [PMID: 37353721 PMCID: PMC10444927 DOI: 10.1007/s40120-023-00501-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 05/17/2023] [Indexed: 06/25/2023] Open
Abstract
INTRODUCTION Poorly developed patient-reported outcome measures (PROs) risk type-II errors (i.e. false negatives) in clinical trials, resulting in erroneous failure to achieve trial endpoints. Validity is a fundamental requirement of fit-for-purpose PROs, with the main determinant of validity being the PROs items, i.e. content validity. Here, we sought to identify fatigue PRO instruments used in multiple sclerosis (MS) studies and to assess the extent to which their development satisfied current content validity standards. METHODS We searched Embase® and Medline® for MS studies using fatigue-based PROs. Abstracts were screened, PROs identified, and their relevant development papers assessed against seven Consensus Standards for Measurement Instruments (COSMIN) criteria for content development. RESULTS From 3814 abstracts, 18 fatigue PROs met our inclusion criteria. Most PROs did not satisfy at least one COSMIN content validity standard. Frequent omissions during PRO development include: clearly defined constructs; conceptual frameworks; qualitative research in representative samples; and literature reviews. PRO development quality has improved significantly since FDA guidance was published (U = 10.0, p = 0.02). However, scatterplots and correlations between PRO COSMIN scores and citation frequency (rho = - 0.62) and clinical trials usage (rho = + 0.18) implied that PRO quality is unrelated to choice. COSMIN scores implied that the Fatigue Symptoms and Impact Questionnaire-Relapsing Multiple Sclerosis (FSIQ-RMS) and Neurological Fatigue Index-Multiple Sclerosis (NFI-MS) had the strongest evidence for adequate content validity. CONCLUSION Most existing fatigue PROs do not meet COSMIN content validity requirements. Although two PROs scored well on aggregate (NFI-MS and FSIQ-RMS), our subsequent evaluation of the item sets that generated their scores implied that both PROs have weaker content validity than COSMIN suggests. This indicates that COSMIN criteria require further development, and raises significant concerns about how we have measured one of the most common and burdensome MS symptoms. A detailed head-to-head psychometric evaluation is needed to determine the impact of different PRO development qualities and the implications of the problems implied by our analyses, on measurement performance.
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Affiliation(s)
- James Close
- Peninsula Schools of Medicine and Dentistry, University of Plymouth, Plymouth, UK
| | | | | | - Jeremy Hobart
- Peninsula Schools of Medicine and Dentistry, University of Plymouth, Plymouth, UK.
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Goërtz YMJ, Spruit MA, Van Herck M, Dukers-Muijrers N, van der Kallen CJH, Burtin C, Janssen DJA. Symptoms and quality of life before, during, and after a SARS-CoV-2 PCR positive or negative test: data from Lifelines. Sci Rep 2023; 13:11713. [PMID: 37474524 PMCID: PMC10359407 DOI: 10.1038/s41598-023-38223-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 07/05/2023] [Indexed: 07/22/2023] Open
Abstract
This study evaluates to what extent symptoms are present before, during, and after a positive SARS-CoV-2 polymerase chain reaction (PCR) test, and to evaluate how the symptom burden and quality of Life (QoL) compares to those with a negative PCR test. Participants from the Dutch Lifelines COVID-19 Cohort Study filled-out as of March 2020 weekly, later bi-weekly and monthly, questions about demographics, COVID-19 diagnosis and severity, QoL, and symptoms. The study population included those with one positive or negative PCR test who filled out two questionnaires before and after the test, resulting in 996 SARS-CoV-2 PCR positive and 3978 negative participants. Nearly all symptoms were more often reported after a positive test versus the period before the test (p < 0.05), except fever. A higher symptom prevalence after versus before a test was also found for nearly all symptoms in negatives (p < 0.05). Before the test, symptoms were already partly present and reporting of nearly all symptoms before did not differ between positives and negatives (p > 0.05). QoL decreased around the test for positives and negatives, with a larger deterioration for positives. Not all symptoms after a positive SARS-CoV-2 PCR test might be attributable to the infection and symptoms were also common in negatives.
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Affiliation(s)
- Yvonne M J Goërtz
- Department of Research and Development, Ciro, Hornerheide 1, 6085 NM, Horn, The Netherlands.
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands.
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands.
| | - Martijn A Spruit
- Department of Research and Development, Ciro, Hornerheide 1, 6085 NM, Horn, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands
| | - Maarten Van Herck
- Department of Research and Development, Ciro, Hornerheide 1, 6085 NM, Horn, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
- Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands
- REVAL - Rehabilitation Research Center, BIOMED - Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Nicole Dukers-Muijrers
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- Department of Sexual Health, Infectious Diseases and Environmental Health, Public Health Service South Limburg, Heerlen, The Netherlands
- Department of Health Promotion, Maastricht University, Maastricht, The Netherlands
| | - Carla J H van der Kallen
- Department of Internal Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
| | - Chris Burtin
- REVAL - Rehabilitation Research Center, BIOMED - Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Daisy J A Janssen
- Department of Research and Development, Ciro, Hornerheide 1, 6085 NM, Horn, The Netherlands
- Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Herman B, Wong MCS, Viwattanakulvanid P. Vaccination status, favipiravir, and micronutrient supplementation roles in post-COVID symptoms: A longitudinal study. PLoS One 2022; 17:e0271385. [PMID: 35862378 PMCID: PMC9302723 DOI: 10.1371/journal.pone.0271385] [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: 03/14/2022] [Accepted: 06/29/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction Post-COVID symptoms are the new concern in the COVID-19 pandemic, where recovered patients experience residual symptoms affecting their quality of life. Therefore, it is imperative to evaluate the role of complete vaccination, prescribed medication, and micronutrients during COVID episodes in the occurrence of post-COVID symptoms. Method A longitudinal evaluation of Indonesia’s recovered COVID-19 patients was performed using the data collected from July 2021 and extracted in mid-February 2022. All participants were confirmed with a Real-Time Polymerase Chain Reaction test (PCR) and/or antigen test. This study collected demography and comorbidities information, symptoms and treatment of COVID-19, and collection of self-reported post-COVID symptoms every 30 days within 90 days after diagnosis/onset. Exposures of interest include vaccination status, Favipiravir administration, Vitamin C, Vitamin D, and Zinc. A Generalized Estimating Equation (GEE) was used to evaluate the longitudinal effect of exposures, presented with adjusted odds ratios and its 95% confidence interval. Results A total of 923 participants (18.2% fully-vaccinated) were involved in the study, with 79.7% being non-hospitalized. Only 25.7% did not develop any residual symptoms within 90 days. Fatigue was the most reported post-COVID symptom in each measurement time (39.5%, 16.3%, and 7.3%). Full-vaccination was effective against chronic cough (aOR 0.527, 95% CI 0.286–0.971), chronic headache (aOR 0.317, 95% CI 0.163–0.616), and chronic arthritis (aOR 0.285, 95% CI 0.116–0.703). The combination of micronutrient supplementations and Favipiravir gave no significant effect on all post-COVID symptoms. However, early initiation of Favipiravir and delaying vitamin D administration were associated with arthritis. Conclusion Full vaccination of COVID-19 prevents the disease and the development of residual symptoms when infected with SARS-COV-2. Hence, it is crucial to reconsider the prescription of micronutrient supplementation or adjust the dose of Favipiravir in the current guideline.
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Affiliation(s)
- Bumi Herman
- College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
- Clinical Epidemiology, Research Development & Publication, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Martin Chi-sang Wong
- School of Public Health and Primary Care (JCSPHPC) at the Chinese University of Hong Kong, Shatin, Hong Kong
- The Chinese Academy of Medical Sciences and the Peking Union Medical College, Beijing, China
- The School of Public Health, The Peking University, Beijing, China
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6
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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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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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8
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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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9
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van Dijk WEM, Penson A, Kuijlaars IAR, Suijker M, van Galen KPM, Knoop H, Schutgens REG. Checklist Individual Strength to measure severe fatigue in immune thrombocytopenia. Br J Haematol 2022; 197:e41-e44. [PMID: 34993959 DOI: 10.1111/bjh.18031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 12/14/2021] [Accepted: 12/17/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Wobke E M van Dijk
- Center for Benign Hematology, Thrombosis and Hemostasis, Van Creveldkliniek, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Adriaan Penson
- Department of Hematology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Isolde A R Kuijlaars
- Center for Benign Hematology, Thrombosis and Hemostasis, Van Creveldkliniek, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Monique Suijker
- Center for Benign Hematology, Thrombosis and Hemostasis, Van Creveldkliniek, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Karin P M van Galen
- Center for Benign Hematology, Thrombosis and Hemostasis, Van Creveldkliniek, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Hans Knoop
- Department of Medical Psychology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam Public health research institute, Amsterdam, the Netherlands
| | - Roger E G Schutgens
- Center for Benign Hematology, Thrombosis and Hemostasis, Van Creveldkliniek, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
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10
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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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11
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Zhang D, Song H, Liu Y, Wang L, Cui Q, Liu L, Liu C, Li M, Wu H. The influence of workplace incivility on the fatigue of female nurses:the mediating effect of engagement. J Nurs Manag 2021; 30:1514-1522. [PMID: 34750924 DOI: 10.1111/jonm.13507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 10/26/2021] [Accepted: 11/03/2021] [Indexed: 11/26/2022]
Abstract
AIMS To identify the associations of workplace incivility, engagement and fatigue among Chinese female nurses, and further explore whether engagement can play a mediating role. BACKGROUND Nurses are at a high risk of fatigue. However, no research has been done to examine the associations among nurses' workplace incivility, engagement and fatigue. METHODS The cross-sectional study was conducted in Jiangsu Province, China. Self-administered questionnaires were distributed to 1,200 female nurses, including The Fatigue Scale, Workplace Incivility Scale, Gallup Workplace Questionnaire and demographic variables. Valid responses were obtained from 1,035 (86.3%) of participants. Hierarchical multiple regression analysis was performed to examine the associations among workplace incivility, engagement and fatigue. RESULTS The mean fatigue score was 6.54±3.07. Workplace incivility and engagement were related to fatigue (P<0.01). Engagement partly mediated the association between workplace incivility and fatigue (a*b =0.086, bias-corrected 95% CI: 0.059, 0.116; P<0.01), and the proportion of the mediating effect accounted for by engagement was 33.0%. CONCLUSION Chinese female nurses suffered from high level of fatigue. The improvement of female nurses' engagement may be helpful to alleviate the impact of workplace incivility on fatigue. IMPLICATIONS FOR NURSING MANAGEMENT Managers should reduce workplace incivility of female nurses by promoting engagement to reduce fatigue.
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Affiliation(s)
- Di Zhang
- School of Medicine, Jiangsu University, Zhenjiang, China.,School of Public Health, China Medical University, Shenyang, China
| | - Huina Song
- Third Medical Center, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Yuping Liu
- Affiliated hospital, Xuzhou Medical University, Xuzhou, China
| | - Lulu Wang
- School of Public Health, China Medical University, Shenyang, China
| | - Qi Cui
- School of Public Health, China Medical University, Shenyang, China
| | - Li Liu
- School of Public Health, China Medical University, Shenyang, China
| | - Chunli Liu
- School of Public Health, China Medical University, Shenyang, China
| | - Mengyao Li
- School of Public Health, China Medical University, Shenyang, China
| | - Hui Wu
- School of Public Health, China Medical University, Shenyang, China
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12
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van Deuren S, Penson A, van Dulmen-den Broeder E, Grootenhuis MA, van der Heiden-van der Loo M, Bronkhorst E, Blijlevens NMA, Streefkerk N, Teepen JC, Tissing WJE, van der Pal HJH, van den Heuvel-Eibrink MM, Versluys BAB, Bresters D, van Leeuwen FE, Ronckers CM, Kremer LCM, Knoop H, Loonen JJ. Prevalence and risk factors of cancer-related fatigue in childhood cancer survivors: A DCCSS LATER study. Cancer 2021; 128:1110-1121. [PMID: 34724201 PMCID: PMC9298343 DOI: 10.1002/cncr.33993] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 08/10/2021] [Accepted: 08/30/2021] [Indexed: 01/28/2023]
Abstract
Background Cancer‐related fatigue is a debilitating late effect after treatment for childhood cancer. The prevalence of fatigue in childhood cancer survivors (CCSs) and associated factors for fatigue has varied widely in previous studies. Two important aspects of cancer‐related fatigue, its severity and chronicity, are often not assessed. This study investigated the prevalence of, and risk factors for, severe chronic fatigue (CF) in a national cohort of Dutch CCSs. Methods In this study, 2810 CCSs (5‐year survivors of all childhood malignancies diagnosed between 1963 and 2001 with a current age of 12‐65 years) and 1040 sibling controls were included. CF was assessed with the Short Fatigue Questionnaire and was defined as a score ≥ 18 and persistence of fatigue for ≥6 months. Cancer‐ and treatment‐related characteristics, current health problems, and demographic and lifestyle variables were assessed as potential risk factors for CF via multivariable logistic regression analyses. Results In adult CCSs and sibling controls (≥18 years old), the prevalence of CF was 26.1% and 14.1%, respectively (P < .001). In adolescent CCSs and sibling controls (<18 years old), the prevalence of CF was 10.9% and 3.2%, respectively. Female gender (odds ratio [OR], 2.13; 95% confidence interval [CI], 1.73‐2.62), unemployment (OR, 2.18; 95% CI, 1.67‐2.85), having 1 or more health problems (OR for 1‐2, 1.48; 95% CI, 1.18‐1.87; OR for >2, 2.20; 95% CI, 1.50‐3.21), and a central nervous system diagnosis (OR, 1.74; 95% CI, 1.17‐2.60) were significantly associated with CF in adult CCSs. Conclusions This study shows that CCSs, regardless of their cancer diagnosis, report CF more often than sibling controls. This study provides new evidence for the prevalence of fatigue in CCSs. One in 4 childhood cancer survivors reports chronic fatigue. Current health problems increase the risk of reporting chronic fatigue.
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Affiliation(s)
- Sylvia van Deuren
- Radboudumc Center of Expertise for Cancer Survivorship, Department of Hematology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Adriaan Penson
- Radboudumc Center of Expertise for Cancer Survivorship, Department of Hematology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Eline van Dulmen-den Broeder
- Department of Pediatric Oncology/Hematology, VU University, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | | | | | - Ewald Bronkhorst
- Department for Health Evidence, Biostatistics Section, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Nicole M A Blijlevens
- Department of Hematology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Nina Streefkerk
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Jop C Teepen
- 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, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | | | | | | | - Dorine Bresters
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Flora E van Leeuwen
- Department of Epidemiology and Biostatistics, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Cécile M Ronckers
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.,Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| | | | - Hans Knoop
- Department of Medical Psychology, University of Amsterdam, Amsterdam University Medical Centers, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.,Expert Center for Chronic Fatigue, Amsterdam Public Health Research Institute, VU University, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Jacqueline J Loonen
- Radboudumc Center of Expertise for Cancer Survivorship, Department of Hematology, Radboud University Medical Center, Nijmegen, the Netherlands
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13
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Truyens M, De Ruyck E, Gonzales GB, Bos S, Laukens D, De Vos M. Prevalence of Fatigue and Unrecognized Depression in Patients with Inflammatory Bowel Disease in Remission under Immunosuppressants and Biologicals. J Clin Med 2021; 10:jcm10184107. [PMID: 34575218 PMCID: PMC8471955 DOI: 10.3390/jcm10184107] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/03/2021] [Accepted: 09/07/2021] [Indexed: 11/29/2022] Open
Abstract
Background: Although highly prevalent among inflammatory bowel disease (IBD) patients, fatigue remains an unmet clinical need. The aim was to describe the prevalence of fatigue in an IBD population in remission and identify factors associated with fatigue. Methods: IBD patients in clinical and biochemical remission under treatment with immunomodulators or biologicals were included. Fatigue, physical tiredness and depression were assessed using the fatigue Visual Analogue Scale (fVAS), the Shortened Fatigue Questionnaire (SFQ) and the Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR), respectively. Relevant clinical and biochemical parameters were included in regression analyses to identify factors associated with physical fatigue. Results: In total, 157 IBD patients were included. Up to 45.9% of patients reported fatigue, physical tiredness was observed in 51% and depression in 10.8%. The majority of patients with subclinical depression were fatigued. Female sex (OR = 4.17 [1.55–6.78], p = 0.002) was independently associated with physical fatigue. Transferrin saturation (OR = −0.11 [−0.22–−0.007], p = 0.037) and treatment with adalimumab (compared to infliximab, OR = −3.65 [−7.21–−0.08], p = 0.045) entailed a lower risk of fatigue. Conclusion: Fatigue is observed in about half of IBD patients in remission and can be a symptom of underlying undetected depression. Sex, transferrin saturation and medication were identified as independent risk factors.
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Affiliation(s)
- Marie Truyens
- IBD Research Unit, Department of Internal Medicine and Pediatrics, Ghent University, 9000 Ghent, Belgium; (M.T.); (S.B.); (M.D.V.)
- VIB Center for Inflammation Research, 9052 Ghent, Belgium
- Department of Gastroenterology, University Hospital Ghent, 9000 Ghent, Belgium
| | - Elodie De Ruyck
- Department of Gastroenterology, AZ Nikolaas, 9100 Sint-Niklaas, Belgium;
| | - Gerard Bryan Gonzales
- Nutrition, Metabolism and Genomics Group, Division of Human Nutrition and Health, Wageningen University, 6700 WE Wageningen, The Netherlands;
| | - Simon Bos
- IBD Research Unit, Department of Internal Medicine and Pediatrics, Ghent University, 9000 Ghent, Belgium; (M.T.); (S.B.); (M.D.V.)
- VIB Center for Inflammation Research, 9052 Ghent, Belgium
| | - Debby Laukens
- IBD Research Unit, Department of Internal Medicine and Pediatrics, Ghent University, 9000 Ghent, Belgium; (M.T.); (S.B.); (M.D.V.)
- VIB Center for Inflammation Research, 9052 Ghent, Belgium
- Correspondence:
| | - Martine De Vos
- IBD Research Unit, Department of Internal Medicine and Pediatrics, Ghent University, 9000 Ghent, Belgium; (M.T.); (S.B.); (M.D.V.)
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14
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Penson A, van Deuren S, Bronkhorst E, Keizer E, Heskes T, Coenen MJH, Rosmalen JGM, Tissing WJE, van der Pal HJH, de Vries ACH, van den Heuvel-Eibrink MM, Neggers S, Versluys BAB, Louwerens M, van der Heiden-van der Loo M, Pluijm SMF, Grootenhuis M, Blijlevens N, Kremer LCM, van Dulmen-den Broeder E, Knoop H, Loonen J. Methodology of the DCCSS later fatigue study: a model to investigate chronic fatigue in long-term survivors of childhood cancer. BMC Med Res Methodol 2021; 21:106. [PMID: 33993873 PMCID: PMC8127233 DOI: 10.1186/s12874-021-01298-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 04/27/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND A debilitating late effect for childhood cancer survivors (CCS) is cancer-related fatigue (CRF). Little is known about the prevalence and risk factors of fatigue in this population. Here we describe the methodology of the Dutch Childhood Cancer Survivor Late Effect Study on fatigue (DCCSS LATER fatigue study). The aim of the DCCSS LATER fatigue study is to examine the prevalence of and factors associated with CRF, proposing a model which discerns predisposing, triggering, maintaining and moderating factors. Triggering factors are related to the cancer diagnosis and treatment during childhood and are thought to trigger fatigue symptoms. Maintaining factors are daily life- and psychosocial factors which may perpetuate fatigue once triggered. Moderating factors might influence the way fatigue symptoms express in individuals. Predisposing factors already existed before the diagnosis, such as genetic factors, and are thought to increase the vulnerability to develop fatigue. Methodology of the participant inclusion, data collection and planned analyses of the DCCSS LATER fatigue study are presented. RESULTS Data of 1955 CCS and 455 siblings was collected. Analysis of the data is planned and we aim to start reporting the first results in 2022. CONCLUSION The DCCSS LATER fatigue study will provide information on the epidemiology of CRF and investigate the role of a broad range of associated factors in CCS. Insight in associated factors for fatigue in survivors experiencing severe and persistent fatigue may help identify individuals at risk for developing CRF and may aid in the development of interventions.
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Affiliation(s)
- Adriaan Penson
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Sylvia van Deuren
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ewald Bronkhorst
- Department of Dentistry, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ellen Keizer
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Tom Heskes
- Institute for Computing and Information Sciences, Radboud University, Nijmegen, The Netherlands
| | - Marieke J H Coenen
- Department of Human Genetics, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Judith G M Rosmalen
- Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, 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
| | - Martha Grootenhuis
- Department of Psychology, 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, 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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