Search Results (701)

Background: In today’s dynamic healthcare environment, Changi General Hospital (CGH) has positioned staff wellbeing and engagement as fundamental priorities that underpin workforce sustainability and quality care delivery. Recognizing that allied health professionals (AHPs) face unique emotional demands and potential empathy fatigue, the CGH Allied Health Division (AHD) uses three strategic pillars: individual empowerment, leaders as key stewards and institutional support systems to address staff wellbeing and engagement. This paper will evaluate the outcomes of implementing the programs and identifying the barriers and enablers to achieving staff wellbeing and engagement. Methods: It adopts a mixed-methods approach using both quantitative survey data and qualitative feedback. Results: A total of 314 AHPs participated with a mean employment duration of 8.89 years. While 95% agreed that their work was meaningful and 76.8% reported happiness at work, 40.8% did not experience being recognized by the organization and approximately 30% did not find higher management responsive to their needs or transparent in their communication. Qualitative analysis revealed concerns about psychological safety of sharing one’s opinions and concerns, and a desire for better renumeration and career progression. Conclusions: AHPs reported happiness and meaningfulness in their clinical work. However, issues with organizational recognition, higher management responsiveness and transparency, as well as psychological safety were elicited. Working towards addressing fostering psychological safety and enhancing recognition and communication with management are important in order to develop and sustain a thriving healthcare workforce capable of high-quality patient care. Overall, the findings reinforced AHD direction of putting employee wellbeing and engagement as a strategic priority. Full article

Background/Objectives: Fibromyalgia syndrome (FMS) is a chronic condition characterized by widespread pain, fatigue, sleep disturbances, and psychological symptoms. Aquatic exercise offers the benefits of physical activity with reduced mechanical stress. This meta-analysis evaluated the effectiveness of AE on pain, functional physical status, and health-related quality of life. Methods: A PRISMA-guided systematic review and meta-analysis (PROSPERO CRD42025115158) included randomized and non-randomized trials up to October 2025 from MEDLINE (PubMed), Cochrane Library, PEDro, CINAHL Complete, SPORTDiscus, and Academic Search Ultimate. Eligible participants were adults diagnosed with FMS undergoing AE programs, alone or combined with other modalities. Standardized mean differences (SMD) with 95% confidence intervals were pooled using random- or fixed-effects models. Methodological quality, risk of bias, and certainty of evidence were evaluated using the PEDro scale, the RoB 2.0 tool, and the GRADE approach. Results: 27 trials (n = 1785; >95% women; mean age 44–62 years) were included. AE significantly improved pain (SMD = −0.92; 95% CI: −1.03 to −0.80; p < 0.00001), physical function (SMD = −0.74; 95% CI: −0.84 to −0.63; p < 0.00001), and HRQoL (SMD = 0.57; 95% CI: 0.42 to 0.72; p < 0.00001). Effects were consistent across time frames, though overall heterogeneity was considerable (Tau² = 4.93; I² = 97%). The mean PEDro score was 5.2/10, and RoB 2.0 indicated moderate methodological limitations mainly due to a lack of blinding. Evidence certainty was low for the main outcomes and moderate for adverse events. Conclusions: Aquatic exercise is an effective and safe complementary therapy for patients with FMS, alleviating pain while enhancing function and quality of life. However, methodological variability and small sample sizes warrant further high-quality trials to confirm these findings and explore underlying mechanisms. Full article

This research addresses the challenge of inferring complex psychological states, including stress, fatigue, anxiety, cognitive load, and boredom, from facial expressions. We propose an interpretable, literature-informed emotion-weighting methodology that transforms the eight-emotion probability outputs of facial emotion recognition models into continuous estimates of these five psychological states using weights derived from the Valence–Arousal framework, providing a principled bridge between discrete emotion predictions and higher-level affective constructs. The proposed formulation is evaluated across six representative deep learning architectures—a baseline CNN (ResNet-50), a modern CNN (ConvNeXt), a hybrid attention-based model (DDAMFN), and three Transformer-based models (ViT, BEiT, and Swin). Our results demonstrate that strong performance on discrete FER tasks does not directly translate to consistent behavior in complex state inference; instead, architectures capable of preserving subtle and distributed affective cues yield more stable and interpretable state estimates, with DDAMFN and Vision Transformer models exhibiting the most consistent performance across the evaluated psychological states. These findings highlight the central role of the proposed emotion-weighting formulation and the importance of architecture selection beyond categorical accuracy in complex affective state analysis. Full article

Introduction: Myasthenia gravis (MG) is a chronic autoimmune disorder in which fatigue represents one of the most burdensome symptoms. This multidimensional manifestation extends beyond neuromuscular fatigability and has a substantial impact on daily functioning, mental health, and quality of life. The present study aimed to evaluate the perception of fatigue in patients with MG, with particular emphasis on its interference with everyday activities and the extent to which it is understood by others. Methods: The study included 67 MG patients (61.2% women, mean age 53 years) treated at the Neurology Outpatient Department of the University Clinical Center in Gdańsk. Data were collected using an author-developed survey and standardized instruments: Chalder Fatigue Scale (CFQ), MG-ADL, MG-QoL15, HADS-M, Mini-COPE, and ACDS. Results: More than 70% of patients reported constant or frequent fatigue. Higher fatigue severity was positively associated with functional impairment (MG-ADL) and lower quality of life (MG-QoL15). More than 70% of patients reported constant or frequent fatigue. Higher fatigue severity was moderately associated with greater functional impairment and poorer quality of life. The extent to which fatigue interfered with daily life was associated with higher levels of depressive symptoms, poorer self-rated health, and less favorable disease-related perceptions (acceptance and influence). In contrast, perceiving fatigue as being better understood by others was associated with lower anxiety and depression and more favorable disease-related perceptions (acceptance, control, understanding), while it was not significantly related to fatigue severity, functional status, or quality of life. Conclusions: Fatigue in myasthenia gravis is a prevalent symptom, closely related to functional impairment and reduced quality of life. Different aspects of fatigue perception show distinct psychosocial correlates, highlighting the importance of considering subjective and social dimensions of fatigue alongside its severity. These findings support the relevance of psychosocial factors in the comprehensive care of patients with MG. Full article

Background: Parental burnout is a form of psychological exhaustion resulting from prolonged parental stress. It is characterized by emotional distancing from one’s children, emotional fatigue, a sense of being overwhelmed, and feelings of failure in the parental role. The aim of our study was to explore the relationships between coping styles, sociodemographic variables, and parental burnout in a Hungarian sample. Methods: A cross-sectional online survey was conducted with 221 parents raising children up to the age of ten. The instruments included the Parental Burnout Assessment (PBA) and the Ways of Coping Questionnaire (WCQ). Results: Our findings indicate that support-seeking coping was associated with lower levels of burnout, whereas emotion-focused coping and poorer self-rated health were related to higher burnout scores (p < 0.05). Postpartum depressive symptoms showed a strong association with emotional exhaustion and parental contrast, suggesting shared psychological mechanisms underlying these phenomena (p < 0.05). Sociodemographic factors were not found to be significant predictors (p > 0.05). Conclusions: Based on our results, parental burnout appears to be primarily psychological in nature, and the development of emotional resilience—particularly through mindfulness-based and cognitive-behavioral interventions—may play a key role in its prevention and treatment. Full article

Background/Objectives: Tinnitus affects various aspects of health, yet its impact on occupational functioning remains less well explored. This study investigated the impact of tinnitus on work productivity, the role of comorbidities of anxiety, depression, and quality of life, and explored whether an evidence-based intervention may potentially influence workplace functioning. Methods: The study used cross-sectional and longitudinal data and employed mixed methods design to enable comparing work productivity before and after undertaking ICBT for tinnitus. Data were collected from 449 participants (64% employed; mean age of 54.4 years) who were seeking to enroll in an internet-based psychological intervention. Of these, 200 also completed an internet-based cognitive behavioral therapy intervention (ICBT). Data were analyzed using descriptive statistics, analysis of variance, qualitative content analysis and comparisons made between those whose work was unaffected due to tinnitus and those who worked less. Results: Pre-intervention, 81% reported no change in work patterns. Because of tinnitus 11% worked fewer hours, 7% had stopped working, and 1% received disability allowance. Participants were significantly less effective in their work capacity prior to undertaking the intervention compared to post-intervention and at follow-up; for the overall sample and post-intervention improvements were observed in tinnitus distress, anxiety, depression, and insomnia. There was significant time difference between group interactions for tinnitus, anxiety and insomnia but not for depression and quality of life when comparing those working and not working. Qualitative findings highlighted challenges related to attention, fatigue, and communication, as well as coping strategies and role modifications. Conclusions: Further studies are required to build on this exploratory research. The present findings underscore the need for workplace policies recognizing tinnitus as a potential disability and providing reasonable accommodation and options to access tinnitus interventions. Clinical interventions should also consider how to improve workplace functioning in individuals with bothersome tinnitus. Future research should explore ways to address cognitive load and enhance productivity. Full article

Background/Objectives: In recent years, quiet quitting has attracted increasing attention in nursing research and is conceptualized as a phenomenon in which nurses perform their professional duties at a minimal level without physically leaving their jobs. This study aimed to adapt the Quiet Quitting Scale into Turkish, evaluate its psychometric properties, and examine the relationships between stress of conscience, compassion fatigue, and quiet quitting among nurses. Methods: This is a descriptive, correlational, and methodological study. This study was conducted between 20 February and March 2025 with the participation of 205 nurses working in a university hospital in Turkey. The data were collected using the Nurse Descriptive Information Form, Stress of Conscience Questionnaire, Compassion Fatigue-Short Scale, and Quiet Quitting Scale. Results: The results indicated positive associations between stress of conscience, compassion fatigue, and quiet quitting. Mediation analysis revealed that compassion fatigue had a significant indirect effect on the association between stress of conscience and quiet quitting, while the direct relationship remained significant, suggesting partial mediation. Conclusions: These findings highlight the importance of supportive work environments where nurses can address ethical concerns and access interventions aimed at preventing compassion fatigue. Organizational strategies that promote psychological well-being may help sustain nurses’ work engagement and reduce quiet quitting. Full article

Background/Aim: Fatigue is a common symptom in individuals with chronic obstructive pulmonary disease (COPD) and is associated with reduced quality of life. The aim of this study was to evaluate the relationships between dietary omega-3 (n-3) and omega-6 (n-6) fatty acid intake, obesity, and stress with fatigue in patients with COPD. Materials and Methods: This descriptive cross-sectional study was conducted between 1 February and 31 July 2025, in the pulmonary outpatient clinics of Ağrı Training and Research Hospital in Ağrı and Atatürk University Research Hospital in Erzurum, Türkiye. Study data were collected using a General Information Questionnaire, the COPD and Asthma Fatigue Scale (CAFS), the Perceived Stress Scale (PSS), and an Adult Semi-Quantitative Food Frequency Questionnaire. Higher CAFS scores indicate greater fatigue severity, while higher PSS scores reflect higher perceived stress. Results: CAFS scores correlated strongly with perceived stress (r = 0.718, p < 0.001) and moderately with COPD exacerbation frequency (r = 0.426, p < 0.001). Although higher n-3 intake was inversely associated with fatigue in univariate analyses, this association weakened after adjustment, suggesting that fatty acid composition was not an independent determinant of fatigue. The n-6/n-3 ratio showed a weak positive correlation with fatigue (r = 0.184, p = 0.024). Female reported higher fatigue levels than male (mean [SD], 60.2 [19.3] vs. 51.9 [19.8]; p = 0.042), and patients with comorbid conditions had higher fatigue scores than those without comorbidities (58.1 [18.3] vs. 46.8 [19.4]; p = 0.001). Smoking status was not significantly associated with fatigue (p = 0.788). In backward multiple linear regression analysis, perceived stress emerged as the strongest independent predictor of fatigue (β = 0.519, p < 0.001). Comorbidity presence (β = 0.206, p = 0.030) and smoking status (β = 0.178, p = 0.026) were also significant, while exacerbation frequency (p = 0.062) and female (p = 0.053) showed borderline associations. Conclusions: These findings indicate that fatigue in COPD is primarily influenced by psychosocial stress and multimorbidity, highlighting the importance of integrative management approaches that address mental health burden and comorbid conditions alongside respiratory treatment. Full article

This study investigated how illuminance and spectrum in office lighting affect psychological fatigue, preference, visual comfort, and cognitive performance. Forty adults participated in a repeated-measures experiment under four conditions with two illuminance levels (500, 1000 lx) and two LED types (full-spectrum, conventional). For each condition, Karolinska Sleepiness Scale scores (fatigue), Office Lighting Survey ratings (preference, visual comfort), and Alphanumeric Verification Task performance (work speed, accuracy) were collected. Linear mixed-effects modeling was applied alongside correlation and regression analyses to examine condition effects and associations between variables. Compared to 500 lx, ΔKSS significantly decreased under 1000 lx, confirming that increased illuminance is associated with reduced psychological fatigue. At the same illuminance level, full-spectrum LEDs showed benefits, including lower fatigue and faster responses. Preference and visual comfort showed minimal direct sensitivity to lighting conditions but were moderately and positively correlated, while fatigue exhibited significant negative correlations with both preference and response speed. An interaction between illuminance and spectrum on accuracy suggested a speed–accuracy trade-off under high-illuminance full-spectrum lighting. Overall, the findings indicate that office lighting, particularly illuminance and spectral quality, acts as a human-centered factor shaping an interconnected response network linking fatigue, affective appraisal, and task performance. Full article

Background and Objectives: Behçet’s disease (BD) is a multisystem inflammatory disorder with significant physical, psychological, and social burdens. However, patient-reported outcomes and subjective symptom experiences remain under-recognized in clinical practice. This study aimed to provide a patient-centric analysis of the disease burden, treatment challenges, and unmet needs in BD. Materials and Methods: A multinational cross-sectional study was conducted using a structured questionnaire among 528 BD patients recruited from online support groups and a specialized clinic. The questionnaire gathered information about participants’ backgrounds, medical histories, how symptoms affected them, psychological and social factors, side effects of treatments, and their suggestions for better care. Data were analyzed descriptively. Results: The mean age of the participants was 41.4 years, and 69.3% were male. The most common symptoms that significantly affected daily life were severe fatigue (82.8%), joint pain and swelling (79.0%), and neurological issues (74.1%). Nearly half of patients perceived that fatigue (49.1%) and neurological symptoms (45.1%) were underestimated by healthcare providers. Psychological distress was prevalent, with 74.1% of participants reporting either depression or anxiety. Side effects related to treatment were frequently encountered (56.3%), resulting in treatment discontinuation for 53.4% of the individuals. The main unmet needs identified were fatigue reduction (59.1%), pain management (43.0%), and the minimization of side effects (59.1%). Furthermore, patients expressed a desire for enhanced communication (62.9%), validation of their unobserved symptoms (74.1%), and comprehensive disease education (67.6%). Conclusions: BD imposes a profound multidimensional burden, with a significant disconnect between patient experiences and their perception of clinical recognition. Fatigue, pain, psychological distress, and treatment-related challenges contribute substantially to unmet needs. A patient-centered approach emphasizing communication, symptom validation, and holistic support is essential to improving care and quality of life in BD. Full article

Background/Objectives: (P)rehabilitation, comprising structured exercise, nutritional optimisation, and/or psychological support delivered pre- or postoperatively, has demonstrated efficacy in improving outcomes across the cancer care continuum. However, access remains limited. Technology-enabled (p)rehabilitation offers a novel solution with the potential to enhance equity and continuity of care. This systematic review aimed to evaluate the efficacy of technology-enabled (p)rehabilitation on perioperative and patient-reported outcomes among individuals undergoing thoracic and/or abdominopelvic cancer surgery. Methods: Six databases were search from inception to October 2024. Eligible studies were randomised controlled trials (RCTs) comparing technology-enabled (p)rehabilitation with usual care, placebo, or non-technology-based interventions in adults undergoing thoracic and/or abdominopelvic cancer surgery. Outcomes included postoperative complications, hospital readmissions, hospital length of stay (LOS), quality of life (QoL), pain, anxiety, depression, fatigue, distress, and satisfaction. Higher scores indicated improved QoL or worse symptom severity. Risk of bias was assessed using the revised Cochrane tool, and evidence strength was determined using GRADE methodology. Relative risks (RR) and mean differences (MD) were calculated using random-effects meta-analysis. Results: Seventeen RCTs (18 publications, n = 1690) were included. Trials most commonly evaluated application-based platforms (n = 8) and the majority exhibited some risk of bias. Technology-enabled (p)rehabilitation was associated with a significant reduction in LOS (MD = 1.33 days; 95% CI: 0.59–2.07; seven trials), and improvements in pain (MD = 6.12; 95% CI: 3.40–8.84; four trials), depression (MD = 2.82; 95% CI: 0.65–4.99; five trials), fatigue (MD = 10.10; 95% CI: 6.97–13.23; three trials) and distress (MD = 1.23; 95% CI: 0.30–2.16; single trial) compared with controls. Conclusions: Technology-enabled (p)rehabilitation shows promise in reducing LOS and improving selected patient-reported outcomes following thoracic and abdominopelvic cancer surgery. Although evidence is limited due to the small number of studies, modest sample sizes, methodological heterogeneity, and intervention variability, the overall findings justify further investigation. Large-scale, adequately powered clinical trials are required to confirm efficacy and guide clinical effectiveness and implementation studies. Full article

Background/Objectives: Nurses are susceptible to compassion fatigue due to the nature of their professional responsibilities. Factors contributing to this vulnerability include daily patient interactions and organizational elements within their work environment, as well as work-related stress and sociodemographic characteristics, including age, marital status, years of professional experience, and, notably, gender. This research investigates the relationship between compassion fatigue and the levels of anxiety and depression, as well as the professional quality of life among nurses providing care to dementia patients in Greece. Methods: A cross-sectional survey was carried out with 115 nurses working in dementia care centers in Greece. The Hospital Anxiety and Depression Scale (HADS), the Professional Quality of Life Scale (ProQOL-5), and the participants’ personal, demographic, and professional information were all included in an electronic questionnaire. Multiple regression analysis was used. Results: A total of 42.6% of nurses rated their working environment as favorable. Additionally, 23.5% of the sample exhibited high levels of compassion satisfaction, whereas 46.1% demonstrated low levels of burnout. Female gender (p = 0.022) and a higher family income (p = 0.046) was positively associated with compassion satisfaction. Regression analysis indicated that elevated symptoms of anxiety and depression were found to correlate with decreased compassion satisfaction, increased burnout, and heightened secondary post-traumatic stress. Conclusions: Engaging in the care of patients with dementia, particularly throughout the pandemic period, has underscored a pronounced susceptibility to compassion fatigue, physical fatigue, pain, psychological stress, and a reduced quality of life. These results highlight the importance for nursing management to adopt specific organizational measures, including proper staffing levels, balancing workloads, and conducting routine mental health assessments. Full article

Background/Objectives: Neurological diseases are a major cause of long-term disability and dependence. In Poland, as in many countries, informal caregivers provide most long-term care for individuals with chronic and progressive neurological conditions. Although essential, this role is associated with substantial physical, psychological, and social burden. This study aimed to assess the scope and nature of support provided by caregivers to people with neurological diseases and to identify factors associated with differences in support and caregiver burden. Methods: A cross-sectional quantitative study was conducted using a CAWI survey. The sample included 104 informal caregivers of adults with various neurological conditions. An author-designed questionnaire and the “Actually Provided Support” subscale of the Berlin Social Support Scales (BSSS) were used. Nonparametric statistical tests were applied (p < 0.05). Results: Caregivers provided a high level of support, particularly emotional and instrumental support, while informational support was less intensive. Women more frequently reported high emotional and instrumental support. Higher buffering–protective support was more common among caregivers aged over 45 years. The most frequently reported difficulties were psychological fatigue (70.9%) and physical fatigue (60.2%), indicating a substantial caregiving burden. Key barriers included limited access to reimbursed healthcare services and the lack of temporary replacement in caregiving. Caregivers most often indicated the need for respite care and better access to information and education. Conclusions: Informal caregivers play a crucial role in the daily functioning of people with neurological diseases, despite high burden and insufficient systemic support. Expanding respite care, improving access to information, and better coordination of healthcare services are urgently needed. Full article

Anxiety is a common psychological challenge among athletes, particularly in response to intense training sessions. This randomized crossover study investigated the immediate effects of a single session of focused attention meditation on anxiety, autonomic responses, and performance during high-intensity intermittent training (HIIT) in twenty-six university-level speed skaters. Participants completed three pre-exercise interventions (focused attention meditation, controlled breathing, and random thinking) on separate occasions in a randomized order. Following each intervention, participants performed a leg cycling-based HIIT protocol consisting of 20 s of maximal effort work followed by 10 s of passive rest, repeated for 8 sets using a cycling ergometer. State anxiety was assessed using the State–Trait Anxiety Inventory, and mood disturbance was evaluated using the Profile of Mood States. Autonomic and physiological responses were assessed via heart rate variability (coefficient of variation), oxygen uptake, and power output, measured before and after the intervention and the HIIT bout. Focused attention meditation significantly reduced state anxiety compared with random thinking (ΔSTAI: −5.0 [6.0] vs. −1.0 [4.3]; p < 0.05, effect size = 0.527), whereas controlled breathing primarily influenced heart rate variability (CV: 0.10 [0.11] vs. 0.07 [0.03]; p = 0.041, effect size = 0.736). No significant differences were observed among conditions in mean power output or fatigue index during HIIT. These findings suggest that single-session focused attention meditation may serve as a practical pre-exercise strategy for an immediate reduction in state anxiety, without compromising subsequent high-intensity exercise performance. Full article

Background/Objectives: Neurodevelopmental disorders (NDDs) require contextual approaches emphasizing family roles. Parents of children with NDDs face a complex socio-emotional reality. They may experience high levels of stress, fatigue, depression, and feelings of guilt and uncertainty, and they are often left feeling isolated and unsupported. All of these factors increase their socio-emotional vulnerability and affect their children’s wellbeing. A significant part of the available evidence has focused on parents of typically developing children or on a single construct. For these reasons, and considering the impact of the COVID-19 pandemic, the aim of this study was to review interventions targeting the improvement of the socio-emotional wellbeing of parents of children with NDDs, in order to characterise recent research, the specific constructs addressed, and the effectiveness of interventions. Methods: No prior protocol/registration. ERIC and Web of Science databases (selected for their broad multidisciplinary coverage in psychology and social sciences) were searched from 2020–2025 (last search: 7 September 2025), limited to English/Spanish publications. Inclusion criteria encompassed parents/primary family caregivers of children with NDDs receiving socio-emotional programs. Two independent reviewers screened the titles/abstracts and full texts, resolving disagreements through discussion. Following PRISMA 2020 guidelines, this systematic review employed narrative synthesis without risk-of-bias assessment and included 16 studies (approximately, 1100 participants). Results: The analysis indicated a scarce but growing scientific output, with a complex methodological landscape showing promising preliminary convergence in intervention outcomes. Interventions effects appeared mediated by cultural suitability, accessibility, and contextual alignment. Conclusions: Future work should pursue multisystemic approaches engaging diverse societal contexts and agents to optimize child and family wellbeing. Full article