ORiginal Article : Fatigue Severity and Factors Associated with High Fatigue Levels in Korean Patients with Inflammatory Bowel Disease

( Suhyeon Yoo ),( Yoon Suk Jung ),( Jung Ho Park ),( Hong Joo Kim ),( Yong Kyun Cho ),( Chong Il Sohn ),( Woo Kyu Jeon ),( Byung Ik Kim ),( Dong Il Park ) The Editorial Office of Gut and Liver 2014 Gut and Liver Vol.8 No.2

Background/Aims: Many patients with inflammatory bowel disease (IBD) often complain of fatigue. To date, only a few studies in Western countries have focused on fatigue related to IBD, and fatigue has never been specifically studied in Asian IBD patients. The aim of the present study was to in-vestigate the fatigue level and fatigue-related factors among Korean IBD patients. Methods: Patients in remission or with mild to moderate IBD were included. Fatigue was assessed using the Functional Assessment of Chronic Illness Therapy-Fatigue and the Brief Fatigue Inventory. Corresponding healthy controls (HCs) also completed both fatigue question-naires. Results: Sixty patients with Crohn disease and 68 patients with ulcerative colitis (UC) were eligible for analysis. The comparison group consisted of 92 HCs. Compared with the HCs, both IBD groups were associated with greater levels of fatigue (p<0.001). Factors influencing the fatigue score in UC patients included anemia and a high erythro-cyte sedimentation rate (ESR). Conclusions: Greater levels of fatigue were detected in Korean IBD patients compared with HCs. Anemia and ESR were determinants of fatigue in UC patients. Physicians need to be aware of fatigue as one of the important symptoms of IBD to better understand the impact of fatigue on health-related quality of life. (Gut Liver 2014;8:148-153)

Fatigue and related factors after liver transplantation

Kwangpyo Hong,Hyeyoung Kim,Jeong-Moo Lee,Kwang-Woong Lee,Nam-Joon Yi,Hae Won Lee,YoungRok Choi,Suk-Won Suh,Suk Kyun Hong,Kyung Chul Yoon,Hyo-Sin Kim,Kyung-Suk Suh 한국간담췌외과학회 2015 한국간담췌외과학회지 Vol.19 No.4

Backgrounds/Aims: Fatigue is common in chronic hepatitis and end-stage liver disease. However, little is known about fatigue after liver transplantation (LT). We therefore evaluated the prevalence, severity, and related factors of fatigue after LT. Methods: We retrospectively reviewed adult recipients who responded to our survey at outpatient clinics between April and May 2013. Fatigue and its severity were assessed using a questionnaire with the Fatigue Severity Scale (FSS). We defined fatigue as FSS of 4.0 or more and severe fatigue as FSS of 5.1 or more. The related factors including hepatocellular carcinoma and complications were analyzed. Results: A total of 93 patients were included in this study. The mean age was 54.9 (19-76) years and two-thirds were men (67.7%). Living donor LT was 77.4%. Hepatitis B related liver disease was the main underlying disease (77.4%), with hepatocellular carcinoma accompanied in 33.3%. The mean follow-up period was 66.8±43.2 (2-171) months. The mean FFS was 2.83±1.48 (1.0-6.7) overall and 5.10±0.82 (4.0-6.7) in the fatigue group. Of the 93 adult patients, fatigue was presented in 20 patients (21.5%). Among these, 9 patients (45.0%) showed severe fatigue. Even though post-LT complications tended to be greater in the fatigue group (50.0% vs. 30.1% in the non-fatigue group, p=0.098), there were no significant related factors of fatigue after LT, including hepatocellular carcinoma and major complication. Conclusions: Fatigue is present in a considerable portion of recipients after LT, and almost half of them have severe fatigue. Further efforts are needed to decrease fatigue in LT recipients.

스테빌라이저바 링크의 피로강도 평가를 위한 해석적 연구

박종현(Jonghyun Park) 한국자동차공학회 2020 한국자동차공학회 부문종합 학술대회 Vol.2020 No.7

In this study, the fatigue strength analysis method of stabilizer bar link was investigated using finite element method. In the vehicle fatigue test, the ball stud of stabilizer bar link was broken. To investigate the reason of ball stud fatigue fracture, material stress-fatigue cycle curve of ball stud was made about 3 load cases. The fatigue analysis results of ball stud was compared in case of ball stud bending fatigue and stabilizer bar link fatigue. The ball stud bending fatigue result was not reasonable to vehicle fatigue test result. but, stabilizer bar link fatigue analysis result was similar to vehicle test result. The effects of offset magnitude on the fatigue cycle of ball stud was investigated by finite element method.

데이터 마이닝을 이용한 서울시교직원의 피로요인 탐색연구

이희우 (Hee Woo Lee),신선미 (Sun Mi Shin) 韓國學校保健學會 2006 韓國學校保健學會誌 Vol.19 No.1

Purpose : To identify general characteristics of school personnel with recent fatigue which was the most frequent symptom among subjective symptoms and to explore fatigue-related factors by evaluating physical and perceived health status, life style, and symptoms through data mining techniques. Methods : We collected a data of the 1,147(male 545, female 602) who were elementary, middle, or high school personnel, answered a questionnaire, and received physical examination in Seoul School Health Center from September to November in 2000. And we investigated the differences between fatigue group and non-fatigue group for demographic characteristics, physical health status, perceived health status, symptoms, and laboratory values by frequency, chi-square test, t-test, or simple logistic regression analysis by SAS package 8.1, and then selected significant variables as input variables of a decision tree analysis of CART model by SAS E-miner. Results : In general characteristics, the fatigue consisted of 41.1%(male 35.2%, female 46.4%) among 1,147 school personnel. In classical statistics, factors related with fatigue were female, lower means of systolic and diastolic pressure, young age, personnel in middle school, irregular eating habit, no exercise a week or less than 30minutes exercise a day, perception of unhealthy status, and subjective symptoms including short of breath at exercise. In simple logistic regression to examine the relationship between selected independent variables and fatigue as a dependent variable, the odds ratio of gender (female vs male) was 1.58 times, and young age ( 20s vs 60s) 20.67 times, and middle vs high school personnel 1.86 times. However, we mined combined several characteristics by SAS-E miner. In CART model, if health perception was healthy, and age was >= 37.5 years, the proportion of the fatigue was only 19.3%. but if health perception was not healthy and symptom was severe 'short of breath' during exercise and age was < 53.5 years, and BMI was >= 22.69, the proportion of the fatigue was up to 84.8%. Conclusions : The fatigue consisted of 41.1%(male 35.2%, female 46.4%). In classical statistics, fatigue-related factors among school personnel were young age, female gender, perceived unhealthy status, subjective physical symptoms, poor life-style, and lower blood pressure rather than only physical health status. However, in data mining, if health perception was healthy and age was >= 37.5 years, the proportion of the fatigue was only 19.3%. but if health perception was not healthy and symptom was severe 'short of breath' during exercise and age was < 53.5 years, and BMI was >= 22.69, the proportion of the fatigue was up to 84.8%.

Reliability and Validity of Turkish Versions of the Child, Parent and Staff Cancer Fatigue Scales

Gerceker, Gulcin Ozalp,Yilmaz, Hatice Bal Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.7

This study was designed to adapt the Turkish versions of scales to evaluate fatigue in children with cancer from the perspectives of the children, parents and staff. The objective of this study was to validate "Child Fatigue Scale-24 hours" (CFS-24 hours), "Parent Fatigue Scale-24 hours" (PFS-24 hours) and "Staff Fatigue Scale-24 hours" (SFS-24 hours) for use in Turkish clinical research settings. Translation of the scales into Turkish and validity and reliability tests were performed. The validity of the translated scales was assessed with language validity and content validity. The reliability of the translated scales was assessed with internal consistency. The scales were evaluated by considering the following: calculation of the Cronbach alpha coefficient for parallel form reliability with 52 pediatric cancer patients, 86 parents and 43 nurses. The internal consistency was estimated as 0.88 for the Child Fatigue Scale-24 hours, 0.77 for the Parent Fatigue Scale-24 hours, and 0.72 for the Staff Fatigue Scale-24 hours (Cronbach's ${\alpha}$). The Turkish version of the Child Fatigue Scale -24 hours, the Parent Fatigue Scale -24 hours and the Staff Fatigue Scale -24 hours were judged reliable and valid instruments to assess fatigue in children and showed good psychometric properties. These scales should assist in understanding to what extent initiatives can minimize or eliminate fatigue. Our scales are recommended for further studies and use in pediatric oncology clinics as routine measurements and nursing initiatives should be planned accordingly.

ENVIRONMENTAL FATIGUE EVALUATION OF WELDS USING STRUCTURAL STRESS AND FRACTURE MECHANICS APPROACH

Jong Sung Kim,Tae Eun Jin 대한기계학회 2006 대한기계학회 춘추학술대회 Vol.2006 No.3

In this paper, a new analysis procedure for LWR environmental fatigue lifetime of nuclear welded structure is proposed on the basis of a structural stress/fracture mechanics approach. The validity of the mesh-insensitive structural stress procedure presented by Pingsha Dong is identified comparing the structural stresses calculated for various FE models. Fatigue crack initiation cycles are determined by using the structural stresses and the fatigue crack growth model considering LWR environmental effect. In addition, in order to compare the new fatigue analysis procedure with the existing procedures such as F<SUB>en</SUB> methods and Battelle's structural stress/fracture mechanics approach, the fatigue crack initiation cycles are determined by using the existing procedures. Environmental fatigue test is also performed to identify the validity of the fatigue analysis procedures. As a result of comparison of analysis results with test data, it is found that the new fatigue analysis based on structural stress/fracture mechanics approach is the most reliable procedure for environmental fatigue. Finally, the additional requirements for developing the more reliable and applicable new fatigue analysis procedure, which is based on structural stress/fracture mechanics, are presented.

The relationship between fatigue and sickness absence from work

Kim Min Sun,Kim Ji Ho,Yang SeongCheol,Lee Dong-Wook,Park Shin-Goo,Leem Jong-Han,Kim Hwan-Cheol 대한직업환경의학회 2023 대한직업환경의학회지 Vol.35 No.1

Background: Although many studies have been conducted on worker fatigue and sickness absence, the association between fatigue and sickness absence is unclear in Korean workers. This study was conducted to investigate the effect of worker fatigue on future sickness absence. Methods: The study was conducted on workers who received medical check-ups at a university hospital for two consecutive years (2014–2015). During check-ups in the first year, the Fatigue Severity Scale (FSS) was used to assess fatigue levels, and during check-ups in the second year, sickness absence was surveyed to determine whether they had been absent from work due to physical or mental illness during previous 12 months. The χ2 test was used to analyze relationships between sociodemographic and occupational characteristics, fatigue levels, and sickness absence. Odds ratios (ORs) were calculated by logistic regression analysis controlled for confounding factors. Results: A total of 12,250 workers were included in the study, and 396 (3.2%) workers experienced more than one day of sickness absence during the study period. Adjusted ORs for sickness absence were 3.35 (95% confidence interval [CI]: 2.64–4.28) in the moderatefatigue group and 6.87 (95% CI: 4.93–9.57) in the high-fatigue group versus the low-fatigue group. For men in the moderate- and high-fatigue groups, adjusted ORs for sickness absence were 3.40 (95% CI: 2.58–4.48) and 8.94 (95% CI: 6.12–13.07), and for women in the moderate- and high-fatigue groups, adjusted ORs for sickness absence were 2.93 (95% CI: 1.68–5.10) and 3.71 (95% CI: 1.84–7.49), respectively. Conclusions: Worker fatigue is associated with sickness absence during the following 12 months, and this association appears to be stronger for men than women. These results support the notion that sickness absence can be reduced by evaluating and managing workrelated fatigue.

우리나라 직장인 피로의 역학적 특성

장세진,강명근,현숙정,차봉석,박종구,박준호,김성아,강동묵,장성실,이경재,하은희,하미나,고상백,Chang, Sei-Jin,Kang, Myung-Gun,Hyun, Sook-Jung,Cha, Bong-Suk,Park, Jong-Ku,Park, Jun-Ho,Kim, Seong-Ah,Kang, Dong-Mug,Chang, Seong-Sil,Lee, Kyung-Jae 대한예방의학회 2005 예방의학회지 Vol.38 No.1

Objective : To elucidate the correlates of self-rated fatigue in Korean employees. Methods : The data for 10,176 (men, 7,984; women, 2,192; mean age, 34.2; SD: 8.8) employees recruited from a nationwide sample were examined. A structured questionnaire was used to measure the participants' fatigue, sociodemographics (sex, age, education, and marital status), job-related characteristics (work duration, grade at work, work hours, shiftwork, employment type, and magnitude of workplace), and health-related habits (smoking, drinking, coffee intake, and exercise). Two types of measurement for fatigue were used to evaluate the magnitude of fatigue: self-rated question and a standardized measurement tool (Multidimensional Fatigue Scale: MFS). Results : According to the self-rated fatigue, 32% of employees reported that they felt fatigue for the past two weeks, and 9.6% of males and 8.7% of females had experienced excessive fatigue (6 months or more). Hierarchical multiple regression analysis showed that fatigue measured by MFS was more common in women, younger, college or more graduated, single, and employees who do not regularly exercise. Fatigue was also associated with long work hours, and the size of the workplace (<1,000 employees). Conclusions : These results suggest that fatigue has been considered as a common complaint, and that it is affected by job-related factors like work hours and the workplace size as well as sociodemographics or health-related behaviors. Further research is needed to clarify the effects of fatigue on adverse health outcomes, work performance, work disability, sick absence and medical utilization, and to examine the relationship of job characteristics (e.g.: work demand, decision latitude) to fatigue.

피로를 호소하는 외래환자에 대한 임상적 관찰

박신명,승현석,김영철,이장훈,우홍정,이지현,Park, Shin-Myong,Seung, Hyun-Suk,Kim, Young-Chul,Lee, Jang-Hoon,Woo, Hong-Jung,Lee, Ji-Hyeon 대한한방내과학회 2001 大韓韓方內科學會誌 Vol.22 No.3

Objectives: Fatigue is a common symptom experienced by many people who visit Oriental medical clinics or hospital. However, there has been little study about the fatigue in the Oriental medical academic world. For this reason, we attempted to investigate the present status of fatigue of outpatients, and its relation with Health Practice Index(HPI). Methods: The subjects were 63 outpatients who visited the Tonification Clinic in Kyunghee Oriental Medical Center between January 1, 2001 and July 31, 2001. Their chief complaint was fatigue and they did not have any physical or mental problem. They were given a questionnaire which included questions reflecting general characteristics, fatigue degree and health habits. We measured degree of fatigue by Chalder scale et al. Health habits were investigated about 5 articles out of 'Breslow 7 Health habits'. Results: Among the subjects, 48 people(76.2%) were considered as 'fatigue patients' by the Chalder scale. Of this 48 fatigue patients, 27 people(56.3%) had manifested fatigue for more than 6 months. The average of scale II for all the patients was 14.05, which indicates moderate degree of fatigue. They complained fatigue, drowsiness and general weakness, dryness and discomfort of the eyes, headache, shoulder pain and neck stiffness, dizziness, heat in the upper part of the body, and poor concentration. There were no differences in degree of fatigue according to Health habits including exercise or not, smoking or not, the frequency of drinking, hours of sleeping, and body mass index. Conclusions: Many people complain fatigue symptom. Therefore doctors should have more interest in fatigue and care. This study can provide standards of prognosis of fatigue patients. Also prospective studies are needed to find relationship between health habits and fatigue degree.

일부 남성 금속제품 조립작업자들의 피로에 영향을 미치는 작업관련요인

장준호,강동묵,고상백,김정원,조병만,이수일 大韓産業醫學會 2004 대한직업환경의학회지 Vol.16 No.2

목적 : 남성 금속제품 조립 작업자들의 피로에 영향을 미치는 작업관련요인을 파악하고자 한다. 방법 : 작업자의 일반적 특성 및 작업관련 특성, 육체적 부하, 직무 스트레스 등을 조사 항목으로 하여 자동차 부품 조립업 1개소(476명), 자동차 엔진 조립업 1개소(610명), 대형 선박 엔진 조립업 1개소(454명)의 작업자(1,540명)를 대상으로 수거된 설문지 중 부실하게 응답한 38부를 제외한 1,136부(총연구대상의 73.8%)를 분석하였고, 피로도와의 연관성을 다중선형회귀분석으로 살펴보았다. 조사는 자기 기입식 설문지를 사용하였다. 육체적 부하를 측정하기 위해서는 Borg의 scale이 사용되었다. 격무 스트레스를 측정하기 위해서는 Karasek의 Job content questionnaire가 사용되었다. 피로의 측정은 전반적 피로도(sum of fatigue), 일상생활 기능장애(daily dysfunctioning), 상황적 피로(situational fatigue), 피로점수의 총합(sum of fatigue)으로 구성되어 있는 다면적 피로척도를 사용하였다. 피로점수의 분포는 본 연구에 응답한 피로점수의 총합을 사분위수로 나누어서 4등급으로 나누었다. 결과 : 피로점수의 분포는 피로점수의 총합을 사분위수로 나누었을 때, 0≤1등급≤73, 74≤2등급≤82, 83≤3등급≤93, 94≤4등급≤133이었다. 다중선형회귀분석에서 피로점수의 총합과 유의한 관계를 보인 경우는 주간근무, 긴 주당 노동시간, 높은 육체적 부하, 높은 직무요구도, 낮은 직무자율성, 낮은 상사의 지지 등이었고, 전반적 피로도와 유의한 관계를 보인 경우는 주간근무, 높은 육체적 부하, 높은 직무요구도, 낮은 직무자율성, 낮은 상사의 지지 등이었다. 일상생활 기능장애와 유의한 관계를 보인 경우는 주간근무, 긴 주당 노동시간, 높은 육체적 부하, 낮은 직무자율성 등이었다. 상황적 피로와 유의한 관계를 보인 경우는 높은 연령, 주간근무, 긴 주당 노동시간, 낮은 직무자율성 등이었다. 결론 : 피로관련 요인은 긴 주당노동시간, 높은 직무요구도, 높은 육체적 부하, 낮은 직무자율성, 낮은 상사의 지지로 생각된다. Objectives: To find work related factors affecting perceived fatigue among male metal product assemblers. Methods: The study subjects were metal product assemblers from three metal product companies (476 car parts assemblers, 610 car engine assemblers, 454 ship engine assemblers). From the total of 1,540 subjects, 1,136 (73.8%) were included and 38 respondents with insufficient replies were excluded. Associations between fatigue score and other variables (general characteristics, job related factors, workload, job stresses) were investigated in terms of the concept of multidimensional fatigue construct by self administered questionnaire. Using MFS (Multidimensional Fatigue Scale), JCQ (Job Content Questionnaire), and Borg's scale, we estimated the fatigue, job stress, and workload, respectively. Fatigue score was estimated by 'sum of fatigue' in MFS. Associations were tested by linear regression analysis using SAS v.8.0. Results: In this study, the fatigue related factors were older age, longer working hours per week, higher workload, higher job demand, lower decision latitude, and lower supervisor support. Conclusions: Prolonged working hours, higher workload, higher job demand, poor supervisor support and lower decision latitude were fatigue related factors among the male metal product assemblers of this study.