1
|
Bouloukaki I, Tsiligianni I, Stathakis G, Fanaridis M, Koloi A, Bakiri E, Moudatsaki M, Pouladaki E, Schiza S. Sleep Quality and Fatigue during Exam Periods in University Students: Prevalence and Associated Factors. Healthcare (Basel) 2023; 11:2389. [PMID: 37685423 PMCID: PMC10487416 DOI: 10.3390/healthcare11172389] [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: 06/19/2023] [Revised: 07/23/2023] [Accepted: 08/23/2023] [Indexed: 09/10/2023] Open
Abstract
The aim of our study was to assess university students' sleep quality and fatigue before and during the academic exam period and identify potential associated factors. A Web-based survey was completed by 940 students of 20 different Tertiary Institutions including demographics, sleep habits, exercise, caffeine, tobacco, alcohol use, subjective sleep quality (Pittsburgh Sleep Quality Index-PSQI), and fatigue (Fatigue severity scale-FSS) at the beginning of the semester and during the examination period. During the exam period, PSQI (8.9 vs. 6.1, p < 0.001) and FSS scores (36.9 vs. 32.7, p < 0.001) were significantly elevated compared to the pre-exam period. An increase in the PSQI score was associated with age (β = 0.111, p = 0.011), presence of chronic disease (β = 0.914, p = 0.006), and depressive symptoms (β = 0.459, p = 0.001). An increase in the FSS score was associated with female gender (β = 1.658, p < 0.001), age, (β = 0.198, p = 0.010), increase in smoking (β = 1.7, p = 0.029), coffee/energy drinks consumption (β = 1.988, p < 0.001), decreased levels of physical exercise (β = 1.660, p < 0.001), and depressive symptoms (β = 2.526, p < 0.001). In conclusion, our findings indicate that exam periods have a negative impact on the sleep quality and fatigue levels of university students. Potential factors were identified that could contribute to the formulation of strategies for improved sleep quality and wellness.
Collapse
Affiliation(s)
- Izolde Bouloukaki
- Department of Social Medicine, School of Medicine, University of Crete, 71500 Heraklion, Greece;
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, 71500 Heraklion, Greece; (G.S.); (M.F.); (A.K.); (E.B.); (M.M.); (E.P.); (S.S.)
| | - Ioanna Tsiligianni
- Department of Social Medicine, School of Medicine, University of Crete, 71500 Heraklion, Greece;
| | - Giorgos Stathakis
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, 71500 Heraklion, Greece; (G.S.); (M.F.); (A.K.); (E.B.); (M.M.); (E.P.); (S.S.)
| | - Michail Fanaridis
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, 71500 Heraklion, Greece; (G.S.); (M.F.); (A.K.); (E.B.); (M.M.); (E.P.); (S.S.)
| | - Athina Koloi
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, 71500 Heraklion, Greece; (G.S.); (M.F.); (A.K.); (E.B.); (M.M.); (E.P.); (S.S.)
| | - Ekaterini Bakiri
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, 71500 Heraklion, Greece; (G.S.); (M.F.); (A.K.); (E.B.); (M.M.); (E.P.); (S.S.)
| | - Maria Moudatsaki
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, 71500 Heraklion, Greece; (G.S.); (M.F.); (A.K.); (E.B.); (M.M.); (E.P.); (S.S.)
| | - Eleptheria Pouladaki
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, 71500 Heraklion, Greece; (G.S.); (M.F.); (A.K.); (E.B.); (M.M.); (E.P.); (S.S.)
| | - Sophia Schiza
- Sleep Disorders Center, Department of Respiratory Medicine, School of Medicine, University of Crete, 71500 Heraklion, Greece; (G.S.); (M.F.); (A.K.); (E.B.); (M.M.); (E.P.); (S.S.)
| |
Collapse
|
2
|
Hartson KR, Huntington-Moskos L, Sears CG, Genova G, Mathis C, Ford W, Rhodes RE. Use of Electronic Ecological Momentary Assessment Methodologies in Physical Activity, Sedentary Behavior, and Sleep Research in Young Adults: Systematic Review. J Med Internet Res 2023; 25:e46783. [PMID: 37384367 PMCID: PMC10365632 DOI: 10.2196/46783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/15/2023] [Accepted: 05/23/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND Recent technological advances allow for the repeated sampling of real-time data in natural settings using electronic ecological momentary assessment (eEMA). These advances are particularly meaningful for investigating physical activity, sedentary behavior, and sleep in young adults who are in a critical life stage for the development of healthy lifestyle behaviors. OBJECTIVE This study aims to describe the use of eEMA methodologies in physical activity, sedentary behavior, and sleep research in young adults. METHODS The PubMed, CINAHL, PsycINFO, Embase, and Web of Science electronic databases were searched through August 2022. Inclusion criteria were use of eEMA; sample of young adults aged 18 to 25 years; at least 1 measurement of physical activity, sedentary behavior, or sleep; English language; and a peer-reviewed report of original research. Study reports were excluded if they were abstracts, protocols, or reviews. The risk of bias assessment was conducted using the National Heart, Lung, and Blood Institute's Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Screening, data extraction, and risk of bias assessments were conducted by independent authors, with discrepancies resolved by consensus. Descriptive statistics and narrative synthesis were used to identify overarching patterns within the following categories guided by the Checklist for Reporting Ecological Momentary Assessments Studies: study characteristics, outcomes and measures, eEMA procedures, and compliance. RESULTS The search resulted in 1221 citations with a final sample of 37 reports describing 35 unique studies. Most reports (28/37, 76%) were published in the last 5 years (2017-2022), used observational designs (35/37, 95%), consisted of samples of college students or apprentices (28/35, 80%), and were conducted in the United States (22/37, 60%). The sample sizes ranged from 14 to 1584 young adults. Physical activity was measured more frequently (28/37, 76%) than sleep (16/37, 43%) or sedentary behavior (4/37, 11%). Of the 37 studies, 11 (30%) reports included 2 movement behaviors and no reports included 3 movement behaviors. eEMA was frequently used to measure potential correlates of movement behaviors, such as emotional states or feelings (25/37, 68%), cognitive processes (7/37, 19%), and contextual factors (9/37, 24%). There was wide variability in the implementation and reporting of eEMA procedures, measures, missing data, analysis, and compliance. CONCLUSIONS The use of eEMA methodologies in physical activity, sedentary behavior, and sleep research in young adults has greatly increased in recent years; however, reports continue to lack standardized reporting of features unique to the eEMA methodology. Additional areas in need of future research include the use of eEMA with more diverse populations and the incorporation of all 3 movement behaviors within a 24-hour period. The findings are intended to assist investigators in the design, implementation, and reporting of physical activity, sedentary behavior, and sleep research using eEMA in young adults. TRIAL REGISTRATION PROSPERO CRD42021279156; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021279156.
Collapse
Affiliation(s)
- Kimberly R Hartson
- School of Nursing, University of Louisville, Louisville, KY, United States
| | | | - Clara G Sears
- Christina Lee Brown Envirome Institute, University of Louisville, Louisville, KY, United States
| | - Gina Genova
- Kornhauser Health Sciences Library, University of Louisville, Louisville, KY, United States
| | - Cara Mathis
- School of Nursing, University of Louisville, Louisville, KY, United States
| | - Wessly Ford
- School of Nursing, University of Louisville, Louisville, KY, United States
| | - Ryan E Rhodes
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
| |
Collapse
|
3
|
Güneş M, Demirer B. A Comparison of Caffeine Intake and Physical Activity According to Fatigue Severity in University Students. Eval Health Prof 2023; 46:92-99. [PMID: 36412049 DOI: 10.1177/01632787221141504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This study aims to compare caffeine intake and physical activity levels in university students with severe and ineffective fatigue and examine the relationship between them. A total of 647 (F:527; M:120) university students were included in this cross-sectional study. Individuals' socio-demographic information, severity of fatigue (Fatigue Severity Scale (FSS)), amount of caffeine intake and physical activity level (International Physical Activity Questionnaire-Short Form (IPAQ-SF)) were evaluated. It was determined that 56.5% of the university students (age: 21.21 ± 2.57) participating in the study had severe fatigue. Caffeine intake and physical activity level of students with severe fatigue were statistically significantly lower than those with ineffective fatigue (p < 0.05). In addition, there was a weak negative correlation between fatigue and caffeine intake (r = -0.157; p < 0.001) and physical activity level (r = -0.096; p < 0.017). There was a significant positive correlation between caffeine intake and physical activity (r = 0.143; p < 0.001). This study showed that a significant portion of university students have severe fatigue. In addition, individuals with severe fatigue have decreased caffeine intake and lower physical activity levels. To reduce fatigue, caffeine intake in safe doses should be encouraged in accordance with the individual's metabolic and physiological parameters. In addition, physical activity counseling should be given to encourage physical activity.
Collapse
Affiliation(s)
- Musa Güneş
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, 175170Karabuk University, Karabuk, Turkey
| | - Büşra Demirer
- Faculty of Health Sciences, Department of Nutrition and Dietetics, 175170Karabuk University, Karabuk, Turkey
| |
Collapse
|
4
|
Gomwe H, Seekoe E, Lyoka P, Marange CS, Mafa D. Physical activity and sedentary behaviour of primary school learners in the Eastern Cape province of South Africa. S Afr Fam Pract (2004) 2022; 64:e1-e8. [PMID: 35384676 PMCID: PMC8991265 DOI: 10.4102/safp.v64i1.5381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 12/13/2021] [Accepted: 01/24/2022] [Indexed: 12/02/2022] Open
Abstract
Background This study was designed to assess physical activity (PA) levels and sedentary behaviour amongst primary school learners in the Eastern Cape province of South Africa. Methods A cross-sectional study was adopted to assess the patterns and levels of PA and sedentary behaviour using the Physical Activity Questionnaire for Older Children (PAQ-C). The sample consisted of primary school learners, both boys and girls, aged 9–14 years. The learners were randomly selected from rural, urban and peri-urban areas in the Eastern Cape province of South Africa. Results Using a complete case analysis, 870 randomly selected participants (boys = 351 and girls = 519) aged 9–14 years were retained. Overall, the sample had a low mean PAQ-C score of 2.33 ± 0.43. The mean of PA in boys was significantly higher (p = 0.003) in comparison with the girls. The 13- to 14-age group had significantly higher PA levels (p = 0.014). Learners from urban areas (n = 136; 77.3%) engaged more in sedentary behaviour compared to those from rural areas (n = 252; 54.9%). Conclusion The findings demonstrated low levels of PA and high engagement of sedentary behaviour across the combined gender groups, which have negative implications on health, growth and development of children. The study, therefore, recommends relevant stakeholders to implement interventions aimed at promoting an increase in PA and a reduction in sedentary behaviours for primary school learners in the Eastern Cape province of South Africa.
Collapse
Affiliation(s)
- Howard Gomwe
- Department of Teaching, Learning and Community Engagement, Faculty of Health Sciences, Sefako Makgatho Health Sciences University, Medunsa.
| | | | | | | | | |
Collapse
|
5
|
The Effects of Sensory Enrichment After a Laboratory Stressor on Human Skin Barrier Recovery in a Randomized Trial. Psychosom Med 2021; 82:877-886. [PMID: 32881761 DOI: 10.1097/psy.0000000000000858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Environmental enrichment (EE) can reduce stress, alter immunity, and speed wound healing in animals. However, it is not known whether these effects translate to humans. This study aimed to investigate whether sensory EE could improve wound healing after a stressor in humans. METHODS A total of 105 participants underwent a tape-stripping procedure and were then stressed using a laboratory stress paradigm. After this, they were randomized to interact for 30 minutes with one of two possible sensory EE interventions (music as auditory enrichment or a Paro robot as multisensory enrichment) or to a control condition. Skin barrier recovery was measured using transepidermal water loss at baseline, after the stressor, and after the intervention. Stress was measured using self-report, heart rate, blood pressure, and salivary stress-related biological measures. Enjoyment during the intervention was measured by self-report as a possible mediator. RESULTS The Paro condition had significantly improved skin barrier recovery (mean [M] = 44%, standard error [SE] = 1.92) compared with the control condition (M = 37% SE = 2.01, F(2,88) = 3.25, p = .043), both with and without controlling for covariates. The music condition did not significantly differ from the other conditions (M = 42%, SE = 1.95, p values > .05). Both objective and subjective stress measures did not significantly differ between conditions. Mediational analysis showed that enjoyment levels during the intervention period significantly mediated the relationship between condition and skin barrier recovery (z = 2.00, p = .046). CONCLUSIONS Paro, or other companion robots, may be an effective form of enrichment to improve skin barrier recovery in humans after a laboratory stressor, and this effect may be due to enjoyment. Further research with patient groups is required to investigate whether Paro can help heal clinical wounds. TRIAL REGISTRATION ACTRN12618000953235, registered at https://anzctr.org.au.
Collapse
|
6
|
Smith RP, Rayburn WF. Burnout in Obstetricians-Gynecologists: Its Prevalence, Identification, Prevention, and Reversal. Obstet Gynecol Clin North Am 2021; 48:231-245. [PMID: 33573788 DOI: 10.1016/j.ogc.2020.11.008] [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] [Indexed: 11/26/2022]
Abstract
Studies indicate that burnout rates among obstetricians-gynecologists range from 40% to more than 75%, which is in the middle to upper one-third of medical specialties. Symptoms range from feelings of underappreciation and unresolved fatigue, to cynicism, depression, physical symptoms, and illness. Burnout is associated with poor job satisfaction, questioning career choices, and dropping out of practice, impacting workforce concerns and patient access. Awareness of the symptoms and some simple stress and fatigue reduction techniques can decrease the risk of being trapped in the downward spiral of burnout. Successful interventions range from more sleep, to hobbies and vacations, to skilled counseling.
Collapse
Affiliation(s)
| | - William F Rayburn
- University of New Mexico School of Medicine, University of New Mexico, Building No. 2, MSC09 53701, Albuquerque, NM 87131, USA
| |
Collapse
|
7
|
Giessing L, Kannen J, Strahler J, Frenkel MO. Direct and Stress-Buffering Effects of COVID-19-Related Changes in Exercise Activity on the Well-Being of German Sport Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7117. [PMID: 34281054 PMCID: PMC8297212 DOI: 10.3390/ijerph18137117] [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] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 05/31/2021] [Accepted: 06/25/2021] [Indexed: 12/24/2022]
Abstract
Maintaining or initiating exercise activity in the COVID-19 pandemic may act as a buffer against the observed stress-related deterioration in well-being, with emotion regulation (ER) discussed as a possible moderator. Therefore, the present study investigated the interaction between stress, exercise activity (EA), and ER on mood. In an online survey, 366 German sports science students (56% women, Mage = 23.04, SD = 2.87) reported their stress levels (general and COVID-19-specific), mood (energy, valence, calmness), EA before and during the pandemic, and use of ER strategies in spring 2020. Pandemic-related change in EA was calculated as residual change. Due to gender differences in mental health and EA, the main and interaction effects were tested in twelve hierarchical regression analyses, separately for men and women. Overall, EA significantly decreased during the pandemic and was positively associated with energy in both men and women. ER was positively associated with women's energy, but negatively with all three mood dimensions in men. Only one three-way interaction appeared significant: in the case of high stress, low levels of EA and high use of ER were associated with the greatest deteriorations in energy in men. Our findings suggest that EA may buffer deteriorations in energy in men with high stress and difficulties in ER.
Collapse
Affiliation(s)
- Laura Giessing
- Institute of Sports and Sports Sciences, Heidelberg University, 69120 Heidelberg, Germany; (J.K.); (M.O.F.)
| | - Julia Kannen
- Institute of Sports and Sports Sciences, Heidelberg University, 69120 Heidelberg, Germany; (J.K.); (M.O.F.)
| | - Jana Strahler
- Faculty of Psychology and Sport Science, Justus-Liebig University Gießen, 35394 Gießen, Germany;
| | - Marie Ottilie Frenkel
- Institute of Sports and Sports Sciences, Heidelberg University, 69120 Heidelberg, Germany; (J.K.); (M.O.F.)
| |
Collapse
|
8
|
Addressing Physician Burnout and Ensuring High-Quality Care of the Physician Workforce. Obstet Gynecol 2021; 137:3-11. [PMID: 33278277 DOI: 10.1097/aog.0000000000004197] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 10/09/2020] [Indexed: 11/25/2022]
Abstract
Burnout in health care is a public health crisis. Burnout is a triad of emotional exhaustion, depersonalization, and feelings of reduced personal accomplishment. More than half of practicing physicians and trainees experience burnout, and the rates are increasing. This review highlights the current prevalence of burnout among U.S. physicians, especially obstetrician-gynecologists. We review personal and systemic risk factors for burnout, consequences of burnout, and proven interventions, especially at the systems level, to treat and prevent burnout.
Collapse
|
9
|
Law M, Jarrett P, Nater UM, Skoluda N, Broadbent E. The effects of environmental enrichment on skin barrier recovery in humans: a randomised trial. Sci Rep 2020; 10:9829. [PMID: 32555211 PMCID: PMC7299948 DOI: 10.1038/s41598-020-66687-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 05/23/2020] [Indexed: 12/16/2022] Open
Abstract
This study investigated whether environmental enrichment (EE) could reduce stress and improve wound healing in humans. 120 participants underwent a standardised tape-stripping procedure and were then randomised to interact for 30 minutes with one of three EE interventions (comfort blankets as tactile enrichment, music as auditory enrichment or a Paro robot as multi-sensory enrichment) or to a control group. Skin barrier recovery (SBR) was measured using transepidermal water loss at baseline, after tape-stripping and after the intervention. Psychological variables, cortisol and alpha-amylase were measured at the three time-points. SBR did not significantly differ between the EE conditions and the control condition. The music condition had higher stimulation levels than the control condition, and the comfort condition had significantly lower relaxation levels than the control condition after the intervention. The EE interventions tested were not beneficial for wound healing compared to a control group. Limitations were that the sample were not stressed and an active control condition was used.
Collapse
Affiliation(s)
- Mikaela Law
- Department of Psychological Medicine, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Paul Jarrett
- Department of Dermatology, Middlemore Hospital, Auckland, New Zealand.,Department of Medicine, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Urs M Nater
- Faculty of Psychology, University of Vienna, Vienna, 1010, Austria
| | - Nadine Skoluda
- Faculty of Psychology, University of Vienna, Vienna, 1010, Austria
| | - Elizabeth Broadbent
- Department of Psychological Medicine, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
| |
Collapse
|
10
|
Eyl RE, Thong MSY, Carr PR, Jansen L, Koch-Gallenkamp L, Hoffmeister M, Chang-Claude J, Brenner H, Arndt V. Physical activity and long-term fatigue among colorectal cancer survivors - a population-based prospective study. BMC Cancer 2020; 20:438. [PMID: 32423448 PMCID: PMC7236466 DOI: 10.1186/s12885-020-06918-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 04/30/2020] [Indexed: 12/31/2022] Open
Abstract
Background Evidence suggests that physical activity (PA) is beneficial for reducing fatigue in colorectal cancer (CRC) survivors. However, little is known regarding long-term effects of PA on fatigue and whether pre-diagnosis PA is associated with less fatigue in the years after diagnosis. Our study aimed to investigate the association of pre- and post-diagnosis PA with long-term fatigue in CRC survivors. Methods This study used a German population-based cohort of 1781 individuals, diagnosed with CRC in 2003–2014, and alive at five-year follow-up (5YFU). Physical activity was assessed at diagnosis and at 5YFU. Fatigue was assessed by the Fatigue Assessment Questionnaire and the EORTC Quality of Life Questionnaire-Core 30 fatigue subscale at 5YFU. Multivariable linear regression was used to explore associations between pre- and post-diagnosis PA and fatigue at 5YFU. Results No evidence was found that pre-diagnosis PA was associated with less fatigue in long-term CRC survivors. Pre-diagnosis work-related PA and vigorous PA were even associated with higher levels of physical (Beta (ß) = 2.52, 95% confidence interval (CI) = 1.14–3.90; ß = 2.03, CI = 0.65–3.41), cognitive (ß = 0.17, CI = 0.05–0.28; ß = 0.13, CI = 0.01–0.25), and affective fatigue (ß = 0.26, CI = 0.07–0.46; ß = 0.21, CI = 0.02–0.40). In cross-sectional analyses, post-diagnosis PA was strongly associated with lower fatigue on all scales. Conclusions In this study, pre-diagnosis PA does not appear to be associated with less fatigue among long-term CRC survivors. Our results support the importance of ongoing PA in long-term CRC survivors. Our findings might be used as a basis for further research on specific PA interventions to improve the long-term outcome of CRC survivors.
Collapse
Affiliation(s)
- Ruth Elisa Eyl
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany
| | - Melissa S Y Thong
- Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany
| | - Prudence R Carr
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany
| | - Lina Jansen
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany
| | - Lena Koch-Gallenkamp
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany
| | - Michael Hoffmeister
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany
| | - Jenny Chang-Claude
- Unit of Genetic Epidemiology, Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany.,Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, Martinistraße 54, 20251, Hamburg, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany.,Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.,German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - Volker Arndt
- Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany.
| |
Collapse
|
11
|
Eyl RE, Koch-Gallenkamp L, Jansen L, Walter V, Carr PR, Hoffmeister M, Chang-Claude J, Brenner H, Arndt V. Physical Activity and Long-term Quality of Life among Colorectal Cancer Survivors-A Population-based Prospective Study. Cancer Prev Res (Phila) 2020; 13:611-622. [PMID: 32253267 DOI: 10.1158/1940-6207.capr-19-0377] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 12/23/2019] [Accepted: 03/30/2020] [Indexed: 12/24/2022]
Abstract
Evidence suggests that physical activity (PA) is positively associated with (health-related) quality of life (QOL) in colorectal cancer survivors. However, little is known regarding long-term effects of PA on QOL and if prediagnosis PA is associated with QOL in the years after diagnosis. Our study aimed to investigate the association of prediagnosis and postdiagnosis PA with long-term QOL in colorectal cancer survivors.This study is based on a population-based cohort from Germany of 1,781 newly diagnosed colorectal cancer survivors over a 5-year period. PA was assessed at diagnosis and at 5-year follow-up (5YFU). Quality of life was assessed by the European Organisation for Research and Treatment of Cancer C Quality of Life Questionnaire QLQ-C30 at 5YFU. Multivariable linear regression was used to explore associations between prediagnosis and postdiagnosis PA and QOL at 5YFU.No evidence of a positive association between higher levels of prediagnosis PA and better long-term QOL was found. Higher levels of prediagnosis work-related PA and vigorous PA were even associated with decreased QOL in domains such as cognitive [Beta(β) = -2.52, 95% confidence interval (CI) = -3.77, -1.27; β = -1.92, CI = -3.17, -0.67) and emotional functioning (β = -2.52, CI = -3.84, -1.19; β = -2.12, CI = -3.44, -0.80). In cross-sectional analyses, higher postdiagnosis PA was strongly associated with higher QOL. Survivors physically active at both prediagnosis and postdiagnosis as well as survivors who increased their PA between prediagnosis and postdiagnosis reported significantly higher long-term QOL compared with survivors who remained inactive at prediagnosis and postdiagnosis. In this study, higher prediagnosis PA does not appear to be associated with higher QOL among long-term colorectal cancer survivors but our results support the importance of ongoing PA throughout survivorship.
Collapse
Affiliation(s)
- Ruth Elisa Eyl
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Medical Faculty Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Lena Koch-Gallenkamp
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Lina Jansen
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Viola Walter
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Prudence R Carr
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael Hoffmeister
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jenny Chang-Claude
- Unit of Genetic Epidemiology, Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany.,German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Volker Arndt
- Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
| |
Collapse
|
12
|
Law M, Minissale G, Lambert A, Nater UM, Skoluda N, Ryckman N, Tahara-Eckl L, Bandzo M, Broadbent E. Viewing Landscapes Is More Stimulating Than Scrambled Images After a Stressor: A Cross-disciplinary Approach. Front Psychol 2020; 10:3092. [PMID: 32038433 PMCID: PMC6992591 DOI: 10.3389/fpsyg.2019.03092] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 12/31/2019] [Indexed: 11/13/2022] Open
Abstract
Research has demonstrated that nature is beneficial for many aspects of one’s health. This pilot study aimed to investigate whether viewing landscape artworks, as a form of representational nature, could improve psychological and physiological recovery from a laboratory stressor. A sample of 30 participants was randomized to one of two conditions: landscape and scrambled. After a laboratory stress task, participants in the landscape condition viewed a series of landscape paintings for 30 min; participants in the scrambled condition viewed digitally scrambled versions of these artworks as a control condition. Pupil size was measured while viewing the images using an eye tracker. Affect, drowsiness and fatigue, and the salivary stress biomarkers, cortisol, and alpha-amylase were measured at baseline, after the stressor, and after the artwork viewing period. After the viewing period, the scrambled condition had increased reports of low negative affect (which contains the variables of sleepy, dull, and sluggish) (p = 0.045, ηp2 = 0.12) and increased reports of drowsiness (p = 0.038, ηp2 = 0.12). Salivary cortisol levels decreased more rapidly while viewing the scrambled images compared to the landscape artworks (p = 0.027, ηp2 = 0.62). Lastly, pupil size while viewing the landscape artworks was larger than when viewing a blank screen (p = 0.025, ηp2 = 0.33), an effect not seen in the scrambled condition. This pilot study suggests that viewing landscape artworks was more stimulating and reduced drowsiness after stress when compared to viewing scrambled images.
Collapse
Affiliation(s)
- Mikaela Law
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Gregory Minissale
- Department of Art History, University of Auckland, Auckland, New Zealand
| | - Anthony Lambert
- School of Psychology, University of Auckland, Auckland, New Zealand
| | - Urs M Nater
- Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Nadine Skoluda
- Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Nathan Ryckman
- School of Psychology, University of Auckland, Auckland, New Zealand
| | | | - Martina Bandzo
- School of Psychology, University of Auckland, Auckland, New Zealand
| | - Elizabeth Broadbent
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| |
Collapse
|
13
|
Schilling R, Herrmann C, Ludyga S, Colledge F, Brand S, Pühse U, Gerber M. Does Cardiorespiratory Fitness Buffer Stress Reactivity and Stress Recovery in Police Officers? A Real-Life Study. Front Psychiatry 2020; 11:594. [PMID: 32670116 PMCID: PMC7331850 DOI: 10.3389/fpsyt.2020.00594] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 06/09/2020] [Indexed: 11/13/2022] Open
Abstract
High levels of cardiorespiratory fitness have the potential to buffer against physical and mental health impairments, which can result from exposure to occupational stress. Police officers are especially at risk of high psychosocial stress; therefore, effective intervention strategies are warranted. Given this background, the purpose of the present study was to examine whether police officers with different levels of cardiorespiratory fitness differ with regard to their (a) physiological stress reactivity during acute real-life stress situations, and (b) physiological recovery related to acute and chronic work stress. In total, 201 police officers took part in this study (M = 38.6 years, SD = 10.1, 35.8% females). Officers were contacted eight times on a smartphone during their workday, and asked to report their current level of positive and negative affect, as well as feelings of stress and anger. Physiological stress responses and recovery (heart rate variability) were assessed using Movisens EcgMove3 devices. The Åstrand bicycle ergometer test was used to assess participants' cardiorespiratory fitness. Chronic work stress was assessed using the effort-reward imbalance model and the job strain model. Multilevel modeling was used to test buffering effects of cardiorespiratory fitness on physiological stress reactivity. Linear regression was applied to test stress-buffering effects of cardiorespiratory fitness on physiological recovery. Results showed lowered physiological stress reactivity to acute work stress in officers with higher levels of cardiorespiratory fitness. However, these results were not consistent, with no effects occurring for feelings of anger, positive affect, and negative affect. Chronic work stress (effort-reward imbalance) was related to lower physiological recovery. Cardiorespiratory fitness was positively related to physiological recovery. Data did not support interactions between work stress and cardiorespiratory fitness on physiological recovery. To some extent, cardiorespiratory fitness seems to have the potential to buffer stress reactivity in police officers in acute stress situations. Therefore, we encourage promoting fitness programs which aim to enhance cardiorespiratory fitness in stressful occupations such as law enforcement. Improvements in cardiorespiratory fitness might further enhance physiological recovery from chronic work stress, which is thought to improve cardiovascular health.
Collapse
Affiliation(s)
- René Schilling
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | | | - Sebastian Ludyga
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Flora Colledge
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Serge Brand
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland.,Center for Affective, Stress and Sleep Disorders, Psychiatric Clinics, University of Basel, Basel, Switzerland.,Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.,School of Medicine, Tehran University of Medical Sciences, Teheran, Iran
| | - Uwe Pühse
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| |
Collapse
|
14
|
Strahler J, Nater UM, Skoluda N. Associations between Health Behaviors and Factors on Markers of Healthy Psychological and Physiological Functioning: a Daily Diary Study. Ann Behav Med 2019; 54:22-35. [DOI: 10.1093/abm/kaz018] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Abstract
Background
Cross-sectional and experimental knowledge highlight the contribution of various health-promoting behaviors, such as physical activity, regular sleep, and healthy nutrition to mental and physical health. Beyond these well-studied lifestyle behaviors, music listening and perceived respect in social interactions are just recently proposed everyday life experiences, which may act as health-promoting factors.
Purpose
This study tested the simultaneous contribution of several health-promoting behaviors and factors and examined listening to music and positive social interaction by means of perceived respect as new potentially preventive and health-promoting behaviors and factors using an ambulatory assessment design.
Methods
Seventy-seven young healthy adults (38 women, 23.9 ± 4.5 years) completed surveys on their psychological state (i.e., mood, stress, and fatigue) five times a day for four consecutive days. A saliva sample was collected with each data entry to explore the physiological stress markers salivary cortisol, alpha-amylase, and flow rate as further outcome variables. As predictors, perceived respect, self-reported physical activity, the sleep’s restfulness, daily coffee, alcohol, vegetable/fruit consumption, and music listening behavior were recorded.
Results
Overall, restful sleep, mean daily perceived respect, and listening to music were most clearly associated with more positive psychological states, that is, better mood and lower fatigue and perceived stress. Associations with daily alcohol, coffee, and vegetable/fruit consumption appeared rather minor. While perceived respect scores were associated with lower daily cortisol output, coffee consumption was positively related to daily cortisol and alpha-amylase. Self-reported physical activity was unrelated to either outcome measure.
Conclusions
These findings provide important insights regarding potential resources of health (i.e., music and respect), their covariation, and which psycho-physiological mechanisms may underlie the links between health factors and well-being. Findings also have implications for the development of interventions aiming to increase resilience and foster health. Here, strategies for improving sleep quality, the use of music, and approaches that emphasize mutual respect and appreciation appear useful additions.
Collapse
Affiliation(s)
- Jana Strahler
- Clinical Biopsychology, Department of Psychology, University of Marburg, Marburg, Germany
- Psychotherapy and Systems Neuroscience, Department of Psychology and Sport Science, Justus Liebig University Giessen, Giessen, Germany
| | - Urs M Nater
- Clinical Biopsychology, Department of Psychology, University of Marburg, Marburg, Germany
- Department of Applied Psychology: Health, Development, Enhancement and Intervention, University of Vienna, Vienna, Austria
| | - Nadine Skoluda
- Clinical Biopsychology, Department of Psychology, University of Marburg, Marburg, Germany
- Department of Psychiatry and Psychotherapy, Medical School, University of Tübingen, Tübingen, Germany
- Department of Applied Psychology: Health, Development, Enhancement and Intervention, University of Vienna, Vienna, Austria
| |
Collapse
|
15
|
Strahler J, Nater UM. Differential effects of eating and drinking on wellbeing—An ecological ambulatory assessment study. Biol Psychol 2018; 131:72-88. [DOI: 10.1016/j.biopsycho.2017.01.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 12/07/2016] [Accepted: 01/18/2017] [Indexed: 10/20/2022]
|
16
|
Abstract
It is estimated that 40% to 75% of obstetricians and gynecologists currently suffer from professional burnout, making the lifetime risk a virtual certainty. Although these statistics make for a dismal view of the profession, if the causes and symptoms can be identified simple steps can be implemented to reverse the threat. With a little care, the enjoyment of practice can be restored and the sense of reward and the value of service can be returned.
Collapse
Affiliation(s)
- Roger P Smith
- Charles E. Schmidt College of Medicine, Florida Atlantic University, 777 Glades Road, BC-71, Room 337, Boca Raton, FL 33431, USA.
| |
Collapse
|
17
|
Doerr JM, Fischer S, Nater UM, Strahler J. Influence of stress systems and physical activity on different dimensions of fatigue in female fibromyalgia patients. J Psychosom Res 2017; 93:55-61. [PMID: 28107893 DOI: 10.1016/j.jpsychores.2016.12.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 12/02/2016] [Accepted: 12/07/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Fatigue is a defining characteristic and one of the most debilitating features of fibromyalgia syndrome (FMS). The mechanisms underlying different dimensions of fatigue in FMS remain unclear. The aim of the current study was to test whether stress-related biological processes and physical activity modulate fatigue experience. METHODS Using an ambulatory assessment design, 26 female FMS patients reported general, mental, and physical fatigue levels at six time points per day for 14 consecutive days. Salivary cortisol and alpha-amylase were analyzed as markers of neuroendocrine functioning. Participants wore wrist actigraphs for the assessment of physical activity. RESULTS Lower increases in cortisol after awakening predicted higher mean daily general and physical fatigue levels. Additionally, mean daily physical activity positively predicted next-day mean general fatigue. Levels of physical fatigue at a specific time point were positively associated with momentary cortisol levels. The increase in cortisol after awakening did not mediate the physical activity - fatigue relationship. There were no associations between alpha-amylase and fatigue. CONCLUSION Our findings imply that both changes in hypothalamic-pituitary-adrenal axis activity and physical activity contribute to variance in fatigue in the daily lives of patients with FMS. This study helps to paint a clearer picture of the biological and behavioral underpinnings of fatigue in FMS and highlight the necessity of interdisciplinary treatment approaches targeting biological, behavioral and psychological aspects of FMS.
Collapse
Affiliation(s)
- Johanna M Doerr
- Clinical Biopsychology, Department of Psychology, University of Marburg, Gutenbergstr. 18, 35037 Marburg, Germany.
| | - Susanne Fischer
- Clinical Biopsychology, Department of Psychology, University of Marburg, Gutenbergstr. 18, 35037 Marburg, Germany.
| | - Urs M Nater
- Clinical Biopsychology, Department of Psychology, University of Marburg, Gutenbergstr. 18, 35037 Marburg, Germany.
| | - Jana Strahler
- Clinical Biopsychology, Department of Psychology, University of Marburg, Gutenbergstr. 18, 35037 Marburg, Germany.
| |
Collapse
|