• Research in Community and Public Health Nursing
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• v.18 no.2
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• pp.223-231
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• 2007

Purpose: This study was to compare differences in and correlation among depression. sleep and fatigue between younger and older elders. Method: A total of 370 subjects aged between 65 and 88 were selected through convenient sampling. Data were collected using a self report questionnaire from March to December, 2005. Results: Younger elders showed lower levels of depression and fatigue than older ones. The level of sleep satisfaction was higher in older elders than in younger ones. In both groups, fatigue was positively correlated to depression, and depression and fatigue were negatively correlated to sleep satisfaction. In addition, fatigue was affected by depression, the number of persons in household and sleep satisfaction. Conclusion: Older elders showed more serious health problems than younger ones. It is necessary to develop comprehensive intervention programs in order to promote healthy lifestyle for older elders.

• Research in Community and Public Health Nursing
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• v.26 no.2
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• pp.100-107
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• 2015

Purpose: To explore the association between sleep and the risk of accidental injury at school among Korean adolescents. Methods: From the database of the Ninth Korea Youth Risk Behavior Web-based Survey (KYRBS), the researcher selected 63,307 adolescents who responded to a survey on sleep hours. We conducted logistic regression with sleep duration and fatigue after sleep as independent variables, the risk of injury at school as a dependent variable, and gender, grade, school type, economic status, parents' education level, number of participations in physical education, and current smoking and drinking as control variables. Results: Using 9 hours of sleep as the reference, the adjusted injury risk (odds ratio) was 1.74 for those sleeping less than 5 hours a day, 1.61 for 5 hours, 1.45 for 6 hours, 1.31 for 7 hours, 1.13 for 8 hours, and 1.40 for 10 hours or longer. The difference between each pair of groups was statistically significant. In this study, injury risk increased as sleep duration decreased and fatigue after sleep increased. Conclusion: The findings suggest that a short nightly duration of sleep and fatigue after sleep can be considered potential risk factorsfor unintentional injuries at school among Korean adolescents.

• Korean Journal of Adult Nursing
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• v.29 no.1
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• pp.87-97
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• 2017

Purpose: The purpose of this study was to investigate the relationship among sleep quality, heart rate variability (HRV), fatigue, depression, and anxiety reported by Korean adults. Methods: A cross-sectional study of 208 adults aged 20~60 years was conducted using a short-term HRV analysis and self-reported questionnaires of Pittsburgh Sleep Quality Index (PSQI), Fatigue Severity Scale, Beck Depression Inventory, and State Trait Anxiety Inventory. Results: Subjects with good sleep quality (PSQI $score{\leq}5$) had higher HRV total power (t=2.03, p=.043) and high-frequency (t=2.04, p=.043) with lower fatigue (t=-4.08, p<.001), depressive mood (t=-3.66, p<.001), and trait anxiety (t=-3.84, p<.001) than subjects with poor sleep quality. Poor sleep quality was negatively correlated with HRV total power (r=-.17, p=.016), high-frequency (r=-.14, p=.049), and positively fatigue (r=.39, p<.001), depression (r=.44, p<.001), state anxiety (r=.23, p=.001) and trait anxiety (r=.34, p<.001). Conclusion: The results indicated that sleep quality is correlated with HRV which reflects the activities of the autonomic nerve system, fatigue, depression, and anxiety in adults.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.27 no.2
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• pp.138-148
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• 2017

Objectives: Sleep quality is directly related to the health, quality of life and working capacity and is affected by age, gender, exercise, life habits. Gender dissimilarities in sleep quality are acknowledged. However, the gender difference in the quality of sleep in shift workers was not well known. Our aim was to study the less known gender differences in the quality of sleep of shift workers. Methods: 1,008 study subjects aged between 21 and 57 years among these, 637(525 male and 112 female workers) were daytime workers and 371(253 males and 118 female workers) were shift workers. Sleep quality was measured by self-report through the Pittsburg Sleep Quality Index(PSQI) and fatigue was measured by using the Chalder Fatigue Scale(CFS). All data was analyzed using SPSS version 19.0 program. The study was approved by the Institutional Review Board of the Occupational Safety and Health Research Institute. Results: Overall, sleep quality was found to be worse in shift workers than in daytime workers and in female than in male. Fatigue in shift female workers was significantly higher than in daytime female workers and shift male workers. In Spearman correlation analysis results, fatigue were significantly associated with gender, drink habit, regular exercise, working hours and sleep quality. With group male workers as the reference, the odds ratio(OR) for having a CFS was 2.115(${\beta}$ value=0.749, p<0.01), and subjective sleep quality, sleep latency, daytime dysfunction and PSQI were 1.541(${\beta}$ value=0.432, p<0.05), 2.297(${\beta}$ value=0.831, p<0.001), 1.798(${\beta}$ value=0.587, p<0.01) and 2.224(${\beta}$ value=0.799, p<0.01), respectively. Conclusions: Shift work played an important role in lowering the quality of sleep, and the effect was more pronounced in female workers than in male workers. Sleep quality was related to fatigue, especially sleep quality, sleep duration, sleep disturbances and daytime dysfunction were significantly related. Therefore, to improve fatigue and sleep quality of shift worker, it is necessary to improve healthy habits such as regular exercise, smoking cessation, and limited drinking. In particular, it is urgent to develop and implement a regular exercise program to reduce fatigue and improve the quality of sleep in workplace.

• Safety and Health at Work
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• v.9 no.2
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• pp.159-163
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• 2018

Background: Fatigue and sleepiness are inter-related and common among road transport drivers. In this study, sleep deprivation and fatigue among chemical transportation drivers were examined. Methods: A cross-sectional study surveying 107 drivers from three hazardous types of chemical production and transportation industries (nonflammable gases, flammable gases, and flammable liquids) was conducted. Data on sleep deprivation were collected using questionnaires of the Stanford Sleeping Scale and the Groningen Sleep Quality Scale. Fatigue was assessed using an interview questionnaire and a flicker fusion instrument. Results: Chemical drivers had a mean sleeping scale (Stanford Sleeping Scale) of 1.98 (standard deviation 1.00) and had a mean score of 1.89 (standard deviation 2.06) on the Groningen Sleep Quality Scale. High-risk drivers had higher scores in both the Stanford Sleeping Scale and the Groningen Sleep Quality Scale with a mean score of 2.59 and 4.62, respectively, and those differences reached statistical significance (p < 0.05). The prevalence of fatigue, as assessed through a critical flicker fusion analyzer, subjective fatigue question, and either of the instruments, was 32.32%, 16.16%, and 43.43%, respectively. Drivers who slept <7 hours and had poor sleep quality were found to have more fatigue than those who slept enough and well. Drivers who had a more sleepiness score resulted in significantly more objective fatigue than those who had a less sleepiness score. Conclusion: Sleep quality and sleeping hour can affect a driver's fatigue. Optimization of work-rest model should be considered to improve productivity, driver retention, and road safety.

• Research in Community and Public Health Nursing
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• v.22 no.4
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• pp.458-464
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• 2011

Purpose: The purpose of this study was to investigate the effect of cardiopulmonary symptoms and sleep on fatigue in pneumoconiosis patients. Methods: Self-administered questionnaires were given to 211 neumoconiosis patients during the period from May 12 to May 20, 2010. Results: The mean score of fatigue was as high as 6.7. The level of fatigue depended on the subjects' leisure activity and complication. Fatigue was significantly correlated with cardiopulmonary symptoms and sleep. The influential factors affecting fatigue were cardiopulmonary symptoms, complication, sleep and leisure activity, which explained about 46.5% of the variance. Conclusion: The results of this study indicate that nursing interventions are needed to reduce fatigue and to improve cardiopulmonary symptoms and insomnia in pneumoconiosis patients.

• Journal of Korean Clinical Nursing Research
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• v.19 no.2
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• pp.285-297
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• 2013

Purpose: This study was conducted to investigate the differences in sleep disturbance, stress, self-efficacy and depression by fatigue level and to identify the factors influencing fatigue in hemodialysis patients. Methods: This study used a cross-sectional design and the subjects were 195 patients undergoing hemodialysis in a local unit. Data were collected using a structured questionnaire and medical records from June to August 2012. The data were analyzed using descriptive statistics, independent t-test, one way ANOVA, $Scheff{\grave{e}}$ test, and Pearson's correlation coefficients. Also a multiple regression analysis was used to assess the independent association between fatigue status and indices of sleep disturbance, stress, self-efficacy and depression. Results: A total of 99 (50.8%) subjects experienced a high level of fatigue and 96 (49.2%) experienced a low level of fatigue. There were significant differences in the levels of sleep disturbance, stress, self-efficacy and depression between the two groups. Fatigue was significantly correlated to sleep disturbance, stress, self-efficacy and depression. The most important factor related to fatigue was stress, followed by sleep disturbance. These factors explained about 37% of fatigue of the respondents. Conclusion: The results of this study showed that sleep disturbance and stress were significant predictors of fatigue in hemodialysis patients. Possible interventions for minimizing fatigue in patients undergoing long-term hemodialysis should be aimed to manage the known contributing factors.

• Korean Journal of Adult Nursing
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• v.29 no.3
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• pp.235-245
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• 2017

Purpose: Reported insomnia and decreased sleep quality are common among older adults. The purpose of this study was to identify factors contributing to insomnia and decreased sleep quality among elderly persons living within a community. The data will be verified with Actigraph which is a non-invasive measurement of rest/activity cycles. Methods: 137 participants over 65 years old were recruited from a senior welfare center. Their mean age was $74.07{\pm}5.18years$ old and majority was women (69.3%). The quality and quantity of nighttime sleep were assessed using Varren-synder-Halper Sleep Scale and a sleep log. Depression and fatigue were assessed using Geriatric Depression Scale Short Form and Fatigue Severity Scale, respectively. Pain was assessed using 11-point Numeric rating scale. An actigraph was used to verify the self-reported sleep. Results: Ninety-two participants (67.2%) reported insomnia. Sixty-eight subjects (49.6%) reported good sleep. Of the participants, 56.2% reported depression and 33.6% reported fatigue. In logistic regression, depression was related to insomnia (OR=3.09, p=.003). Sleep quality was related to depression (OR=2.13, p=.045) and fatigue (OR=2.24, p=.044). The data from the Sleep logs correlated with data obtained from the actigraph. Conclusion: Depression significantly influenced insomnia and sleep quality whereas fatigue only influenced sleep quality. Thus, depression and fatigue should be closely monitored among elderly persons with sleep disturbances.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.16 no.2
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• pp.190-199
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• 2009

Purpose: This study was conducted to identify the factors contributing to sleep disorders in patients on hemodialysis. Methods: A descriptive correlational study design was used. The participants were 135 patients on hemodialysis in hemodialysis clinics. Data were collected from March to May 2007 using structured questionnaires and hematologic sample. Stepwise multiple regression was used to identify factors influencing sleep disorders among the demographic-clinical factors, depression and fatigue. Results: About 69% of the patients had a sleep disorders. There were significant differences in sleep disorders according to marital status, caregiver, religion, economic level, insurance, erythropoietin, somnifacient, and antihypertensive agents. But there were no differences according to age, gender, dialysis period, or antidepressants. Their sleep disorders had significant correlations with depression, and fatigue, and a significant negative correlation with Protein, Albumin, Phosphate and BUN. But there were no correlations with hematocrit, hemoglobin, creatinine, sodium, potassium, or calcium. Depression and fatigue were factors influencing sleep disorders. They accounted for 43.8% of the variance in sleep disorders in these patients. Conclusion: Findings provide an understanding of sleep disorders and the factors that are an influence in patients on hemodialysis. To promote sleep in these patients, nursing interventions to manage depression and fatigue are needed.

• The Journal of Korean Society for School & Community Health Education
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• v.17 no.3
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• pp.103-116
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• 2016

Objectives: The purpose of this study was to compare the differences of sleep quality, fatigue and depression between school lessons and clinical practicum term in nursing students. Methods: This study was conducted through a survey on 84 $4^{th}$ grade nursing students. Data collection was conducted from April to June, 2015. Participants completed a questionnaire assessing sleep quality, fatigue and depression. Data were analyzed by the SPSS/WIN 21.0 using descriptive statistics, paired t-tests, ANOVAs, Pearson's correlations and multiple regression. Results: The mean scores of fatigue and depression during the school lesson were significantly high compared to those of the clinical practicum. On the contrary, the score of sleep quality did not showed difference. Sleep quality showed negative correlations with fatigue and depression respectively, and fatigue showed positive correlation with depression. Subjective health status was the influential factor predicting fatigue and depression after school lessons, and subjective health status and major satisfaction were the influential factors predicting fatigue and depression after clinical practicum term. Conclusions: Nursing students showed different characteristics between school lessons and clinical practicum term. Thus, it is essential to identify physical and psychological problems and related factors respectively, then to devise appropriate programs to improve nursing curriculums.