The prevalence of fatigue among Chinese nursing students in post-COVID-19 era

Shou Liu; Hai-Tao Xi; Qian-Qian Zhu; Mengmeng Ji; Hongyan Zhang; Bing-Xiang Yang; Wei Bai; Hong Cai; Yan-Jie Zhao; Li Chen; Zong-Mei Ge; Zhiwen Wang; Lin Han; Pan Chen; Shuo Liu; Teris Cheung; Brian J Hall; Feng-Rong An; Yu-Tao Xiang

doi:10.7717/peerj.11154

The prevalence of fatigue among Chinese nursing students in post-COVID-19 era

PeerJ. 2021 Apr 13:9:e11154. doi: 10.7717/peerj.11154. eCollection 2021.

Authors

Shou Liu^#^{1

2

3}, Hai-Tao Xi^#⁴, Qian-Qian Zhu^{5

6}, Mengmeng Ji⁷, Hongyan Zhang⁸, Bing-Xiang Yang⁹, Wei Bai^{2

3}, Hong Cai^{2

3}, Yan-Jie Zhao^{2

3}, Li Chen⁴, Zong-Mei Ge⁴, Zhiwen Wang⁷, Lin Han⁸, Pan Chen⁹, Shuo Liu⁹, Teris Cheung¹⁰, Brian J Hall¹¹, Feng-Rong An⁶, Yu-Tao Xiang^{2

3}

Affiliations

¹ Department of Public Health, Medical College, Qinghai University, Xining, Qinghai province, China.
² Centre for Cognitive and Brain Sciences, University of Macau, Macao, China.
³ Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao, China.
⁴ Nursing College, Jilin University, Changchun, Jilin province, China.
⁵ School of Nursing, Capital Medical University, Beijing, China.
⁶ The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, School of Mental Health, Beijing, China.
⁷ School of Nursing, Peking University, Beijing, China.
⁸ School of nursing, Lanzhou University, Lanzhou, Gansu province, China.
⁹ School of Health Sciences, Wuhan University, Wuhan, Hubei province, China.
¹⁰ School of Nursing, Hong Kong Polytechnic University, Hong Kong, China.
¹¹ School of Global Public Health, New York University, New York, NY, USA.

^# Contributed equally.

Abstract

Background: Due to the COVID-19 outbreak, all teaching activities in nursing schools were suspended in China, and many nursing students were summoned to work in hospitals to compensate for the shortage of manpower. This study examined the prevalence of fatigue and its association with quality of life (QOL) among nursing students during the post-COVID-19 era in China.

Methods: This was a multicenter, cross-sectional study. Nursing students in five Chinese universities were invited to participate. Fatigue, depressive and anxiety symptoms, pain and QOL were measured using standardized instruments.

Results: A total of 1,070 nursing students participated. The prevalence of fatigue was 67.3% (95% CI [64.4-70.0]). Multiple logistic regression analysis revealed that male gender (P = 0.003, OR = 1.73, 95% CI [1.20-2.49]), and being a senior nursing student (second year: OR = 2.20, 95% CI [1.46-3.33], P < 0.001; third year: OR = 3.53, 95% CI [2.31-5.41], P < 0.001; and fourth year OR = 3.59, 95% CI [2.39-5.40], P < 0.001) were significantly associated with more severe fatigue. In addition, moderate economic loss during the COVID-19 pandemic (OR = 1.48, 95% CI [1.08-3.33], P < 0.015; compared to low loss), participants with more severe depressive (OR = 1.48, 95% CI [1.22-1.78], P < 0.001) and anxiety symptoms (OR = 1.12, 95% CI [1.05-1.20], P = 0.001), and more severe pain (OR = 1.67, 95%CI [1.46-1.91], P < 0.001) were significantly associated with reported more severe fatigue. After controlling for covariates, nursing students with fatigue had a lower overall QOL score compared to those without (F _{(1, 1070)} = 31.4, P < 0.001).

Conclusion: Fatigue was common among nursing students in the post-COVID-19 era. Considering the negative impact of fatigue on QOL and daily functioning, routine physical and mental health screening should be conducted for nursing students. Effective stress-reduction measures should be enforced to assist this subpopulation to combat fatigue and restore optimal health.

Keywords: COVID-19 pandemic; Fatigue; Nursing students; Quality of life.

Grants and funding

The study was supported by the National Science and Technology Major Project for investigational new drug (2018ZX09201-014), the Beijing Municipal Science & Technology Commission (No. Z181100001518005), the 2020 Higher Education Teaching Achievement Cultivation Project of Gansu Province, the Fundamental Research Funds for the Central Universities (2020YJ065), the University of Macau (MYRG2019-00066-FHS) and the National Natural Science Foundation of China (81860606). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.