| Summary: | 碩士 === 國立臺灣大學 === 預防醫學研究所 === 93 === Background: Fatigue is not only commonly seen in clinical patients but also prevails in healthy population. Risk factors associated with fatigue were reported to vary from population to population. Few studies have been conducted to address fatigue in postgraduate students that are supposed to be a high risk group for being afflicted with fatigue in Taiwan.
Objectives: The aims of this thesis are therefore to estimate the prevalence rate of fatigue and to identify significant risk factors responsible for fatigue with the emphasis on postgraduate students.
Materials and Methods: In the fall term of 2004, a total of 2688 graduate students newly admitted to National Taiwan University were invited to take health check-ups. Of 2688 invited students, 2144 attended the physical check-up. Of 2144 attendee, 1806 agreed to participate in our fatigue survey with 84% of response rate. During the check-up time , basic information and the Checklist Individual Strength questionnaire (CIS-20) with four dimensions was administered: subjective fatigue, reduced motivation, reduced concentration, and reduced activity and the measurement of physical activity questionnaire were collected. The Cronbach’s α was adopted to test the internal consistency of CIS-20’s. The definition for estimating prevalence rate of fatigue was CIS-20 greater than 76. We investigated risk factors associated with fatigue in two types of outcome, one based on binary outcome and another leaning on fatigue score divided into four levels (normal, mild, moderate, and severe). The former was analyzed by using logistic regression model and the latter using proportional odds model.
Results: The prevalence rate of fatigue was 45.8% for males and 48.9% for females. The CIS-20 has good internal consistency with Cronbach´s α high up to 0.92, yielding three constructs for male and four constructs for female. In multivariate analysis with adjusting for variables in each other, variables still remained statistically significant including the identity (OR = 0.61 (95% CI: 0.45 ~ 0.82) doctorate students versus master students), individuals having systemic disease without hepatitis history (OR = 1.61 (95% CI: 1.19 ~ 2.19)), insomnia at least once per week versus none (OR = 2.23 (95% CI: 1.79 ~ 2.76)), sleeping greater than seven hours versus less than seven hours (OR =0.7 (95% CI: 0.56 ~ 0.87)), regular 3 meal per day versus irregular (OR = 0.69 (95% CI: 0.51 ~ 0.80)), regular exercise versus irregular (OR = 0.68 (95% CI: 0.54 ~ 0.87)), physical activity in four levels from the smallest to the greatest ( OR = 0.72 (95% CI: 0.54 ~ 0.95) for Q2, 0.50 (95% CI: 0.38 ~ 0.66) for Q3, and 0.36 (95% CI: 0.26 ~ 0.50) for Q4). There was a statistically significant trend in physical activity by four levels (p < 0.01). Similar findings were reported by using proportional odds model.
Conclusion: High prevalence rate of fatigue measured by CIS-20 among graduate students has been demonstrated. Such high risk among these postgraduate students may not be only related to existing chronic disease and insomnia but also attributed to lacking of regular life styles and exercise. These findings have a significant implication for clinical management of postgraduate students with fatigue as a chief complaint.
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