MENTAL FATIGUE AMONG JAMAICAN: POST COVID-19

Abstract

Mental fatigue is a psychobiological state resulting from prolonged, demanding cognitive work that causes a subjective sense of exhaustion, diminished cognitive function, and altered brain activation.

Full text

Bourne et al.: Mental fatigue among Jamaican: Post Covid-19.
- 1 -
QUANTUM JOURNAL OF MEDICAL AND HEALTH SCIENCES 2(2): 1-12.
eISSN: 2785-8243
www.qjmhs.com
MENTAL FATIGUE AMONG JAMAICAN: POST COVID-19
BOURNE, P. A.1* – ANDREWS, J.2 – BOWEN, J.2 – FORBES, P. G.2 – MCFARLANE, S.2 – ROACH, J.
A.2 – MCLEAN, C.3 – FALLAH, J.4
1 Department of Institutional Research, Northern Caribbean University, Mandeville, Jamaica.
2 Department of Nursing, Northern Caribbean University, Mandeville, Jamaica.
3 Department of Innovation and Simulation, Northern Caribbean University, Mandeville,
Jamaica.
4 Department of Dental Hygiene, Northern Caribbean University, Mandeville, Jamaica.
*Corresponding author
e-mail: paul.bourne[at]ncu.edu.jm
(Received 22nd January 2023; accepted 03rd March 2023)
Abstract. Mental fatigue is a psychobiological state resulting from prolonged, demanding cognitive work
that causes a subjective sense of exhaustion, diminished cognitive function, and altered brain activation.
Mental fatigue can develop after a limited amount of cognitive exertion and increase the possibility of
mistakes. The objective study is to determine if COVID-19 affects mental fatigue in the elderly, fifty-five
years and older in Jamaica. Researchers used stratified multi-stage probability sampling to collect data
from respondents across the 14 parishes in Jamaica. Researchers collected the data from Lars Rönnbäck
and Birgitta Johansson’s Mental Fatigue Scale (MFS). The data collection occurred between October to
November, 2022; from 1122 respondents. Researchers performed descriptive analyses on the collected
data. Sixty per cent of the respondents (n=672) were classified as not experiencing mental fatigue at the
time of this study (i.e., 3 in every 5 Jamaicans 55+ years old). However, 40% were classified as having
different levels of mental fatigue (i.e., 2 in every 5 Jamaicans 55+ years old; 67.3% of those 85+ years
old, 44.1% of those 75-84 years old, 38.4% of those 65-74 years old, and 34.4% of those 55-64 years
old), with 10% having serious mental fatigue (i.e., 1 in every 10 Jamaicans 55+ years old). The findings
revealed that more of the female-sampled respondents had a higher level of mental fatigue (43.9%,
n=258) compared to the male (35.6%, n=188). Most elderly 55 years and older did not experience Mental
Fatigue during the COVID-19 Pandemic in Jamaica.
Keywords: COVID-19, elderly, Jamaica, mental fatigue, post COVID-19, social gerontology
Introduction
Ageing is a phenomenon that spans decades and pertains to the natural progression of
individuals through an expected lifespan. Gerontology is described by Encyclopedia
Britannica as the scientific study of the phenomenon of ageing, which includes the
gradual changes that occur in a cell, a tissue, an organ system, a whole organism, or a
collection of organisms over time (Comfort, 2021). Mental fatigue is a psychobiological
state brought on by prolonged, demanding cognitive work that causes a subjective sense
of exhaustion, diminished cognitive function, and/or altered brain activation (Bourne
and Eldermire-Shearer, 2018). Mental fatigue can develop after only a limited amount
of cognitive exertion, raising the possibility of mistakes. The rise in the perception of
exertion rating is the alteration brought on by mental fatigue that is most consistent
(Mosler, 2015). The purpose of this study is to determine how COVID-19 affects
mental fatigue in the elderly (fifty-five years and older) in Jamaica. The older adult

Bourne et al.: Mental fatigue among Jamaican: Post Covid-19.
- 2 -
QUANTUM JOURNAL OF MEDICAL AND HEALTH SCIENCES 2(2): 1-12.
eISSN: 2785-8243
www.qjmhs.com
population can be divided into three life-stage subgroups: the young-old (approximately
65-74), the middle-old (ages 75-84), and the old-old (over age 85) (Little, 2016).
Serious sickness is more likely to strike older persons and those with underlying
medical illnesses including cancer, diabetes, cardiovascular disease, or chronic
respiratory diseases (WHO, 2022). The SARS-CoV-2 virus is an infectious disease
known as coronavirus disease (COVID-19). The COVID-19 pandemic has drastically
changed Jamaicans’ lives, including the elderly population. Older adults tend to
experience loneliness, age discrimination, and excessive worry. It is therefore
reasonable to anticipate that they would experience greater negative outcomes related to
the COVID-19 pandemic and are at risk for complications than younger adults
(Lebrasseur et al., 2021). The COVID‐19 pandemic restrictions imposed additional
barriers to social networks for older adults. This population experienced rapid
restrictions to in‐person gatherings, travel, visitations in long‐term care facilities and
nursing homes, recreation, and entertainment. Spiritual institutions closed their doors,
exercise facilities shut down, and family gatherings were cancelled (Webb and Chen
2022).
There was heightened awareness in the medical community of the risk of mental
health issues in older adults due to their predisposition to social isolation and increased
risk of severe illness from SARS‐CoV‐2. One survey from July 2020 showed that 46%
of adults 65 years and older felt that their mental health was negatively influenced by
coronavirus‐related worries. This had increased from 31% of older adults 2 months
earlier (Koma et al., 2020). A cross-sectional study was conducted in Istanbul, Turkey,
between March and June 2020, where a total of 4,700 persons were approached and
3,672 (78%) participants (64.4% male and 35.6% females) completed the Knowledge
Attitude Practices (KAP) and Fatigue Assessment Scale (FAS) questionnaires. This
study revealed that 64.1% of participants were categorized as psychologically fatigued
and 35.9% as normal (Morgul et al., 2021). The results showed that there may be an
increase in mental fatigue among the elderly 55 years and older during the COVID-19
pandemic in Jamaica.
Theoretical framework
The term "compassion fatigue" was used by Figley (1995) to describe the "natural
subsequent behaviours and feelings following news about a traumatic incident suffered
by a significant other-the stress resulting from assisting, or trying to help, a traumatized
or suffering person" (Figure 1). According to researchers, the phenomenon is related to
the therapeutic interaction between the patient and healthcare practitioner in that the
patient's traumatic or painful experience sets off a myriad of responses in the provider
(Chachula, 2022). Emotional tiredness, a diminished feeling of personal achievement or
significance at work, mental exhaustion, social isolation, and physical exhaustion are
common characteristics of both burnout and compassion fatigue (Dehghani and asoumi,
2020). Jean Watson's notion of human caring is the theoretical framework that
underpins the concept of compassion fatigue. According to Sitzman and Watson, taking
care of oneself is crucial to providing appropriate care for others and fostering a healing
atmosphere (Academic Support for Nursing Students, 2022). Based on research, the
Compassion Fatigue theory is used to describe those who provide care such as teachers,
nurses, and doctors. This research applies the part of the theory that looks into mental
exhaustion, emotional tiredness, and physical exhaustion which connects back to the
Mental Fatigue Scale and our research.

Bourne et al.: Mental fatigue among Jamaican: Post Covid-19.
- 3 -
QUANTUM JOURNAL OF MEDICAL AND HEALTH SCIENCES 2(2): 1-12.
eISSN: 2785-8243
www.qjmhs.com
Figure 1. The compassion fatigue process.
Source: Figley (1995).
Materials and Methods
Researchers used a quantitative design to determine if COVID-19 affects mental
fatigue in the elderly (fifty-five years and older) in Jamaica. Quantitative research
generates statistics through the use of large-scale survey research, using methods such
as questionnaires or structured interviews (Dawson, 2019). For the research, Jamaica’s
elderly population in 2018-2019 (i.e., 492,221 people 55+ years) determined the sample
size. The probability sampling research method was used by utilizing a confidence
interval of 95% and a margin of error of 2.924 per cent (Harvard Medical School, 2022)
which calculated a sample size of 1121 (Charan and Biswas, 2013). Stratified multi-
stage probability sampling was used to collect data from respondents across the 14
parishes in Jamaica: Manchester, Kingston & St. Andrew, Trelawny, Hanover,
Westmorland, St. James, St. Ann, Hanover, St. Mary, Clarendon, St. Elizabeth,
Portland, St. Thomas, and St Catherine. Data collection occurred between October 1,
2022, to December 1, 2022. A self-administered web-based survey was used to collect
data from the respondents. The standardized instrument consists of 20 closed-ended
questions and 1 open-ended question. The researchers obtained permission to use
Johansson and Ronnback (2014) to assess the mental fatigue of the sampled
respondents.
Johansson and Ronnback (2014) conducted a study and created the Mental Fatigue
Scale (MFS) which is used to measure mental fatigue in persons. The MFS is accessible
by downloading the mobile app. The MFS is a self-reported scale including 15 items of
which 14 were used for this research. The items include fatigue, lack of initiative,
mental fatigue, mental recovery, concentration difficulties, memory problems, slowness
of thinking, sensitivity to stress, increased tendency to become emotional, irritability,
sensitivity to light, sensitivity to noise, decreased sleep at night and increased sleep. The
scale measures are: 0-normal, 0.5, 1-slight, 1.5, 2-fairly serious, 2.5, and 3-problems. A
score of 0 corresponds to normal function and 1-3 indicates an increasing problem with
mental fatigue. The study found a cut-off score of no mental fatigue is scored between
0-10, and above 10.5 signifies a problem. Participants were informed of the research

Bourne et al.: Mental fatigue among Jamaican: Post Covid-19.
- 4 -
QUANTUM JOURNAL OF MEDICAL AND HEALTH SCIENCES 2(2): 1-12.
eISSN: 2785-8243
www.qjmhs.com
purpose, its confidentiality and anonymity with an invitation to Jamaican citizens 55
years or older to participate. To achieve the sample, target the survey was shared on
multiple social media platforms (WhatsApp, Instagram, and Facebook). The researchers
gathered a total of 1121 responses with 49 incomplete responses, 34 from persons ages
21-54 and 15 invalids in which persons placed their date of birth or placed a dot in place
of their age. There were a total of 1072 successful responses from Jamaicans 55 and
older. The data was retrieved and analyzed using the Statistical Package for Social
Science (SPSS) database by IBM for Windows to evaluate and analyse the findings and
determine the statistical significance. The data was analysed using frequencies,
descriptive statistics, cross-tabulations, reliability and confirmatory factor analysis. A p-
value of 5 per cent was used to determine the level of statistical significance.
One thousand, one hundred and twenty-one elderly Jamaicans (ages 55+ years) were
used to assess the validity and reliability of the Mental Fatigue Scale (MFS). The 14
items scale had a reliability of 0.948, which is extremely good to assess mental fatigue
among Jamaicans 55 years and older. The fourteen items' Likert-scale mental fatigue
scale’s (MFS) descriptive statistics lie between 0.51 and 0.75, with the inter-item
correlation lying between 0.430 and 0.720 (of which 3 correlation coefficients were
more than 0.69). The communalities value for the 14-item Likert scale construct lie
between 0.556 and 0.760, with one value less than 0.6. The Kaiser-Meyer-Olkin
Measure of Sampling Adequacy (KMO) was 0.963 and Bartlett’s test was 10965.554
with a P<0.0001 (Knight, 2021; Lebrasseur et al., 2021; Koma et al., 2020; Little, 2016;
Marra et al., 2003). For the 14 items, the total variance explained was 67.128%, with
two Eigenvalues being at least one. The Component Correlation Matrix value was
0.728. Hence, by way of the Principal Component Analysis (PCA), the 14 items are
suitable and appropriate for measuring mental fatigue among those 55 years, and older
in Jamaica. The MFS was computed by summing the 7-point Likert scale 14 items and
higher scores indicate a greater level of mental fatigue among the sampled respondents.
The scores were classified as no mental fatigue (i.e., scores from 0 - 10), slight mental
fatigue (i.e., scores from 10.5 to 14.5), fairly serious mental fatigue (i.e., scores from
15-20), and serious mental fatigue (i.e., scores from 20.5 and beyond).
Table 1 presents the demographic characteristics of the sampled respondents
(n=1120). The majority of the respondents were female (52.5%, n=588), between the
ages group of Approaching Old (55-64 years) (46.4%, n= 520, and resided in Kingston
and St. Andrew (24.1%, n=270). Most respondents were married (35.2%, n=395), and
secondary education was the highest level of education completed (42.3%, n= 474).
Table 1. Sociodemographic characteristics.
Category
Frequency [N] (Percentage, %)
Age (years)
Approaching old (55-64)
520 (46.4)
Young old (65-74)
334 (29.8)
Old-Old (75-84)
166 (14.8)
Oldest old (85+)
101 (9)
Gender
Male
528 (47.1)
Female
588 (52.5)
Non-binary
4 (0.4)
Area of residence
Kingston/St. Andrew
270 (24.1)

Bourne et al.: Mental fatigue among Jamaican: Post Covid-19.
- 5 -
QUANTUM JOURNAL OF MEDICAL AND HEALTH SCIENCES 2(2): 1-12.
eISSN: 2785-8243
www.qjmhs.com
St. Elizabeth
60 (5.4)
Clarendon
98 (8.7)
Manchester
105 (9.4)
St. Catherine
204 (18.2)
St. Thomas
38 (3.4)
Hanover
28 (2.5)
Westmoreland
66 (5.9)
St. Mary
43 (3.8)
Portland
34 (3.0)
St. James
75 (6.7)
Trelawny
31 (2.8)
St. Ann
68 (6.1)
Highest level of education completed
Tertiary
371 (33.1)
Secondary
474 (42.3)
Primary
232 (20.7)
None
43 (3.8)
Marital status
Single
160 (14.3)
Married
395 (35.2)
Widowed
187 (16.7)
Divorced
128 (11.4)
Common law union
161 (14.4)
Separated
89 (7.9)
Figure 2 shows a bar graph representing the percentage of each age group of
sampled respondents (n=1120). Most of the respondents fall under the approaching old
(55-64 years) age group (46.4%, n=520) and the least respondents are from the oldest
old (85+ years) age group (9.0%, n=101). Of the sampled respondents (n=1121), 99.9%
were used for assessing mental fatigue (n=1120). Figure 2 depicts the categorization of
the Mental Fatigue Scale (MFS) among Jamaicans 55+ years post-COVID-19. Sixty per
cent of the respondents (n=672) were classified as not experiencing mental fatigue at the
time of this study (i.e., 3 in every 5 Jamaicans 55+ years old). However, 40% were
classified as having different levels of mental fatigue (i.e., 2 in every 5 Jamaicans 55+
years old), with 10% having serious mental fatigue (i.e., 1 in every 10 Jamaicans 55+
years old).

Bourne et al.: Mental fatigue among Jamaican: Post Covid-19.
- 6 -
QUANTUM JOURNAL OF MEDICAL AND HEALTH SCIENCES 2(2): 1-12.
eISSN: 2785-8243
www.qjmhs.com
Figure 2. Mental fatigue scale (MFS) among Jamaicans 55+ years.
Table 2 presents a cross-tabulation between the Mental Fatigue Scale (MFS) and the
gender of the sampled respondents. The findings revealed that more of the female-
sampled respondents had a higher level of mental fatigue (43.9%, n=258) compared to
the male (35.6%, n=188) and those who classify themselves as non-binary gender (50%,
n=2), χ2(df=6)=15.983, P=0.014). Furthermore, 10.7% (n=63) of the female-sampled
respondents were classified as having serious mental fatigue compared to 12.2% (n=54)
of the male-sampled respondents, and none of those in the non-binary gender
classification.
Table 2. A cross-tabulation between the mental fatigue scale and gender.
Mental fatigue scale (MFS)
Gender
Total
[N (%)]
Male [N (%)]
Female [N (%)]
Non-binary [N (%)]
No mental fatigue
340 (64.4)
330 (56.1)
2 (50.0)
672 (60.0)
Slight mental fatigue
80 (15.2)
101 (17.2)
0 (0.0)
181 (16.2)
Fairly serious mental fatigue
54 (10.2)
94 (16.0)
2 (50.0)
150 (13.4)
Serious mental fatigue
54 (10.2)
63 (10.7)
0 (0.0)
117 (10.4)
Total
528 (100)
588 (100)
4 (100)
1120 (100)
Notes: N=Frequency; %=Percentage
Table 3 presents a cross-tabulation between the Mental Fatigue Scale (MFS) and the
age cohort of the sampled respondents. The findings revealed that most of those in the
oldest-old age cohort were classified with different levels of mental fatigue (67.3%,
n=68) followed by those in the old-old age cohort (44.0%, n=73), those in the young-old
age cohort (38.4%, n=128), and those approaching old age (34.4%, n=179), χ2
(df=9)=67.474, P<0.001). Furthermore, 26.7% (n=27) of the oldest-old sampled
respondents were classified as having serious mental fatigue compared to 15.7% (n=26)
of those in the old-old age cohort, and so forth. Table 4 presents a cross-tabulation
between the Mental Fatigue Scale (MFS) and the educational level of the sampled
respondents. The findings revealed that most of those in primary-level education were
classified with different levels of mental fatigue (55.6%, n=129) followed by those with
secondary-level education (43.9%, n=208), χ2 (df=9)=65.339, P<0.001). Furthermore,
16.8% (n=39) of those with primary-level education were classified as having serious
mental fatigue compared to 14.0% (n=6) of those with no educational level, and so
forth.

Bourne et al.: Mental fatigue among Jamaican: Post Covid-19.
- 7 -
QUANTUM JOURNAL OF MEDICAL AND HEALTH SCIENCES 2(2): 1-12.
eISSN: 2785-8243
www.qjmhs.com
Table 3. A cross-tabulation between mental fatigue scale and age cohort.
Mental fatigue scale (MFS)
Age cohort (years)
Total
[N (%)]
Approaching old
(55-64)
[N (%)]
Young-old
(65-74)
[N (%)]
Old-old
(75-84)
[N (%)]
Oldest-old
(85+)
[N (%)]
No mental fatigue
341 (65.6)
205 (61.6)
93 (56.0)
33 (32.7)
672 (60.0)
Slight mental fatigue
89 (17.1)
53 (15.9)
23 (13.9)
16 (15.8)
181 (16.2)
Fairly serious mental fatigue
56 (10.8)
45 (13.5)
24 (14.5)
25 (24.8)
150 (13.4)
Serious mental fatigue
34 (6.5)
30 (9.0)
26 (15.7)
27 (26.7)
117 (10.4)
Total
520 (100)
333 (100)
166 (100)
101 (100)
1120 (100)
Notes: N=Frequency; %=Percentage
Table 4. A cross-tabulation between mental fatigue scale and educational level.
Mental fatigue scale (MFS)
Education level
Total
[N (%)]
Tertiary
[N (%)]
Secondary
[N (%)]
Primary
[N (%)]
None
[N (%)]
No mental fatigue
276 (74.4)
266 (56.1)
103 (44.4)
27 (62.8)
672 (60.0)
Slight mental fatigue
37 (10.0)
92 (19.4)
45 (19.4)
7 (16.3)
181 (16.2)
Fairly serious mental fatigue
32 (8.6)
70 (14.8)
45 (19.4)
3 (7.0)
150 (13.4)
Serious mental fatigue
26 (7.0)
46 (9.7)
39 (16.8)
6 (14.0)
117 (10.4)
Total
371 (100)
474 (100)
232 (100)
43 (100)
1120 (100)
Notes: N=Frequency; %=Percentage
Table 5 presents a cross-tabulation between the Mental Fatigue Scale (MFS) and the
union status of the sampled respondents. The findings revealed that most of the
widowed sampled respondents were classified with different levels of mental fatigue
(56.6%, n=106) followed by those in the separated union status (42.2%, n=54), and so
forth, χ2 (df=15)=62.136, P<0.001). Furthermore, 20.3% (n=38) of the widowed
sampled respondents were classified as having serious mental fatigue compared to
11.80% (n=6) of those in common-law unions, and so forth. Table 6 presents an
Ordinary Least Square (OLS) model of Mental Fatigue by selected socio-demographic
variables. One thousand one hundred and twenty respondents were used to establish this
OLS model. Based on the ANOVA test, OLS can be used for the mental fatigue
estimators (i.e., F[13, 1106]=13.940, P<0.001). This study tests the hypothesis that
mental fatigue is influenced by the age, gender, educational status, and marital status of
respondents who are 55+ years old in Jamaica (Eq. (1):
MF=ƒ(A, G, ED, MS) Eq. (1)
Where; MF is mental fatigue by way of the Mental Fatigue Scale, A denotes the age
cohorts, G represents the gender of the respondents, ED is the educational level/status,
and MS is the marital status of the respondent. Based on the OLS estimator model
(Table 6), mental fatigue among Jamaicans ages 55+ years old is influenced by A, G,
and ED. The three estimates of mental fatigue for Jamaicans ages 55+ years account for
13.1% of the variability in mental fatigue (i.e., adjusted R squared value).
Table 5. A cross-tabulation between mental fatigue scale and union status.
Mental fatigue scale
(MFS)
Education level
Total
[N (%)]
a
[N (%)]
b
[N (%)]
c
[N (%)]
d
[N (%)]
e
[N (%)]
f
[N (%)]
No mental fatigue
94 (58.8)
263 (66.6)
81 (43.3)
74 (57.8)
108 (67.1)
52 (58.4)
672 (60.0)
Slight mental fatigue
37 (23.1)
60 (15.2)
26 (13.9)
24 (18.8)
21 (13.0)
13 (14.6)
181 (16.2)
Fairly serious mental fatigue
18 (11.3)
45 (11.4)
42 (22.5)
18 (14.1)
13 (8.1)
14 (15.7)
150 (13.4)

Bourne et al.: Mental fatigue among Jamaican: Post Covid-19.
- 8 -
QUANTUM JOURNAL OF MEDICAL AND HEALTH SCIENCES 2(2): 1-12.
eISSN: 2785-8243
www.qjmhs.com
Serious mental fatigue
11 (6.9)
27 (6.8)
38 (20.3)
12 (9.4)
19 (11.8)
10 (11.2)
117 (10.4)
Total
160 (100)
395 (100)
187 (100)
128 (100)
161 (100)
89 (100)
1120 (100)
Notes: N=Frequency; %=Percentage; a=single; b=married; c=widowed; d=divorced;
e=common law union; f=separated.
Table 6. Ordinary least square (OLS) model of mental fatigue by selected socio-
demographic variables (n=1020).
Model
Unstandardized
coefficient
Standardized
coefficient
t
p-value
95.0% CI
B
Std.
Error
Beta
Lower
bound
Upper
bound
Constant
5.952
1.389
-
4.284
<0.001
3.226
8.678
Female
1.259
0.472
0.076
2.669
0.008
0.334
2.184
Non-binary
1.902
3.903
0.014
0.487
0.626
-5.757
9.561
Reference male
1.000
-
-
-
-
-
-
Young old
0.670
0.551
0.037
1.214
0.225
-0.412
1.752
Old-old
2.188
0.712
0.094
3.073
0.002
0.791
3.586
Oldest old
5.973
0.863
0.206
6.918
<0.001
4.279
7.667
Reference (approaching old)
1.000
-
-
-
-
-
-
Tertiary
-1.232
1.273
-0.070
-0.968
0.333
-3.729
1.265
Secondary
1.431
1.249
0.085
1.146
0.252
-1.019
3.882
Primary
3.652
1.291
0.178
2.828
0.005
1.118
6.186
Reference (No formal education)
1.000
-
-
-
-
-
-
Married
-0.647
0.733
-0.037
-0.882
0.378
-2.086
0.792
Widowed
2.963
0.849
0.133
3.489
<0.001
1.297
4.629
Divorced
0.908
0.926
0.035
0.980
0.327
-0.910
2.726
Common law
0.181
0.873
0.008
0.208
0.836
-1.532
1.895
Separated
0.456
1.028
0.015
0.444
0.657
-1.561
2.474
Reference (single)
1.000
-
-
-
-
-
-
The Coronavirus disease 2019 (COVID-19) was a biological disease (Knight, 2021;
Dehghani and Masoumi, 2020; WHO, 2020; Zhang et al., 2020; Marra et al., 2003),
with psychosocial components (Hosseini-Nezhad et al., 2022; Kelly, 2021; Pereira et
al., 2020; Saladino et al., 2020; Raza et al., 2020; Zou et al., 2020); with little emphasis
placed on the latter at the onset of the outbreak. Hosseini-Nezhad et al (2022) noted,
“The pandemic has had an overall detrimental effect on everyone to some extent, with a
disproportionate impact on more vulnerable populations” (Hosseini-Nezhad et al.,
2022), which is the rationale for the current study. The present study examines those
55+ years old which is a vulnerable population within all contemporary societies, the
elderly. This cohort is frequently studied in the area of gerontology. Gerontology is
described by Encyclopedia Britannica as the scientific study of the phenomenon of
ageing, which includes the gradual changes that occur in a cell, a tissue, an organ
system, a whole organism, or a collection of organisms over time (Britannica, 2021).
Researchers focused on developing a broad understanding of the experiences of people
at specific ages, such as mental and physical well-being. The older adult population can
be divided into three life-stage subgroups: the young-old (approximately 65-74), the
middle-old (ages 75-84), and the old-old (over age 85). Today’s young-old age group is
generally happier, healthier, and financially better off than the young-old of previous
generations (Little, 2016). The present study examines a vulnerable population from a
psychological perspective, mental fatigue more so post COVID-19.
Using statistics for 2018, 13.0% of the population in Jamaica are 60+ years old (i.e.,
355,574/2,727,503*100), 18.0% are 55+ years old (492,221/2,727,503*100), and 9.2%
are 65+ years (249,789/2,727,503*100) (Statistical Institute of Jamaica, 2018). The
researchers of this current study included persons 55 years and older simply because
those 55-64 years are approaching young old age and will be classified into the elderly

Bourne et al.: Mental fatigue among Jamaican: Post Covid-19.
- 9 -
QUANTUM JOURNAL OF MEDICAL AND HEALTH SCIENCES 2(2): 1-12.
eISSN: 2785-8243
www.qjmhs.com
population (65+ years) in less than a decade and some in 12 months. Sabharwal et al.
(2015) opined, “Although persons who are 65 years of age were commonly described as
elderly, this accounted for less than half of the studies we examined. Furthermore, there
is considerable heterogeneity amongst these definitions of elderly age with a range of
50-80 years of age observed within the observed orthopaedic studies” (Sabharwal et al.,
2015), which provides a context for studying those 55 years and older in Jamaica. Data
was collected via a Google Document form for an online survey, which was developed
through the use of the Mental Fatigue Scale by Johansson and Ronnback (2014), who
created the original survey (Johansson and Ronnback, 2014) and permitted use in this
current research. The Mental Fatigue Scale aids in investigating if the elderly
experienced having a hard time paying attention to information, understanding new
information, making decisions and plans, solving problems, focusing their thoughts, and
remembering things (Dhakal and Bobrin, 2023; NYC Langone Hospitals, 2023;
Harvard Medical School, 2022; Howieson, 2015; Alhola and Polo-Kantola, 2007;
Glisky, 2007). The current study will provide some context of the challenges
experienced by those 55+ years in Jamaica post COVID-19 by examining their mental
fatigue.
Of the sampled respondents in the present research, 40% of them experienced some
level of mental fatigue during the post COVID-19 era (i.e., October 1, 2022, to
December 1, 2022). On reviewing the literature, no studies emerged that examined
mental fatigue during COVID-19 and post-COVID-19 in Jamaica, which means there
can be no comparison of the findings in this study and others. However, a study
conducted by Morgul et al. (2021) and Zou et al. (2020) between May 22 to July 15,
2020, in four outpatient geriatric psychiatry facilities in China (i.e., Beijing Anding
Hospital, Guangji Hospital, Lanzhou University Second Hospital, and Xiamen Xianyue
Hospital) found that 47.1% of the 1063 patients experienced mental fatigue.
Furthermore, 67.3% of those 85+ years old in Jamaica experienced some degree of
fatigue compared to 44.1% of those 75-84 years old, 38.4% of those 65-74 years old,
and 34.4% of those 55-64 years old. The mental fatigue of those 85+ years old in
Jamaica is 1.4 times more than elderly psychiatric outpatients in four locations in China.
Although a high per cent of Jamaicans 55+ years old experienced some degree of
mental fatigue a study in Istanbul, Turkey, between March and June 2020 found that
64.1% of 4,700 sampled respondents experienced some degree of mental fatigue
(Morgul et al., 2021). Although the per cent of those who experienced mental fatigue
was extremely high among those 85+ years in Jamaica this is in keeping with a study
conducted by Moreh et al. (2010). In a Jerusalem, Longitudinal Cohort Study, Moreh et
al. (2010) found that 68% of those 85+ years experienced mental fatigue, which is
similar to the results of the current study.
Conclusion
The purpose of this study was to determine how COVID-19 affects mental fatigue in
the elderly, fifty-five years and older in Jamaica. The Mental Fatigue Scale constructed
by Lars Rönnbäck and Birgitta Johansson was used to create the survey that was sent
out. Most of the elderly 55 years and older did not experience Mental Fatigue post-
COVID-19 era; but those 85+ years and older substantially experienced mental fatigue
(67.1%). The vast majority of respondents said they did not feel mentally fatigued by
COVID-19, while a small percentage said they were. Individuals could practice some of

Bourne et al.: Mental fatigue among Jamaican: Post Covid-19.
- 10 -
QUANTUM JOURNAL OF MEDICAL AND HEALTH SCIENCES 2(2): 1-12.
eISSN: 2785-8243
www.qjmhs.com
these activities to help reduce the likelihood of mental fatigue in the elderly during
future pandemics: spending time in nature, discovering and engaging in a hobby,
limiting screen time, taking breaks when jobs or tasks become too demanding,
organizing with friends and family group sessions for bonding time, either online or in
person and reducing the amount of noise you are exposed to. The Government of
Jamaica (GOJ) is committed to making sure that the elderly populations live in a society
that upholds their rights and supports their health and safety. As result, the GOJ offers a
wide range of assistance services to Jamaica's senior citizens through the National
Council for Senior Citizens (NCSC), Golden Age Home, and MOHW's Mental Health
Unit. Therefore, the offering of seminars, outreach, or meetings to educate the elderly
about these services and what they can do to reduce their chance of experiencing mental
fatigue may be beneficial.
Acknowledgement
This research study is self-funded.
Conflict of interest
The authors confirm that there is no conflict of interest involve with any parties in
this research.
REFERENCES
[1] Academic Support for Nursing Students (2022): Concept analysis: Causes and effects of
compassion fatigue. – Business Bliss Official Portal 9p.
[2] Alhola, P., Polo-Kantola, P. (2007): Sleep deprivation: Impact on cognitive performance.
– Neuropsychiatric Disease and Treatment 3(5): 553-567.
[3] Bourne, P.A., Eldermire-Shearer, D. (2018): Population Ageing and the State of the
Elderly, with Emphasis on Aged Jamaicans. – MOJ Gerontol Ger 3(1): 89-102.
[4] Chachula, K.M. (2022): A comprehensive review of compassion fatigue in pre-licensure
health students: antecedents, attributes, and consequences. – Current Psychology 41(9):
6275-6287.
[5] Charan, J., Biswas, T. (2013): How to calculate sample size for different study designs in
medical research? – Indian Journal of Psychological Medicine 35(2): 121-126.
[6] Comfort, A. (2021): Gerontology and geriatrics. – Britannica Official Portal. Retrieved
from:
https://www.britannica.com/science/gerontology
[7] Dawson, C. (2019): Introduction to research methods. – Robinson 160p.
[8] Dehghani, A., Masoumi, G. (2020): Could SARS-CoV-2 or COVID-19 be a biological
weapon? – Iranian Journal of Public Health 49(Suppl 1): 143-144.
[9] Dhakal, A., Bobrin, B.D. (2023): Cognitive deficits. – National Library of Medicine 9p.
[10] Figley, C.R. (1995): Compassion fatigue: Toward a new understanding of the costs of
caring. – Sidran Press 28p.
[11] Glisky, E.L. (2007): Changes in cognitive function in human aging. – Brain Aging 20p.
[12] Harvard Medical School (2022): How aging affects focus. – Harvard Health Publishing
Official Portal. Retrieved from:
https://www.health.harvard.edu/staying-healthy/how-aging-affects-focus

Bourne et al.: Mental fatigue among Jamaican: Post Covid-19.
- 11 -
QUANTUM JOURNAL OF MEDICAL AND HEALTH SCIENCES 2(2): 1-12.
eISSN: 2785-8243
www.qjmhs.com
[13] Hosseini-Nezhad, S., Safdar, S., Hosseini-Nezhad, P., Luu, L. A.N. (2022): Psychological
Perspectives on COVID-19. – Socioeconomic Dynamics of the COVID-19 Crisis:
Global, Regional, and Local Perspectives 31p.
[14] Howieson, D.B. (2015): Cognitive skills and the aging brain: what to expect. – In
Cerebrum: The Dana Forum on Brain Science, Dana Foundation 13p.
[15] Johansson, B., Ronnback, L. (2014): Evaluation of the mental fatigue scale and its
relation to cognitive and emotional functioning after traumatic brain injury or stroke. –
International Journal of Physical Medicine and Rehabilitation 2(1): 7p.
[16] Kelly, M.P. (2021): The relation between the social and the biological and COVID-19. –
Public Health 196: 18-23.
[17] Knight, D. (2021): COVID-19 pandemic origins: bioweapons and the history of
laboratory leaks. – Southern Medical Journal 114(8): 465-467.
[18] Koma, W., True, S., Fuglesten Biniek, J., Cubanski, J., Orgera, K., Garfield, R. (2020):
One in four older adults report anxiety or depression amid the COVID-19 pandemic. –
KFF-Medicare. Retrieved from:
https://www.kff.org/medicare/issue-brief/one-in-four-older-adults-report-anxiety-or-
depression-amid-the-covid-19-pandemic/
[19] Lebrasseur, A., Fortin-Bédard, N., Lettre, J., Raymond, E., Bussières, E.L., Lapierre, N.,
Faieta, J., Vincent, C., Duchesne, L., Ouellet, M.C., Gagnon, E. (2021): Impact of the
COVID-19 pandemic on older adults: rapid review. – JMIR Aging 4(2): 18p.
[20] Little, W. (2016): Aging and the elderly. – Introduction to Sociology-2nd Canadian
Edition 417p.
[21] Marra, M.A., Jones, S.J., Astell, C.R., Holt, R.A., Brooks-Wilson, A., Butterfield, Y.S.,
Khattra, J., Asano, J.K., Barber, S.A., Chan, S.Y., Cloutier, A. (2003): The genome
sequence of the SARS-associated coronavirus. – Science 300(5624): 1399-1404.
[22] Moreh, E., Jacobs, J.M., Stessman, J. (2010): Fatigue, function, and mortality in older
adults. – Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences
65(8): 887-895.
[23] Morgul, E., Bener, A., Atak, M., Akyel, S., Aktaş, S., Bhugra, D., Ventriglio, A., Jordan,
T.R. (2021): COVID-19 pandemic and psychological fatigue in Turkey. – International
Journal of Social Psychiatry 67(2): 128-135.
[24] Mosler, M. (2015): A note on the multiplying factors for various chi-square
approximations. – Journal of the Royal Statistical Society 16: 396-398.
[25] NYU Langone Health (2023): Diagnosing memory loss. – NYU Langone Health Official
Portal. Retrieved from:
https://nyulangone.org/conditions/memory-loss/diagnosis
[26] Pereira, L.J., Pereira, C.V., Murata, R.M., Pardi, V., Pereira-Dourado, S.M. (2020):
Biological and social aspects of Coronavirus Disease 2019 (COVID-19) related to oral
health. – Brazilian Oral Research 34: 11p.
[27] Raza, S.H., Haq, W., Sajjad, M. (2020): COVID-19: a psychosocial perspective. –
Frontiers in Psychology 11: 12p.
[28] Sabharwal, S., Wilson, H., Reilly, P., Gupte, C.M. (2015): Heterogeneity of the definition
of elderly age in current orthopaedic research. – Springerplus 4: 1-7.
[29] Saladino, V., Algeri, D., Auriemma, V. (2020): The psychological and social impact of
Covid-19: new perspectives of well-being. – Frontiers in Psychology 11: 6p.
[30] Statistical Institute of Jamaica (2018): Population statistic. – Statistical Institute of
Jamaica Official Portal. Retrieved from:
https://statinja.gov.jm/Demo_SocialStats/PopulationStats.aspx
[31] Webb, L.M., Chen, C.Y. (2022): The COVID‐19 pandemic's impact on older adults'
mental health: Contributing factors, coping strategies, and opportunities for improvement.
– International Journal of Geriatric Psychiatry 37(1): 7p.
[32] World Health Organization (WHO) (2022): Coronavirus disease (COVID-19). – WHO
Official Portal. Retrieved from:

Bourne et al.: Mental fatigue among Jamaican: Post Covid-19.
- 12 -
QUANTUM JOURNAL OF MEDICAL AND HEALTH SCIENCES 2(2): 1-12.
eISSN: 2785-8243
www.qjmhs.com
https://covid19.who.int/region/euro/country/ch
[33] Zhang, X.Y., Huang, H.J., Zhuang, D.L., Nasser, M.I., Yang, M.H., Zhu, P., Zhao, M.Y.
(2020): Biological, clinical and epidemiological features of COVID-19, SARS and
MERS and AutoDock simulation of ACE2. – Infectious Diseases of Poverty 9(04): 10-
20.
[34] Zou, S., Liu, Z.H., Yan, X., Wang, H., Li, Y., Xu, X., Du, X., Zhang, L., Zhang, Q.,
Jackson, T., Ungvari, G.S. (2020): Prevalence and correlates of fatigue and its association
with quality of life among clinically stable older psychiatric patients during the COVID-
19 outbreak: a cross-sectional study. – Globalization and Health 16: 7p.