Tele-Rehabilitative Exercise Training Program in Nurses With Long COVID

The Chinese version of the Fatigue Severity Scale (CFSS) (Wang et al., 2016) assesses the severity of fatigue in the participants. The scale is a self-administered questionnaire. The scale evaluates the severity of fatigue symptoms and their impact on daily activities over the past two weeks. It consists of 9 items, rated on a 7-point scale, with scores ranging from 1 to 7, where 1 indicates strong disagreement and 7 indicates strong agreement. The minimum score is 9, and the maximum score is 63. Higher scores indicate more severe fatigue, with a total score of 36 (inclusive) or higher indicating severe fatigue.

It means the heart pumps O2 volume by each heart beat, and also means left ventricle function.

Maximal VO2 during testing, also means aerobic capacity

Maximal Working load during testing

Heart rate recovery is measured by recording your heart rate immediately after stopping exercise, and then at intervals (e.g., 1 minute and 2 minutes) after the exercise ends, which reflects autonomic nervous system function.

The point during exercise at which lactate (a byproduct of anaerobic metabolism) starts to accumulate in the blood faster than it can be removed. This indicates a shift from primarily aerobic energy production to more anaerobic energy production.

This study uses the Chinese version of the Post-COVID-19 Functional Status Scale (PCFS) translated by Liao and Cheng (2023), which was originally developed by Frederikus A. Klok. It assesses changes in daily living, work and study activities, social activities, and overall functional status over the past week (Klok et al., 2020). The scale consists of two parts: the functional status scale and the symptom checklist. The first part, the functional status scale, is divided into five levels from 0 to 4. The second part, the post-infection symptom checklist, checks for specific symptoms that appear after COVID-19 infection. It is divided into five levels. This checklist evaluates respiratory, cardiovascular, gastrointestinal, neurological, psychological, and musculoskeletal symptoms.

The indicator of quality of life in this study will use Taiwan Concise Version of the World Health Organization Quality of Life Questionnaire (WHOQOL) to evaluate. The Taiwan version development team led by Yao Kaiping developed a brief version of the questionnaire (WHOQOL-BREF) based on WHOQOL-100. The questionnaire includes 1 question measuring the overall quality of life, 1 question measuring general health, and 7 questions measuring the physical domain. , 6 questions measure the psychological domain (psychological domain), 3 questions measure the social relationship domain (social relationships domain), and 8 questions measure the environment domain (environment domain), and add 1 local question to the social relationship and environment domains, totaling 28 questions. The item is a 5-point scale, with higher scores indicating a higher quality of life. The total score ranges from 25 to 140.

The Chinese version of the Perceived Stress Scale (PSS) measures the perception of stress (Chiu, 2012). The original scale was developed by Cohen et al. (Cohen et al., 1983). The Chinese version has shown good reliability and validity in a study of nurses in Taiwan, with a Cronbach's alpha of 0.73. The scale is a self-administered questionnaire that measures the level of perceived stress in the past month. It consists of 14 items, all rated using a Likert scale with five response options: "Never," "Occasionally," "Sometimes," "Often," and "Always" (0-4 points). Seven of the items (4, 5, 6, 7, 9, 10, 13) are positive questions that need to be reverse-scored. The total score ranges from 0 to 56, with higher scores indicating higher perceived stress. A score of 0-28 is considered within the normal stress range, 29-37 indicates high stress, and 38-56 suggests the need to seek external support.