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FAKTOR DETERMINAN KASUS Open Defecation Free (ODF) DI DESA DINGIL KECAMATAN JATIROGO KABUPATEN TUBAN TAHUN 2020 Hasanah, Uswatun; ., Winarko; Suryono, Hadi
Jurnal Higiene Sanitasi Vol. 2 No. 1 (2022): April 2022
Publisher : Jurusan Kesehatan Lingkungan Poltekkes Kemenkes Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36568/hisan.v2i1.3

Abstract

A family latrine is a building that is used to dispose of human feces or najis for a family which is commonly called a latrine or WC. For houses that do not have latrines, it is certain that they will use rice fields, rivers, gardens, ponds, or other places to defecate. Dingil Village in Jatirogo District has 1,011 houses with the highest number of Open Defecation (OD) namely 199 houses (20%) still open defecation, 812 houses have access to healthy latrines. The purpose of this study was to determine the determinant factors associated with the high number of OD in Dingil Village, Jatirogo District, Tuban Regency. This study uses an analytical method with a case control approach. Data was collected by interview and observation using a questionnaire sheet and instruments. The population in this study was 199 houses consisting of 66 people defecating (case group) and 66 people defecating in the toilet (as control). The data obtained were then analyzed using the Odds Ratio. The results showed that the aspects of knowledge, attitude and availability of good clean water turned out to be more than 65% of the community still defecating in any place, except for the type of good latrine, only 18.2% were open defecation. Knowledge, attitude and availability of clean water are not determinants of the high number of OD, except the type of latrine is a determinant factor of the high number of OD. It is recommended that the community no longer use rice fields, rivers, swamps for open defecation, share with family members whose houses are close together and apply a clean and healthy lifestyle to create an environment free of dirt/feces.
DESCRIPTION OF WORKERS' KNOWLEDGE AND ATTITUDES TOWARDS FIRE HAZARDS IN THE CHEMICAL MANUFACTURING INDUSTRY IN 2021 Rizkhe Safina; Suryono, Hadi; Ngadino; Winarko
Jurnal Higiene Sanitasi Vol. 1 No. 1 (2021): Oktober 2021
Publisher : Jurusan Kesehatan Lingkungan Poltekkes Kemenkes Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

The level of knowledge and attitudes could affect workers in dealing with fire hazards. The purpose of this study was to describe the knowledge and attitudes of workers towards fire hazards (based on age, education, length of service, and fire simulation) at the chemical manufacturing industry.Type of research was descriptive. The sampling technique used was simple random sampling. The data that had been obtained was then analyzed descriptively by describing the data that had been collected. The results of the analysis were categorized and then described in the form of a narrative.From the results of the study indicate that the level of knowledge of respondents with a good category with a percentage of 95, 4% and respondents with a sufficient category with a percentage of 4, 6%. The attitude of the respondents in the category of strongly agreed with the percentage of 55%, the attitude of the respondents with the category of agreeing with the percentage of 43.1%, and the attitude of the respondents in the category of disagreeing with the percentage of 1.8%. the level pf knowledge and attitude of workers in the chemical manufacturing industry was influenced by age, education, length of work, and fire simulation. The advice given is that the company paid more attention to workers who have never participated in a fire simulation and installed posters to increase worker awareness in responding to fire hazards.
Pengaruh Beban Kerja Fisik, Usia, Durasi Kerja, dan Kecukupan Tidur terhadap Kelelahan Kerja Swindriaswara; Winarko; Ngadino; Demes Nurmayanti; Pratiwi Hermiyanti
Jurnal Higiene Sanitasi Vol. 4 No. 2 (2024)
Publisher : Jurusan Kesehatan Lingkungan Poltekkes Kemenkes Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36568/hisan.v4i2.95

Abstract

Keselamatan dan Kesehatan Kerja perlu diperhatikan di pertambangan batu kapur agar terhindar dari kecelakaan kerja dan kelelahan. Kelelahan bisa dipengaruhi beban kerja fisik, usia, durasi kerja, dan kecukupan tidur. Sebanyak 8 pekerja CV X sebesar 75% mengalami kelelahan kerja dengan 62.5% pekerja mengalami beban kerja fisik berat. Tujuan dari studi ini guna menganalisis pengaruh beban kerja fisik, usia, durasi kerja, dan kecukupan tidur terhadap kelelahan kerja di CV X. Penelitian ini menerapkan desain observasional analitik dan pendekatan cross-sectional. Besar sampel 29 pekerja dipilih secara simple random sampling dari 30 pekerja, variabel beban kerja fisik, usia, durasi kerja, kecukupan tidur, dan kelelahan kerja dikumpulkan melalui pengukuran wawancara. Data terkumpul, diolah, dan analisis memakai uji statistik Chi Square dengan tingkat kesalahan (α) sebesar 5%. Hasil penelitian menunjukkan bahwa dari 29 pekerja mengalami beban kerja fisik 75,9% sedang dan 24,1% agak berat, usia 72,4% > 30 tahun dan 27,6% < 30 tahun, durasi kerja 100% < 8 jam, kecukupan tidur 93,1% normal dan 6,9% tidak normal, kelelahan kerja 41,4% sedang, 41,4% tinggi, dan 17,2% sangat tinggi, 54,5% kelelahan kerja tinggi banyak dirasakan pekerja dengan bebean kerja sedang, 57,15% kelelahan kerja tinggi banyak dialami pekerja berusia > 30 tahun, serta 44,44% kelelahan kerja sedang banyak dialami pekerja dengan kecukupan tidur normal. Kesimpulan penelitian menunjukkan bahwasannya kelelahan dipengaruhi beban kerja fisik dan usia, sedangkan durasi kerja dan kecukupan tidur tidak berpengaruh. Disarankan agar pekerja mengurangi beban yang diangkat dan pekerja yang berusia > 30 tahun diberi pekerjaan bervariasi.
Basic Sanitation Factors and Clean and Healthy Living Behavior as Determinants of Stunting: A Case Study in Bondowoso Wibasusanti, Gilang Putri; Thohari, Imam; Winarko; Wardoyo, Iva Rustanti Eri; Sulistijowati; Laksono, Cahyo Widoko
Public Health Research Development Vol. 1 No. 2 (2024): Public Health Research Development
Publisher : Indonesian Association Environmental Health of West Kalimantan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36568/phrd.v1i2.11

Abstract

Stunting is a nutritional problem that remains high in Indonesia, especially in rural areas like Bondowoso. Poor basic sanitation and bad implementation of Clean and Healthy Living Behavior are often associated with stunting in children under five. This study aims to analyze the relationship between basic sanitation factors and Clean and Healthy Living Behavior as a determinant of stunting in the working area of Sempol Community Health Center in 2024. This research used a case-control study methodology in conjunction with observational analytics. The samples were houses with stunting and non-stunting toddlers in the working area of Sempol Community Health Center. The samples are 24 for each group, using a systematic random sampling technique from a population of 925 toddlers. Data analysis using the Chi-square test with 0.05 degree of error. The result of this research showed that there are differences in basic sanitation facilities of houses and Clean and Healthy Living Behavior in stunting and non-stunting toddlers in the working area of Sempol Community Health Center in 2024. Basic sanitation and Clean and Healthy Living Behavior factors are important factors in efforts to prevent stunting. Improving access to sanitation and promoting the Clean and Healthy Living Behavior program must be a priority in the Public Health Intervention Program in Bondowoso.
Evaluation of Waste Bank Management in Mojo Village, Gubeng Sub-district, Surabaya City Auly, Ahdina Khoirunnisa’ul; Hadi Suryono; Winarko; Thohari, Imam; Laksono, Cahyo Widoko; Suharno
Jurnal Higiene Sanitasi Vol. 5 No. 1 (2025)
Publisher : Jurusan Kesehatan Lingkungan Poltekkes Kemenkes Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36568/hisan.v5i1.106

Abstract

Poor waste management can lead to environmental pollution. Waste banks, based on the 3R principles (reduce, reuse, recycle), are an effort to manage waste sustainably while enhancing community income. However, the effectiveness of waste bank operations is often hampered by low community participation, suboptimal operational mechanisms, and inconsistent application of standard operating procedures (SOPs). This study aimed to evaluate the management of waste banks in Mojo Urban Village, Gubeng District, Surabaya City. A cross-sectional observational method with descriptive analysis was employed. Variables assessed included waste generation, waste sources, operational mechanisms, and SOP components across seven waste banks. Data collection involved interviews and observations. Results showed the dominant waste types were plastic (1317.3 kg, average 219.55 kg), paper (1195.7 kg, average 199.28 kg), metal (217 kg, average 36.17 kg), and glass (81 kg, average 13.5 kg), with an overall average of 1.12 kg/day per neighborhood unit (RW). Waste originated entirely from residential areas. Operational mechanisms were rated 100% compliant, while SOP implementation reached 84.3%, categorized as good. It is recommended that waste bank managers conduct monthly community education sessions on waste separation and improve the implementation of two SOP components: waste collection and waste condition requirements. Strengthening these areas can further enhance the sustainability and effectiveness of waste bank management.
Mewujudkan Pembangunan Jamban Masyarakat Desa Pagerngumbuk Kecamatan Wonoayu Kabupaten Sidoarjo Dalam Program Percepatan Odf (Open Defecation Free) Melalui Pemberdayaan Masyarakat Pencegahan Penyakit Menular Tahun 2025 Suryono, Hadi; Winarko, Winarko; Marlik, Marlik; Nurmayanti, Demes
Jurnal Kreativitas Pengabdian Kepada Masyarakat (PKM) Vol 8, No 10 (2025): Volume 8 No 10 (2025)
Publisher : Universitas Malahayati Lampung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jkpm.v8i10.22209

Abstract

ABSTRAK Tingginya angka kejadian diare pada balita di Desa Pager Ngumbuk, Kecamatan Wonoayu, Kabupaten Sidoarjo, menunjukkan adanya persoalan sanitasi lingkungan yang belum terselesaikan, khususnya terkait praktik Buang Air Besar Sembarangan (BABS). Data dari Puskesmas Wonoayu mencatat peningkatan kasus diare dari 1.147 (2021) menjadi 1.207 kasus pada 2023. Survei rumah tangga menunjukkan bahwa sebagian besar keluarga tidak memiliki jamban sehat dan jarak antara sumber air bersih dengan pencemar kurang dari 10 meter. Masalah ini diperburuk oleh rendahnya tingkat pengetahuan ibu rumah tangga mengenai perilaku hidup bersih dan sehat (PHBS). Meskipun Jawa Timur telah mencatatkan 92,78% desa berstatus ODF (Open Defecation Free), Kabupaten Sidoarjo, termasuk Desa Wonoayu, masih tertinggal dalam pencapaian tersebut. Kegiatan pengambian kepada mayrakat ini adalah untuk membangun Jamban Masyarakat Desa Pagerngumbuk Kec. Wonoayu Kab. Sidarjo Dalam Program Percepatan ODF (Open Devecation Free) melalui pemberdayaan  Masyarakiat Untuk  Pencegahan Penyakit Menular Tahun 2025.Kegiatan pengabdian masyarakat ini dilaksanakan selama Maret hingga   Oktober 2025 dengan pendekatan partisipatif dan pemberdayaan. Metode yang akan digunakan mencakup penyuluhan, Focus Group Discussion (FGD), pembangunan jamban sehat sesuai SNI2398:2017, serta monitoring dan coaching pasca pembangunan. Sasaran utama adalah lima rumah tangga prioritas yang belum memiliki jamban dan tergolong keluarga berpenghasilan rendah, dengan anggota rentan seperti balita dan lansia. Strategi cost-sharing diterapkan untuk meningkatkan rasa kepemilikan masyarakat terhadap fasilitas yang dibangun. Hasil kegiatan menunjukkan peningkatan signifikan dalam pemanfaatan jamban dan penerapan PHBS. Seluruh keluarga sasaran telah meninggalkan praktik BABS dan mulai merawat fasilitas jamban secara mandiri. Monitoring selama dua bulan menunjukkan bahwa 80% keluarga menerapkan perilaku hidup bersih secara konsisten. Strategi edukasi berkelanjutan, pelibatan tokoh masyarakat, dan pendekatan berbasis komunitas terbukti efektif dalam mendorong perubahan perilaku dan keberlanjutan program sanitasi. Keberhasilan kegiatan pengabdian masyarakat di Desa Pagerngumbuk sangat didukung oleh partisipasi dan motivasi masyarakat dan tokoh setempat.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     Kata Kunci: Pembangunan Jamban, Percepatan ODF, Masyarakat Desa Pager Ngumbuk ABSTRACT The high incidence of diarrhea in toddlers in Pager Ngumbuk Village, Wonoayu District, Sidoarjo Regency, indicates an unresolved environmental sanitation problem, particularly related to the practice of Open Defecation (BABS). Data from the Wonoayu Community Health Center recorded an increase in diarrhea cases from 1,147 (2021) to 1,207 cases in 2023. Household surveys showed that most families do not have healthy latrines and the distance between clean water sources and pollutants was less than 10 meters. This problem was exacerbated by the low level of knowledge of housewives regarding clean and healthy living behaviors (PHBS). Although East Java has recorded 92.78% of villages with ODF (Open Defecation Free) status, Sidoarjo Regency, including Wonoayu Village, was still lagging behind in achieving this goal. This community outreach activity is to build a Community Latrines in Pagerngumbuk Village, Wonoayu District, Sidoarjo Regency. Sidarjo is participating in the Open Devection Free (ODF) Acceleration Program through Community Empowerment for Infectious Disease Prevention in 2025. This community service activity will be conducted from March to October 2025 using a participatory and empowerment approach. Methods will included outreach, Focus Group Discussions (FGDs), and latrine construction. The primary target was five priority households without latrines and classified as low-income families with vulnerable members such as toddlers and the elderly. A cost-sharing strategy would be implemented to increase community ownership of the constructed facilities. The results of the activity showed a significant increasing in latrine utilization and the implementation of Clean and Healthy Living (PHBS). All target families have stopped practicing open defecation and have begun maintaining their latrine facilities independently. Two-month monitoring shows that 80% of families consistently practice clean living behaviors. The strategy of ongoing education, the involvement of community leaders, and a community-based approach have proven effective in encouraging behavior change and the sustainability of the sanitation program. The success of the community service activity in Pagerngumbuk Village is strongly supported by the participation and motivation of the community and local leaders. Keywords: Latrine Construction, ODF Acceleration, Pagerngumbuk Village Community
Analysis of Family Duty with Diet Compliance in Mellitus Diabetes Patients in the Working Area of Dinas Kesehatan, Jayawijaya District Winarko, Winarko; Indasah, Indasah
Journal for Quality in Public Health Vol. 5 No. 1 (2021): Journal for Quality in Public Health
Publisher : Master of Public Health Program Institut Ilmu Kesehatan STRADA Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30994/jqph.v5i1.260

Abstract

Non-Communicable Diseases (PTM) has become a serious health problem in the community. One PTM that has received a lot of attention is Diabetes Mellitus (DM) which occurs when the body cannot produce enough of the hormone insulin or cannot use insulin effectively. The aim of this study was to analyze the relationship between family support tasks and dietary adherence in Diabetes Mellitus patients in Jayawijaya District Health Office. The type of research used is survey research with explanatory research methods. The population in this study were 145 diabetes mellitus patients treated at the Jayawijaya District Health Office. The sample of this study were patients with militus diabetes who underwent treatment at the Jayawijaya District Health Office who met the sample criteria of 58 people. The sampling technique used in this research is purposive sampling technique. Based on the results of the study there is a relationship between family duties and dietary compliance in diabetus mellitus patients using spearman correlation calculations of 0.000 < 0.05 in addition to data obtained as many as 38 (65.5% ) respondents from 43 respondents of family duties are good and obedient to the diet diabetus mellitus, while from 13 respondents with family duties are quite obtained data as many as 7 respondents (12.1%) disobedient. And from 2 respondents with family duties, less data was obtained by 2 respondents (3.4%) disobedient. Based on the results of the research, it is hoped that further communication, information, and education (IEC) will improve regarding the dietary needs of diabetes mellitus.
Daya Proteksi Minyak Biji Ketumbar (Coriandrum sativum L.) dalam Basis Gel Hidroksipropil Metilselulosa sebagai Repelen Aedes aegypti: Protection of Coriander Seed Oil (Coriandrum sativum L.) in Hydroxypropyl Methyl Cellulose (HPMC) Gel Based as Aedes aegypti Repellent Ogotan, Zefanya Meylan Avenia Merry Prasetyo; Winarko; Sulistio, Irwan; Rusmiati
Aspirator Vol 14 No 1 (2022): Jurnal Aspirator Volume 14 Nomor 1 2022
Publisher : Perkumpulan Entomologi Kesehatan Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22435/asp.v14i1.5287

Abstract

Abstract. One of the efforts to prevent Dengue Hemorrhagic Fever is to control its vector, namely the Aedes aegypti. Research on mosquito repellents using natural active ingredients has developed a lot, for example, coriander seed extract oil (Coriandrum sativum L.). However, its pure extract is volatile and less effective when used directly as a repellent. The study aimed to analyze the effect of the hydroxypropyl methylcellulose (HPMC) gelling agent on the protective duration and power of coriander seed oil gel as a repellent against Aedes aegypti. The method used was a true experimental with posttest-only control group design. The treatment group was given coriander seed oil gel using HPMC concentrations of 7.5%, 10%, and 12.5% with six replications. The control group consisted of positive control, namely pure 60% coriander seed extract in 96% ethanol and negative control, namely the arm without any spread. Data analysis used the Mann-Whitney and Kruskal-Wallis test with a confidence level of 95%. The result showed that 7,5% of HPMC had the least number of Aedes aegypti landed for at least 6 hours with an average perch of 3.2%. The temperature and humidity of the research room were homogeneous. The addition of HPMC has increased protection and duration against the Aedes aegypti. The 7,5% HPMC result was complies to the Pesticide Commission’s standards (1995) with an average protective power of 97% for 6 hours. In conclusion, gelling agents such as HPMC can be an alternative to increase the protective power of for 6 hours. Abstrak. Satu upaya pencegahan penyakit Demam Berdarah Dengue adalah dengan mencegah kontak manusia dan vektornya, yaitu Aedes aegypti. Penelitian repelen nyamuk menggunakan bahan aktif dari alam telah banyak dilakukan, contohnya minyak ekstrak biji ketumbar (Coriandrum sativum L.). Akan tetapi, ekstrak murni biji ketumbar mudah menguap dan kurang efektif apabila digunakan secara langsung sebagai repelan Aedes aegypti. Penelitian ini bertujuan untuk menganalisis pengaruh variasi konsentrasi gelling agent hidroksipropil metilselulosa (HPMS) terhadap lama waktu perlindungan dan daya proteksi gel minyak biji ketumbar sebagai repelen terhadap Aedes aegypti. Metode penelitian ini adalah eksperimen murni dengan desain posttest-only control group design. Kelompok perlakuan diberi gel minyak biji ketumbar menggunakan konsentrasi HPMS 7,5%; 10%; dan 12,5% dengan 6 kali replikasi. Kelompok kontrol terdiri dari kontrol positif yaitu ekstrak biji ketumbar murni konsentrasi 60% dalam etanol 96% dan kontrol negatif yaitu lengan tanpa olesan apapun. Analisa data menggunakan uji Mann–Whitney dan Kruskal-Wallis dengan taraf kepercayaan 95%. Hasil penelitian menunjukan bahwa HPMS 7,5% memiliki jumlah nyamuk hinggap paling sedikit selama 6 jam pengamatan dengan rerata hinggap 3,2%. Suhu dan kelembaban ruang penelitian homogen. Penambahan HPMS terbukti memberikan peningkatan daya proteksi dan lama perlindungan yang sebelumnya belum maksimal terhadap nyamuk Aedes aegypti. Konsentrasi HPMS 7,5% sesuai standart Komisi Pestisida (1995) dengan rerata daya proteksinya adalah 97% selama 6 jam. Kesimpulan dari penelitian ini adalah gelling agent seperti HPMS dapat menjadi alternatif untuk meningkatkan daya proteksi selama 6 jam perlindungan.
Pengaruh Penggunaan APD dan Masa Kerja Terhadap Kecelakaan Kerja pada Petugas Pengolah Sampah di Depo TPS Sutorejo Surabaya Tahun 2024 Prasetiyo, Adrian Hilmy; Suryono, Hadi; Anggraeni, Sri; Winarko, Winarko; Marlik, Marlik
Buletin Keslingmas Vol. 44 No. 1 (2025): BULETIN KESLINGMAS: VOL. 44 NO. 1 TAHUN 2025
Publisher : Poltekkes Kemenkes Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31983/keslingmas.v44i1.12433

Abstract

Puncak kinerja fisik petugas pengolah limbah terjadi sekitar usia 15 tahun dan menurun seiring bertambahnya usia. Petugas pengolah limbah sering bersentuhan langsung dengan sampah, sehingga penggunaan Alat Pelindung Diri (APD) secara konsisten sangat penting. Penelitian ini bertujuan mengkaji pengaruh penggunaan APD dan masa kerja terhadap kecelakaan kerja pada petugas pengolah sampah di Depo TPS Sutorejo, Surabaya, tahun 2024. Desain penelitian yang digunakan adalah deskriptif kualitatif dengan pendekatan cross-sectional. Sampel penelitian berjumlah 29 tenaga kerja yang dipilih secara random sampling dari populasi 31 orang. Data dikumpulkan melalui observasi dan wawancara, lalu dianalisis menggunakan uji korelasi chi-square dengan α = 0,05. Hasil penelitian menunjukkan bahwa 75,8% responden mengalami kecelakaan kerja, dan 58,6% responden menggunakan APD tidak lengkap. Uji chi-square menunjukkan adanya pengaruh signifikan antara penggunaan APD terhadap kecelakaan kerja dengan p-value 0,000 (p<0,05). Selain itu, ditemukan pula pengaruh signifikan masa kerja terhadap kecelakaan kerja. Kesimpulannya, penggunaan APD dan masa kerja berpengaruh terhadap kecelakaan kerja pada petugas pengolah sampah di Depo TPS Sutorejo. Penelitian ini menyarankan pentingnya pemantauan kinerja petugas untuk meminimalkan risiko kecelakaan kerja
Characteristics and Physical Workload of Nurses on Night Shifts with Work Fatigue Octavia, Ari Dian; Nurmayanti, Demes; Darjati; Winarko; Suryono, Hadi
JURNAL INFO KESEHATAN Vol 20 No 2 (2022): JURNAL INFO KESEHATAN
Publisher : Research and Community Service Unit, Poltekkes Kemenkes Kupang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31965/infokes.Vol20.Iss2.865

Abstract

At RSUD Sidoarjo, it was discovered that 44% of nurses experienced fatigue. Fatigue occurs due to several factors, one of which is the physical workload. The objective of this study is to examine the physical workload and characteristics of nurses on night shifts on the fatigue of inpatient tulip nurses at RSUD Sidoarjo in 2022. The number of samples was 30 respondents with the sampling technique encompassing all of population of nurses on night shifts. The results demonstrated that there was no influence between physical workload on work fatigue with a value of 0.717, as well as characteristics incorporating age, length of service and gender which had no effect on work fatigue with a value of 0.636, respectively; 0.747 and 0.235. The result of the study indicates that workload, age, working period, and gender of nurses have no effect on nurses' work fatigue. The conclusion is there was no influence between physical workload and characteristics of nurses on night shifts on the fatigue of inpatient tulip nurses at RSUD Sidoarjo in 2022. It is recommended that future researchers will conduct research on nurse fatigue employing various variables such as mental workload on nurses, hospital physical environment, distance of residence, and marital or family status.