The fatigue that is observed in patients who are undergoing dialysis is usually associated with an impaired quality of life. The present cross-sectional study was conducted from January to April 2009 in three hemodialysis units in Kuala Lumpur, Malaysia. In this study, the Multidimensional Fatigue Inventory and Depression Anxiety and Stress Score 21 were used to determine the level of fatigue, depression, anxiety, and stress of patients who were undergoing dialysis. The data were obtained from a calculated sample of 116 and a total of 103 respondents participated in the study. A total of 56 (54.4%) and 47 (45.6%) respondents experienced a high level and a low level of fatigue, respectively. There was a significant relationship between the duration of treatment and the level of fatigue. The respondents who had been receiving treatment for > 2 years experienced more fatigue, compared to the respondents who had been undergoing hemodialysis for > 2 years. There was a significant difference in relation to the age of the participants regarding the level of fatigue. No significant relationship between the sex of the participants, anemia, depression, anxiety, stress, and the level of fatigue was observed. Special attention needs to be paid to both the younger and older adults who are receiving treatment. In addition, proper planning is needed for the patients regarding their daily activities in order to reduce fatigue. Nurses who work in hemodialysis units are recommended to provide exercise classes or group therapy in order to boost the energy levels among patients who are undergoing dialysis. Health professionals should provide appropriate treatment for patients who are experiencing fatigue in order to prevent any other complications that could arise.

Patient safety is crucial for health care quality and is one of the major parameters monitored by all health care organizations around the world. Nurses play a critical role in improving the quality of care and patient safety because they take care of patients for the full 24 hours and engage with families and other health professionals. Thus, this study aimed to identify patient safety culture and its associated factors among nurses in Karawang, Indonesia. This study was conducted using a cross-sectional design. It was estimated that 220 participants would be needed to have confidence in the results at a medium-effect size. A convenience sampling technique was applied to select participants. This study used the Hospital Survey on Patient Safety Culture questionnaire. Linear regression analyses were used to investigate the factors associated with patient safety culture. Most of the nurses (52.79%) had a nursing diploma and 7% had been married. Approximately 70% were nurses at the level 1 to 3 range. The mean score was 3.05 (SD = 1.43). The highest domains score was teamwork (4.03, SD = 1.76), and the lowest score was reporting patients’ safety events (2.21, SD = 1.43). Gender, education level, and working unit contributed significantly to the variance in patient safety culture and the R-squared was 28.8%. This study found that patient safety culture among nurses was moderate. Therefore, in order to improve patient safety, a training program for nurses is needed alongside strategies to improve professional communication. Keywords: patient safety, culture, nurses, Indonesia