Fatigue and resilience in Master’s and PhD students in the Covid-19 pandemic in Brazil: A cross-sectional study

Izabel Alves das Chagas Valóta; Rafael Rodrigo da Silva Pimentel; Ana Paula Neroni Stina Saura; Rodrigo Marques da Silva; Ana Lucia Siqueira Costa Calache; Marcelo José dos Santos

doi:10.1371/journal.pone.0295218

. 2023 Dec 1;18(12):e0295218. doi: 10.1371/journal.pone.0295218

Fatigue and resilience in Master’s and PhD students in the Covid-19 pandemic in Brazil: A cross-sectional study

Izabel Alves das Chagas Valóta ^1,^*,^#, Rafael Rodrigo da Silva Pimentel ^2,^#, Ana Paula Neroni Stina Saura ¹, Rodrigo Marques da Silva ³, Ana Lucia Siqueira Costa Calache ^1,^‡, Marcelo José dos Santos ^2,^‡

Editor: Pauline M Ross⁴

PMCID: PMC10691712 PMID: 38039268

Abstract

The aim of this study was to analyze levels of fatigue and resilience of Brazilian graduate students during the COVID-19 pandemic and to determine whether there is an association between fatigue and resilience and sociodemographic and academic factors. Data were analyzed using descriptive and inferential statistics, and it was discovered that the variables associated with higher levels of resilience were age; having children; being retired; receiving income above five minimum wages; having had greater problems in other phases of the research schedule; coming from private universities; being from the north of Brazil; studying the area of Health; and having their research schedule unaffected during the pandemic. On the other hand, lack of resilience was associated with not having children; being less well-off financially; being younger; being a woman; studying in a public university; and having to postpone part of the research during the pandemic. The conclusion of the study indicated the need for graduate programs to design strategies to deal with fatigue and promote resilience in Master’s and PhD students.

1. Introduction

The pandemic caused by the SARS-Cov-2 infection (COVID-19) in 2019 brought great challenges that resulted in the need for adaptation in all spheres of society and whose consequences could be observed in the functioning of institutions and social practices throughout the world. In higher education institutions this reality was no different, and institutions attempted to preserve the safety of their community and maintain public health care. Protocols were therefore adopted that transferred the traditional model of teaching and learning to a completely online form. Traditional work practices were also replaced by the remote model, and public spaces for social interaction were closed [1].

Given this scenario, graduate students, who were already in a challenging environment, marked by psychological pressure with instability [2], now had to deal with considerable changes in guidance and financial uncertainty. With the closure of physical spaces at universities, it was necessary to cancel long-term experiments and interrupt or delay the data collection period [1], change the class schedule, qualification exams, and dissertation and thesis presentations, which were now carried out remotely. In addition, graduate students had to deal with the family, personal, and emotional consequences of the new limits imposed by Covid restrictions [3], which may have impacted students’ mental health and led to fatigue.

The demands present in this situation have been found to lead to the development of mental disorders, especially in individuals who are psychologically more vulnerable [2, 4]. The mental health problems of graduate students have received attention in recent years, with the development of systematic reviews and primary studies reporting the negative psychological effects on the health of these individuals [5, 6]. A study carried out in Belgium indicates that one in two PhD students experiences psychological distress and one in three is at risk of a common psychiatric illness [7]. In the US, a study showed that 90% of doctoral students are six times more likely to have anxiety and depression compared to the general population [8].

Fatigue can be seen as a universal phenomenon, experienced by healthy and sick people. There is a consensus that it is a subjective, multifactorial and multidimensional phenomenon, understood as an unpleasant physical sensation, with cognitive and emotional components, manifested in a feeling of tiredness that is not relieved by the usual energy restoration strategies [9–11]. Manifestations of fatigue involve a decrease in self-care, physical capacity, memory and concentration, lack of interest and motivation in activities, weakness, irritability, frustration, sadness and spiritual anguish [12, 13].

Fatigue is a crucial factor to be identified in the training of students as it can affect academic success and learning [14, 15]. In the literature, fatigue has been investigated under different conditions. Among university students it has been identified as severe [15], and among doctoral students in Chiropractic [14], Medical, Social and Natural Sciences, Languages and Literatures, Mathematics and Computer Sciences it was at a moderate level [16].

In recent decades, positive psychology has emerged as an alternative in the search for psychological resources to deal with the onset of fatigue, anxiety and depression [17, 18]. Psychological constructs such as self-efficacy, resilience, hope, and optimism have played positive roles in alleviating fatigue symptoms [19].

A study carried out with doctors in China showed a high incidence of fatigue among the professionals interviewed, with resilience being negatively associated with fatigue [20]. Similar findings emerged in another study of hospital workers in South Korea, which showed that lower levels of resilience were positively associated with symptoms of physical fatigue [21].

Resilience can be conceptualized as a unidimensional or multidimensional construct [22]. Given the various definitions, several concepts have emerged [23, 24], including resilience as a personal quality that moderates the impact of negative stressors; as a necessary quality to deal with adverse and traumatic situations [22, 25]; and as an element in the interaction between the individual and biological, cognitive, interpersonal and contextual factors [22–24]. Evidence indicates that resilience can also affect perseverance, student empowerment [26] and academic success [27–30].

Fatigue and resilience are thus two phenomena that deserve attention among students, especially in challenging periods such as those of the COVID-19 pandemic. These two phenomena are present in the daily lives of students and have been little studied among graduate students in Brazil. Therefore, the following questions arose: what were the fatigue and resilience levels of master’s and doctoral students during the Covid-19 pandemic in Brazil? Was there an association between sociodemographic and academic factors with the performance of fatigue and resilience levels? This study therefore aims to analyze the level of fatigue and resilience among Brazilian Master’s and PhD students during the COVID-19 pandemic and to determine whether there is an association with sociodemographic and academic factors.

2. Method

This is an observational and cross-sectional study.

2.1 Population and recruitment

Only those graduate students aged over 18 years, enrolled in Brazilian educational institutions and who responded to all survey items, were included in this study. Students who did not answer all questions in the survey were excluded.

Data collection was carried out in online format from July to August 2020. The dissemination and invitation to participate in the research were carried out on Facebook^® and Linkedin^® through posts in research and graduate groups. Emails identified in a government repository were sent to 4,648 Master’s and PhD graduate programs throughout Brazil, with a request to circulate the survey link among students.

2.2 Measures

2.2.1 Questionnaire with sociodemographic and academic data

The collected sociodemographic and academic data questionnaire addressed age, sex, marital status, children, region of Brazil and state, monthly income, supplementary income, current course, area of knowledge, institution, Ministry of Education graduate program grade, source of income, whether monthly income was sufficient to support oneself, impact of COVID-19 on family income and on the progress of the research schedule, and phase of greatest impact. See a complete version of the questionnaire in S1 Questionnaires.

2.2.2 The Revised Piper Fatigue Scale (PFS)

The revised Piper Fatigue Scale (PFS), developed by Barbara Piper [9] and validated for use in Brazil [13, 31], assessed fatigue in a multidimensional way. It had an internal consistency of 0.94, and for the subscales it ranged between 0.84 and 0.94 (Cronbach’s alpha) [31]. In this study internal consistency presented values in the Behavioral dimensions of 0.884; Affective 0.905; Sensory 0.913; and Cognitive 0.897.

The original revised scale contained 22 items distributed in four dimensions: Behavioral/Intensity; Affective; Sensory; and Cognitive/Humour. Each dimension receives a score that corresponded to the average of the scores for each item and varies from zero to ten. Clinically, in order to consider the presence of fatigue, a score greater than four was adopted, considering the total score [31]. In addition to the 22 scored items, there were five open questions (Items 1, and 24 to 27) that were not used to calculate the instrument score. In this study, in addition to the 22 items, Item 1 was used to verify the fatigue time.

2.2.3 The Visual Analog Fatigue Scale (VAFS)

To assess the level of fatigue, the VAFS of pain intensity adapted for fatigue was used [32]. The scale went from 0 to 10 cm, with higher scores representing greater severity or intensity of fatigue, while lower scores represented mild levels of fatigue. The fatigue cut-off point was considered as mild = 1–2; moderate = 3–6 and intense = 7–10 [32].

2.2.4 The Wagnild and Young Resilience Scale

The Wagnild and Young Resilience Scale, validated in Brazil [33], was used to measure resilience levels of positive psychosocial adaptation when confronting important events. It contained 25 items on a Likert-type scale ranging from one (strongly disagree) to seven (strongly agree). It presented two factors in the original version: Factor 1 “Personal Competence”; and Factor II “Acceptance of Self and Life” [25, 33]. It had an internal consistency of 0.80 (Chronbach’s alpha) [25]. In this study in “Personal Competence” it was 0.885 and in “Acceptance of Self and Life” 0.693. The resilience scale score was obtained by the sum of the total responses of the 25 items ranging from 25 to 175 points, and the higher the score, the higher the individual’s resilience [25, 33]. A result below 120 was considered “low resilience”; between 121 and 145 “moderately low to moderate resilience”; and above 145 “moderate-high to high resilience” [34].

2.3 Data analysis

Data were collected and organized in the Research Electronic Data Capture (REDcap) software [35] and analyzed in the R software statistical package (Version 3.6.1) and in the Statistical Package for the Social Sciences (SPSS) (Version 20.0). Qualitative variables were presented as absolute (N) and relative (%) frequencies, and quantitative variables were presented as mean, standard deviation, and confidence interval (95% CI). The internal consistency of the PFS and the resilience scale were analyzed, and Cronbach’s alpha coefficients were determined considering values between 0.65 and 0.70 as acceptable, 0.70 and 0.80 as good, and 0.90 as very good.

In the bivariate analysis, non-parametric Mann-Whitney, Brunner-Munzel and Kruskal-Wallis statistical tests were applied to analyze the association between sociodemographic and numerical academic variables and the level of fatigue and resilience. To assess the effect size of the tests, the following classification was adopted: null (0 to 0.10); weak (0.11 to 0.29); moderate (0.30 to 0.49); strong (≥ 0.50) [36].

Pearson’s correlation coefficient was used to calculate the relationshi11p between fatigue and resilience in the applied scales and their dimensions and to correlate age with levels of fatigue and resilience. The following correlation coefficients (r) were established: 0.00–0.19 very weak correlation; 0.20–0.39 weak correlation; 0.40–0.59 moderate correlation; 0.60–0.79 strong correlation; and 0.80–1.00 very strong correlation [37].

The application of the Bonferroni correction on the values of the hypothesis tests adjusted the significance level for this study to 0.36% (0.0036).

2.4 Ethical aspects

This study was approved by the Research Ethics Committee of the School of Nursing at the University of São Paulo, Brazil (Opinion number: 4,420,446/2020), meeting national and international research standards.

3. Results

Of the 5,492 forms accessed, 3,331 (60.6%) fully completed the survey. The age of the participants ranged from 21 to 70 years, with a mean of 32.4 years (SD: 7.68). Most students were female (70.28%); with a partner (62.08%); without children (78.93%); residing in the Southeast region of Brazil (49.86%). 21.66% of the total number of female students had children. Income ranged from one to two times the minimum wage (47.76%), with the majority receiving some type of scholarship (49.29%), but most did not receive additional income during the pandemic (83.40%). 50.53% reported insufficient income to support themselves. However, 59.44% considered that there was no impact on their income during the pandemic (Table 1).

Table 1. Distribution of Master’s and PhD students, according to sociodemographic data (N = 3,331) Brazil, 2023.

Variables	N	%
Sex
Female	2,341	70.28
Male	990	29.72
Marital status
With partner	2,068	62.08
Without partner	1,263	37.92
Children
Yes	702	21.07
No	2,629	78.93
Region of Brazil
Centre-west	283	8.50
Northeast	544	16.33
North	76	2.28
Southeast	1,661	49.86
South	767	23.03
Income ^a
1 to 2 minimum wages	1,591	47.76
3 to 4 minimum wages	1,002	30.08
> 5 minimum wages	738	22.16
Source of income
Retired	10	0.30
Scholarship	1,642	49.29
Family resources	253	7.60
Fixed employment	1,208	36.27
Informal employment	209	6.27
Others^*	9	0.27
Complementary income ^b
Yes	553	16.60
No	2,778	83.40
Income sufficient to live on
Yes	1,648	49.47
No	1,683	50.53
Impact of COVID-19 on income
Yes	1,351	40.56
No	1,980	59.44

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*Others: 2—Unemployment benefit; 3—Self-employed; 4—Help from the government during the pandemic.

^aFamily income based on the value of a minimum wage = R$1,045.00 / US$193.96 –rate on February 2, 2021.

^b Complementary income provided by the Federal Government during the pandemic R$600.00/US$111.36.

The majority of the students were from Master’s courses (50.65%) and public universities (92.22%); and a large number were from the area of health sciences (23.18%). There was a predominance of graduate programs, evaluated by the government agency responsible for evaluation of graduate programs with grades 4 [good] and 5 [very good] (59.20%). Most students (84.39%) reported an impact on the research schedule during the pandemic period, with the data collection and analysis phases (53.53%) suffering the greatest impact (Table 2).

Table 2. Distribution of Master’s and PhD students, according to course characteristics and research impact (N = 3,331) Brazil, 2023.

Variables	N	%
Course
Master’s	1,687	50.65
PhD	1,644	49.35
Area of knowledge ^a
Health Sciences	772	23.18
Human Sciences	496	14.89
Applied Social Sciences	410	12.31
Exact and Earth Sciences	331	9.94
Biological Sciences	324	9.73
Engineering	303	9.10
Agricultural Sciences	263	7.90
Linguistics, Languages and Literature, and Arts	233	6.99
Multidisciplinary	199	5.97
University
Private	259	7.78
Public	3,072	92.22
Grade of graduate course ^b
1 to 3 [poor]	470	14.11
4 to 5 [good and very good]	1,972	59.20
6 to 7 [excellent]	889	26.69
Impact of COVID-19 on the research schedule
Yes	2,811	84.39
No	520	15.61
Phase of greatest impact
Data analysis and collection	1,503	53.53
Courses taken	443	15.78
Project and qualification exam	583	20.76
Final writing	260	9.26
Others^*	19	0.68

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*Others: 7—Internship during the international doctorate (sandwich PhD); 3—Presentation of the dissertation or thesis; 5—Adaptation to the course; 2—Publication of articles; 2—Consultation of bibliography.

^aNomenclatures of academic areas of knowledge according to the Brazilian National Council for Scientific and Technological Development (CNPq). According to the classification, “Health Sciences” includes Medicine, Nutrition, Dentistry, Pharmacy, Nursing, Public Health, Physical Education, Speech Therapy, Physical Therapy, and Occupational Therapy.

^uGraduate programs evaluated by the Coordination for the Improvement of Higher Education Personnel (CAPES), a specific government agency that defines the concept of the program, ranging from 1 [low] to 7 [high], taking into account the scientific production of students and advisors, among other aspects.

The students had an average PFS score of 6.08 (SD = 2.04, CI = 6.01–6.15), which indicates the presence of fatigue. In the Behavioral dimension, the mean score was 6.53 (SD = 2.23, CI = 6.46–6.61), Affective 5.87 (SD = 2.46, CI = 5.79–5.95), Sensory 5.96 (SD = 2.43, CI = 5.88–6.05), Cognitive 5.89 (SD = 2.21, CI = 5.82–5.97). The mean fatigue time reported by 62.53% of the students was 8.5 months; 14.56% reported 5.3 weeks; 7.41% 46.7 days; for 3.27% it averaged 0.2 hours; and 1.53% of students reported 22.3 minutes.

The students showed moderate fatigue on the VAFS (6.10; SD = 2.51, CI = 6.02–6.19). Variation of results is observed between the two fatigue scales, and the average fatigue value is described according to Brazilian states (Fig 1).

Fig 1 — Presentation of the Revised Piper Fatigue Scale (FFS) (A) and the Visual Analogue Scale (VAS) (B). Darker colors represent higher levels of fatigue in individuals. Map created in free and open source software QGIS^® Version 3.24.1. For the limits of states and countries, the base of the Brazilian Institute of Geography and Statistics (IBGE/DGC). Continuous Cartographic Base of Brazil, 1:250.000 –BC250: version 2017. Rio de Janeiro, 2017 - https://www.ibge.gov.br/geociencias/cartas-e-maps/bases-cartograficas-continuas/15759-brasil.html?=&t=access-to-product).

Students had a mean resilience score of 126.00 (SD = 19.81; CI = 125.56–126.90), which indicates levels of “moderately low to moderate resilience”, with the mean resilience value shown according to Brazilian states in Fig 2.

Fig 2 — Darker colors represent higher levels of resilience in individuals. Map created in free and open source software QGIS^® Version 3.24.1. For the limits of states and countries, the base of the Brazilian Institute of Geography and Statistics (IBGE/DGC). Continuous Cartographic Base of Brazil, 1:250.000 –BC250: version 2017. Rio de Janeiro, 2017 - https://www.ibge.gov.br/geociencias/cartas-e-maps/bases-cartograficas-continuas/15759-brasil.html?=&t=access-to-product).

In the Competence dimension, the mean resilience score was 90.64, ranging from 24 to 119 (SD = 14.52, CI = 90.14–91.13); in Acceptance, the mean score was 35.36, ranging from 12 to 56 (SD = 7.31, CI = 35.03–35.53).

The inferential analysis showed that women had higher mean levels of fatigue (p<0.001) on both scales. Age showed a weak positive correlation with the mean level of resilience (r = 0.221, p<0.001), very weak negative correlation in the PFS (r = -0.106, p<0.001) and in the VAFS (r = -0.077, p<0.001). Students from the northern region of Brazil showed higher levels of resilience (p<0.001).

Students with children also showed higher levels of resilience (p<0.001). Having an income which is at least five times greater than the minimum wage is correlated with greater resilience (p<0.001), whereas students with income between one and two minimum wages showed greater fatigue (p<0.001) in the evaluation on both scales. Having retirement as a source of income favored resilience (p<0.001); and financial dependence on family resources made students more fatigued (p = 0.002) on the PFS. Impact on income due to the pandemic favored higher levels of fatigue (p<0.001), shown on both scales (Table 3).

Table 3. Mean fatigue and resilience scores by sociodemographic factors, Brazil, 2023.

Variables	Fatigue–PFS			Fatigue–VAFS			Resilience
Variables	M	SD	p-value (ES)	M	SD	p-value (ES)	M	SD	p-value (ES)
Sex
Female	6.24	1.99	< 0.001^a (0.12)	6.31	2.44	< 0.001^b (0.12)	125.37	19.99	0.008^a
Male	5.68	2.12	< 0.001^a (0.12)	5.62	2.60	< 0.001^b (0.12)	127.47	19.32	0.008^a
Marital status
With partner	6.03	2.06	0.105^a	6.07	2.52	0.376^a	126.70	19.56	0.007^a
Without partner	6.15	2.02	0.105^a	6.16	2.49	0.376^a	124.85	20.18	0.007^a
Children
Yes	5.86	2.21	0.010^b	5.98	2.73	0.520b	132.37	18.36	< 0.001b (0.18)
No	6.13	1.99	0.010^b	6.14	2.44	0.520b	124.29	19.84	< 0.001b (0.18)
Region of Brazil
Centre-west	6.38	1.95	0.095^c	6.32	2.42	0.580^c	125.64	20.09	< 0.001^c (0.19)
Northeast	6.06	2.13		6.01	2.56		125.20	20.03
North	5.94	2.22		6.11	2.54		134.92	20.01
Southeast	6.09	1.97		6.14	2.45		125.54	19.22
South	5.97	2.13		6.02	2.62		126.79	20.59
Income
1 to 2 minimum wages	6.31	1.96	< 0.001^c (0.13)	6.32	2.38	< 0.001^c (0.08)	122.90	20.48	< 0.001^c (0.20)
3 to 4 minimum wages	5.96	2.07		5.98	2.56		126.89	19.52
> 5 minimum wages	5.72	2.12		5.80	2.66		131.46	17.30
Source of income
Retired	3.95	1.40	0.002^c (0.22)	4.00	2.11	0.075^c	147.40	13.53	< 0.001^c (0.25)
Scholarship	6.13	1.95		6.10	2.40		124.10	19.63
Family resources	6.28	2.00		6.17	2.46		121.53	21.44
Fixed employment	5.98	2.10		6.09	2.61		129.46	18.79
Informal employment	6.11	2.35		6.24	2.70		125.35	21.41
Others^*	5.84	2.54		5.56	3.05		124.22	25.83
Complimentary income
Yes	6.11	1.90	0.959^b	6.09	2.46	0.698^a	124.58	20.23	0.072^a
No	6.07	2.07	0.959^b	6.11	2.51	0.698^a	126.28	19.72	0.072^a
Impact of COVID-19 on income
Yes	6.27	2.05	< 0.001^a (0.03)	6.31	2.50	< 0.001^a (0.01)	125.98	20.40	0.826^b
No	5.94	2.03	< 0.001^a (0.03)	5.97	2.50	< 0.001^a (0.01)	126.01	19.40	0.826^b

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PFS = Revised Piper Fatigue Scale. VAFS = Visual Analog Fatigue Scale. ES = Effect Size. Tests:

^aMann-Whitney;

^bBrunner-Munzel;

^ckruskal-Wallis.

*Others: Unemployment insurance; self-employed; complementary income provided by the Federal Government during the pandemic R$600.00/US$111.36.

Students from private universities, who suffered no impact on their research schedule, were more resilient (p<0.001). Students enrolled in public universities had higher levels of fatigue in the PFS (p = 0.001); and students whose research schedule was affected had higher levels of fatigue (p<0.001) on both scales.

In the area of Health Sciences students whose research schedule was affected in other phases were more resilient (p<0.001); however, in the area of Agricultural Sciences, those who were in the phase of the final writing of the dissertation or thesis were more fatigued (p<0.001). There was no significant statistical impact on the following variables: supplementary income in the pandemic, marital status, course, and grade of the graduate program (Table 4).

Table 4. Mean fatigue and resilience scores by academic factors, Brazil, 2023.

Variables	Fatigue–PFS			Fatigue–VAFS			Resilience
Variables	M	SD	p-value (ES)	M	SD	p-value (ES)	M	SD	p-value (ES)
Course
Master’s	6.13	2.04	0.097^a	6.13	2.49	0.597^a	125.33	20.28	0.113^b
PhD	6.02	2.04	0.097^a	6.08	2.52	0.597^a	126.68	19.29	0.113^b
University
Public	6.11	2.03	0.001^a (0.17)	6.13	2.49	0.036b	125.50	19.81	< 0.001^a (0.10)
Private	5.69	2.14	0.001^a (0.17)	5.76	2.72	0.036b	131.91	18.88	< 0.001^a (0.10)
Area of knowledge
Health Sciences	5.79	2.17		5.84	2.65		129.71	18.80
Human Sciences	6.04	2.04		5.96	2.55		124.30	20.40
Applied Social Sciences	6.08	1.97		6.27	2.47		126.81	19.17
Exact and Earth Sciences	6.10	1.93		6.09	2.36		124.68	18.77
Biological Sciences	6.34	1.96	< 0.001^c (0.04)	6.28	2.36	0.010^c	123.24	21.19	< 0.001^c (0.03)
Engineering	5.98	1.98		6.02	2.46		126.20	18.89
Agricultural Sciences	6.36	2.05		6.37	2.41		125.24	20.66
Linguistics, Languages and Literature, and Arts	6.34	1.88		6.30	2.46		121.44	20.11
Multidisciplinary	6.25	2.14		6.46	2.49		126.87	20.44
Grade of graduate course
1 to 3 [poor]	5.97	2.14	0.057^c	5.95	2.60	0.006^c	127.28	19.76	0.085^c
4 to 5 [good and very good]	6.13	2.05		6.21	2.50		126.04	20.26
6 to 7 [excellent]	6.01	1.97		5.96	2.47		125.21	18.79
Impact of COVID-19 on research schedule
Yes	6.23	1.97	< 0.001^b (0.09)	6.29	2.41	< 0.001^b (0.07)	125.13	19.76	< 0.001^a (0.00)
No	5.23	2.24	< 0.001^b (0.09)	5.11	2.77	< 0.001^b (0.07)	130.69	19.41	< 0.001^a (0.00)
Phase of greatest impact
Collection and analysis of data	6.18	1.96	< 0.001^c (0.21)	6.20	2.41	< 0.001^c (0.25)	125.50	19.80	< 0.001^c (0.18)
Courses taken	5.94	2.09		5.95	2.55		127.45	18.98
Elaboration of project and qualification exam	6.47	1.87		6.60	2.27		123.33	20.44
Final writing of dissertation or thesis	6.62	1.79		6.89	2.20		122.44	18.70
Others^*	4.77	2.39		4.21	2.62		132.53	21.32

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PFS = Revised Piper Fatigue Scale. VAFS = Visual Analog Fatigue Scale. ES = Effect Size. Tests:

^aMann-Whitney;

^bBrunner-Munzel;

^ckruskal-Wallis.

*Others: International mobility; Thesis presentation; Adaptation to the course; Publication of articles; Consultation of the bibliography.

The variables with moderate negative correlations with resilience were the sensory (r = - 0.427) and cognitive (r = - 0.431) dimensions. The variables with weak negative correlations with resilience were the behavioral (r = - 0.370) and affective (r = - 0.338) dimensions.

The two resilience dimensions were negatively correlated with the four fatigue dimensions. The variables with the weakest negative correlation with the competence dimension included the general level of fatigue (r = - 0.395), behavioral (r = - 0.319), affective (r = - 0.296), sensory (r = - 0.388), and cognitive (r = - 0.385) dimensions. In the acceptance dimension there was a moderate negative correlation with the level of fatigue (r = - 0.424), with the cognitive dimension (r = - 0.405) and a weak negative correlation with the behavioral (r = - 0.371), affective (r = - 0.328), and sensory (r = - 0.384) dimensions.

Scores on the Resilience Scale and PFS assessments showed a moderate negative correlation, suggesting that higher levels of resilience were associated with lower levels of fatigue (r = - 0.446, CI = -0.473 to—0.418, p<0.001).

4. Discussion

This study assessed the impact of the COVID-19 pandemic on graduate students in Brazil and some key instruments to analyze fatigue and resilience. These two constructs were highlighted as they can affect student performance and learning [14, 15, 30]. Our results indicate that academic and socioeconomic aspects were associated with higher levels of fatigue and resilience.

The pandemic had an impact on the research schedule and the completion of students’ theses and dissertations. Concern for one’s own health and that of loved ones, difficulty concentrating, changes in sleep patterns and a reduction in social interactions [38, 39] were stressors that may have led students with difficulties in the final writing stage of their dissertation or thesis to present greater fatigue.

Studies carried out in the pre-pandemic period indicated the relationship between fatigue and academic activities [14, 16] and showed that graduate students were already fatigued, which may have increased in the pandemic. On the other hand, similar to our results, a study with graduate students from all over Brazil during the pandemic showed that 72.0% of students made changes to their projects [40], which may have jeopardized the other phases of their research schedules, similar to those evidenced in this study. This may have caused both psychosocial and academic frustrations, leading to adaptive behaviors and resilience [41]. Adjustments in expectations between the training that students envisioned and what was possible during the pandemic may have been a positive strategy for their performance in terms of resilience.

The areas of knowledge present different ways of working with in terms of research and knowledge development. In health sciences, students were more likely to adapt to changes, face challenges and see themselves as people capable of overcoming difficulties [42, 43], and this was related to resilience. Knowledge of forms of transmission of other diseases and prevention mechanisms may have contributed to these individuals having greater emotional balance to deal with and adapt positively to adversity. On the other hand, students in the area of agricultural sciences had higher levels of fatigue. The reasons that may support such a finding have already been shown as the pandemic meant that students had to interrupt and/or modify their research [40], which in this area is mostly experimental, often including cultivation and field and laboratory planting [44].

In public universities in Brazil there is a constant demand for academics or researchers to increase their scientific production as they are under pressure from government classification processes which rank institutions and graduate programs on their research productivity [45]. Researchers or academics must then prioritize their work in teaching, research and extension activities. If they are to be promoted and be competitive for jobs then they must produce publications and have success in obtaining research funding. This pressure and bureaucratic structure can cause an overload on academics which is transferred to and has a direct impact on graduate students.

This is in contrast to private universities in Brazil where there is less demand for research publications and a greater focus on teaching. Academics are often on more balanced workload allocations with contracts which are not solely based on research. Graduate students are also in better financial situations and this is correlated with resilience. But it should be stated that research in private universities is very limited, and less than eight percent of students in this survey were from private universities.

The economic aspect also impacts the lives of graduate students as many depend on grants for their subsistence and/or depend on the financial support of their families. These resources may be insufficient for maintaining themselves. However, obtaining other sources of income is difficult because graduate studies require a large amount of time for students to carry out their academic activities. The pandemic worsened this situation as the monetary loss of students or their families and the search for another job during the pandemic were elements that led to higher levels of fatigue [46, 47]. Graduate students who had economic difficulties were identified as more fatigued.

The studied population is predominantly female and does not have children; however, the variable ’having children’ was associated with resilience. Children can be a source of motivation to face adverse situations [48]. This fact can also be linked to the performance of academic resilience, defined as ’’the dynamic process and interaction between an academic and their constantly changing environment that uses available internal and external resources to produce positive results in response to different contextual challenges, environmental and development issues” [49, p.13]. In this definition, emphasis is given to the relational characteristic of resilience when considering social interactions to the detriment of the focus on the individual [50].

The study found that women are more fatigued than men. Other studies also reached the same result [14, 51–54]. Care must be taken with the interpretation of this result in order to avoid a superficial narrative in discussions of sex and gender as the interaction of ecological, family, behavioral and physiological mechanisms can drive decisions related to gender health, exposure to risks and biological vulnerabilities [55]. In this sense, men can minimize fatigue due to their masculine traits of stoicism and resistance [56], while women express and communicate feelings, emotions and symptoms more easily [57, 58]. The environment should also be considered as social characteristics such as the division of labor by gender and exposure to institutionalized sexism can be drivers of fatigue [52]. During the pandemic, graduate students had to deal with an increase in tasks and work hours, which may have contributed to greater emotional exhaustion.

Age was an important determining factor for both fatigue and resilience. Older students, who had experienced more adversities throughout their lives, had greater resilience [59–61]. Younger graduate students were more fatigued, a fact that differs from a study carried out before the pandemic, in which the age of students was not a significant factor for fatigue [14]. During the pandemic, young people may have had fewer of their own and/or institutional resources to deal with psychic stressors. The lack of a support network and social interactions for many young people may have been a risk factor for fatigue.

The results show that there is a need to implement university programs that favor the improvement of resilience among students so that they can overcome the challenges present during their time as graduate students. This would result in the most demanding situations being experienced with less suffering and without the characteristic repercussions of fatigue. Some strategies for improving resilience are psychotherapeutic approaches; resilience training [24]; mindfulness-based workshops [62]; and group intervention [63]. Other strategies for coping with psychological distress in the face of COVID-19 carried out by universities were physical exercise; Zoom meetings with friends from religious communities; staying connected with family, friends and professors; and establishing self-help techniques such as meditation, relaxation, listening to music, and staying positive) [64, 65].

Fatigue and resilience can vary in traumatic or more intense situations; however, this general assessment of students’ resilience and fatigue provides a good basis to work from. It is also noteworthy that resilience was a mediator for fatigue as increasing one reduces the other and vice versa. In addition, this study demonstrates the association between resilience and fatigue in graduate students during the COVID-19 pandemic in Brazil and is therefore a breakthrough for Brazilian and world science in understanding how these two phenomena develop in critical times for society.

A limitation of this study was the non-homogeneous sample as there are differences in the proportions of graduate students in various regions of Brazil.

5. Conclusion

Most students had significant and moderate average levels of fatigue and moderately low levels of resilience. The higher the level of resilience, the lower the levels of fatigue. Sociodemographic and academic factors were associated with these phenomena. Understanding the relationships between graduate students’ individual characteristics and external factors can be important for developing strategies to deal with fatigue and improve students’ resilience. The COVID-19 pandemic may have intensified fatigue and required individuals, in the face of adversity, to develop resilience.

Supporting information

S1 Database

(XLSX)

Click here for additional data file.^{(908.4KB, xlsx)}

S1 Questionnaires. Questionnaire on sociodemographic and academic data.

(DOCX)

Click here for additional data file.^{(29.3KB, docx)}

Acknowledgments

The authors would like to thank all graduate students who voluntarily participated in the study and all graduate programs that helped to publicize this research.

Data Availability

All relevant data are within the paper and its Supporting information files.

Funding Statement

Valóta IAC - 88887.356470/2019-00 - “This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (CAPES) – Finance Code 001”. https://www.gov.br/capes/pt-br Pimentel RRS - 88887.508751/2020-00 - “This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (CAPES) – Finance Code 001”. https://www.gov.br/capes/pt-br The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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PONE-D-21-28536Fatigue and resilience in master's and doctoral students during the COVID-19 pandemic in Brazil: a cross-sectional studyPLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: No

Reviewer #2: Partly

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: No

Reviewer #2: I Don't Know

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: No

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Please see my uploaded comments. However, as I am forced to also use this box for some reason, I have copied the comments below:

The authors of this study raise and attempt to address an intriguing question – how did the pandemic affect postgraduate students? To achieve this, an impressively large scale questionnaire was disseminated to students throughout Brazil, resulting in over 3000 responses. Unfortunately, many of the conclusions drawn appear to be very shallow in nature and I worry about the lack of novelty presented in the article (e.g. it comes as little surprise that individuals with more financial support and whose research remained unimpacted were better off). Additionally, there appear to some statistical flaws and deeply concerning demographic questions being utilised, which overall detract from the study. I will detail such examples below, but I am sadly unconvinced that this article should be published. Lastly, your introduction is not sufficient with only one page provided to cover the entire area of study relating to the difficulties of post-graduate work (which is a large field in and of itself!).

To begin, I wish to raise the issue of your demographic questions. Without seeing the questionnaire itself (which is absent from the appendix), I can’t fully confirm this, but it appears that you asked participants if their race/colour was Yellow, White, Indigenous, Brown or Black. Not only is this deeply inappropriate, but you did not even raise that you were investigating race in your methodology. As you ultimately find no statistical relevance here, I found strongly recommend removing this data. As for why this is inappropriate, ‘Yellow’ is a deeply offensive term often used to combine many distinct Asian identities (e.g. Korean, Japanese, Chinese, Taiwanese etc.). Furthermore, did you only ask if the participants were ‘male’ or ‘female’? What of non-binary or trans people? As it stands, I can’t actually confirm what you asked but I suspect you may have fallen back onto old stereotypes.

Following on from these stereotypes, I worry about many of the conclusions drawn. You state ‘Being a woman often involves the accumulation of work and domestic functions’. While it is true that societal conventions often result in women undertaking more housework, I fail to see how this is related to their biological sex of gender identity. As written, it implies that the two are deeply connected, rather than an outcome of patriarchal values. Furthermore, you provide no references for this comment.

The next statement of concern was ‘Not having children can be an element that, by reducing the social interaction and emotional support brought by the mother-child relationship, can increase the chance of fatigue in women’. I am unsure why you feel that the lack of a parent-child support structure was only relevant to women? As written, are you suggesting that such a connection is less relevant to fathers? I see no reason why such a specific gender-based correlation should exist. This is compounded by an error is your statistical analysis, in which the p cut-off value does not appear to be corrected for the number of items utilised in your questionnaire. A Bonferroni correction requires you to divide the p value by the number of items in your questionnaire, which likely lowered the cut-off to <0.01 (the significance you saw for this comparison) and thereby may invalidate this analysis. Additionally, you provide no literature based justification for the use of correlation values as effect sizes. Traditionally, each statistical test has an associated effect size calculation which it appears you have chosen to not use.

Next on the list of statements that need justification is ‘Therefore, a study suggests that government officials periodically review the effectiveness of the isolation measures implemented and consider ways to make such measures more flexible in order not to compromise the health of the population [16] or consider the need for emergency aid as an aid to maintain the minimum family income’. I am surprised by the implication here that government agencies are not already taking this into account. As such, and this relates to my overall concern around the lack of novelty in this article, I’m not sure what this statement adds to the topic area of interest.

You have also stated that ‘Another important aspect is that biological science students may have been more resilient, as they faced challenges inherent to the benchtop researcher [19] and maintained good results in the resilience score’. I’m sorry, but I’m not sure what you mean by this. Are not all bench researchers facing challenges ‘inherent to the benchtop researcher’? How is the experience of Biological Science students unique? Surely not all of them experienced the frontline of the pandemic as you raise for the Health Science students? In fact, what are these grouped together and, indeed, why and how were any of the groups combined (i.e. why are the Exact Sciences and Earth, Engineering, and Agricultural Sciences combined into one?).

I have two last comments before I wrap up. Firstly, the lack of acknowledgements is surprising to me, as I would have at the very least expected an extension of gratitude to the students who took the time to complete the questionnaire. Secondly, the writing of this article, while generally reasonable, occasionally contained grammatical errors or signs of a lack of detailed proofreading. Some examples are below:

1) Therefore, a study suggests that government officials periodically review the effectiveness of the isolation measures … (I presume you mean - therefore, this study suggests …)

2) … such measures more flexible in order not to compromise the health of the population … (I presume you mean mental health).

Overall, without a full justification of the statistical testing undertaken, the removal of stereotypical assumptions, the presence of the actual questionnaire used AND the novelty of this work better highlighted, I unfortunately cannot recommend this work for publication.

Reviewer #2: Comments for authors:

Overall. The study analyses the relationship between fatigue and resilience while controlling for academic and sociodemographic factors for postgraduate students in Brazil. The findings and the contribution could be strengthened by linking the discussion better to your data, and discussing what already happens in universities in terms of resilience training. Many programs already offer co-curricular and extra-curricular workshops and seminars on time management, mindfulness, etc. all of which I would argue might be helpful in mitigating fatigue and learning resilient behaviours. This is not considered in the current manuscript version. Also, it is not clear to me whether you found any particular factors to be the major ‘dealbreakers’ or ‘deal-makers’. You suggest financial hardships might be a significant factor, perhaps even more important in causing stress and fatigue than lack of social support. I would strongly recommend that you highlight and emphasise your main findings in the discussion. Overall, the paper would benefit from professional editing. A few expressions are unclear in what they mean or refer to. I hope further detailed comments below will be helpful in revising the paper.

Intro:

Page13line66: expression “behaviours that promote protection’ is odd, resilience is not a behaviour per se, rather a quality or attribute I would argue, what might be examples of resilient behaviours?

Method:

Consider explaining in a few words what a prospective study is.

Why is sense strict in italics?

P4l82-83: “All of the students who did not fully respond to the data collection” perhaps simplify to who did not answer all survey questions…

L89 Survey link capitalised

Discussion:

Overall, I suggest revising the structure to better orient the reader through your argument. Currently this section is somewhat disjointed. For example, the last paragraph on ‘resilience building strategies seems disconnected and not well integrated with the rest.

P15l295; change to impact OF increased levels of stress and anxiety

P16l312-313: which Brazilian study do you refer to here: “Different results from those found in a Brazilian study showed that 56% of students were doctoral students”

P17l338-340: the role of this sentence is unclear: “It is expected that younger students suffer more from fatigue and have a less resilient behaviour pattern when compared to older ones. “ Who expects that? Does your data speak to this directly? If so, you need to make the connection to your research clearer here. And who are the researchers in line 340, you or other research?

How would you explain the finding that females who were financially disadvantaged by covid-19 experienced more fatigue but students with children were more resilient. This question comes up naturally for the reader when reading the abstract. Consider explaining this contrasting finding.

P18l371: “marked devaluation” do you mean that academic activities became less of a preference for them? Who devalued such activities?

P18l375: What do you mean by ‘intense adversity in this region’ here?

Limitations:

You state that finding other studies on this subject was difficult but you refer to several similar studies throughout.

P20l4090411, how realistic is it to conduct similar studies before pandemic, perhaps use a more nuanced language and say a general assessment of students’ resilience and fatigue would provide a good baseline or basis to work with.

Conclusion:

Review the second sentence and consider splitting in two.

**********

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Reviewer #1: No

Reviewer #2: No

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Attachment

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Attachment

Submitted filename: Reviewer Recommendation and Comments for Manuscript Number PONE.docx

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PLoS One. 2023 Dec 1;18(12):e0295218. doi: 10.1371/journal.pone.0295218.r002

Author response to Decision Letter 0

22 Apr 2022

Reviewer 1

The authors of this study raise and attempt to address an intriguing question – how did the pandemic affect postgraduate students? To achieve this, an impressively large-scale questionnaire was disseminated to students throughout Brazil, resulting in over 3000 responses. Unfortunately, many of the conclusions drawn appear to be very shallow in nature and I worry about the lack of novelty presented in the article (e.g. it comes as little surprise that individuals with more financial support and whose research remained unimpacted were better off).

The conclusions made were discussed and supported internationally. It is important to emphasize that a quality study does not necessarily need to have new information. In addition, our study advances scientific knowledge by presenting the relationship between fatigue and resilience in a population that deserves greater attention.

Additionally, there appear to some statistical flaws and deeply concerning demographic questions being utilised, which overall detract from the study.

We have made the necessary adjustments.

I will detail such examples below, but I am sadly unconvinced that this article should be published. Lastly, your introduction is not sufficient with only one page provided to cover the entire area of study relating to the difficulties of post-graduate work (which is a large field in and of itself!).

We have made additions to the Introduction.

We have added the instruments used in the survey.

We have taken out the data on race and colour.

As for why this is inappropriate, ‘Yellow’ is a deeply offensive term often used to combine many distinct Asian identities (e.g. Korean, Japanese, Chinese, Taiwanese etc.).

We emphasize that in Brazilian culture, the term “yellow” is not offensive. In Brazil, the Brazilian Institute of Geography and Statistics (IBGE), the government agency responsible for carrying out a population census every decade, conducts a survey on the colour/race of Brazilians based on self-declaration, which when asked about their colour/race according to the following options: white, black, mixed race, indigenous or yellow (https://cnae.ibge.gov.br/en/component/content/article/95-7a12/7a12-vamos-know-o-brasil/ our-people/16049-color-or-race.html)

Furthermore, did you only ask if the participants were ‘male’ or ‘female’? What of non-binary or trans people? As it stands, I can’t actually confirm what you asked but I suspect you may have fallen back onto old stereotypes.

We only considered biological sex.

We have rewritten the paragraph and supported it with literature on gender.

We have rewritten the analysis and taken out this paragraph.

This is compounded by an error in your statistical analysis, in which the p cut-off value does not appear to be corrected for the number of items utilised in your questionnaire. A Bonferroni correction requires you to divide the p value by the number of items in your questionnaire, which likely lowered the cut-off to <0.01 (the significance you saw for this comparison) and thereby may invalidate this analysis. Additionally, you provide no literature-based justification for the use of correlation values as effect sizes. Traditionally, each statistical test has an associated effect size calculation which it appears you have chosen to not use.

We have applied Bonferroni correction to adjust the values of hypothesis tests and have added a justification based on the literature for the use of effect size values.

At the time of writing the manuscript, there were no standardized government measures. We have modified the paragraph.

As for the “lack of novelty” note, to date, we have not found any study of this magnitude which has evaluated more than 3,000 graduate students in Brazil during the pandemic. It is worth mentioning that when we carry out research, we do not necessarily find new data, which does not detract from the merit of the study.

We have rewritten the paragraph.

In fact, what are these grouped together and, indeed, why and how were any of the groups combined (i.e. why are the Exact Sciences and Earth, Engineering, and Agricultural Sciences combined into one?)

We have regrouped according to the classification of areas of knowledge of the National Council for Scientific and Technological Development (CNPq), an entity linked to the Ministry of Science, Technology and Innovation to encourage research in Brazil. (https://www.gov.br/capes/pt-br/centrais-de-conteudo/TabelaAreasConhecimento_072012_atualizada_2017_v2.pdf).

Participants in this study were acknowledged by the authors of the work during data collection. In the manuscript, we now thank the graduate students who participated in our research.

Secondly, the writing of this article, while generally reasonable, occasionally contained grammatical errors or signs of a lack of detailed proofreading. Some examples are below:

1) Therefore, a study suggests that government officials periodically review the effectiveness of the isolation measures … (I presume you mean - therefore, this study suggests …)

2) … such measures more flexible in order not to compromise the health of the population … (I presume you mean mental health).

A professional editor has made the necessary changes.

We have rewritten the complete justification of the statistical tests performed, removed the assumptions considered stereotyped, added the questionnaires, and highlighted the new elements of this work.

Reviewer 2

The study analyses the relationship between fatigue and resilience while controlling for academic and sociodemographic factors for postgraduate students in Brazil. The findings and the contribution could be strengthened by linking the discussion better to your data, and discussing what already happens in universities in terms of resilience training. Many programs already offer co-curricular and extra-curricular workshops and seminars on time management, mindfulness, etc. all of which I would argue might be helpful in mitigating fatigue and learning resilient behaviours. This is not considered in the current manuscript version. Also, it is not clear to me whether you found any particular factors to be the major ‘dealbreakers’ or ‘deal-makers’. You suggest financial hardships might be a significant factor, perhaps even more important in causing stress and fatigue than lack of social support. I would strongly recommend that you highlight and emphasise your main findings in the discussion. Overall, the paper would benefit from professional editing. A few expressions are unclear in what they mean or refer to. I hope further detailed comments below will be helpful in revising the paper.

We have restructured the discussion and have been helped by a professional editor.

Intro:

Page13 line 66: expression “behaviours that promote protection’ is odd, resilience is not a behaviour per se, rather a quality or attribute I would argue, what might be examples of resilient behaviours?

We have changed the paragraph and aligned it with the definition of resilience used by Wagnild and Young (Wagnild GM, Young HM. Development and psychometric evaluation of resilience scale. J Nurs Meas. 1993;1(2):165-78.)

Method:

Consider explaining in a few words what a prospective study is.

We have rewritten the paragraph/sentence.

Why is sense strict in italics?

A formatting error has been corrected.

P4l82-83: “All of the students who did not fully respond to the data collection” perhaps simplify to who did not answer all survey questions…

We have made the suggested change.

L89 Survey link capitalised.

We have rewritten the paragraph/sentence.

Limitations:

You state that finding other studies on this subject was difficult but you refer to several similar studies throughout.

We agree with the point and have rewritten the paragraph in the limitations of the study.

Conclusion:

Review the second sentence and consider splitting it into two.

We have rewritten the paragraph/sentence as suggested.

Attachment

Submitted filename: Response to Reviewers.docx

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PLoS One. doi: 10.1371/journal.pone.0295218.r003

Decision Letter 1

Pauline M Ross

30 Aug 2022

PONE-D-21-28536R1Fatigue and resilience in Master's and PhD students in the Covid-19 pandemic in Brazil: a cross-sectional studyPLOS ONE

Dear Dr. Valóta,

==============================

Could you please make the changes as required by the reviewer so that this review can be completed. I notice the reviewer comments that there are sections which still are not logical in flow. This is very important to fix in this version. Following the revision, I will complete what I hope is a final read and edit – so that this manuscript can be resolved. This very much depends however on the quality of the next revised version. I encourage you to persist and perhaps obtain some assistance to produce a quality manuscript. Best wishes and I look forward to the resolution.

==============================

Please submit your revised manuscript by Oct 14 2022 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
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An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

We look forward to receiving your revised manuscript.

Kind regards,

Pauline M. Ross, PhD

Academic Editor

PLOS ONE

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #2: All comments have been addressed

Reviewer #3: (No Response)

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2. Is the manuscript technically sound, and do the data support the conclusions?

Reviewer #2: Partly

Reviewer #3: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #2: I Don't Know

Reviewer #3: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

Reviewer #2: Yes

Reviewer #3: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

Reviewer #2: Yes

Reviewer #3: Yes

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6. Review Comments to the Author

Reviewer #2: (No Response)

Reviewer #3: This study provides a large cross-sectional study to assess the impact of the COVID-19 pandemic on postgraduate students in Brazil. The authors should be commended in collecting and analysing a large body of data that provides a snapshot of some key instruments for analysis to assess the impact of fatigue and resilience. I can see from the response to the reviewers that the authors have made a considerable effort to review and adjust based on the feedback provided. Having not read the original submission, I can only comment directly on the revision that has been submitted.

Overall, the manuscript has had much more description and link to previous studies, which does enhance the study, however, in places, the information does lack coherence and flow. There seem to be some paragraphs that are quite short (see first paragraph of introduction) that could be linked better throughout. The 7th paragraph of the introduction, the final sentence needs re-wording – “Literature data” is not correct to refer to and you should include what the significant effects were (greater/improved?).

Your overall aim, in addition to analysing the level of fatigue and resilience, is to also consider the association with sociodemographic and academic factors, which I feel is what is lacking in the discussion. You do a good job of discussing the literature around fatigue and resilience, however, given you present two key figures associated with demographic data, I would like to see more detail around this. The novelty of your paper is that you are assessing Brazilian students – the demographics play a significant role here and this is the novelty in my opinion. This will allow you to utilise the nice studies you have to support your findings in other countries.

Whilst fatigue is not my field, I am curious as to why both a PFS and a VAFS scale are used? I may be misinterpreting this, but they seem to give slightly differing results? You also only seem to primarily discuss the PFS results. I also was unclear (for VAFS) what best result versus worst result meant? If these are common terms for these scales, please ignore, if not, please edit what this means.

In 2.3 you refer to n number as (n), however in each table it is referred to as N – please edit.

Paragraph prior to table 2 starts with “The students” – I assume you mean Most students? Or “The survey found that…”

The figure legends for the 2 images are underwritten. Whilst it is good you have included the source, you should also provide the reader with a description of what the images represent. For example, darker colour means more fatigue etc. I also recommend that figure 1 be given an A and B for each image to help the reader.

The discussion is generally good (see comments above), but I do feel it lacks flow. I am also slightly confused with paragraph 2, where you refer to females having family commitments may have significant affects on their careers, however in your study the majority of respondents were female and did not have children? Please review this data in relation to your outcomes. It would also be interesting to see what % of the female respondents did have children.

For your age data, you mention this differs from the current literature – do you have a suggestion as to why your data may differ?

4.1 – I’m not sure you require the strong points section – this should be the focus of the discussion and come through to the reader without having to state it.

Overall, whilst the language has been improved, I would suggest further proof reading and structural/grammar checks prior to resubmission. Thank you for your interesting study and I wish you well with the revision.

**********

7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #2: No

Reviewer #3: No

**********

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PLoS One. 2023 Dec 1;18(12):e0295218. doi: 10.1371/journal.pone.0295218.r004

Author response to Decision Letter 1

2 Mar 2023

Academic Editor

Response: We have made substantial changes to the manuscript in response to reviewers' requests and presented an improved version.

Reviewer 2:

Thank you for revising the manuscript. I still have concerns about the suitability of this paper for publication. Reading Reviewer 1 comments and the authors’ responses further support my concerns. I will leave it to Reviewer 1 to check the technical aspects of the analysis and how the authors responded. I also echo Reviewer 1 concern about the statements made in regard to ‘yellow’. I do not think that this is appropriate for an international audience and might be highly offensive to international readers, although I take the authors’ response on board about the use of this term by Brazilian government agencies.

Response: Thank you for the comments. We believe that the manuscript has publication potential as we could not find in the literature an extensive assessment of fatigue and resilience among graduate students in such a challenging scenario. We considered the suggestions of Reviewer 1 in the previous round, and, as you can see in the manuscript, the race/yellow color variable has been removed.

The authors are also well advised to provide a more reflective and considerate response in regard to traditional gender roles, as per Reviewer 1 suggestions.

Response: We have reconsidered traditional gender roles and our results. We have reformulated the text in the Discussion.

Please also note that my original comments on the Discussion section were not at all addressed in the authors’ response.

Response: We apologize for not addressing your previous points in the response letter and only changing them throughout the manuscript. In this round we address the different points.

I have re-read the Discussion again and have further points for authors to consider: The writing still needs a major revision throughout the manuscript, perhaps with the help of a Native English speaker? Some examples include:

‘food products’ e.g. ‘food’?

‘bringing higher levels of fatigue’ e.g. ‘causing’?

‘Overcoming the “publish or perish” mentality’, is an odd expression

“an Indian study [69] with the same theme”, a study in India? Do you mean research questions when you say ‘theme’?

Response: We have revised the text with the help of a native speaker.

“Graduate students who carry out their studies at private universities in Brazil may feel more institutionally helpless because they have a restricted involvement within the academic community in the pandemic.” Unclear and needs explaining.

Response: We have reformulated to Discussion text and presented an explanation for this point.

This paragraph does not make clear what data it draws on:

“The northern region of Brazil was initially the most affected by the pandemic [67]. In addition, it receives less help and is the region with most economic, political, social adversities, which can influence the performance of students’ resilience levels as they have encountered a period of intense adversity in this region. Similar data have been found in northern Italy [66].” If this is not backed up by the authors’ data, why is it relevant in the discussion?

Response: We have reformulated the Discussion and emphasized the main results.

There are other similar expressions that I find difficult to understand. (Existem outras expressões semelhantes que acho difícil de entender).

Response: We have revised the translation of the text with the help of a native speaker.

The main problem I see in the discussion is that a large section of it reads like an extension of a literature review. Surprisingly little reflection and reference is given to the authors’ data, considering the significance of the sample size. I would expect much more comparing and contrasting in reference to the authors’ data segments, e.g. gender differences, academic vs low SES demographic comparison, disciplinary comparison, perhaps institutional comparison. I agree with Reviewer 1 that much deeper insights should be gained from such rich data. Unfortunately, the analysis, at least in the way it’s presented in the discussion, remains fairly superficial and doesn’t know clearly add novel insights.

Response: We have reformulated the entire text of the Discussion and presented insights and considerations on the main findings. We have responded to your suggestion and have presented comparisons between gender differences, academic characteristics versus low socioeconomic status, and disciplinary and institutional differences.

The “limitations and strong points” section is weak and seems unnecessary. You could add more value by proposing a number of programs, workshops or offerings universities could add to support PhD students’ resilience building.

Response: We have removed the limitations and strengths section and included suggestions for programs and strategies for universities in the Discussion.

Reviewer 3:

This study provides a large cross-sectional study to assess the impact of the COVID-19 pandemic on postgraduate students in Brazil. The authors should be commended in collecting and analysing a large body of data that provides a snapshot of some key instruments for analysis to assess the impact of fatigue and resilience. I can see from the response to the reviewers that the authors have made a considerable effort to review and adjust based on the feedback provided. Having not read the original submission, I can only comment directly on the revision that has been submitted.

Response: Thank you for your comments and time spent reading this version.

Response: We have reformulated the paragraphs of the introduction and revised the entire text, aiming to give it greater coherence and flow. We have readjusted the seventh paragraph of the Introduction.

Response: We have rewritten the entire text of the Discussion and have presented insights and thoughts on the main findings. We have included considerations on sociodemographic and academic factors.

Response: We have included a justification in the Methods section “We have chosen these two instruments (PFS and VAFS) to assess fatigue, seeking to ensure a more global and reliable analysis”. The use of more than one instrument to assess the same phenomenon is not uncommon in the literature. The results of the two scales were very close to the PFS, with an average level of 6.08, and the VAFS with an average level of 6.10. What was slightly different was the inferential analysis in which the PFS seemed to be more sensitive to the characteristics that may be associated with fatigue (Source of income). We have modified the description of the result for VAFS.

In 2.3 you refer to n number as (n), however in each table it is referred to as N – please edit.

Response: The alteration has been made.

Paragraph prior to table 2 starts with “The students” – I assume you mean Most students? Or “The survey found that…”.

Response: The alteration has been made.

Response: We have included an explanatory note for each figure and have identified the fatigue figures.

Response: We have reviewed the data and presented the % of women who had children. We have rewritten the Discussion and improved the analysis of gender differences.

Similar to a previous reviewer, there is mention of many measures currently in place – I suggest you restructure this paragraph to be towards the latter section of the discussion in order to link this in with what you are also suggesting is implemented across the country. For your age data, you mention this differs from the current literature – do you have a suggestion as to why your data may differ?

Response: We have restructured the Discussion as suggested and left the strategies and measures at the end of the section. We have added an insight into why our age data diverged from a pre-pandemic study “We think that in the pandemic young students had fewer of their own and/or institutional resources to deal with psychic stressors. The lack of a support network and social interactions for many young people may have been risk factors for fatigue”.

4.1 – I’m not sure you require the strong points section – this should be the focus of the discussion and come through to the reader without having to state it.

Response: We have removed the limitations and strengths section and included it in the Discussion. We have revised the translation with a native speaker.

Attachment

Submitted filename: RESPONSE TO REVIEWER.docx

Click here for additional data file.^{(44.4KB, docx)}

PLoS One. doi: 10.1371/journal.pone.0295218.r005

Decision Letter 2

Pauline M Ross

25 Apr 2023

PONE-D-21-28536R2Fatigue and resilience in Master's and PhD students in the Covid-19 pandemic in Brazil: a cross-sectional studyPLOS ONE

Dear Dr. Valóta,

Please see attached file.

Please submit your revised manuscript by Jun 09 2023 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

We look forward to receiving your revised manuscript.

Kind regards,

Pauline M. Ross, PhD

Academic Editor

PLOS ONE

Additional Editor Comments:

PONE-D-21-28536

"Fatigue and resilience in Master's and PhD students in the Covid-19 pandemic in Brazil: a cross-sectional study"

When this manuscript was submitted – it was sent out for review – because it was so novel and original. The review has now been a long process, with over four reviewers at different times. One reviewer suggested a rejection, two suggested a major review and one a minor review. Each time I have suggested a major review – in light of the reviewer’s comments. Each time the revised version has improved, but not significantly enough to allow a change my views to a minor revision or preferably an acceptance. On each occasion because of the continued novelty and timeliness of the manuscript I have also tried to provide feedback which would be helpful to try and seek an improvement in the manuscript so that it can move towards being published.

I have decided with this final version to do the review myself – in an effort to provide the detail which I hope you may be able to use to bring this manuscript to a conclusion.

As indicated in my last set of comments – this manuscript needed a rigorous review. It still does.

These are my comments from the previous review:

This was the response: We have made substantial changes to the manuscript in response to reviewers' requests and presented an improved version.

Unfortunately although the response from the authors was positive, this 3rd review has not gone far enough. There remains several coherency and language issues – which I have detailed below. There are still some interpretation issues – and general formatting of tables and figures which require further attention.

After considerable reflection, I have made the decision to allow one more major revision. This will be the final review. If the authors decide to review again – then please seek English language assistance in the next review of the manuscript. If the manuscript does not improve considerably in language and formatting – then I will need to reject the next version. I really don’t want to reject this manuscript, given the considerable time it has taken to review – and the efforts of the authors. I urge you to make sure the next version – has dealt with the issues described here and in previous reviews. I start with the reviewers comments which I do not believe have been adequately addressed and move onto more specific comments from this version of the manuscript.

Reviewer comments which have not yet adequately addressed:

1. I am also slightly confused with paragraph 2, where you refer to females having family commitments may have significant affects on their careers, however in your study the majority of respondents were female and did not have children? Please review this data in relation to your outcomes. It would also be interesting to see what % of the female respondents did have children.

2. I have re-read the Discussion again and have further points for authors to consider: The writing still needs a major revision throughout the manuscript, perhaps with the help of a Native English speaker?

3. The main problem I see in the discussion is that a large section of it reads like an extension of a literature review. Surprisingly little reflection and reference is given to the authors’ data, considering the significance of the sample size. I would expect much more comparing and contrasting in reference to the authors’ data segments,

Detailed feedback

Introduction

Lines 75-76 Delete from “before and in…. - up until financial” in line 76. This should then read – “marked by psychological pressure with instability” and insert “with”

Line 77 replace “to” with “in”, delete “their teaching and research activities” and replace with “guidance and financial instability”.

Line 79 insert “and” between “experiments interrupt”

Line 83 delete “can lead” and replace with “have been found to”

Line 87 Replace “a” with “for example, a”

Line 88 Make “experiences” experience”

Line 89 Insert “Also” before “In”

Line 92 Delete “Given this scenario” and start at “Fatigue”

Line 113 Delete “data” and replace with “findings”

Line 120 Delete “the” and replace with “being that”

Line 121 Delete “that” and “and” and replace “Authors” with “Studies”

Line 122 Replace “state” with “have found” and delete from “has…… up until adaptive capacity” and replace with “and” and then replace “and” with “are”

Line 123 Replace “helping” with “required” and “seen as a” with “is also”

Line 124 Delete “multidimenionsal construct” and “by” and “among different elements” so that this reads “defined as the interaction between the individual and”

Line 125 delete “contains such as”

Line 126 Insert “also” in between can affect”

Line 138 Delete “probably”

Lines 133-134 Delete “and to verify” and replaced with “and to determine”

2.1 Population and recruitment.

Lines 140 Delete Stricto sensu – as this needs translation – and instead use “only those” and delete from “all areas of knowledge” – as the meaning is unclear. Move up “over 18 years of age from line 141 and put after “graduate students” and insert “who” “and” so that this reads “only those graduate students who were 18 years and over and enrolled in Brazilian educational institutions and responded to all survey items were included in this study”.

Line 142 insert “in the survey and delete “the research”

Line 145 Replace “were” with “was”

Line 147 Delete “subsequently” and “the”

Line 152 Delete “constructed by the authors” and start at “This” and add “collected sociodemographic and academic data”

Line 156 Delete “the phase of greatest impact” as meaning is unclear

Line 161 replace “assess” with “assessed” – past tense

Line 167 Move “as well as total score” to later in the text.

Line 169 Replace “is” with “was – once again should be past tense

Line 184 Delete “addresses resilience and is” and replace with “was” and on line 185 insert “resilience and “ before “levels”

3. Results

Line 224 replace “forms” with “survey”

Line 266 replace “having” with “had” – past tense required. Insert :”were” before “without”

Line 242 replace “from” with “enrolled”

4. Discussion

This need a complete reflective re-write as indicated several times by reviewers. Comments below are for English language – but I have not completed the entire re-write of this discussion – as this is up to the authors – and goes beyond what is reasonable.

Line 357 Replace “assesses” with “assessed

Line 369 Delete “students with difficulties in the two impacted stages showing”

Line 317-377 needs a complete re-write. Start with “delete “in the literature and we found that indicate the” and replace with “Other studies have found a”

Line 372 Replace “investigations” with “studies” to be consistent with previous sentence

Line 373 Insert after “fatigued” “ prior to the COVID-19 pandemic” and delete “this”

Line 374 Delete “this challenging scenario” and replace with “during the COVID-19 pandemic”

Line 374 Move up from line 377 “similar to our results” and place after “hand,”

Line 385 Delete “also” and change ”work” to “worked”

Line 390. Add full stop after [44} and start with “such change created “ and delete “bringing” and delete “the development or an” and replace with “on top of already”

Paragraph from lines 393- 401 requires a complete re-write. The changes are so many thay it is easier for me and perhaps clearer for the authors to understand – if I just write out what should be there.

So replace lines 393-406 with the following text:

In public universities in Brazil there is a constant demand for academics or researchers to increase their scientific production as they are under pressure from government classification processes which rank institutions and graduate programs on their research productivity. Researchers or academics must then prioritise their work into teaching, research and extension activities. If they are to be promoted and be competitive for jobs then they must produce publications and have success in research funding. This pressure and bureaucratic structure can cause an overload on academics which is transferred to and has a direct impact on graduate students

It is really beyond my role to rewrite the rest of the text from lines 405-466. This needs however a complete re-write following what I have written above. I have not re-written pages 23-25 lines 426-486 – need careful re-write to bring out the main points.

However – a brief look

Line 425 – delete the entire line as this does not make sense.

Line 437 – more issues with past tense – this should be “were” delete “are”

5. Conclusion

Lines 481-486 Re write from lines 481-487.

Final comments to authors - please review this manuscript in detail - and ensure your efforts to date can be used to bring this to a positive conclusion.

[Note: HTML markup is below. Please do not edit.]

Attachment

Submitted filename: PLOSReviewdasChagasValota.docx

Click here for additional data file.^{(21.2KB, docx)}

PLoS One. 2023 Dec 1;18(12):e0295218. doi: 10.1371/journal.pone.0295218.r006

Author response to Decision Letter 2

1 Sep 2023

Academic Editor

When this manuscript was submitted – it was sent out for review – because it was so novel and original. The review has now been a long process, with over four reviewers at different times. One reviewer suggested a rejection, two suggested a major review and one a minor review. Each time I have suggested a major review – in light of the reviewer’s comments. Each time the revised version has improved, but not significantly enough to allow a change to a minor revision or preferably an acceptance. On each occasion because of the continued novelty and timeliness of the manuscript I have also tried to provide feedback which would be helpful to try and seek an improvement in the manuscript so that it can move towards being published.

I have decided with this final version to do the review myself – in an effort to provide the detail which I hope you may be able to use to bring this manuscript to a conclusion.

As indicated in my last set of comments – this manuscript needed a rigorous review.

Response: From the outset, we have tried to meet all the requests from all the reviewers. I believe that some questions have been difficult due to a lack of understanding of the request, which may be due to the difference in language and also the way in which it is written. In this version we have made every effort to meet the editor with very pertinent suggestions.

After considerable reflection, I have made the decision to allow one more major revision. If the authors decide to review again – then please seek English language assistance in the next review of the manuscript. If the manuscript does not improve considerably in language and formatting – then I will need to reject the next version. I really don’t want to reject this manuscript, given the considerable time it has taken to review – and the efforts of the authors. I urge you to make sure the next version – has dealt with the issues described here and in previous reviews. I start with the reviewers comments which I do not believe have been adequately addressed and move onto more specific comments from this version of the manuscript.

Response: Thank you for this opportunity to review the manuscript and for your comments on any changes.

Reviewer comments which have not yet adequately addressed:

Response: We have reviewed the data and presented the % of women who had children. The change is in the lines: 216-217. We have changed the discussion and emphasized the finding based on our data. The change is in the lines: 407-416.

Response: We have revised the translation of the text with the help of a native speaker.

Response: We have amended the discussion based on the suggestions and the suggested model paragraph. /Alteramos a discussão com base nas sugestões e no modelo de parágrafo que foi sugerido.

Detailed feedback:

Introduction

Lines 75-76 Delete from “before and in…. - up until financial” in line 76. This should then read – “marked by psychological pressure with instability” and insert “with”.

Response: The alteration has been made.

Line 77 replace “to” with “in”, delete “their teaching and research activities” and replace with “guidance and financial instability”.

Response: The alteration has been made.

Line 79 insert “and” between “experiments interrupt”.

Response: The alteration has been made.

Line 83 delete “can lead” and replace with “have been found to”

Response: The alteration has been made.

Line 87 Replace “a” with “for example, a”

Response: The alteration has been made.

Line 88 Make “experiences” experience”

Response: The alteration has been made.

Line 89 Insert “Also” before “In”

Response: The alteration has been made.

Line 92 Delete “Given this scenario” and start at “Fatigue”

Response: The alteration has been made.

Line 113 Delete “data” and replace with “findings”

Response: The alteration has been made.

Line 120 Delete “the” and replace with “being that”

Response: The alteration has been made.

Line 121 Delete “that” and “and” and replace “Authors” with “Studies”

Response: The alteration has been made.

Line 122 Replace “state” with “have found” and delete from “has…… up until adaptive capacity” and replace with “and” and then replace “and” with “are”

Response: The alteration has been made.

Line 123 Replace “helping” with “required” and “seen as a” with “is also”

Response: The alteration has been made.

Line 124 Delete “multidimenionsal construct” and “by” and “among different elements” so that this reads “defined as the interaction between the individual and”

Response: The alteration has been made.

Line 125 delete “contains such as”

Response: The alteration has been made.

Line 126 Insert “also” in between can affect”

Response: The alteration has been made.

Line 138 Delete “probably”

Response: The alteration has been made.

Lines 133-134 Delete “and to verify” and replaced with “and to determine”

Response: The alteration has been made.

2.1 Population and recruitment.

Response: The alteration has been made.

Line 142 insert “in the survey and delete “the research”

Response: The alteration has been made.

Line 145 Replace “were” with “was”

Response: The alteration has been made.

Line 147 Delete “subsequently” and “the”

Response: The alteration has been made.

Line 152 Delete “constructed by the authors” and start at “This” and add “collected sociodemographic and academic data”

Response: The alteration has been made.

Line 156 Delete “the phase of greatest impact” as meaning is nuclear

Response: The alteration has been made.

Line 161 replace “assess” with “assessed” – past tense

Response: The alteration has been made.

Line 167 Move “as well as total score” to later in the text.

Response: The alteration has been made.

Line 169 Replace “is” with “was – once again should be past tense

Response: The alteration has been made.

Line 184 Delete “addresses resilience and is” and replace with “was” and on line 185 insert “resilience and “ before “levels”

Response: The alteration has been made.

3. Results

Line 224 replace “forms” with “survey”

Response: The alteration has been made.

Line 266 replace “having” with “had” – past tense required. Insert :”were” before “without”

Response: The alteration has been made.

Line 242 replace “from” with “enrolled”

Response: The alteration has been made.

4. Discussion

This need a complete reflective re-write as indicated several times by reviewers.

Response: We changed it and tried to write more reflectively.

Comments below are for English language – but I have not completed the entire re-write of this discussion – as this is up to the authors – and goes beyond what is reasonable.

Line 357 Replace “assesses” with “assessed

Response: The alteration has been made.

Line 369 Delete “students with difficulties in the two impacted stages showing”

Response: The alteration has been made.

Line 317-377 needs a complete re-write. Start with “delete “in the literature and we found that indicate the” and replace with “Other studies have found a”

Response: The alteration has been made.

Line 372 Replace “investigations” with “studies” to be consistent with previous sentence

Response: The alteration has been made.

Line 373 Insert after “fatigued” “ prior to the COVID-19 pandemic” and delete “this” Response: The alteration has been made.

Line 374 Delete “this challenging scenario” and replace with “during the COVID-19 pandemic”

Response: The alteration has been made.

Line 374 Move up from line 377 “similar to our results” and place after “hand,”

Response: The alteration has been made.

Line 385 Delete “also” and change ”work” to “worked”

Response: The alteration has been made.

Line 390. Add full stop after [44} and start with “such change created “ and delete “bringing” and delete “the development or an” and replace with “on top of already” Response: The alteration has been made.

So replace lines 393-406 with the following text:

In public universities in Brazil there is a constant demand for academics or researchers to increase their scientific production as they are under pressure from government classification processes which rank institutions and graduate programs on their research productivity. Researchers or academics must then prioritise their work into teaching, research and extension activities. If they are to be promoted and be competitive for jobs then they must produce publications and have success in research funding. This pressure and bureaucratic structure can cause an overload on academics which is transferred to and has a direct impact on graduate students

Response: We would like to thank you for the paragraph template, it was very useful for reformulating the whole discussion.

Response: We rewrote the paragraphs carefully and thoughtfully.

Line 425 – delete the entire line as this does not make sense.

Response: The alteration has been made.

Line 437 – more issues with past tense – this should be “were” delete “are”

Response: The alteration has been made.

5. Conclusion

Lines 481-486 Re write from lines 481-487.

Response: We have rewritten the second paragraph of the conclusion to make it more objective.

Final comments to authors - please review this manuscript in detail - and ensure your efforts to date can be used to bring this to a positive conclusion.

Response: Thank you for the opportunity to review the manuscript once again.

Attachment

Submitted filename: RESPONSE TO REVIEWERS.docx

Click here for additional data file.^{(37.2KB, docx)}

PLoS One. doi: 10.1371/journal.pone.0295218.r007

Decision Letter 3

Pauline M Ross

2 Oct 2023

PONE-D-21-28536R3Fatigue and resilience in Master's and PhD students in the Covid-19 pandemic in Brazil: a cross-sectional studyPLOS ONE

Dear Dr. Valóta,

In general this manuscript has improved and it is very close to acceptance for publication. I would still like to have the authors seek further advice on sentence structure from a native English speaker. I understand this may have already been done – but it could be repeated. The discussion reads better than the introduction – but the purpose of the introduction is to engage the reader – and more could be done here.

Specific areas to fix.

Write the abstract as a coherent 300 word statement without subheadings. Also in the conclusion replace intensify with design – lines 61

See examples on line and the instructions to authors below

The Abstract should:

Describe the main objective(s) of the study
Explain how the study was done, including any model organisms used, without methodological detail
Summarize the most important results and their significance
Not exceed 300 words

Add the aims and research question at the end of the introduction – lines 134 – so that the reader understands the purpose of the study clearly.

Line 175 What is meant here by “horizontal line” – do you mean the scale goes from 0-10? I am not sure how measurements in centimetre are involved? The one I researched on line is a scale from 0-10 – remove reference to cm.

Line 312 What is income five minimum wages above? Perhaps you mean “Having an income which is at least five times greater than the minimum wage is correlated with greater resilience ” Please use this sentence and replace if correct.

Line 314 If these were Master’s students – then why are they retired – what proportion of masters students were retired – is this an important finding? Perhaps reconsider.

Discussion –

Should mainly be written in the past tense – see line 404 – replace “is” with “was” and check throughout.

Line 424 Commence with “This study found” and delete “It was identified”

Line 437 Replace “are” with “were” – past tense again.

==============================

Please submit your revised manuscript by Nov 16 2023 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

We look forward to receiving your revised manuscript.

Kind regards,

Pauline M. Ross, PhD

Academic Editor

PLOS ONE

Journal Requirements:

Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice.

Additional Editor Comments:

Specific areas to fix.

1. Write the abstract as a coherent 300 word statement without subheadings. Also in the conclusion replace intensify with design – lines 61

See examples on line and the instructions to authors below

The Abstract should:

• Describe the main objective(s) of the study

• Explain how the study was done, including any model organisms used, without methodological detail

• Summarize the most important results and their significance

• Not exceed 300 words

2. Add the aims and research question at the end of the introduction – lines 134 – so that the reader understands the purpose of the study clearly.

Line 314 If these were Master’s students – then why are they retired – what proportion of masters students were retired – is this an important finding? Perhaps reconsider.

Discussion –

Should mainly be written in the past tense – see line 404 – replace “is” with “was” and check throughout.

Line 424 Commence with “This study found” and delete “It was identified”

Line 437 Replace “are” with “were” – past tense again.

[Note: HTML markup is below. Please do not edit.]

PLoS One. 2023 Dec 1;18(12):e0295218. doi: 10.1371/journal.pone.0295218.r008

Author response to Decision Letter 3

16 Nov 2023

Academic Editor

Response: We have changed the logic and tried to involve the reader in the new version of the introduction.

Specific areas to fix.

Write the abstract as a coherent 300 word statement without subheadings. Also in the conclusion replace intensify with design – lines 61

Response: The alteration has been made.

Add the aims and research question at the end of the introduction – lines 134 – so that the reader understands the purpose of the study clearly.

Response: We added the questions associated with the objectives that were already described at the end of the introduction.

Response: The alteration has been made.

Line 314 If these were Master’s students – then why are they retired – what proportion of masters students were retired – is this an important finding? Perhaps reconsider.

Response: We have modified the text. This paragraph shows that students who have a source of income from retirement are more resilient and this is important data, as it was a statistically significant variable. Of the 10 students whose source of income comes from retirement, 5 are master's students (50%) and have an average age of 60.

Discussion –

Should mainly be written in the past tense – see line 404 – replace “is” with “was” and check throughout.

Response: The alteration has been made.

Line 424 Commence with “This study found” and delete “It was identified”

Response: The alteration has been made.

Line 437 Replace “are” with “were” – past tense again.

Response: The alteration has been made.

Attachment

Submitted filename: RESPONSE TO REVIEWERS.docx

Click here for additional data file.^{(38.1KB, docx)}

PLoS One. doi: 10.1371/journal.pone.0295218.r009

Decision Letter 4

Pauline M Ross

20 Nov 2023

Fatigue and resilience in Master's and PhD students in the Covid-19 pandemic in Brazil: a cross-sectional study

PONE-D-21-28536R4

Dear Dr. Valóta,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org.

If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org.

Kind regards,

Pauline M. Ross, PhD

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

PLoS One. doi: 10.1371/journal.pone.0295218.r010

Acceptance letter

Pauline M Ross

23 Nov 2023

PONE-D-21-28536R4

Fatigue and resilience in Master's and PhD students in the Covid-19 pandemic in Brazil: a cross-sectional study

Dear Dr. Valóta:

I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department.

If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org.

If we can help with anything else, please email us at customercare@plos.org.

Thank you for submitting your work to PLOS ONE and supporting open access.

Kind regards,

PLOS ONE Editorial Office Staff

on behalf of

Professor Pauline M. Ross

Academic Editor

PLOS ONE

Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

S1 Database

(XLSX)

Click here for additional data file.^{(908.4KB, xlsx)}

S1 Questionnaires. Questionnaire on sociodemographic and academic data.

(DOCX)

Click here for additional data file.^{(29.3KB, docx)}

Attachment

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Attachment

Submitted filename: R2 comments.docx

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PERMALINK

Fatigue and resilience in Master’s and PhD students in the Covid-19 pandemic in Brazil: A cross-sectional study

Izabel Alves das Chagas Valóta

Rafael Rodrigo da Silva Pimentel

Ana Paula Neroni Stina Saura

Rodrigo Marques da Silva

Ana Lucia Siqueira Costa Calache

Marcelo José dos Santos

Roles

Abstract

1. Introduction

2. Method

2.1 Population and recruitment

2.2 Measures

2.2.1 Questionnaire with sociodemographic and academic data

2.2.2 The Revised Piper Fatigue Scale (PFS)

2.2.3 The Visual Analog Fatigue Scale (VAFS)

2.2.4 The Wagnild and Young Resilience Scale

2.3 Data analysis

2.4 Ethical aspects

3. Results

Table 1. Distribution of Master’s and PhD students, according to sociodemographic data (N = 3,331) Brazil, 2023.

Table 2. Distribution of Master’s and PhD students, according to course characteristics and research impact (N = 3,331) Brazil, 2023.

Fig 1. Distribution of the average Fatigue score among graduate students, according to Brazilian states, Brazil, 2023.

Fig 2. Distribution of the average resilience score among graduate students, according to Brazilian states, Brazil, 2023.

Table 3. Mean fatigue and resilience scores by sociodemographic factors, Brazil, 2023.

Table 4. Mean fatigue and resilience scores by academic factors, Brazil, 2023.

4. Discussion

5. Conclusion

Supporting information

Acknowledgments

Data Availability

Funding Statement

References

Decision Letter 0

Pauline M Ross

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Author response to Decision Letter 0

Decision Letter 1

Pauline M Ross

Roles

Author response to Decision Letter 1

Decision Letter 2

Pauline M Ross

Roles

Author response to Decision Letter 2

Decision Letter 3

Pauline M Ross

Roles

Author response to Decision Letter 3

Decision Letter 4

Pauline M Ross

Roles

Acceptance letter

Pauline M Ross

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Associated Data

Supplementary Materials

Data Availability Statement

ACTIONS

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