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Fatigue and recovery among Malaysian doctors: the role of work-related activities during non-work time.

ABSTRACT: OBJECTIVES:This paper aims to estimate the level of acute fatigue, chronic fatigue and intershift recovery among doctors working at public hospitals in Malaysia and determine their inter-relationship and their association with work-related activities during non-work time. DESIGN:Cross-sectional. SETTING:Seven core clinical disciplines from seven tertiary public hospitals in Malaysia. PARTICIPANTS:Study was conducted among 330 randomly-sampled doctors. Response rate was 80.61% (n=266). RESULTS:The mean score of acute fatigue, chronic fatigue and intershift recovery were 68.51 (SD=16.549), 54.60 (SD=21.259) and 37.29 (SD=19.540), respectively. All these scores were out of 100 points each. Acute and chronic fatigue were correlated (r=0.663), and both were negatively correlated with intershift recovery (r=-0.704?and r=-0.670, respectively). Among the work-related activities done during non-work time, work-related ruminations dominated both the more frequent activities and the association with poorer fatigue and recovery outcomes. Rumination on being scolded/violated was found to be positively associated with both acute fatigue (adjusted regression coefficient (Adj.b)=2.190, 95% CI=1.139 to 3.240) and chronic fatigue (Adj.b=5.089, 95% CI=3.876 to 6.303), and negatively associated with recovery (Adj.b=-3.316, 95% CI=-4.516 to -2.117). Doing work task at workplace or attending extra work-related activities such as locum and attending training were found to have negative associations with fatigue and positive associations with recovery. Nevertheless, doing work-related activities at home was positively associated with acute fatigue. In terms of communication, it was found that face-to-face conversation with partner did associate with higher recovery but virtual conversation with partner associated with higher acute fatigue and lower recovery. CONCLUSIONS:Work-related ruminations during non-work time were common and associated with poor fatigue and recovery outcomes while overt work activities done at workplace during non-work time were associated with better fatigue and recovery levels. There is a need for future studies with design that allow causal inference to address these relationships.

SUBMITTER: Mohd Fauzi MF

PROVIDER: S-EPMC7520834 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Fatigue and recovery among Malaysian doctors: the role of work-related activities during non-work time.

Mohd Fauzi Mohd Fadhli MF Mohd Yusoff Hanizah H Mat Saruan Nur Adibah NA Muhamad Robat Rosnawati R Abdul Manaf Mohd Rizal MR Ghazali Maisarah M

BMJ open 20200925 9

<h4>Objectives</h4>This paper aims to estimate the level of acute fatigue, chronic fatigue and intershift recovery among doctors working at public hospitals in Malaysia and determine their inter-relationship and their association with work-related activities during non-work time.<h4>Design</h4>Cross-sectional.<h4>Setting</h4>Seven core clinical disciplines from seven tertiary public hospitals in Malaysia.<h4>Participants</h4>Study was conducted among 330 randomly-sampled doctors. Response rate w ...[more]

PMID: 32978189

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Project description:Neurophysiologic theory and some empirical evidence suggest that fatigue caused by physical work may be more effectively recovered during "diverting" periods of cognitive activity than during passive rest; a phenomenon of great interest in working life. We investigated the extent to which development and recovery of fatigue during repeated bouts of an occupationally relevant reaching task was influenced by the difficulty of a cognitive activity between these bouts. Eighteen male volunteers performed three experimental sessions, consisting of six 7-min bouts of reaching alternating with 3 minutes of a memory test differing in difficulty between sessions. Throughout each session, recordings were made of upper trapezius muscle activity using electromyography (EMG), heart rate and heart rate variability (HRV) using electrocardiography, arterial blood pressure, and perceived fatigue (Borg CR10 scale and SOFI). A test battery before, immediately after and 1 hour after the work period included measurements of maximal shoulder elevation strength (MVC), pressure pain threshold (PPT) over the trapezius muscles, and a submaximal isometric contraction. As expected, perceived fatigue and EMG amplitude increased during the physical work bouts. Recovery did occur between the bouts, but fatigue accumulated throughout the work period. Neither EMG changes nor recovery of perceived fatigue during breaks were influenced by cognitive task difficulty, while heart rate and HRV recovered the most during breaks with the most difficult task. Recovery of perceived fatigue after the 1 hour work period was also most pronounced for the most difficult cognitive condition, while MVC and PPT showed ambiguous patterns, and EMG recovered similarly after all three cognitive protocols. Thus, we could confirm that cognitive tasks between bouts of fatiguing physical work can, indeed, accelerate recovery of some factors associated with fatigue, even if benefits may be moderate and some responses may be equivocal. Our results encourage further research into combinations of physical and mental tasks in an occupational context.

Dataset Information

Fatigue and recovery among Malaysian doctors: the role of work-related activities during non-work time.

Publications

Fatigue and recovery among Malaysian doctors: the role of work-related activities during non-work time.

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