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.
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CITATION STYLE
Mohd Fauzi, M. F., Mohd Yusoff, H., Mat Saruan, N. A., Muhamad Robat, R., Abdul Manaf, M. R., & Ghazali, M. (2020). Fatigue and recovery among Malaysian doctors: the role of work-related activities during non-work time. BMJ Open, 10(9), e036849. https://doi.org/10.1136/bmjopen-2020-036849