Nur Adibah Mat Saruan

The COVID-19 pandemic potentially increases doctors’ work demands and limits their recovery opportunity; this consequently puts them at a high risk of adverse mental health impacts. This study aims to estimate the level of doctors’ fatigue, recovery, depression, anxiety, and stress, and exploring their association with work demands and recovery experiences. This was a cross-sectional study among all medical doctors working at all government health facilities in Selangor, Malaysia. Data were collected in May 2020 immediately following the COVID-19 contagion peak in Malaysia by using self-reported questionnaires through an online medium. The total participants were 1050 doctors. The majority of participants were non-resident non-specialist medical officers (55.7%) and work in the hospital setting (76.3%). The highest magnitude of work demands was mental demand (M = 7.54, SD = 1.998) while the lowest magnitude of recovery experiences was detachment (M = 9.22, SD = 5.043). Participants reported a higher acute fatigue level (M = 63.33, SD = 19.025) than chronic fatigue (M = 49.37, SD = 24.473) and intershift recovery (M = 49.97, SD = 19.480). The majority of them had no depression (69.0%), no anxiety (70.3%), and no stress (76.5%). Higher work demands and lower recovery experiences were generally associated with adverse mental health. For instance, emotional demands were positively associated with acute fatigue (adj. b = 2.73), chronic fatigue (adj. b = 3.64), depression (adj. b = 0.57), anxiety (adj. b = 0.47), and stress (adj. b = 0.64), while relaxation experiences were negatively associated with acute fatigue (adj. b = −0.53), chronic fatigue (adj. b = −0.53), depression (adj. b = −0.14), anxiety (adj. b = −0.11), and stress (adj. b = −0.15). However, higher detachment experience was associated with multiple mental health parameters in the opposite of the expected direction such as higher level of chronic fatigue (adj. b = 0.74), depression (adj. b = 0.15), anxiety (adj. b = 0.11), and stress (adj. b = 0.11), and lower level of intershift recovery (adj. b = −0.21). In conclusion, work demands generally worsen, while recovery experiences protect mental health during the COVID-19 pandemic with the caveat of the role of detachment experiences.

Unplanned absenteeism (UA), which includes medically certified leave (MC) or emergency leave (EL), among nurses may disturb the work performance of their team and disrupt the quality of patient care. Currently, there is limited study in Malaysia that examines the role of stressors in determining absenteeism among nurses. Therefore, apart from estimating the prevalence and the reasons of UA among nurses in Malaysia, this study aims to determine its stressor-related determinants. A cross-sectional study was conducted among 697 randomly sampled nurses working in Selangor, Malaysia. Most of them were female (97.3%), married (83.4%), and working in shifts (64.4%) in hospital settings (64.3%). In the past year, the prevalence of ever taking MC and EL were 49.1% and 48.4%, respectively. The mean frequency of MC and EL were 1.80 (SD = 1.593) and 1.92 (SD = 1.272) times, respectively. Meanwhile, the mean duration of MC and EL were 4.24 (SD = 10.355) and 2.39 (SD = 1.966) days, respectively. The most common reason for MC and EL was unspecified fever (39.2%) and child sickness (51.9%), respectively. The stressor-related determinants of durations of MC were inadequate preparation at the workplace (Adj.b = −1.065) and conflict with doctors (adjusted regression coefficient (Adj.b) = 0.491). On the other hand, the stressor-related determinants of durations of EL were conflict with spouse (Adj.b = 0.536), sexual conflict (Adj.b = −0.435), no babysitter (Adj.b = 0.440), inadequate preparation at workplace (Adj.b = 0.257), lack of staff support (Adj.b = −0.190) and conflict with doctors (Adj.b = −0.112). The stressor-related determinants of the frequency of MC were conflicts over household tasks (Adj.b = −0.261), no time with family (Adj.b = 0.257), dangerous surroundings (Adj.b = 0.734), conflict with close friends (Adj.b = −0.467), and death and dying (Adj.b = 0.051). In contrast, the stressor-related determinants of frequency of EL were not enough money (Adj.b = −0.334), conflicts with spouse (Adj.b = 0.383), pressure from relatives (Adj.b = 0.207), and inadequate preparation (Adj.b = 0.090). In conclusion, apart from the considerably high prevalence of unplanned absenteeism and its varying frequency, duration and reasons, there is no clear distinction in the role between workplace and non-workplace stressors in determining MC or EL among nurses in Malaysia; thus, preventive measures that target both type of stressors are warranted. Future studies should consider longitudinal design and mixed-method approaches using a comprehensive model of absenteeism.

Introduction: Doctors are exposed to various psychosocial hazards such as high task demands and demanding work schedule which may influence fatigue, recovery, stress, job satisfaction, wellbeing, and work-family interface. This research generally aims to examine the interrelationship between work-home domain variables with outcomes of fatigue, its recovery, and others related outcomes such as work-to-family conflict, general wellbeing, and perceived stress level among doctors working at public hospital at general and day-level on-call duty. Methods: This is a multicenter analytical mix cross sectional (general) and longitudinal (day-level) research among proposed 390 randomly-sampled on-call doctors working at seven core clinical disciplines from seven public tertiary hospitals in Malaysia. Data will be collected three times: (a) any days after obtaining informed consent (cross sectional), (b) at the end of on-call duty (first wave longitudinal), and (c) at the beginning of subsequent work period (second wave longitudinal). Data will be modelled by covariance-based structural equation modelling (SEM). Conclusion: This research is well justifiable in view of limited available research on complex interrelationship of work domain, home domain and work-home boundary control with fatigue, recovery and other psychological health consequences (e.g. stress, wellbeing, work-home conflict) among doctors, particularly in Asia and developed countries, including Malaysia. This research is expected to provide strong evidence to policy makers in developing prevention and management policy related to fatigue, recovery and other psychological health consequences among doctors. Keywords: doctor, fatigue, recovery, on-call, intershift, wellbeing, stress,

Dual competing responsibilities between work and family are the challenges faced by most of the healthcare staff. Ineffective handling of these responsibilities may contribute to absenteeism which further disrupt the quality of work and reduce customer satisfaction. The aims of this study were to determine the prevalence of job absenteeism and to identify the association between family responsibilities and job absenteeism among nurses in teaching hospital. This was a cross sectional study targeted to nurses working in medical and surgical field based in a hospital. Questionnaires were distributed using stratified random sampling. Those with working services of less than one year were excluded. The mean age was 35.9 (SD=6.44) years old. Majority were female (94.0%) and Malay (96.0%). The one-year prevalence of absenteeism was 78.0% and majority were due to emergency leaves. Taking care of elderly and no help obtained for taking care of child showed significant associations with job absenteeism which both yielded four times higher odds for being absent. Employees with additional family responsibilities should receive support by the organisation to prevent further job absenteeism among nurses.