{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T13:00:22Z","timestamp":1793106022240,"version":"4.5.0"},"reference-count":75,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2020,9,25]],"date-time":"2020-09-25T00:00:00Z","timestamp":1600992000000},"content-version":"unspecified","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004515","name":"Universiti Kebangsaan Malaysia","doi-asserted-by":"publisher","award":["Geran Peneraju Cabaran Perdana (GIP-2018-005)"],"award-info":[{"award-number":["Geran Peneraju Cabaran Perdana (GIP-2018-005)"]}],"id":[{"id":"10.13039\/501100004515","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2020,8,25]]},"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Seven core clinical disciplines from seven tertiary public hospitals in Malaysia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Study was conducted among 330 randomly-sampled doctors. Response rate was 80.61% (n=266).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      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=\u22120.704\u2009and r=\u22120.670, 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.\n                      <jats:italic>b<\/jats:italic>\n                      )=2.190, 95% CI=1.139 to 3.240) and chronic fatigue (Adj.\n                      <jats:italic>b<\/jats:italic>\n                      =5.089, 95% CI=3.876 to 6.303), and negatively associated with recovery (Adj.\n                      <jats:italic>b<\/jats:italic>\n                      =\u22123.316, 95% CI=\u20134.516 to \u20132.117). 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.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-036849","type":"journal-article","created":{"date-parts":[[2020,9,25]],"date-time":"2020-09-25T17:35:45Z","timestamp":1601055345000},"page":"e036849","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Fatigue and recovery among Malaysian doctors: the role of work-related activities during non-work time"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6826-8391","authenticated-orcid":false,"given":"Mohd Fadhli","family":"Mohd Fauzi","sequence":"first","affiliation":[{"name":"Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia"},{"name":"Occupational and Environmental Health Unit, Selangor State Health Department, Shah Alam, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanizah","family":"Mohd Yusoff","sequence":"additional","affiliation":[{"name":"Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nur Adibah","family":"Mat Saruan","sequence":"additional","affiliation":[{"name":"Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia"},{"name":"Occupational and Environmental Health Unit, Selangor State Health Department, Shah Alam, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosnawati","family":"Muhamad Robat","sequence":"additional","affiliation":[{"name":"Occupational and Environmental Health Unit, Selangor State Health Department, Shah Alam, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohd Rizal","family":"Abdul Manaf","sequence":"additional","affiliation":[{"name":"Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maisarah","family":"Ghazali","sequence":"additional","affiliation":[{"name":"Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia"},{"name":"Occupational and Environmental Health Unit, Selangor State Health Department, Shah Alam, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,9,25]]},"reference":[{"key":"2026062608034043000_10.9.e036849.1","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.trf.2015.01.003","article-title":"A review of definitions of fatigue \u2013 and a step towards a whole definition","volume":"29","author":"Phillips","year":"2015","journal-title":"Transp Res Part F Traffic Psychol Behav"},{"key":"2026062608034043000_10.9.e036849.2","doi-asserted-by":"crossref","first-page":"1098","DOI":"10.1002\/ajim.22503","article-title":"Real-time fatigue reduction in emergency care clinicians: the SleepTrackTXT randomized trial","volume":"58","author":"Patterson","year":"2015","journal-title":"Am J Ind Med"},{"key":"2026062608034043000_10.9.e036849.3","unstructured":"Meijman TF . 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