Med & Health 2011; 6(1)(Suppl) | 78
7th Malaysia Indonesia Brunei Medical Science Conference
'TOWARDS A HOLISTIC AND INTEGRATIVE APPROACH IN HEALTHCARE' Equatorial Hotel, Bangi
Day 1: 22nd July 2011 (Friday)
07:30 Registration
08:45
Opening Ceremony Speech by Vice-Chancellor UKM
Speech by Guest of Honour: Deputy Minister of Health
10:05 Morning Tea/Poster exhibition
10:30
Keynote Lecture Medical Education in Malaysia
Professor Tan Sri Dato Wira Dr Sharifah Hapsah Syed Shahabudin Vice-Chancellor UKM
11:00
Plenary 1 (Brunei)
National Cervical Cancer Prevention and Control Programme in Brunei Darussalam Dr Hjh Maslina Haji Mohsin
(Brunei)
11:45 Lunch Symposium 1
12:30 Friday Prayer/Poster exhibition
14:45
Symposium 1 Cancer: Prevention & Risk
Factors
Symposium 2 Medical Education
Symposium 3 Special Research Collaboration Presentation:
ASEAN Doctors’ stress
14:45 - 15:05
Cervical cancer prevention in low resource setting Jakarta –
Indonesian perspective Dr Laila Nuranna
(Indonesia)
PPD in the Medical Curriculum:
Needs & Challenges
Associate Professor Dr Harlina Siraj
(Malaysia)
Dr Mohd Ayub Sadiq @ Lin Naing
(Brunei)
15:05 - 15:25
HPV vaccination for the prevention of cervical cancer
Dr Paul Ng (Malaysia)
The role of spirituality in Holistic Healthcare
Dr Tayyab Hassan (Brunei)
Several coping strategies may protect medical doctors to be
distress Dr Irawati Ismail
(Indonesia)
Stress and its influence factors among doctors in Central Java
Indonesia Dr Zahroh Shaluhiyah
(Indonesia)
15:25 - 15:45
Perceptions, attitudes &
knowledge on Pap smear Test amongst Bruneian – An interim
analysis
Dk Dr Nurol Aini Pg Hj Muhd Kifli
(Brunei)
Tracer Study: Capturing the soft skills competency of FMUI's
medical graduates Dr Estivana Felaza
(Indonesia)
Dr Halim Ismail (Malaysia)
Med & Health 2011; 6(1)(Suppl) | 102
SYMPOSIUM 3 Zahroh S
STRESS AND ITS INFLUENCE FACTORS AMONG DOCTORS IN CENTRAL JAVA INDONESIA
Zahroh S, Antono S
Universitas Diponegoro, Semarang, Indonesia
Background:
Doctor’s stress is interrelated with the quality of care, patient satisfaction, patient compliance and continuity of care. This study identified coping mechanism related to stress level among doctors in an area of Indonesia.
Materials and Methods:
A purposive sampling method among medical doctors (MDs) was carried out in Central Java between March till May 2011. Personal stress inventory was employed to assess stress scale, coping orientation and problem experienced (COPE) using ASEAN doctor stress survey questionnaire. Linear regressions were used to identify the relationship between the stressors, coping mechanism and stress level.
Results:
A total number of 218 MDs participated this study. Mean score of stress level for female was 6.6 (SE 5.8) and male 7.8 (SE 4.7). The higher mean score was managerial duties 11.8 (SE 4.9) for female and 12.6 for male, and job dissatisfaction 8.6 (SE 4.6) for female and 9.3 (SE 4.7) for male. Active coping and planning was the highest score of coping mechanism, for both gender. All stressor variables had significant correlation to stress level, denial and behavioural disengagement for both gender. Males showed that conflict with work and home life had a direct effect on stress level (t value 2.06), however indirect effects on stress level suggested that work environment affects coping mechanism (t value -2.09). Managerial duties also affected the coping strategy (t value 3.36) which in turn affects stress level. In addition females revealed that only conflict at work and home life has a direct effect on stress level.
Conclusion:
The majority of doctors had relatively low score of stress level. Male doctors had slightly higher level of stress compared with female doctors. Managerial duties and job dissatisfaction were salient stressors. In order to reduce the problems, most doctors used an active coping and planning strategy. Further research is needed to explore and implement intervention strategies.
Key words:
stress, coping mechanism, medical doctor, central java
Stress and its influence factors among doctors in (Central Java) Indonesia
Dr.Zahroh Shaluhiyah,MPH,PhD Master Program of Health Promotion Diponegoro University Indonesia
Background
• Health services in Indonesia are undergoing enormous change
• Health care professionals especially doctors are experiencing pressure
• Stressfull doctors jeopardizing the quality of health care services, lowered to patient care quality, increasing in absenteeism, health care costs, and personnel turn over
Background
• Work-related stress has been identified as an occupational hazard for various professionals.
• Estimated 20-60% physicians in developed countries reported having stress
• Strongly related with workload, longer shift work, interference of work on home life, feeling undervalued, unsupported, boredom, abide by rules and regulations
• Female doctors are reported having higher level of stress compare to their male counterpart
Background
• Coping mechanism to reduce stress
• Coping is the process through which the
individual manages the demands of the person- environment relationship that are appraised as stressful and the emotions they generate
• The functions : dealing with the problem and regulating emotion
• Lazarus (1984)
Background
• The situation of stress among doctors in ASEAN region is still not well studied
• the instruments used are based mostly on the tools made for the population of developed countries
• ASSET :
Malaysia (UKM)
Indonesia ( UI and UNDIP)
Brunei (Univ of Brunei Darusalam Singapore (NUS)
Objectives
• This study assessed the stress level among doctors
• Identified the stressors and coping mechanism related to stress level among doctors in Central Java Indonesia.
STRESSORS:
1. Work Environment
2. Conflict with work and home life 3. Organizational, interaction and support 4. Job dissatisfaction
5. Managerial duties 6. Patient care 7. Role 8. Job task
COPING STRATEGIES:
1. Active coping and planning
2. Denial and behavioral disengagement 3. Seeking social support for instrumental and
emotional reasons 4. Turning to religion
STRESS LEVEL Conceptual Framework
Method
• Study population.
▫ Medical doctors who are registered to the medical council/board in Central Java Indonesia
• Study Design
▫ Cross sectional study
• Sample method and sampling size
▫ Purposive Sampling by urban and rural, private and public practices at hospitals and clinics in Central Java, Indonesia.
▫ Totally 216 doctors involved
Method
• Personal stress inventory was employed to assess the stress scale
• Coping orientation and problem experienced (COPE) by Carver employed to identify coping mechanism used by individual to reduce stress.
• ASEAN stressor inventory was developed and employed to assess the stressors.
Method
• Simple linear regression were used to identify the relationship between the stressors, coping mechanism and stress level
• Multiple linear regression used to predict the factors influence the stress level.
• Path analysis also employed to provide estimates of the magnitude and significance causal connections between sets of variables.
Respondent Characteristics
Total respondents:
216 doctors
Personal and family characteristics
No Variables Male (%) Female
(%) 1 Age
25-30 37-42
> 42
36.2 22.1 41.7
31.4 24.8 44.8 2 Marital status
Single Married Divorce
12.8 86 1.2
14.3 85.7 0 3 Number of family burden
Less than 3 persons 3 persons or more
60 40
74.1 25.9
Education
Institution
Working characteristics
No Variables Male (%) Female (%)
1 Employment status Government
Private company Private practice Other
86.7 8.9 2.2 2.2
84.1 8.8 1.8 5.3 2 Working period
Less than 1o years 10-20 years More than 20 years
84.4 9.60 6.0
87.2 12.0 0.8 3 Position
Functional physicians Structural phycisians residency
46.0 34.2 19.8
51.6 34.1 14.3
Stress Level
mean score of stress level for female is 6.6 (SD 5.8) and male 7.8 (SD 4.7) (range score 0-54)
Stressors variable
Univariate
• the higher mean score are managerial duties 11.8 (SD 4.9) for female and 12.6 for male, and job dissatisfaction 8.6 (SD 4.6) for female and 9.3 (SD 4.7) for male.
Bivariate analysis
• All stressor variables have significant correlation to stress level
Stressors variable
Multivariate analysis
• Conflict with work and home life as predictor of stress level for both male and female
• Job dissatisfaction as predictor of stress level for male only
• Managerial duties as predictor of stress level for female only
Stressors
Coping mechanism
• Univariate
Active coping and planning is the highest score of coping mechanism for both female (mean 21.1, SD 4.1) and male (mean18.7, SD 5.6)
• Bivariate analysis
Turning to religion (male t -2.405 an female t - 2.504) and denial and behavioral disengagement (male t 3.406 and female t 3.506) have
correlation to stress level
Coping mechanism
Multivariate analysis
• Denial and behavioral disengagement as predictor to stress level for male t 3.406
• Denial and behavioral engagement (t 3.367 and turning to religion (t -2.295) as predictor of stress level for female
Coping Strategies
Path diagram
• Male respondents shows that conflict with work and home life has a direct effect on stress level with t value 2.06
• Indirect effects on stress level shows that work environment affect coping mechanism with t value 2.09 which in turn affects stress level
• Managerial duties also affect coping strategy with t value 3.36 which in turn affect stress level
Path Diagram
• For female respondents path analysis revealed that only conflict with work and home life has a direct effect on stress level t value 1.97
CONCLUSION
• The majority of doctors in this study have
relatively low score of stress level. Male doctors have slightly higher mean score level of stress compare with female doctors. Managerial duties is the highest score of stressors for female and job dissatisfaction is the highest score for male.
• In terms of reducing the problems, most doctors used an active coping and planning strategy and
turning to religion.
CONCLUSION
• Conflict with work and home life has a direct effect to stress level for both male and female
• Denial and behavioral disengagement is the factors influenced stress level for both female and male
• Work environment and managerial duties have indirect effect to stress level through coping mechanism for male.
