Work–family conflict and prolonged fatigue among Japanese married male physicians

  • Hiroshi Ohta
  • Koji Wada
  • Masatoshi Kawashima
  • Mayuri Arimatsu
  • Toshiaki Higashi
  • Toru Yoshikawa
  • Yoshiharu Aizawa
Original Article



Fatigue experienced by physicians may not only endanger their own health but may also affect the safety of patients. Such fatigue may be associated with the work environment and personal factors such as work–family conflict (WFC). This study aimed to determine the association between WFC and prolonged fatigue among Japanese married male physicians.


Physicians who graduated from a Japanese medical school answered a mailed anonymous self-report questionnaire. For assessment of WFC and prolonged fatigue, the Japanese versions of the WFC scale and the Checklist of Individual Strength questionnaire (CIS) were used. Prolonged fatigue was defined as the upper quartile of total CIS scores. The WFC scale comprises six dimensions. Total scores were divided into tertiles: low, intermediate, and high levels of WFC. A multiple logistic regression analysis was performed to examine the association between WFC and prolonged fatigue.


A total of 540 male physicians answered the questionnaire, and the data of 444 married male physicians were analyzed. The data were then adjusted for age and work condition factors. Prolonged fatigue was significantly associated with high strain-based work interference with family (WIF; corrected odds ratio, 5.56; 95% confidence interval, 2.55–12.1), intermediate strain-based WIF (2.53, 1.25–5.10), high time-based family interference with work (FIW; 1.92, 1.08–3.40), and there was a weak association with high strain-based FIW (1.93, 0.98–3.83).


Employers should take measures to improve working conditions in hospitals, and give physicians the opportunity to learn how to cope with WFC. These measures could ultimately help prevent prolonged fatigue.


Prolonged fatigue Married male physicians Work–family conflict Japan 



We thank all the physicians who participated in this research. This study was partially funded by the Health Science Center, Sagamihara.

Conflict of interest

None declared.


  1. Aratake Y, Tanaka K, Wada K, Watanabe M, Katoh N, Sakata Y, Aizawa Y (2007) Development of Japanese version of the checklist individual strength questionnaire in a working population. J Occup Health 49:453–460CrossRefGoogle Scholar
  2. Beurskens AJHM, Bültmann U, Kant I, Vercoulen JHMM, Bleijenberg G, Swaen GMH (2000) Fatigue among working people: validity of a questionnaire measure. Occup Environ Med 57:353–357. doi: 10.1136/oem.57.5.353 CrossRefGoogle Scholar
  3. Byron K (2005) A meta-analytic review of work-family conflict and its antecedents. J Vocat Behav 67:169–198. doi: 10.1016/j.jvb.2004.08.009 CrossRefGoogle Scholar
  4. Carlson D, Kacmar K, Williams L (2000) Construction and initial validation of a multidimensional measure of work-family conflict. J Vocat Behav 56:249–276CrossRefGoogle Scholar
  5. Duxbury L, Higgins C (2003) Work-life conflict in Canada in the new millennium. A status report final report. Health Canada, CanadaGoogle Scholar
  6. Fuss I, Nubling M, Hasselhorn H-M, Schwappach D, Rieger M (2008) Working conditions and work-family conflict in german hospital physicians: Psychosocial and organisational predictors and consequences. BMC Public Health 8:1–17. doi: 10.1186/1471-2458-8-353 CrossRefGoogle Scholar
  7. Gaba DM, Howard SK (2002) Patient safety: fatigue among clinicians and the safety of patients. N Engl J Med 347:1249–1255CrossRefGoogle Scholar
  8. Greenhaus J, Beutell N (1985) Sources of conflict between work and family roles. Acad Manage Rev 10:76–88Google Scholar
  9. Greenhaus J, Parasuraman S, Collins K (2001) Career involvement and family involvement as moderators of relationships between work-family conflict and withdrawal from a profession. J Occup Health Psychol 6:91–100CrossRefGoogle Scholar
  10. Hammig O, Gutzwiller F, Bauer G (2009) Work-life conflict and associations with work- and nonwork-related factors and with physical and mental health outcomes: a nationally representative cross-sectional study in Switzerland. BMC Public Health 9:435. doi: 10.1186/1471-2458-9-435 CrossRefGoogle Scholar
  11. Harkonmäki K, Rahkonen O, Martikainen P, Silventoinen K, Lahelma E (2006) Associations of SF-36 mental health functioning and work and family related factors with intentions to retire early among employees. Occup Environ Med 63:558–563. doi: 10.1136/oem.2005.022293 CrossRefGoogle Scholar
  12. Hiyama T, Yoshihara M (2008) New occupational threats to Japanese physicians: karoshi (death due to overwork) and karojisatsu (suicide due to overwork). Occup Environ Med 65:428–429. doi: 10.1136/oem.2007.037473 CrossRefGoogle Scholar
  13. Jansen NW, Kant IJ, van Amelsvoort LG, Kristensen TS, Swaen GM, Nijhuis FJ (2006) Work-family conflict as a risk factor for sickness absence. Occup Environ Med 63:488–494CrossRefGoogle Scholar
  14. Janssen N, Kant I, Swaen G, Janssen P, Schroer C (2003) Fatigue as a predictor of sickness absence: results from the Maastricht cohort study on fatigue at work. Occup Environ Med 60:i71–i76CrossRefGoogle Scholar
  15. Kant I, Bültmann U, Schröer KAP, Beurskens AJHM, van Amelsvoort LGPM, Swaen GMH (2003) An epidemiological approach to study fatigue in the working population: the Maastricht cohort study. Occup Environ Med 60:i32–i39. doi: 10.1136/oem.60.suppl_1.i32 CrossRefGoogle Scholar
  16. Kato M, Yamazaki Y (2009) An examination of factors related to work-to-family conflict among employed men and women in Japan. J Occup Health 51:303–313CrossRefGoogle Scholar
  17. McCue JD (1982) The effects of stress on physicians and their medical practice. N Engl J Med 306:458–463. doi: 10.1056/NEJM198202253060805 CrossRefGoogle Scholar
  18. Miller M, McGowen K (2000) The painful truth: physicians are not invincible. Southern Med J 93:966Google Scholar
  19. Myers M, Gabbard G (2008) The physician as patient: a clinical handbook for mental health professionals. American Psychiatric Pub, Arlington, VirginiaGoogle Scholar
  20. Netemeyer R, Boles J, McMurrian R (1996) Development and validation of work-family conflict and family-work conflict scales. J Appl Psychol 81:400–410CrossRefGoogle Scholar
  21. Payette M, Chatterjee A, Weeks W (2009) Cost and workforce implications of subjecting all physicians to aviation industry work-hour restrictions. Am J Surg 197:820–825CrossRefGoogle Scholar
  22. Simoens S, Hurst J (2006) The supply of physician services in OECD countries. Organisation for Economic Co-operation and Development (OECD) Health Working Papers No 21. Accessed 15 Dec 2010
  23. SPSS (2007) SPSS for windows version 15.0. SPSS Inc., CHICAGOGoogle Scholar
  24. Swaen G, Van Amelsvoort L, Bültmann U, Kant I (2003) Fatigue as a risk factor for being injured in an occupational accident: results from the Maastricht cohort study. Occup Environ Med 60:i88–i92CrossRefGoogle Scholar
  25. Vercoulen J, Swanink C, Fennis J, Galama J, van der Meer J, Bleijenberg G (1994) Dimensional assessment of chronic fatigue syndrome. J Psychosom Res 38:383–392CrossRefGoogle Scholar
  26. Wada K, Arimatsu M, Yoshikawa T, Oda S, Taniguchi H, Higashi T, Aizawa Y (2008) Factors on working conditions and prolonged fatigue among physicians in Japan. Int Arch Occup Environ Health 82:59–66CrossRefGoogle Scholar
  27. Watai I, Nishikido N, Murashima S (2006) Development of a Japanese version of the work-family conflict scale (WFCS), and examination of its validity and reliability. Sangyo Eiseigaku Zasshi 48:71–81 [in Japanese]CrossRefGoogle Scholar
  28. Watai I, Nishikido N, Murashima S (2008) Gender difference in work-family conflict among Japanese information-technology engineers with preschool children. J Occup Health 50:317–327CrossRefGoogle Scholar
  29. West CP, Tan AD, Habermann TM, Sloan JA, Shanafelt TD (2009) Association of resident fatigue and distress with perceived medical errors. JAMA 302:1294–1300CrossRefGoogle Scholar
  30. Yazaki Y, Hasegawa T, Yoshimura H, Yamamoto S, Honda M et al. (2007) A report of the study group on physician supply and demand—survey of working condition of physician. Ministry of Health, Labour and Welfare. Japan. Accessed 15 Dec 2010. [in Japanese]

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Hiroshi Ohta
    • 1
  • Koji Wada
    • 1
  • Masatoshi Kawashima
    • 2
  • Mayuri Arimatsu
    • 3
  • Toshiaki Higashi
    • 3
  • Toru Yoshikawa
    • 4
  • Yoshiharu Aizawa
    • 1
  1. 1.Department of Preventive Medicine and Public HealthKitasato University School of MedicineMinami-ku, SagamiharaJapan
  2. 2.Department of Occupational Health, Graduate School of Medical SciencesKitasato UniversitySagamiharaJapan
  3. 3.Department of Work Systems and Health, The Institute of Industrial Ecological SciencesUniversity of Occupational and Environmental HealthKitakyushuJapan
  4. 4.Department of ResearchThe Institute for Science of LabourKawasakiJapan

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