Journal of Preventive Medicine and Public Health

Original Article

Modeling Fatigue and Work Stress in Aircraft Maintenance Personnel at Sultan Hasanuddin Airport, Makassar, Indonesia: A PLS-SEM Study on Quality of Life: Lalu Muhammad Saleh, Syamsiar Siang Russeng, Mahfuddin Yusbud, Tae-Gu Kim, Nurul Mawaddah Syafitri, Fatimah Azzahrah Zainuddin, Andi Alifah Kultsum Umniyah Tenri; J Prev Med Public Health. 2026;59(3):308-317. Published online April 6, 2026; DOI: https://doi.org/10.3961/jpmph.25.726

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Abstract Summary PDF: Objectives
This study aimed to develop and test a comprehensive model analyzing direct and indirect relationships among workload, demographic factors, fatigue, work stress, and quality of life among aircraft maintenance personnel (AMP).
Methods
This cross-sectional study was conducted at the maintenance, repair, and overhaul facility at Sultan Hasanuddin Airport, Makassar. Data collection combined structured interviews, standardized questionnaires (the NASA Task Load Index, Work Fatigue Feeling Measurement Questionnaire, Depression Anxiety Stress Scale-21, and World Health Organization Quality of Life-BREF), and objective measures (a Cocoro Meter for stress and an oximeter for physical workload). The model was examined using partial least squares structural equation modeling (PLS-SEM), which is well-suited to complex models with latent variables and non-normally distributed data.
Results
In the PLS-SEM analysis, physical workload (β=0.229, p=0.018) and work experience (β=0.277, p=0.007) were significantly and directly associated with fatigue. Age significantly predicted work stress (β=0.371, p=0.001). Crucially, fatigue (β=−0.344, p=0.002) and work stress (β=−0.385, p<0.001) had significant negative direct effects on quality of life and were central mediators. No direct effects of exogenous variables on quality of life were observed. Cross-tabulation supported these findings; subgroups with higher physical demands, longer tenure, and older age reported greater fatigue, higher stress, and lower quality of life.
Conclusions
Fatigue and work stress are pivotal mediators that are significantly associated with reduced quality of life among AMP. Interventions to reduce physical workload and provide targeted support for more experienced and older workers may improve well-being and safety in the aviation maintenance industry.; Summary

Key Message
Fatigue and work stress are serious occupational health concerns that can threaten aviation safety. This study showed that greater physical workload, longer work experience, and older age were associated with higher fatigue and work stress, which in turn were significantly associated with lower quality of life among AMP. Strategic interventions, such as improved ergonomic design, structured breaks, and targeted support for more experienced and older workers, may help address these risks. By investing in the well-being of AMP, aviation organizations may strengthen both worker health and the reliability and safety of flight operations.

English Abstract

Relationship between Job Stress Contents, Psychosocial Factors and Mental Health Status among University Hospital Nurses in Korea.: Hyun Suk Yoon, Young Chae Cho; J Prev Med Public Health. 2007;40(5):351-362.; DOI: https://doi.org/10.3961/jpmph.2007.40.5.351

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OBJECTIVES
The present study was intended to assess the mental health of nurses working for university hospitals and to establish which factors determine their mental health. METHODS: Self-administered questionnaires were given to 1,486 nurses employed in six participating hospitals located in Daejeon City and Chungnam Province between July 1st and August 31st, 2006. The questionnaire items included sociodemographic, job-related, and psychosocial factors, with job stress factors (JCQ) as independent variables and indices of mental health status (PWI, SDS and MFS) as dependent variables. For statistical analysis, the Chi-square test was used for categorical variables, with hierarchical multiple regression used for determining the factors effecting mental health. The influence of psychosocial and job-related factors on mental health status was assessed by covariance structure analysis. The statistical significance was set at p<0.05. RESULTS: The factors influencing mental health status among subject nurses included sociodemographic characteristics such as age, number of hours of sleep, number of hours of leisure, and subjective health status; job-related characteristics such as status, job satisfaction, job suitability, stresses such as demands of the job, autonomy, and coworker support; and psychosocial factors such as self-esteem, locus of control and type A behavior patterns. Psychosocial factors had the greatest impact on mental health. Covariance structure analysis determined that psychosocial factors affected job stress levels and mental health status, and that the lower job stress levels were associated with better mental health. CONCLUSIONS: Based on the study results, improvement of mental health status among nurses requires the development and application of programs to manage job stress factors and/or psychosocial factors as well as sociodemographic and job-related characteristics.

Summary

Citations

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Original Article

Industrial fatigue due to banking operations with VDT.: Jung Wan Koo, Seung Han Lee; Korean J Prev Med. 1991;24(3):305-313.

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Abstract PDF: In order to investigated industrial fatigue due to visual display terminal (VDT) work of banking operations, the questionnaires survey for subjective symptoms of fatigue was carried out on 470 bank clerks who had been engaged in VDT work for various length of work hours. The questionnaires comprised three groups of 10 items each, representing dullness and sleepiness (level of cerebral activation), difficulty in concentration (level of motivation) and bodily projection of fatigue. The results were as follows: 1. Of the 30 items of questionnaires, the highest percentage was accounted for by 'eye strain' (51.5%), followed by 'feel stiffness in the neck or the shoulders' (33.4%), 'feel a pain in the low back' (26.8%), 'whole body feels tired' (19.6%) and 'feel headache' (17.9%) in the order of sequence. 2. Ten average weighted score for the first group of questionnaire items (dullness and sleepiness) was the largest among three groups and was followed by the third group (bodily projection of fatigue) and the second item group (difficulty in concentration) in the order of sequence, suggesting the heavier mental stress of VDT work in banking operations rather than physical burden. 3. In terms of the age and sex of workers, work duration and VDT work percentage, the difference in average weighted score was noted only between sex, the score of female being larger than that of male. 4. The complaint rates of subjective symptoms showed close associations with the subjective optimums of room temperature, ventilation, illumination and noise level. 5. The significant correlation was showed between age, work duration and item of 'whole body feels tired', between VDT work percentage and items of 'eye strain' and 'feel stiffness in the neck or shoulders' and between all items of subjective symptoms.; Summary

English Abstracts

Correlates of Self-rated Fatigue in Korean Employees.: Sei Jin Chang, Sang Baek Koh, Myung Gun Kang, Sook Jung Hyun, Bong Suk Cha, Jong Ku Park, Jun Ho Park, Seong Ah Kim, Dong Mug Kang, Seong Sil Chang, Kyung Jae Lee, Eun Hee Ha, Mina Ha, Jong Min Woo, Jung Jin Cho, Hyeong Su Kim, Jung Sun Park; J Prev Med Public Health. 2005;38(1):71-81.

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Abstract PDF: OBJECTIVE
To elucidate the correlates of self-rated fatigue in Korean employees. METHODS: The data for 10, 176 (men, 7, 984; women, 2, 192; mean age, 34.2; SD: 8.8) employees recruited from a nationwide sample were examined. A structured questionnaire was used to measure the participants' fatigue, sociodemographics (sex, age, education, and marital status), job-related characteristics (work duration, grade at work, work hours, shiftwork, employment type, and magnitude of workplace), and health-related habits (smoking, drinking, coffee intake, and exercise). Two types of measurement for fatigue were used to evaluate the magnitude of fatigue: self-rated question and a standardized measurement tool (Multidimensional Fatigue Scale: MFS). RESULTS: According to the self-rated fatigue, 32% of employees reported that they felt fatigue for the past two weeks, and 9.6% of males and 8.7% of females had experienced excessive fatigue (6 months or more). Hierarchical multiple regression analysis showed that fatigue measured by MFS was more common in women, younger, college or more graduated, single, and employees who do not regularly exercise. Fatigue was also associated with long work hours, and the size of the workplace (< 1, 000 employees). CONCLUSIONS: These results suggest that fatigue has been considered as a common complaint, and that it is affected by job-related factors like work hours and the workplace size as well as sociodemographics or health-related behaviors. Further research is needed to clarify the effects of fatigue on adverse health outcomes, work performance, work disability, sick absence and medical utilization, and to examine the relationship of job characteristics (e.g.: work demand, decision latitude) to fatigue.; Summary

Fatigue Subjective Symptoms and Risk Factors in Bank Workers with VDT.: Joo Ja Kim, Kyung Jae Lee; J Prev Med Public Health. 2005;38(1):45-52.

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Abstract PDF: OBJECTIVES
To investigate the fatigue subjective symptoms and VDT related risk factors in bank workers. METHODS: A total of 2178 workers (62.8% male, 37.2% female) were surveyed with a self-administered and structured questionnaire consisting of 30 fatigue symptoms and other VDT related factors regarding work characteristics, work postures, work environments, personal medical histories, etc. Fatigue subjective symptoms were divided into 3 groups of 10 questions each: a dull, drowsy and exhausted feeling (Group I), a mental decline of working motivation (Group II), or a feeling of incongruity in the body and dysfunction of autonomic nervous system (Group III). Each question was weighted as 0 for 'none', 1 for 'sometimes', and 2 for 'always'. RESULTS: Mean age was 35.8+/-7.2 years (38.9+/-6.0 in males, 30.6+/-5.8 in females), Mean work duration was 7.7+/-7.1 years (8.4+/-7.4 in males, 6.5+/-6.4 in females). Mean symptom score in males was 11.0+/-8.1 (4.9+/-3.1 in Group I, 3.0+/-3.1 in Group II, 3.1+/-2.8 in Group III) and in females was 17.5+/-9.5 (7.0+/-3.8 in Group I, 4.6+/-3.5 in Group II, 5.9+/-3.4 in Group III). Mean scores were higher in the order of Group I> III> II. Females had significantly higher scores than males in all three groups (p< 0.001). Most common symptoms complained of as 'always' or 'sometimes' were 'feel strained in the eyes' (85.4%) among Group I, 'find difficulty in thinking' (54.2%) among Group II, and 'feel stiff in the shoulders' (72.3%) among Group III. In multiple regression analysis, female, non-straight spine at workstation, more VDT work hours, history of physical therapy, glare of screen, overtime work, young age, and non-horizontal elbow position were significantly related with high score of symptoms. CONCLUSIONS: More supportive VDT work environment and education for correct work postures for VDT workers are recommended.; Summary

Original Article

Comparison of Subjective Symptoms of Fatigue and Salivary pH among Teachers between Special School and Elementary.: Soon Ja Lee, Doohie Kim; Korean J Prev Med. 1989;22(4):506-517.

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Abstract PDF: Two hundred and fifty teachers of special school (for the disabled) and 414 elementary school teachers were selected for the targets in order to compare their degrees of fatigue symptoms and to find what kind of relationship is between subjective symptoms of fatigue and pH is the saliva. It was 30 minutes before their closing hours on April 21th, 1989 that their physical, mental and neuro-sensory symptoms and salivary pH were examined. The test results are summarized as follows: It is observed that an interrelation between subjective fatigue and pH in their saliva shows a significant relationship between physical and neuro-sensory symptoms in a sense of statistics. The rate of subjective fatigue complained by the special teachers is higher than that by the elementary teachers. In the case of salivary pH, the special teachers' is as a whole lower than the elementary teachers'. The complain rates in each item, checked of special teachers are generally higher than those of the elementary teachers. It is in the mental symptom related item that there are many sub-items which show significant difference. According to the average of salivary pH based on the degrees of complained symptoms shown in the pH related items, the salivary pH of the group with complained symptoms is lower than that of the group without complained symptoms. In the rate of complaints, by sex, both sexes of the special teachers show high ones but salivary pH is low. The complain rate of mental symptoms shown by female group from the special teacher is significantly higher(p<0.05). By age, the group in their thirties from the special teachers show the higher complain rate of mental symptoms (29.3%) and the lower salivary pH (p<0.05) than that (15.1%) of the elementary teachers belonging to the same age category. However, the special teachers in their forties show the lower complain rate of physical symptoms that of the elementary teachers (p<0.05). From the viewpoint of their working years, the special teachers below 14 years and elementary teachers above 15 years in their career show high complain rates. Among those who belong to the category of 10-14 working years, the special teachers show the higher complain rate of mental symptoms than that of their counterparts. In the case of the salivary pH, the special teachers of all working-year categories show the higher pH than that of the elementary teachers. But there is not significantly difference. From the viewpoint of sleeping hours in the previous night of the questionnaire surveyed, among those who slept for over 7 hours, the special teachers show the higher complain rate of mental symptoms with significant difference, but the lower salivary pH than that of their counterparts. From the viewpoint of their marital status, existence of disease history, the special teachers show the higher complain rate of subjective fatigue, but the lower salivary pH than that of the elementary teachers respectively. According to the above results, the special teachers generally show the higher complain rate of subjective fatigue, the lower salivary pH, and the higher complain rate of mental symptoms. To prevent the possible accumulation of mental fatigue of the special teachers, ways and means to make use of leisure time, recreational facilities are necessarily provided. Since the degree of fatigue and salivary pH have a correlation to some extent, it is necessary that further continuous studies on the correlation between the degrees of fatigue and salivary pH should be pursued.; Summary

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