MALTESE DOCTORS

AND THEIR WELLBEING

MGT 3181 APPLIED RESEARCH TOOLS FOR BUSINESS

KirstyFarrugia_3181_proposal.docx
372100L
TABLE OF CONTENTS

Table Of Contents.....................................................................................................................................................1
Section 1: Stating The Problem................................................................................................................................1
Section 2: Research Project Rationale And Issues...................................................................................................2
Section 3: Research Rationale And Philosophy........................................................................................................4
Section 4: Your Reflections About Your Project.......................................................................................................6
References................................................................................................................................................................7
 MALTESE DOCTORS AND THEIR
WELLBEING
SECTION 1: STATING THE PROBLEM

Throughout the years, the definition of wellbeing evolved away from the basic clinical
definition; ‘absence of disease or infirmity’. According to the World Health Organization
(WHO), wellbeing conceptualizes health as a basic human right which safeguards the
complete physical, mental, and social aspects of people.

Medical doctors are fundamental in promoting a healthy lifestyle and advise against risky
behaviours amongst the general population. Safeguarding the practitioners’ wellbeing will
ultimately influence the biopsychosocial aspects of their patient cohort, while allowing for an
effective approach in optimizing patient safety within the community. The doctors’ training
curriculum is too focused on clinical theory and practice which in turn gives less importance
to their basic personal wellbeing. Authorities tend to forget the burden and great
responsibility that doctors’ shoulder through their work with patients and their families.
Unfortunately, this problem poses multiple sequelae in their mental and physical health
status. Keeping in mind all the above, the question stands; do doctors practice what they
preach?

The aim of this study is to answer two pertinent questions:

1. How many doctors are obese?

2. How many of the practitioners suffer from depression?

Key words: Wellbeing/ Obesity/ Depression/ Lifestyle

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SECTION 2: RESEARCH PROJECT RATIONALE AND ISSUES

Recent advances in science and technology have left a positive impact on the quality of life of
human beings. Doctors play a crucial role in health promotion within the population.
Investing in proposals and schemes which encourage safe practices and healthy work
environments amongst the medical community, will allow for better patient care and
adequate use of resources without jeopardizing the populations’ wellbeing. This study will
focus on two factors which are integral to the health status of medical doctors: depression and
obesity.

Depression:

Depression is a major health concern worldwide, and recent research suggests that
approximately 264 million people suffer from a form of depressive disorder (W.H.O, 2020).
This mental condition affects people of any age and due to its complexity and vague
symptomatology, it remains underdiagnosed and underestimated in many populations.
Depression is detrimental to the physical health of a person allowing for unfavourable
consequences to the biological processes and the social interactions. Its definition spans on a
spectrum, from mild and temporary to severe and persistent, requiring varied clinical
management decisions and appreciation of its severity and manifestation in different people
(Hall-Flavin, n.d).

Although several governments invest in programmes to increase awareness of depression in

the community, this mental condition remains a taboo, especially at the workplace. Several
factors have been implicated in the susceptibility of depression among doctors including long
hours, constant contact with ill patients and the great responsibility one shoulders. Modern
meta-analyses have observed higher rates of depression among medical practitioners in
comparison to the general population. In fact, a study conducted in Cape Town, South Africa,
confirmed that 30% of healthcare doctors suffered from moderate to grievous depression
(Outhoff, 2019).

Furthermore, Atif et al. (2016), conducted a study aimed to monitor doctors working at
Combined Military Hospital, Lahore (Pakistan), between February ’14 to January ’15 for
anxiety and depression. Data revealed that 34% and 24.8% of doctors experienced a moderate
level of anxiety and depression while 7.2% and 1% experienced severe levels.

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Mata et al (2015), conducted a systematic review and meta-analysis with the aim to provide a
summarized estimate of the prevalence of depression and depressive symptoms amongst
doctors. This study included a systematic search of EMBASE, ERIC, MEDLINE, and
PsycINFO for data issued between January 1963 – September 2015. It resulted that the
summary estimate was 28%.

Obesity.

The outbreak of the increase in obesity experienced by all countries around the world
imposes a greater challenge towards the prevention and promotion of health. Obesity can be
defined as excess fat accumulating within the body which may impair a person’s physical
health (W.H.O, n.d). The underlying cause of obesity is having an imbalance between the
calorie intake and the calories used. According to the World Health Organization, having a
body mass index higher than 25 implies being overweight while higher than 30 means obese.
Obesity can be seen to be fueled by the dynamic environment in which we live in such as
economic growth, globalization, advancements in modern transportation and the increase in
the consumption of processed foods (Hruby et al. , 2014). The issue of obesity has escalated
to significant proportions, contributing to millions of deaths per year.

Medical practitioners are there to set an example for their patients, passing on the message
that obesity can lead to many chronic diseases such as diabetes, cancer and cardiac disease.
However, they themselves are still not impervious to the obesity crisis. In the 2007
Physicians Health Study, involving 19,000 doctors, 40% resulted to be overweight while 23%
were obese (Hansra, 2019).

Another study conducted by Mohd Isa et al. (2016), aimed to estimate the prevalence of
obesity amongst doctors working in Brunei Darussalam (South East Asia). This was a cross-
sectional study where data was obtained from the doctor’s occupational health records. Using
the W.H.O classification, it was concluded that out of a total of 431 doctors, 160 (37.1%)
resulted to be overweight and 73 (16.9%) to be obese.

Furthermore, Gonzalez- Ortiz et al. (2008) conducted a cross-sectional study in Mexico with
the aim of identifying the prevalence of obesity and dyslipidemia in health care workers. The
study was carried out on 775 doctors which, according to themselves, were presumed to be
healthy. Out of all the 775 participants, 63.3% resulted to be overweight or obese.

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SECTION 3: RESEARCH RATIONALE AND PHILOSOPHY

The first step towards achieving a credible research is to establish and build a solid research
methodology by identifying the research philosophy. The research philosophy represents the
researchers’ beliefs and views on the world. As a philosophy for our research, we will follow
with positivism adhering to the view that our research findings are observable and can be
quantified. We will act independently, working towards an objective study by quantifying
and observing the wellbeing of doctors by viewing how many of the doctors are obese and/or
suffer from depression.

Based on this view, we can adopt the deductive approach. A deductive approach starts from a
captivating theory/hypothesis and ends by testing its implications with relevant data. As
aforementioned, various research showed that obesity and depression is observed amongst
medical doctors. We will use the deductive approach to observe whether this is also the case
among Maltese medical doctors. Furthermore, we will make use of a mono-method,
conducting this research by using the quantitative methodology. This requires the
encompassing of a collection of methods involved with the systematic investigation of a
phenomena by making use of statistics and numerical data. Using the quantitative method, we
will collect and analyse data which can be objectively measured using numbers and statistics
to be able to answer our two prominent research questions. By taking a large same of medical
doctors, we can show through statistics and numbers, how much of our Maltese doctors are
obese and suffer from depression.

Additionally, we will need to formulate our research strategy that will allow us to collect the
right data. For the purpose of this study, we shall be using surveys, specifically
questionnaires, to collect primary data. Questionnaires offer a practical, quick, and cheap way
to collect large volumes of information as well as they allow for easy analysis of the results.
The questionnaire will be split into 2 parts, relating to each research question respectively. It
will include a mix of both open ended and closed ended questions depending on the
information needed. Once the research strategy is formed, we must decide on the time
horizon for the study. We will conduct a cross-sectional study, focusing on data at a specific
point in time. A cross-sectional study fits bets as it is observational with the aim to describe
the characteristics of the medical doctors in terms of obesity and depression, and not to
determine the cause-and-effect.

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Moving on to data collection, we will engage in the process of collecting and analyzing
insights for our research. To enable us to have a credible research, it is crucial to collect data
that is accurate, relevant, and reliable to ultimately be able to make an accurate statistical
analysis. There are various methods on how data can be collected such as through in-person
interviews, online surveys, phone surveys and mail surveys. For this study, we shall use
online surveys. As our participants are medical doctors, having very tight work schedules, it
fits best to send out a survey on their e-mail address, enabling them to answer at their own
leisure. In this period of time, everybody checks and communicates via e-mail and therefore
one would expect an adequate response rate. Additionally, this method of collection can be
viewed as low cost and prone to a low probability of data error.

For this qualitative research, it is essential that the sample chosen is representative of the
whole population. The sample will follow a non-probability convenience technique where the
participants will be doctors serving at Mater Dei Hospital and that have been working in this
profession at this chosen hospital for at least one year. Both genders coming from different
health departments will be included in the sample. Since we will be making use of the
convenience technique, no sample size will be chosen. A list of all the eligible doctors will be
obtained from Mater Dei as well as a formal approval from the ethics committee and a
written approval from the participants. The questionnaire will be then sent via e-mail address
to the selected sample.

Finally, the last step is to analyze the collected data. We need to engage ourselves in a
process to take the data and transform it to derive insights and information. This process is
normally done using a computer software. The Statistical Package for the Social Sciences
(SPSS) will be the software used to perform the statistical analysis of our data.

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SECTION 4: YOUR REFLECTIONS ABOUT YOUR PROJECT

Depression and obesity are two subjects which are dominant in our society, yet they are still
seen to be taboo topics, especially on the workplace. People may not want to give in to the
idea that they may be depressed or obese. But the reality is that depression and obesity are
two of the world’s major problems. Being such a sensitive topic to many individuals, one of
the biggest challenges in conducting this research is the lack of participation from the
doctors. They may be hesitant to face the truth that they are giving advice and promoting a
healthy wellbeing while in fact they themselves may be depressed and/or obese. An
additional difficulty that we may encounter is that our sample is not representative of all the
characteristics of the doctors at Mater Dei Hospital. Since we are using the convenience
sampling technique, we can not produce representative results. Furthermore, as we had
previously mentioned, doctors have a busy and stressful job, having minimum free time,
therefore doctors may not respond to the questionnaire.

The aim for this study is to uncover the truth of whether the life of a doctor imposes threats to
their wellbeing. On a daily basis, they are giving constant advice to help their patients recover
while no one, not even themselves, are giving attention to their own wellbeing. Through the
results of this research, we will benefit from a greater awareness and therefore potential for
further treatment and help towards doctors which will ultimately benefit both their own
wellbeing and also the service and advice given to their patients.

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REFERENCES

 Atif, K., Khan, H., Zia Ullah, M., Shah, F. and Latif, A., 2016. Prevalence of anxiety
and depression among doctors; the unscreened and undiagnosed clientele in Lahore,
Pakistan. Pakistan Journal of Medical Sciences,.
 Hall-Flavin, D., n.d. Severe, persistent depression. [online] Mayo Clinic. Available at:
<https://www.mayoclinic.org/diseases-conditions/depression/expert-answers/clinical-
depression/faq-20057770> [Accessed 1 March 2021].
 Hansra, D., 2019. Physicians Should Lead by Example to Combat the Obesity
Epidemic - The ASCO Post. [online] The ASCO post. Available at:
<https://ascopost.com/issues/november-25-2019/physicians-should-lead-by-example-
to-combat-the-obesity-epidemic/> [Accessed 1 March 2021].
 Hruby, A. and Hu, F., 2014. The Epidemiology of Obesity: A Big
Picture. PharmacoEconomics, 33(7), pp.673-689.
 M. Gonzalez-Ortiz, E. Martinez-Abundis, E. Hernandez-Salazar and J.A. Robles-
Cervantes, 2008. Obesity and dyslipidaemia in primary care physicians. Acta
Cardiologica, 63(3), pp.331-334.
 Mata, D., Ramos, M., Bansal, N., Khan, R., Guille, C., Di Angelantonio, E. and Sen,
S., 2015. Prevalence of Depression and Depressive Symptoms Among Resident
Physicians A Systematic Review and Meta-analysis. JAMA,.
 MILLER, M. and McGOWEN, K., 2000. The Painful Truth. Southern Medical
Journal, 93(10), pp.966-973.
 Mohd Isa, A., Lai, A., Ghouse, H. and Sonk King, O., 2016. Prevelance of overweight
and obesity among doctors in Brunei Darussalam. Brunei International Medical
Journal, [online] 12(4), pp.127-133. Available at:
<http://www.bimjonline.com/PDF/Bimj%202016%20Volume%2012,%20Issue
%204/bimj2016124127.pdf> [Accessed 1 March 2021].
 Oxtoby, K., 2016. Doctors’ own mental health issues. thebmj,.
 Who.int. 2020. Depression. [online] Available at:
<https://www.who.int/news-room/fact-sheets/detail/depression> [Accessed 1 March
2021].
 Who.int. n.d. Obesity. [online] Available at:
<https://www.who.int/health-topics/obesity#tab=tab_1> [Accessed 1 March 2021].