The application of FGD to support concept of National Policy on health and safety work procedures on ATC employees in Indonesia
Lalu Muhammad Saleha,
, Syamsiar S. Russenga, Istiana Tadjuddinb, Nurul Mawaddah Syafitria, Iva Hardi Yantic, Mahfuddin Yusbuda
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a Department of Occupational Safety and Health, Faculty of Public Health, Hasanuddin University, Makassar 90245, Indonesia
b Psychology Program, Faculty of Medicine, Hasanuddin University, Makassar 90245, Indonesia
c Department of Epidemiology, Faculty of Public Health, Hasanuddin University, Makassar 90245, Indonesia
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Russeng, Istiana Tadjuddin, Nurul Mawaddah Syafitri, Iva Hardi Yanti, Mahfuddin Yusbud" "autores" => array:6 [ 0 => array:4 [ "nombre" => "Lalu Muhammad" "apellidos" => "Saleh" "email" => array:2 [ 0 => "ms_lalu79@yahoo.com" 1 => "pmc@agri.unhas.ac.id" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Syamsiar S." "apellidos" => "Russeng" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Istiana" "apellidos" => "Tadjuddin" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Nurul Mawaddah" "apellidos" => "Syafitri" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "Iva Hardi" "apellidos" => "Yanti" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 5 => array:3 [ "nombre" => "Mahfuddin" "apellidos" => "Yusbud" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Department of Occupational Safety and Health, Faculty of Public Health, Hasanuddin University, Makassar 90245, Indonesia" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Psychology Program, Faculty of Medicine, Hasanuddin University, Makassar 90245, Indonesia" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Department of Epidemiology, Faculty of Public Health, Hasanuddin University, Makassar 90245, Indonesia" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Indonesian aviation Industry has been developed rapidly in the last 10 years. According to International Air Transport Association (IATA), Indonesia has enormous potential in the aviation sector and it is estimated that in 2034 Indonesia will be one of the big six in air travel market in the world.<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">1,2</span></a> It is also expected that there will be 270 million domestic and international passengers who will across Indonesia airspace.<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">1,2</span></a> Therefore, to anticipate this situation, the government airline companies and flight attendants should find the best solution in preventing flight accidents. The occupational health and safety (OHS) aspect are important to identify the hazards and risks which potentially causing flight accidents. Prevention and control of occupational accidents and diseases in aviation world should be implemented and should be the responsibilities of airline companies, employees, and passengers.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Air traffic controller (ATC) plays important roles in airplane flights due to their function in driving and guiding the pilot during the airplane operation which starts from take-off until landing process. However, these responsibilities are burdening since there was an enormous number of airplane which crossing the airspace in the expeditious speed at the same time.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">3</span></a> In other words, the ATC working procedure requires a high level of professionalism, concentration, velocity, accuracy, and dexterity.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">4</span></a> Therefore, occupational health and safety of ATC officer should be a main priority and should receive sufficient attention in which will optimize the working performance of ATC officer.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Relaxation and wellness program play important role in reducing fatigue and stress.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">6</span></a> Payne (2000) in Sudram et al. (2016) states the most effective and commonly used strategy in relieving stress and creating deep relax condition, especially in muscle relaxation is the progressive muscle relaxation techniques.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">6</span></a> In addition, a study by Alexopoulus et al. (2014) shows that simple relaxation training (respiration and progressive muscle relaxation) leads to a significant decrease in stress and cortisol level among professional workers after eight weeks.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">7</span></a> This study aims to conduct a focused discussion regarding the concept of a national policy on health and safety work procedures for ATC employees in Indonesia.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="par0020" class="elsevierStylePara elsevierViewall">This study is a qualitative study with a case study design. Data were collected by Focus Group Discussion (FGD) which was conducted on 14–15 November 2019. A total of 11 respondents were applied in this study, including Manager for Control and Evaluation of AirNav Indonesia Personnel, GM of Lombok branch, GM of Surabaya branch, Operations Manager of Surabaya branch, GM of Denpasar branch, Chairman and Member of the Central International Air Transport Association (IATCA), Manager Safety, Security and Standardization of MATSC branch, Chairman and Member of the IATCA Branch Management Council of MATSC Branch and ATC Employee.</p><p id="par0025" class="elsevierStylePara elsevierViewall">In the implementation of focus group discussion, questions to informants were in the form of open-ended questions. Informants can freely express opinions regarding the draft national policy draft on health and safety work procedures for ATC employees in Indonesia. Data was analyzed with content analysis approach. A content analysis approach was done to draw conclusions by identifying FGD results. As for the data collection instruments used were FGD guidelines, audio recorders, cameras, and stationery.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Result</span><p id="par0030" class="elsevierStylePara elsevierViewall">A total of 11 respondents participated in this study. From the FGD, it was found that all of the respondents have a positive perception to this research and show their willingness to support the study.<span class="elsevierStyleDisplayedQuote" id="dsq0005"><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">“…relaxation as one of the outputs from this research is very good and I will fully support this research since no academician has ever focused on ATC. In our company, there are various regulations targeting the operational aspect. However, the regulation related to humanist aspects is limited…”</span></p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">(GM of Lombok branch)</p></span><span class="elsevierStyleDisplayedQuote" id="dsq0010"><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">“Hopefully, it will give a positive output for us, the government should develop a national policy regarding how to handle stress so that the ATC officers will have a longer life, are prevented from stroke, and not lose their job due to stress. Me, personally really support it…”</span></p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">(GM of Denpasar branch)</p></span><span class="elsevierStyleDisplayedQuote" id="dsq0015"><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">“Basically we very support it, sir and maybe the implementation can be seen after three years. Is not it sir? Maybe after three years we will involve you guys to see the safety aspects.”</span></p><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">(Manager for Control and Evaluation of AirNav Indonesia Personnel)</p></span></p><p id="par0035" class="elsevierStylePara elsevierViewall">Some informants give their support to this research since it is a new idea in the aviation industry and important for creating a solution, however, it is often forgotten.<span class="elsevierStyleDisplayedQuote" id="dsq0020"><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">“…we fully support this event, if it possible we should do it continuously because we as a board of trustee feel that these aspects have not been done to any people in this organization…”</span></p><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">(Chairman of the Central International Air Transport Association)</p></span><span class="elsevierStyleDisplayedQuote" id="dsq0025"><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">“I am really interested because it is a new idea, relaxation as an output of this research. One of them is very good and I really support it because previously the academician never focus on ATC officers.”</span></p><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">(GM of Lombok branch)</p></span></p><p id="par0040" class="elsevierStylePara elsevierViewall">In this FGD, some informants give their suggestions related to research location which revealed that high stress level does not only occur in a location with high traffic but also among ATC officers in low traffic.<span class="elsevierStyleDisplayedQuote" id="dsq0030"><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">“what Ms. Minke said is right, in some cases break down observation does not only occur during high traffic but also in low traffic, such as two. It means that if we see the relation of productivity and stress, stress not only occurs because of busyness but also could occur due to jobless.”</span></p><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">(Manager Safety, Security and Standardization of MATSC branch)</p></span></p><p id="par0045" class="elsevierStylePara elsevierViewall">Some ATC officers also participated in this study and shared their perception related to one month of relaxation.<span class="elsevierStyleDisplayedQuote" id="dsq0035"><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">“Personally, what I felt in that one month is that when I have a night shift previously I feel tired and directly fall asleep. But after relaxation, I feel fresh, especially on a hard night shift and in the morning I have some activities. During this time the office has a lot of activities and I was very busy but unexpectedly I feel good.”</span></p><p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">(TA-ATC Employee)</p></span><span class="elsevierStyleDisplayedQuote" id="dsq0040"><p id="spar0095" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">“my testimony in the 30 days of accompaniment, it was really relaxed. When I want to go for work I feel I have new spirit.”</span></p><p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">(RH-ATC Employee)</p></span></p><p id="par0050" class="elsevierStylePara elsevierViewall">It is expected that this research will result in more professional policy to ensure ATC officer wellness that will create a better working environment, accuracy, emotional intelligence, concentration, and healthy mind in which will create better information to the pilot.<span class="elsevierStyleDisplayedQuote" id="dsq0045"><p id="spar0105" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">“if the findings of this research show good benefit I would say that it is needed. I could say that this research is needed … I will support this research because it highly needed.”</span></p><p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">(Member of the Central International Air Transport Association)</p></span><span class="elsevierStyleDisplayedQuote" id="dsq0050"><p id="spar0115" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">“…this tools is required since we do not have it yet. How is the simple relaxation in working place? But if it compulsory it can be regulated with standard operational procedure (SOP). Just adjust it with the needs. But this is good recommendation, relaxation should be done based on the needs, is not it?”</span></p><p id="spar0120" class="elsevierStyleSimplePara elsevierViewall">(GM of Lombok Branch)</p></span><span class="elsevierStyleDisplayedQuote" id="dsq0055"><p id="spar0125" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">“If there is a good perception towards relaxation why not put it into policy so that it will have regulation. So we will work will regulation but in organizational aspect for me, if we see it as a good thing maybe we will inform the member that it is good and instruct the member to do it.”</span></p><p id="spar0130" class="elsevierStyleSimplePara elsevierViewall">(Chairman of the Central International Air Transport Association)</p></span></p><p id="par0055" class="elsevierStylePara elsevierViewall">Related to the input of the draft and academic script, informants gave some inputs related to the words redaction, additional reference related to the aviation regulation, and regulation related to ATC's authority. In addition, the determination of relaxation time among ATC members should be flexible since all airports have different control time.<span class="elsevierStyleDisplayedQuote" id="dsq0060"><p id="spar0135" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">“I just have a short look, just redactional suggestion, … just add task and authority of ATC adjusted with the regulation.”</span></p><p id="spar0140" class="elsevierStyleSimplePara elsevierViewall">(Manager for Control and Evaluation of AirNav Indonesia Personnel)</p></span><span class="elsevierStyleDisplayedQuote" id="dsq0065"><p id="spar0145" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">“…in my opinion, it will be better if it is flexible. For example, it does not have to be 08.30… for me, it is better if there is no time because it for all of us. So in the morning shift, just write on rest, do not have to mention the time. Because in every airport there is an arrangement. Maybe there is airport which starts at 8, does not necessarily 7 o’clock. There are which start at 6, in every branch is different. So just adjust with the rest hours…”</span></p><p id="spar0150" class="elsevierStyleSimplePara elsevierViewall">(Member of the IATCA Branch Management Council of MATSC Branch)</p></span></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Discussion</span><p id="par0060" class="elsevierStylePara elsevierViewall">Based on this research, generally informants have a positive perception of the research among ATC office since their work requires a high level of accuracy in controlling the airplane during take-off and landing. According to the informant, it is highly possible for ATC officers to have high level of stress because ATC working unit is very complex and systematic since they have to ensure flight safety. Informants suggest that stress among ATC officers is caused by several factors such as high traffic. Some studies revealed factors that affect mental health of ATC officers. A study by Jou and Tang (2013) in Taiwan revealed that workforce in Taiwan is inadequate, therefore the work pressure and workload is significantly higher and causing stress.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">4</span></a> Stress among ATC officers will give a negative impact on the officer's work which could cause a human error as well as flight accidents.</p><p id="par0065" class="elsevierStylePara elsevierViewall">According to Susanti (2017), to prevent mental health disorders and fatigue as well as minimizing human error caused by ATC officer's workload, the availability of policy to ensure and optimize flight safety is important.<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">8</span></a> In 2018, Saleh et al. found a safety performance model for ATC officer, which is progressive muscle relaxation technique.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">5</span></a> In our study, two ATC officers who already perform relaxation in one month gave positive reactions regarding the changes they experienced.</p><p id="par0070" class="elsevierStylePara elsevierViewall">The purpose of relaxation is to reduce stimulation and bring the psychological and physiological relax atmosphere In psychological aspect, relaxation could stimulate healthy, relax, and peaceful feeling as well as reducing tension and anxiety.<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">9</span></a> In addition, the physiological benefit of relaxation is to reduce blood pressure, and to improve respiration and heart rate. There is a significant difference in work stress between pre-test and post-test in the intervention group with a value of <span class="elsevierStyleItalic">z</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>−2670 and a value of <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.008 (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05) so that there is a significant reduction in work stress after being given relaxation therapy.<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">10</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">All of air space activities, flight navigation, airplanes, flight security and safety as well as the supporting and general facilities have been regulated in Government Regulation no. 77 in 2012 about General Company of Indonesian Flight Navigation Services Institute and Law no. 1 in 2009 about aviation.<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">11−13</span></a> However, those regulations have not fully optimized for the reduction of flight accidents as well as security and safety of aviation workers. Therefore, it is necessary to develop national policy related to health and safe working procedure for ATC officers which include management model of psychological fatigue that will increase ATC officers’ health status.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Conclusion</span><p id="par0080" class="elsevierStylePara elsevierViewall">It can be concluded that in general all informants view positively and support the concept of a national policy on health and safety work procedures for ATC employees in Indonesia. Informants are aware of the workload borne by ATC officers and on the other hand, they have to maintain performance to stay focused on controlling flight safety so that solutions are needed to reduce the workload, besides that this research is seen as a new idea because eventually things are forgotten. So far it can be noticed by academics. The existence of this national policy is expected to have a good impact on ATC officers. Therefore, it is hoped that a policy will be formed that focuses on improving ATC performance so that it can work healthily and safely, either as a national policy or as one of the Standard Operating Procedures (SOP) for ATC officers.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conflicts of interest</span><p id="par0085" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:9 [ 0 => array:3 [ "identificador" => "xres1632514" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1456666" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 3 => array:2 [ "identificador" => "sec0010" "titulo" => "Methods" ] 4 => array:2 [ "identificador" => "sec0015" "titulo" => "Result" ] 5 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 6 => array:2 [ "identificador" => "sec0025" "titulo" => "Conclusion" ] 7 => array:2 [ "identificador" => "sec0030" "titulo" => "Conflicts of interest" ] 8 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2021-06-28" "fechaAceptado" => "2021-07-30" "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1456666" "palabras" => array:5 [ 0 => "ATC" 1 => "FGD" 2 => "Health" 3 => "Policy" 4 => "Safety" ] ] ] ] "tieneResumen" => true "resumen" => array:1 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">This study aims to conduct a focused discussion regarding the concept of a national policy on health and safety work procedures for ATC employees in Indonesia.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The research is a qualitative study with case study design. Data was collected through Focus Group Discussion (FGD) method. A total of 11 informants participated in this study. Data were analyzed with content analysis method.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">It was found that all informants have positive perception to this model and agree to support the ATC employee's policy development.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">It can be concluded that in general, all informants support the concept of a national policy on health and safety work procedures for ATC employees in Indonesia. Therefore, it is hoped that a policy will be formed that focuses on improving ATC performance so that it can work healthy and safely.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Peer-review under responsibility of the scientific committee of the 3rd International Nursing, Health Science Students & Health Care Professionals Conference. 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