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 Table of Contents  
ORIGINAL ARTICLE
Year : 2018  |  Volume : 19  |  Issue : 2  |  Page : 141-149

The relationship between professional quality of life and general health of postgraduates in a Tertiary Care Hospital


1 Post Graduate, Department of Psychiatry, Mamata Medical College, Khammam, Telangana, India
2 Associate Professor, Department of Psychiatry, Mamata Medical College, Khammam, Telangana, India
3 Professor, HOD, Department of Psychiatry, Mamata Medical College, Khammam, Telangana, India
4 Professor, Department of Psychiatry, Mamata Medical College, Khammam, Telangana, India

Date of Web Publication31-Dec-2018

Correspondence Address:
Dr. Raghuram Macharapu
Department of Psychiatry, Mamata Medical College, Khammam, Telangana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/AMH.AMH_32_18

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  Abstract 


Introduction: Professional quality of life (ProQOL) is the measure that everyone feels in relation to their work. Both the positive and negative aspects of doing a job, influence the ProQOL. The majority of people spend more time at work than they do anywhere else, doing anything else.
Aims and Objectives: The aim of this research is to study the relationship between ProQOL and general health in the postgraduates of a tertiary care hospital.
Methodology: This is a cross-sectional study, which is conducted at Mamata General Hospital in Khammam, Telangana during a 6-month period (2017). The tools used are the ProQOL questionnaire and general health questionnaire.
Results: Statistical analysis needs to be done, and the results will be analyzed and presented later.
Conclusion: The current study is carried out to support the findings between the ProQOL and general health among postgraduates at a tertiary care hospital.

Keywords: General Health, professional quality of life, relationship


How to cite this article:
Narukurthi P, Macharapu R, Mallepalli PK, Babu RS. The relationship between professional quality of life and general health of postgraduates in a Tertiary Care Hospital. Arch Ment Health 2018;19:141-9

How to cite this URL:
Narukurthi P, Macharapu R, Mallepalli PK, Babu RS. The relationship between professional quality of life and general health of postgraduates in a Tertiary Care Hospital. Arch Ment Health [serial online] 2018 [cited 2019 May 26];19:141-9. Available from: http://www.amhonline.org/text.asp?2018/19/2/141/248887




  Introduction Top


Postgraduates are under constant emotional tension, physical, and mental fatigue. Overwork can negatively influence both, medical personnel, and health care of patients, because of the risk of an injury increases, as well as emotional exhaustion and risks of professional errors.[1] Sustained fatigue caused by work may lead to a cascade of symptoms which leave negative effect on the quality of professional actions and on the physical life of a medical person himself/herself.[2] Therefore, the typical psychosocial issues are the burnout (BO) syndrome and compassion fatigue (CF). The BO syndrome is mentioned as one of the main health issues concerning work among the professionals in health-care.[3]

The professional quality of life (ProQOL) measures the quality of the way that people feel in relation to their work. ProQOL is influenced by both negative and the positive aspects of doing the job. The compassion of fatigue and compassion satisfaction (CS) are two aspects of ProQOL. The positive part is CS, and the negative one is CF. CS is things such as anger, frustration, and depression type of BO. The second part, which is secondary traumatic stress, is the negative aspect that includes feeling driven by fear and work related to trauma.[4] Supporting the positive and negative effects of care such as BO, depression, or fatigue are essential aspects of recruiting and retaining workers in their professional job. Three major phenomena that have been documented in other professions are CF, CS, and BO.[5]

CF comprises two components–BO and secondary traumatic stress. The symptoms of this condition are normal displays of chronic stress. Physicians experience these symptoms resulted from associating with patients who are suffering, traumatized or time demanding.[6] CS, a related concept, is about the pleasure a clinician derives from being able to do his work well. For example, the clinician may feel it be a pleasure to treat patients through his skills. He may feel positive about his colleagues or his ability to contribute to the work setting or even the greater good of society. A term with related connotations is BO. It is defined as a feeling of hopelessness and difficulties in dealing with work or in carrying out one's job effectively. These negative feelings usually have a gradual onset. They often stem from the feeling that one's effort make no difference, or they result from a very high workload or a nonsupportive work environment.

ProQOL is a complex concept because it is directly affected by dynamics of the work environment (organizational and task-wise), the individual's personal characteristics and one's exposure to trauma in the workplace, both primary and secondary trauma.[7]

Secondary traumatic stress is a negative feeling driven by fear and work-related trauma. It is important to remember that some trauma at work can be direct (primary) trauma. Work-related trauma is a combination of both primary and secondary trauma, resulting from the knowledge about a traumatizing event experienced by a significant other. It is the stress resulting from helping or wanting to help traumatic stress acquires symptoms by exposure to a traumatized individual and not from exposure to the traumatic event itself. Empathy and exposure are two central concepts in secondary traumatic stress.[8] Secondary traumatic stress can develop suddenly and without much warning. Symptoms of secondary traumatic stress can also include a sense of helplessness and confusion and feeling isolated from supporters. These symptoms often are not connected to real causes.[9] Secondary traumatic stress can be viewed as an occupational hazard for persons who provide direct patient care to traumatized victims.

The current study focusses to determine the relationship between ProQOL (CS, BO, and secondary traumatic stress) and the general health (physical dysfunction, anxiety and sleep disorder, social dysfunction, and severe depression) of postgraduates at Mamata Medical College and General Hospital, Khammam, Telangana.

Aims and objectives

The aim is to study the relationship between ProQOL and general health in the postgraduates of a Tertiary Care Hospital.


  Methodology Top


Place of study

A study was conducted among Postgraduates of Medical, Surgery and Para-clinical departments, respectively, in Mamata Medical College and General Hospital, Khammam, Telangana.

Study period

The study period is from August 2017 to January 2018.

Study sample

A total of 150 postgraduates were approached. They were then provided with the questionnaires with a verbal introduction. Participants were asked to rate their responses for the two scales used in this study.

Study design

This was cross-sectional study.

Inclusion criteria

All the postgraduates during the study duration were included in the study.

Exclusion criteria

Postgraduates who did not agree to participate in the study.

Materials

Two questionnaires were used in the current research study:

  1. ProQOL questionnaire[10],[11]


  2. This is a 30-item version of self-report instrument designed to measure the positive and negative affect of helping others, who experience suffering and trauma. Health-related ProQOL includes three subdomains; CS, BO and secondary traumatic stress, respectively. Each subdomain has 10 questions. Questions of CS include question numbers 3, 6, 12, 16, 18, 20, 22, 24, 27, 30. Questions of BO scale include 1, 4, 8, 10, 15, 17, 19, 21, 26, 29. Questions for secondary traumatic stress include 2, 5, 7, 9, 11, 13, 14, 23, 25, 28. Each question had six options (0 = never; 1 = rarely; 2 = a few times; 3 = somewhat often; 4- often; 5 = very often). Each subdomain is scored individually as low, average, or high (Low-22 or less, Average-23 to 41, and High-42 or more out of 50).

  3. General health questionnaire (GHQ)[12],[13]


  4. This is a 28-item self-report questionnaire developed by Goldberg in 1978 that contains four subscales measuring somatic symptoms, anxiety and sleep disorder, social dysfunction, and depression. Each sub-scale contains seven items and each item is scored on a four-point Likert scale. The score for each subscale ranges from 0 to 21. The total score is obtained by summing up the scores of all subscales indicating ranges from 0 to 84 and a lower score indicates higher general health status. The validity and reliability of the questionnaire were determined in various studies and were also estimated and confirmed in Iran. By conducting a pilot study, Yaghoubi assessed the specificity and sensitivity of the questionnaire as 86.5% and 82%, respectively, and the cut-off score as 23 based on a Likert-scale scoring. The reliability coefficient of the questionnaire was estimated at 88% using test-retest and Cronbach's alpha.


Sociodemographic profile

Age, profession, economic, and marital status.

Procedure

The participants were provided with a general introduction to the study and were then asked to volunteer to complete the survey. Those who agreed (134 students) completed the two questionnaires.

Statistical analysis

The data from both the scales was coded using Microsoft Excel- spreadsheet. All the entries were double checked for any possible keyboard error. Karl Pearson's Coefficient of Correlation was used to determine the relationship between General Health and ProQOL. Statistical analysis was performed by using statistical package for social sciences[14] for windows version 20.0 (IBM Corp., IBM SPSS Statistics for Windows, Armonk, NY, USA).


  Results Top


Overall, 134 postgraduates with a mean age of 28.05± (2.54) years were included in the study, among whom there were 69 (51.4%) males and 65 (48.5%) females. [Table 1] shows the population information regarding gender, marital status, socioeconomic status, and department group. [Table 2] indicated sociodemographic characteristics in individual study groups. [Table 3] indicated the distribution of mean and standard deviation of general health and ProQOL subscales. [Table 4] includes the mean and standard deviation general health and ProQOL in individual groups (medical, surgical, and paraclinical postgraduates). [Table 5], [Table 6], [Table 7] include a correlation matrix of the study variables and their subscales. According to the information provided in [Table 7], there is a significant negative relationship between the general health subscales (physical dysfunction, anxiety-sleep disturbance, and depression) and CS. A negative relationship means that if the general health subcomponents reduce, this will increase compassion in postgraduates. Furthermore, there is a positive relationship between the components of ProQOL (BO and secondary traumatic stress) and general health subcomponents (physical dysfunction, anxiety-sleep disturbance, and depression). This means that whenever the ProQOL subcomponent increases, it will increase general health subcomponent resulting in distress. [Table 8] shows the mean and standard deviation of sociodemographic variables in the study population with respect to the ProQOL and general health. [Table 9] includes correlation among the sociodemographic variables and the subdomains of ProQOL. [Table 10] notes the correlation between sociodemographic variables and the sub domains of general health. [Table 11] shows the mean and standard deviation of sociodemographic variables in the study population with respect to ProQOL and general health among postgraduates of medical, surgical, and para-clinical departments. [Table 12] notes the correlation between sociodemographic variables and the subdomains of ProQOL among postgraduates of medical departments. [Table 13] includes the correlation between sociodemographic variables and the subdomains of general health among postgraduates of medical departments. [Table 14] notes the correlation between sociodemographic variables and the subdomains of ProQOL among postgraduates of surgical departments. [Table 15] shows the correlation between sociodemographic variables and the subdomains of general health among postgraduates of surgical departments. [Table 16] notes the correlation between sociodemographic variables and the subdomains of ProQOL among postgraduates of para-clinical departments. [Table 17] includes the correlation between sociodemographic variables and the subdomains of general health among postgraduates of para-clinical departments.
Table 1: Frequency distribution and percentage of gender, marital status, socioeconomic status, and department group of the study population (n=134)

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Table 2: Sociodemographic characteristics in individual study groups

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Table 3: Distribution of mean and standard deviation of general health and professional quality of life

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Table 4: Mean and standard deviation of general health and professional quality of life in medical, surgical, and para clinical postgraduates

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Table 5: Correlation between sub-domains of general health

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Table 6: Correlation between subdomains of professional quality of life

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Table 7: Correlation between subdomains of general health and professional quality of life

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Table 8: Mean and standard deviation of sociodemographic variables in the study population with respect to professional quality of life and general health

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Table 9: Correlation between the sociodemographic variables and the sub domains of professional quality of life

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Table 10: Correlation between sociodemographic variables and the sub domains of general health

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Table 11: Mean and standard deviation of sociodemographic variables in the study population with respect to professional quality of life and general health among postgraduates of medical, surgical, and para clinical departments

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Table 12: Correlation between sociodemographic variables and the sub domains of professional quality of life among postgraduates of medical departments

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Table 13: Correlation between sociodemographic variables and the sub domains of general health among postgraduates of medical departments

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Table 14: Correlation between sociodemographic variables and the sub domains of professional quality of life among postgraduates of surgical departments

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Table 15: Correlation between sociodemographic variables and the sub domains of general health among postgraduates of surgical departments

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Table 16: Correlation between sociodemographic variables and the sub domains of professional quality of life among postgraduates of para clinical departments

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Table 17: Correlation between sociodemographic variables and the sub domains of general health among postgraduates of para clinical departments

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  Discussion Top


The study resulted in a significant relationship between ProQOL and GHQ dimensions. It shows that reducing BO and secondary traumatic stress as well as increasing CS has a direct impact on decreasing general health problems in postgraduates. CS has a negative relationship with physical dysfunction, anxiety and sleep disorders, social dysfunction and depression. BO and secondary traumatic stress have a positive relation with these health-related factors. Male postgraduates are significantly more burnt-out than females. Married postgraduates have significant general health distress, depression, and secondary traumatic stress. PGs belonging to upper socioeconomic status have significant anxiety and sleep disturbance. Whereas, postgraduates belonging to middle socioeconomic status are significantly depressed. Medical postgraduates who are married experienced a significant secondary traumatic stress. Male postgraduates of the surgical department have significant BO. A significant secondary traumatic stress is experienced by para-clinical postgraduates.

The positive associations between BO and four of the subscales that were measured by the GHQ (somatic symptoms, anxiety, distress, and social dysfunction) are consistent with the findings of Musa and Hamid.[15] Furthermore, Kasraie and Zadeh showed that there is an inverse correlation between job stress and quality of work life (QWL), where the quality of life decreases by increasing stress.[16] The study by Wu et al. concluded that reduction in stress could lead to BO prevention.[17] This conclusion is consistent with the findings of Conrad and Kellar-Guenther, who reported that BO could result from extreme job stress, thus controlling psychological stress can help mitigate BO. Moreover, the negative association between sympathy satisfaction (job satisfaction) and BO were supported by this research.[18]

Another study showed that BO is common, and the main causes of BO are staff crisis in hospitals and work overload. This study suggests that nurses need special attention in Iran. Many nursing staff remains at their positions for only a few months around the world.[19] Study of Hsu showed that the development of a questionnaire is reliable and valid for examining the quality of working life of medical health professionals.[20]

Mohammadi et al. studied the relationship of nurse's psychological problems and QWL in the Intensive Care Unit of Tehran Hospitals, in 2010. The study showed that it is necessary to consider the anxiety of medical health professionals, especially by directors due to the impact of anxiety on the reduction of staff.[21]

The subscales of ProQOL were not related to the position type of the employee, age, or gender. Employees, who were leaving their position showed higher BO and lower CS scores.[22] Berceli et al. showed that chronic stress has a negative effect on the health-related quality of life.[23]

Study of Kasraie and Zadeh showed relationships between hospital job stress, job satisfaction, QWL, and citizenship behavior.[16]

Musa and Hamid examined the relationships between QWL subscales including job satisfaction or CS, CF or secondary traumatic stress, BO, and distress. In this study, three instruments were used to measure the target relations and they concluded that there is a need to create a positive work climate through equipping aid workers with adequate training, psychological support services, and cultural orientation to decrease the psychological suffering of aid workers.[15] In a study by Khaghanizadeh et al., nurses were selected via probable multistage sampling. They explained that the nurses with high QWL tended to have lower job stress.[24]


  Conclusion Top


Taking into consideration, all the results obtained in our study, we have found that the subdomains of general health have a significant negative correlation with compassion satisfaction and there is a significant positive correlation between burnout and secondary traumatic stress. Therefore, authorities in the health care system should develop strategies and intervention programs toward improving the these attributes, which will lead to improving the quality of staff's working life, increasing the quality of patient care, and saving health-care organizations..

In addition, the analysis suggested that it may be useful to investigate the effective factors on ProQOL and GHQ dimensions, which will help managers, apply better policies to increase their staff performance.

Limitations

  • The lack of good cooperation of some staff to fill out the questionnaires
  • The study population had been selected from only one hospital
  • Low number of the target population; small sample size. Hence results cannot be generalized to the population. Further research can be conducted on a large sample.


Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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Kasraie SS, Zadeh P. The relationship between quality of work life, job stress, job satisfaction and citizenship behavior in oshnaviyeh hospital's staff. Patient Saf Qual Improv J 2014;1:77-81.  Back to cited text no. 16
    
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    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8], [Table 9], [Table 10], [Table 11], [Table 12], [Table 13], [Table 14], [Table 15], [Table 16], [Table 17]



 

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