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ORIGINAL ARTICLE
Year : 2018  |  Volume : 11  |  Issue : 5  |  Page : 406-411  

Life satisfaction and correlates among working women of a tertiary care health sector: A cross-sectional study from Delhi, India


1 Department of Community Medicine, Hamdard Institute of Medical Sciences and Research, New Delhi, India
2 Department of Community Medicine, ESIC Medical College and Hospital, Faridabad, Haryana, India
3 Department of Community Medicine, Dr. Baba Saheb Ambedkar Medical College and Hospital, New Delhi, India

Date of Web Publication5-Sep-2018

Correspondence Address:
Mitasha Singh
ESIC Medical College and Hospital, Faridabad - 121 001, Haryana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mjdrdypu.MJDRDYPU_240_17

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  Abstract 


Background: The dual role of women at home and workplace negatively impacts their quality of life. The health-care system demands quality services and urbanization and globalization have increased the demands of every individual to lead a satisfactory life. Objective: The aim of this study is to find the correlates of life satisfaction (LS) among working women of the health sector. Methodology: A descriptive cross-sectional study was conducted among female staff in the campus of a tertiary care center of New Delhi for 6 months (2011–2012). A sample of 345 women was selected with equal representation from all the departments of the institution. All participants were asked to complete modified pretested semi-structured LS scale by Alam and Srivastava. Results: The prevalence of overall satisfaction among working females in our study was 39.3%. Females were highly satisfied with their job, but satisfaction level in health and the economic domain was low. Age, type of occupation, mode of transport, family type, and income as compared to the husband's income were the significant correlates of satisfaction level in different domains. Conclusions: Satisfaction among workers that to females in the health sector is proportional to job profile which comes at the cost of their personal needs. These tentative conclusions demand further investigations determining causality of the observed associations. It is high time to make our workplace environment worker-friendly to increase the output.

Keywords: Females, health center, predictors, satisfaction, staff


How to cite this article:
Parashar M, Singh M, Lal P. Life satisfaction and correlates among working women of a tertiary care health sector: A cross-sectional study from Delhi, India. Med J DY Patil Vidyapeeth 2018;11:406-11

How to cite this URL:
Parashar M, Singh M, Lal P. Life satisfaction and correlates among working women of a tertiary care health sector: A cross-sectional study from Delhi, India. Med J DY Patil Vidyapeeth [serial online] 2018 [cited 2019 Aug 25];11:406-11. Available from: http://www.mjdrdypv.org/text.asp?2018/11/5/406/240381




  Introduction Top


Life satisfaction (LS) is a subjective, cognitive evaluation of an individual's life as a whole.[1] Nowadays, the relationship between psychological factors and somatic health has been a growing field of research interest.[2],[3] Judgments regarding satisfaction depend on comparing life circumstances against a standard considered appropriate.[4] Women comprise nearly half of the national population of any country. Hence, the development of any country is inseparably linked with the status of development of women. The modern life, which is so full of stresses of various kinds, LS has acquired supreme significances.[5] These modern life stresses are job security, not earning enough money, disagreement with colleagues and friends and lack of personal time. However, there are many more which are region and culture-specific.

It is of utmost importance among working women of the health sector as they have inbuilt job stress. This is partly because medical service involves taking care of other people's lives, therefore, mistakes or errors could be costly and sometimes irreversible. It is thus expected that the medical doctors, nurses, and other medical staff should be in a perfect state of satisfied mind devoid of morbid worries and anxieties. Safe, effective, convenient, and affordable medical and health services could be achieved through the establishment and improvement of basic healthcare systems. Theory and research from a field outside of rehabilitation have suggested that LS is one factor in the more general construct of subjective well-being.[4] A study conducted on Iranian women through self-reporting questionnaires [6] and on among old age residents of Jammu [7] have revealed the various domains of LS as health, economic, personal, social, family, and job satisfaction. The process of adjustment also by its inherent nature involves active coping with internal and external satisfaction and dissatisfaction. Sociodemography of an individual has been identified as an important predictor of LS and quality both by a study conducted in Northern Cyprus [8] and Poland.[9] Studies across India have been conducted among different working class women or on postmenopausal women. So far, there is a paucity of literature focusing on correlates of satisfaction among healthcare sector females. The present study is first of its kind in an attempt to report the prevalence of LS, and its sociodemographic correlates among working women of health sector. Besides this, the present study also aims to report the domain-specific associations with various sociodemographic variables.


  Methodology Top


Study design and study population

A cross-sectional study was conducted among female staff in the campus of a tertiary care hospital and attached medical college of Delhi. The minimum sample size calculated to study the prevalence and correlates of LS among women in health sector came out to be 315 at 95% confidence interval (taking prevalence in females from literature as 27%).[10] To account for nonresponse rate of 10% we approached 347 working professional and paramedical staff women for 6 months (September 2011–June 2012) of which 345 women agreed to participate in the study.

Inclusion criteria

All who gave their consent and were willing to participate were included.

Exclusion criteria

Women who were on medications for any diagnosed chronic medical illness, mental illness, or unable to respond were excluded.

Ethical clearance permission

Necessary permission to conduct the study was obtained from the concerned authority. Written informed consent was obtained from the respondents after explaining the nature and objectives of the study. The study was approved by the Institutional Review Board and Institutional Ethical Committee.

Study tool

Data were collected by face-to-face interview method using modified pretested semi-structured LS scale (LSS) by Alam and Srivastava.[11]

The semi-structured questionnaire included two sections:

  1. Demographic profile – it contained information on age, sex, education, occupation, and the income of the respondent
  2. Adapted version of modified LSS – Alam and Srivastava including questions on various domain of LS.


The fifty items related to five areas of life, namely, health, personal, economic, social, and the job was taken from the scale. Satisfaction in each of the domains' responses were scored using five-point Likert's scale with responses including; always, most of the time, sometimes, rarely, never. Where positive responses were expected, scores of 5, 4, 3, 2, and 1 were given for always, most of the time, sometimes, rarely, and never responses, respectively. On the other hand, in questions where negative responses were expected, scores of 5, 4, 3, 2, and 1 were given for never, rarely, sometimes, most of the time, and always responses, respectively. The scores in each of the domain were added up, and the minimum and maximum score was identified. Thereafter, for each study participant, each domain's total score was used to calculate percentage scores.

The adapted version was pretested on 25 random adult working females who were not from the same study area. Any discrepancy and difficulty faced were dealt with by the experts of the domain.

Data collection

The list of women employees from the 19 clinical and paraclinical departments of the teaching hospital-wise was sought from the administrative section of the institute. For equal distribution of sample across all the departments, it was calculated to contribute 18 female staff members from each. In departments where the number of female staff was smaller than required, all the females were approached for the purpose of the study. In case number of females exceeded from required in any department, sample was selected through simple random sampling using random number table.

The study purpose was explained to all eligible participants, and informed consent was obtained from all who were willing to participate. In case the selected participants did not match inclusion criteria, the next available staff was approached. The interns posted in our department distributed the questionnaires to the eligible participants and get it filled in their working places. After collecting the questionnaires, they were checked by investigators for completeness. Following completion, results of each participant was revealed to them.

Data and statistical analysis

The data were analyzed using IBM SPSS software version 21.0. IBM Corp., Armonk, NY, USA. Percentage scores were presented as mean and standard deviation. The mean scores of satisfaction in each domain were stratified into various sociodemographic variables. ANOVA was applied to test the significant difference of the mean scores among variables with more than two groups. Independent t-test was applied to test the significant difference between two groups of variables. A further analysis using post hoc Tukey's honest significant difference (HSD) test was applied to the correlates with P < 0.05 on ANOVA. Level of significance was set at 5%.


  Results Top


The profile of women working in health sector shows that majority (45.5%) were of middle age group (31–45 years) and married (68.4%). Around 78% lived in a nuclear family and 51.3% had children; majority (61.6%) having two. Around 63% used public transport while commuting. The proportion of female staff who reported a high level of satisfaction in all the domains was 39.4%.

The maximum mean score percentage in each domain was 100 which represent maximum level of dissatisfaction in social, economic, personal, and health domains except for job domain where highest score represents a high level of satisfaction. Economic domains' mean score percentage was higher as compared to other domains (64.15 ± 14.66) representing a high level of dissatisfaction; health domains scored lowest (36.37 ± 28.08) hence highest in satisfaction level. Similarly, job domains' mean score was high (63.26 ± 16.55) denoting high satisfaction level. The mean percentage scores of satisfaction in various domains are distributed across various sociodemographic variables [Table 1].
Table 1: Mean percentage scores of satisfaction in various domains distributed across various sociodemographic variables

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Economic and personal dissatisfaction was observed to be significantly (P < 0.01) higher among younger age groups (18–30 years). Middle-aged females (31–45 years) reported the significantly higher level of job satisfaction as compared to other groups (P < 0.001). Economic dissatisfaction increased as the mode of transport changed from private-to-public to walking (P < 0.01). However, health dissatisfaction showed an insignificant inverse trend as the mode of transport changed from private-to-public to walk. Social dissatisfaction among study participants showed a significant distribution with occupation (P = 0.02). It was observed to be highest among unskilled workers and lower among skilled staff. Personal and economic un-satisfaction was observed to be the highest among skilled and professional staff as compared to other groups (P < 0.01). Marital status otherwise did not have a significant effect on any of the domains of satisfaction. A significantly higher mean percentage satisfaction was observed in personal and job domain among those who lived in nuclear families (P < 0.001). Participants from joint families, however, reported a higher social satisfaction (P = 0.03) but dissatisfaction in other domains compared to those from nuclear families. Participants who had children reported a lower level of dissatisfaction in economic and higher personal dissatisfaction as compared to those who did not have. Income equal to husband gave a higher economic dissatisfaction (P < 0.001) and higher job satisfaction (P < 0.001) to the participants as compared to those with a higher income than the husband [Table 1].

A further analysis using post hoc Tukey's HSD analysis on independent variables with significant ANOVA results in different domains revealed that the pairwise significant difference was observed with higher social dissatisfaction among unskilled as compared to skilled workers (P = 0.011). Unskilled workers also scored significantly higher in economic dissatisfaction as compared to all other types of occupation groups. The pair-wise difference among age groups was observed to be significant job satisfaction in higher age group as compared to middle ages and young age group (P = 0.000). Middle-age workers scored significantly higher in dissatisfaction in the personal domain as compared to higher age group (P = 0.032). Economic dissatisfaction was higher (P = 0.001) among younger age group (18–30 years) as compared to higher age group (46–60 years). Mode of transport and occupation did not yield any significant pair-wise comparisons in personal satisfaction domain. Those preferring walking as a mode of transport scored significantly higher on economic dissatisfaction as compared to public (P = 0.028) and private transport (P = 0.008) [Table 2].
Table 2: Domain wise Tukey honest significant difference test showing effect of various factors on satisfaction of women

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  Discussion Top


Females support both formal and informal sectors both directly and indirectly. Women are undertaking the dual role of homemaker and a worker outside the home. The health sector is one area where the contribution of women is immense. Satisfaction with life plays a substantial role in actual physiological and psychological health and well-being of the individual. If an employee is satisfied in all the spheres of his/her life the productivity increases and absenteeism decreases and this, in turn, increases the quality of care provided by the healthcare providers.

Satisfaction is a way a person perceives how his or her life has been and how they feel about where it is going in the future, i.e., a measure of wellbeing.[2] The study focused on health sector which involves odd and long working hours and dealing with human diseases and lives hence is one of the possible reasons for the higher proportion of stress in this group.[12] The overall satisfaction scores was high in job and health domain of participants of our study. Furthermore, economic satisfaction remained the lowest. Working in a health sector gives a sense of security in terms of feasibility of healthcare seeking behavior. Among females, medical profession is the most sought after professions and those possessing it are observed to be satisfied with it. A similar finding of a higher proportion of job satisfaction was reported by health professionals of Saudi Arab.[13]

Across all the domains of life measured; age, type of occupation and mode of transport to and from work emerged as significant predictors of satisfaction. Lack of satisfaction may be reflected in lack of adjustment in either of the areas identified earlier herein. Young age females were economically and personally dissatisfied as compared to higher age groups. This finding was supported by women from Jammu and Kashmir and the United Arab Emirates.[10],[14] Age is an important moderator of the effect of marital status, income, health, and social support on LS. Contrasting nonsignificant association with age was reported by Jadhav among working women from Karnataka.[15] In our study setting scenario, the older and more experienced a person is; his/her chances of securing a permanent or regular job is increased. This is consistent with many studies that demonstrated that young and presumably less experienced staff has difficulties coping with the demands of work hence less satisfied.[10],[16],[17],[18]

An obvious level of dissatisfaction was observed among the unskilled staff of health sector probably related to the level of education they have attained. This may be because highly educated people tend to seek better jobs with higher pay and prestige and consequently, have higher self-esteem.[10] Those using private vehicles for transporting to and from work reported a high level of economic satisfaction as compared to those using public transport. A high level of personal satisfaction was also observed but not significant in post hoc analysis. Commuting in public transport increases the level of stress due to tiredness in traveling long distances, standing for long and constant fear of reaching safely at their destination in metropolitan cities like Delhi.[10] Mode of transport is not an independent predictor of satisfaction. Traveling in private transport gives a sense of self-esteem among those who can afford; but no significant level of satisfaction in other domains was observed with private transport.

Women who resided in joint families were satisfied socially but personally were dissatisfied. Family acts as social security and joint families have an advantage over nuclear families in sharing responsibilities hence providing a higher level of social security leading to satisfaction.[19] Joint families provide economic security to those who are dependent on earning member; but on the cost of personal and job satisfaction. To maintain a work home balance a working female in a joint family cannot look after her health leading to high level of dissatisfaction in the health domain. The attempt of working women to integrate, organize and balance personal and professional responsibilities in their different roles simultaneously results in the lack of satisfaction.

Those having children reported a significant level of economic satisfaction but personal dissatisfaction. This again highlights the satisfaction in one domain at the expense of personal needs. A study on the US pediatricians reported a higher proportion of female pediatricians with children self-reported a higher level of satisfaction in life; however, this was not significantly associated after adjusting for other factors.[20] Those earning more than their husbands reported significant higher economic as well as job satisfaction as they contributed more in their family and probably a higher status at workplace too.

The study represents a small cross-section of the population confined to only working women of tertiary care health sector in a developing country, which is one of the limitations. The fact that there is no control group does compromise the results and the LSS though validated on Indian population was not specifically validated on working women of the health sector, but the results show positive trends. Future projects with larger samples with a robust methodology representing all categories of the population are on the way.


  Conclusion and Recommendation Top


The health sector females have lower economic and personal satisfaction; interestingly, they have higher job satisfaction. This sector involves dealing with people, their health and diseases. It sometimes consumes most of the time which a female may utilize for personal life and also in maintaining work-life balance. Hence satisfaction in one domain is achieved on the cost of other. Even though tentative conclusions could be drawn, further investigations determining causality of the observed associations are warranted. Still, monitoring LS among aging women is a field of research. Potential modification of the modifiable factors is recommended as they may lead to the improvement of the subjective well-being of working women.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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    Tables

  [Table 1], [Table 2]



 

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