|Year : 2016 | Volume
| Issue : 4 | Page : 1106-1111
The effect of diabetes and hypertension on work productivity and job satisfaction
Mahmoud E Abu Salema1, Nagwa N Hegazy2, Shaimaa G Mohamed3
1 Department of Public Health and Community Medicine, Faculty of Medicine, Menoufia University, Tala, Menoufia, Egypt
2 Department of Family Medicine, Faculty of Medicine, Menoufia University, Tala, Menoufia, Egypt
3 Resident of Family Medicine in Health Sector, Tala, Menoufia, Egypt
|Date of Submission||25-Feb-2016|
|Date of Acceptance||24-Apr-2016|
|Date of Web Publication||21-Mar-2017|
Shaimaa G Mohamed
Resident of Family Medicine in Health Sector, Tala, Menoufia, 32611
Source of Support: None, Conflict of Interest: None
The objective of this paper was to assess the effect of diabetes mellitus (DM) and hypertension on work productivity and job satisfaction.
Work is a basic human activity through which every individual realizes their own livelihood. DM and hypertension are diseases with a high prevalence of growth globally; the question of the ability of this patient's to be productive is extremely important in terms of work productivity and job satisfaction evaluation.
Patients and methods
The study was a nested case–control cross-sectional study. A total of 800 participants were recruited (400 patients and 400 controls). They were enrolled from urban and rural family health units as follows: 223 DM patients, 177 hypertensive patients, and 400 participants in the control group. All the participants were interviewed using a prestructured questionnaire and their medical record was revised. The questionnaire contained an Arabic validated version of work productivity and impairment, the general health version (WPAI: GH), and job satisfaction questionnaire.
Work absenteeism, work productivity loss, and impairment were more with the diabetic patients than with the hypertensive patients (P < 0.000). There was a statistically significant difference between studied groups and job satisfaction, where job satisfaction score was lower for diabetic patients than for hypertensive patients. There was a positive correlation among the studied groups regarding job satisfaction score and work productivity score.
DM appears to reduce an individual's ability-to-work in comparison with patients with hypertension.
Keywords: diabetes mellitus, job satisfaction, work productivity
|How to cite this article:|
Abu Salema ME, Hegazy NN, Mohamed SG. The effect of diabetes and hypertension on work productivity and job satisfaction. Menoufia Med J 2016;29:1106-11
|How to cite this URL:|
Abu Salema ME, Hegazy NN, Mohamed SG. The effect of diabetes and hypertension on work productivity and job satisfaction. Menoufia Med J [serial online] 2016 [cited 2020 Sep 29];29:1106-11. Available from: http://www.mmj.eg.net/text.asp?2016/29/4/1106/202484
| Introduction|| |
Work is a basic human activity through which every individual realizes their own livelihood. It is closely associated with the categories of health and quality of life. Diabetes mellitus (DM), as a disease with a high prevalence of growth globally, threatens to become a global epidemic risk, and thus the question of the ability of a patient's productivity is extremely important in terms of professional orientation, professional selection, work absenteeism, and disability evaluation .
Low productivity at work is an important concern for employees, employers, and society. Moreover, the complications related to DM are major cause of disability, reduced quality of life, and death.
Employees with DM may stop working prematurely and this can lead to unemployment, which could translate into a reduction in earned income and savings, as well as loss of self-esteem. For employers too, low productivity because of absenteeism, disability, and early retirement is an important economic issue ,.
Work ability assessment is a continuous process that in ideal social circumstances should accompany a person throughout their entire life. Basically, it has to answer the question of whether there is a match between the worker's psychophysical ability and the demands of working conditions and the work environment.
The most common causes of work absenteeism are disease, occupational disease, injury at work place, injury outside of work place, care for a family member, or some other reason provided by law .
According to estimates made by the International Labour Organization for sick leave, about 5% of the total employed labor force is absent from work every day. The average number of sick days per employee in the European Union was 4.6 days per year .
DM is a common cause of absenteeism in the population. An estimated 171 million people were suffering from DM in the year of 2000, and this number could total 366 million by the year 2030 . Diabetes affects 23.6 million people in the USA, with an additional 57 million individuals exhibiting prediabetic symptoms. Type 1 diabetes, which has an autoimmune etiology, accounts for ˜10% of cases and largely affects children and young adults. In contrast, type 2 diabetes accounts for 90% of cases and is associated with obesity and insulin resistance .
Data provided by the Public Health Institute of Republika Srpska  show that the prevalence of DM is 42% and for hypertension it was 14% for the year of 2012.
The objective of this paper was to assess the effect of DM and hypertension on patient's work productivity and job satisfaction. These two chronic diseases were chosen because of their high prevalence in the community and similar hazardous effect on the cardiovascular system and overall health.
| Patients and Methods|| |
The study was a nested case–control cross-sectional study.
The study was conducted in two sites, one in an urban area and other in a rural area:
- The urban area was the primary healthcare unit of Shebin EL-Kom city, Shebin district, Menoufia Governorate
- The rural area was the primary healthcare unit of Batanon village, Shebin EL-Kom district, Menoufia Governorate.
The study population data was recruited as follow: all the participants were recruited in a duration of six months between May 2015 and October 2015. All hypertensive and diabetic patients and one of their relevant attending the primary healthcare center during the period of the study were invited to participate in the study. Selection of participants was done according to inclusion the eligible criteria for the cases: diabetic patients confirmed DM, Hypertensive patients confirmed hypertension and controlled group having no morbidity.
- Exclusion criteria for diabetic patients were comorbidity with hypertension, comorbidity with cardiovascular disease, comorbidity with renal failure, comorbidity with obesity, comorbidity with pulmonary diseases or presence of other chronic diseases, and being unavailable to complete the questionnaire
- Exclusion criteria for hypertension patients were comorbidity with diabetes, comorbidity with cardiovascular disease, comorbidity with renal failure, comorbidity with obesity, comorbidity with pulmonary diseases, being unavailable to complete the questionnaire, and the presence of other chronic diseases.
A total of 800 participants (400 patients and 400 control) were recruited. They were enrolled from an urban and a rural family health unit as follows:
- Urban area (Shebin El-Kom city): 218 patients had participated in the study (93 hypertensive and 125 diabetic)
- Rural area (Batanon village): 182 patients had participated in the study (84 hypertensive and 98 diabetic)
- A similar number 400 control participants were recruited for the study.
| Tools of the Study|| |
All the attendants were subjected to an interview, which aimed to discuss of the study aims and designs, taking a formal written consent. Questionnaires were filled with the patients' own words, and their answers were registered in the questionnaire.
A standardized questionnaire was used to collect sociodemographic data regarding the respondents' characteristics and disease questions .
The second outcome was the ability to work. It included absenteeism and productivity loss. The data about absenteeism were recorded using the Arabic version of work productivity and impairment – the general health version (WPAI: GH) – questionnaire, in which respondents were asked questions about work and activity impairment due to health problems .
Job satisfaction questionnaire shows that workers who do not feel they have any control over their jobs suffer more health problems than workers who have some control. Having control over your job means having some discretion in how to best tackle problems, apply skills, and envision outcomes. The higher the total score, the greater your job satisfaction .
Data were collected, translated to English to facilitate data manipulation, and double-entered into microsoft access, and data analysis was performed using statistical package of the social sciences software, version 18 under windows 7 (SPSS Inc., Chicago, Illinois, USA).
For qualitative data
Simple descriptive analysis was performed in the form of numbers and percentages for qualitative data.
- χ2- Test to compare two or more than two qualitative groups
- Odds ratio to determine significant risk factors.
For quantitative data
Arithmetic means as central tendency measurement, SD as measure of dispersion, and t-test were performed for quantitative data.
- The level of P value up to 0.05 was considered the cutoff value for significance.
| Results|| |
The study included 223 (28%) diabetic patients, 177 (22%) hypertensive patients, and 400 (50%) healthy controls [Figure 1].
|Figure 1: Frequency of diabetic and hypertensive patients within the studied group.|
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Participants' sociodemographic characteristics are presented, and the studied groups were mainly of male sex (52.9%). The average age of the studied group with mean ± SD was 51.7 ± 8.5 years for diabetic patients, 46.6 ± 8.2 for hypertensive patients, and 39.3 ± 12.8 years for the healthy group. The majority of studied groups had university education (50.3). Most participants were working. The majority of the studied groups was using computer at some point (42.6). There were statically significant differences between socioeconomic score and studied groups, where a medium score was scored by most of studied groups (71.8) ([Table 1]).
The age of patients with diabetes ranged from 1 to 30 years, with a mean ± SD of 9.7 ± 6.8 years. About 51.6% of patients with diabetes used oral hypoglycemic, whereas 18.4% used insulin and 30.0% used both of them. The age of patients with hypertension ranged from 1 to 20 years, with a mean ± SD of 6.6 ± 4.8 years. About 65.9% of hypertensive patients used oral drugs, 9.5% were on diet and exercise, and 24.6% used both of them ([Table 2]).
The largest number of diabetic and hypertensive patients were employees. There was statistically significant difference between diabetic and hypertensive patients regarding the attendance and absent days. In absent days diabetic patients were more than the hypertensive patients ([Table 3]).
There was a statistically significant difference between studied group and all domains of work productivity, where work absenteeism, work productivity loss, and impairment of patients with diabetes was more than those of hypertensive patients, which means that diabetes patients had more disability than hypertensive patients. There was a statistically significant difference between the studied group and job satisfaction, where diabetic patients scored below the average job satisfaction score and hypertensive patients scored close to the average job satisfaction score ([Table 4]).
|Table 4 Comparison among studied groups regarding work productivity and job satisfaction|
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Correlation between job satisfaction and work productivity of studied groups was statistically significant. There was a high correlation between job satisfaction and work productivity in the studied groups ([Table 5]).
|Table 5 Correlation between job satisfaction, quality of life, and work productivity|
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There was highest correlation between patients with diabetes and job satisfaction and work productivity [Figure 2] and [Table 5]).
|Figure 2: Correlation between job satisfaction and work productivity in diabetic patients.|
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There was highest correlation also between patients with hypertension and job satisfaction and work productivity [Figure 3] and [Table 5]).
|Figure 3: Correlation between job satisfaction and work productivity in hypertensive patients.|
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| Discussion|| |
This study showed that patients with DM were more likely to face problems with work productivity and being constrained in terms of work and other activities.
These findings are consistent with other studies. The systematic review by Breton et al.  included 23 studies investigating the impact of diabetes on ability-to-work outcomes. Studies were conducted in many countries using different study designs and involving different settings (general population or specific population of workers) and age groups. In addition, outcomes definition of productivity measures, recall periods, statistical analyses, and variables used for adjustment differ considerably across those studies that assessed the same outcomes. The effects of DM on absenteeism, productivity loss, and early retirement are generally consistent across studies with high methodological quality. In the majority of studies, DM had a significant negative impact on the ability-to-work outcomes considered. Studies focusing on presenteeism are not considered to have low risk of bias ,,,,,.
From the results of different studies, it was evident that the working ability of the population is an extremely important issue for each country because it involves the labor force as an element of economic power, and thus it is not only an individual but also a social category. The active population or labor force of a country (ages 15–65 years), according to a WHO  report, comprises ˜50–60% of the population whose labor produces all its economic and material values, ensuring the socioeconomic development of the country. Different studies showed that work disability is significantly higher for individuals with DM than for those without diabetes at all ages, and results in a significant decrease in earnings ,.
Our study showed that there was a significant correlation between work productivity and work absence. There is the evidence that DM affects patients, employers, and society not only by reducing employment but also by contributing to work loss and health-related work limitations for those who remain employed.
This agreed with the result of Vijan et al. , who demonstrated that the effects of diabetes and hypertension on employment and work productivity are likely to become more pressing for society, even after controlling for other factors presumed to be relevant to the decision to work, such as other chronic health conditions and job characteristics.
This is also consistent with the result of Breton et al. , who found that diabetes reduced the absolute likelihood of working. The economic burden associated with DM is likely to increase as DM becomes more prevalent. As DM is a progressive disease, one may speculate that the occurrence or progression of DM complications may lead to functional impairment or limitations to performance, and in turn these individuals stop working.
This study showed that job satisfaction of diabetic patients was below the average job satisfaction score, whereas job satisfaction of hypertensive patients was close to the average job satisfaction score.
This agreed with the result of Siua et al. , in which patients with chronic diseases such as diabetes and hypertension were fairly satisfied with their jobs.
Our study showed the highest correlation between patients with diabetes and job satisfaction and work productivity. The highest correlation was also found between patients with hypertension job satisfaction and work productivity.
This agreed with the result of Kumar et al. , which showed that patients with chronic diseases such as diabetes and hypertension who experience more workplace support and those who had less work limitations were more likely to be satisfied in the workplace.
This study did, however, have some limitations. This was a cross-sectional study, and thus it cannot determine cause and effect, but it can identify potential associations. Larger and more longitudinal data are needed to provide a better assessment of the causes and effects of diabetes and hypertension on ability-to-work outcomes.
| Conclusion and Recommendation|| |
DM appears to reduce an individual's ability to work. Patients with DM experienced more difficulties in performing work compared with the hypertensive group. There is a need for setting up diabetes prevention programs and to develop and implement effective targeted intervention to help workers better manage their disease. Otherwise, this DM-related burden could worsen in the working-age population. Efficient employer-implemented intervention programs to improve the physical health and well-being of their workers with diabetes could be a good strategy for controlling productivity. Therefore, the prevention of both DM and its complications through medication, diet, and exercise is likely to yield economic benefits, in addition to preserving the health status and quality of life of individuals who are at risk for developing diabetes or who already have diabetes.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Reif N. Principles of professional expertise in pension and disability insurance scheme [In Croatian]. In: Čapeta R, Reif N, Ribarić M, Rismondo M, editors Work ability and disability
. Zagreb: University in Zagreb – Faculty of medicine; 1987. 57–76.
Alivinia SM, Burdorf A. Unemployment and retirement and ill-health: a cross-sectional analyses across European countries. Int Arch Occup Environ Health 2008; 82
Breton MC, Guenette L, Amiche MA, Kayibanda JF, Gregoire JP, Moisan J. Burden of diabetes on the ability to work: a systematic review. Diabetes Care 2013; 36
Pavlović M, Marić-Milić B, Janičić L. Prevalence of diabetes mellitus in emloyees with disability [In Serbian]. Medicinski Zapisi 2009; 32 (Suppl 1)
Bilbao: European Agency for Safety and Health at Work Inc.; c1998–2014. Available at: https://osha.europa.eu/en/
. [Last Accessed on 2014 Nov 01].
Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care 2004; 27
Elsaadani AE, Marey HM, Badawy NM, Omran SF. Effects of diabetes mellitus on the eye. Menoufia Med J 2015; 28
Public Health Institute of Republic of Srpska. Analysis of population health in Republic of Srpska
. Banja Luka: RM Print; 2012.
Fahmya SI, Nofald LM, Shehatad SF, El Kady HM, Ibrahim HK. Updating indicators for scaling the socioeconomic level of families for health research. J Egypt Public Health Assoc 2015; 90
Reilly MC, Zbrozek AS, Dukes EM. The validity and reproducibility of a work productivity and activity impairment instrument. Pharmaco Economics 1993; 4
Diener and Biswas-Diener. PMW Associates, 232 West Avenida Gaviota, San Clemente, California (ISBN 978-1-4051*4661-1). Available at: http://www.pmwassociates.com
. [Last Accessed on 2015 Jan].
Cawley J, Rizzo JA, Haas K. The association of diabetes with job absenteeism costs among obese and morbidly obese worker. J Occuo Environ Med 2008; 50
Vamos EP, Mucsi I, Keszei A, Kopp MS, Novak M. Comorbid depression in associated with increased healthcare utilization and lost productivity in persons with diabetes: a large nationally representative Hungarian population survey. Psychosom Med 2009; 71
Mayfield JA, Deb P, Whitecotton L. Work disability and diabetes. Diabetes Care 1999; 22
Tunceli K, Bradley CJ, Nerenz D, Williams LK, Pladevall M, Elston Lafata J. The impact of diabetes on employment and work productivity. Diabetes Care 2005; 28
World Health Organization (WHO). Labour force of a country, global strategy on occupational health for all
Geneva, Switzerland: World Health Organization (WHO); 1995; 4
Musich SA, Schultz AB, Burton WN, Edington DW. Overview of disease management approaches: implications for corporate sponsored programs. Dis Manag Health Outcomes 2004; 28
Vijan S, Hayward RA, Langa KM. The impact of diabetes on workforce participation: results from a national household sample. Health Serv Res 2004; 39
Siua AMH, Hung A, Lama AYL, Chengb A. Work limitations, workplace concerns, and job satisfaction of persons with chronic disease. Work 2013; 45
Kumar R, Ahmed J, Shaikh BT, Hafeez R, Hafeez A. Job satisfaction among public health professionals working in public sector: a cross sectional study from Pakistan. Hum Resour Health 2013; 11
[Figure 1], [Figure 2], [Figure 3]
[Table 1], [Table 2], [Table 3], [Table 4], [Table 5]