Professional quality of life among postretired academic university employees in Thailand

Main Article Content

Wonpen Kaewpan
Karl Peltzer
Surintorn Kalampakorn
Sutteeporn Moolsart
Cite this article:  Kaewpan, W., Peltzer, K., Kalampakorn, S., & Moolsart, S. (2017). Professional quality of life among postretired academic university employees in Thailand. Social Behavior and Personality: An international journal, 45(4), 669-676.


Abstract
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We examined professional quality of life (ProQOL) and organizational climate among 122 postretired university academics from 19 universities, who were randomly selected from all 4 regions in Thailand. Participants completed measures of ProQOL, work ability, organizational climate, and psychological morbidity. Results indicated that the mean score for compassion satisfaction (CS) was 42.4, for burnout (BO) was 29.7, and for secondary traumatic stress (STS) was 20.3, whereas the proportions of participants with high levels of CS, BO, and STS were 21.3%, 28.7%, and 16.4%, respectively. Multiple linear regression analysis results revealed that younger age (60–65 years), excellent work ability, and an organizational climate of warmth and standards were significantly associated with CS; no psychological distress and lack of responsibility were significantly associated with BO; and lack of responsibility was significantly associated with STS. These results may help health managers at universities to improve ProQOL among their retired workforce.

According to Stamm (2010, p. 9) professional quality of life (ProQOL) includes “positive compassion satisfaction (CS) and negative compassion fatigue (CF).” CF includes burnout (BO), which comprises exhaustion, frustration, anger, and depression, and secondary traumatic stress (STS), which is defined as “a negative feeling driven by fear and work-related trauma” (Stamm, 2010, p. 9). Various researchers in the field of helping professions have found mean scores for CS that range from 32.8 out of 50 (among Korean nurses; Kim, Han, & Kim, 2015) to 40.6 out of 50 (among medical practitioners in India; Bhutani, Bhutani, Balhara, & Kalra, 2012); for BO that range from 17.2 out of 50 (among Israeli hospital physicians; Haber, Palgi, Hamama-Raz, Shrira, & Ben-Ezra, 2013) to 29.0 out of 50 (among Korean nurses; Kim et al., 2015); and for STS that range from 12.3 out of 50 (among American nurses; Yoder, 2010) to 27.3 out of 50 (among Korean nurses; Kim et al., 2015). Among UK therapists, high scores were found for STS (70%), BO (25.8%), and CS (38.8%; Sodeke-Gregson, Holttum, & Billings, 2013).

CS and CF may be influenced by one’s work, clients, or environment (Stamm, 2010). In a study of lecturers, readers, and professors that was conducted in Oman, Aseem and Nazir (2008) found that lecturers had a lower level of emotional exhaustion compared to readers and professors. Among the few scholars who have examined professional quality of life (ProQOL) and the work environment, Ray, Wong, White, and Heaslip (2013) found that higher levels of CS, lower levels of CF or STS, and a higher-quality overall work environment (workload, control, reward, community, values, and fairness) predicted lower levels of burnout. In addition, various sociodemographic, personal, and work-related variables have been found to be associated with CS, such as developmental stage of life (i.e., age), perceived level of management support (Sodeke-Gregson et al., 2013), being employed on a fixed-term contract, low stress (Musa & Hamid, 2008; Rossi et al., 2012), and good work conditions (Bhutani et al., 2012). Likewise, sociodemographic, personal, and work-related variables, such as younger age; lack of management support (Sodeke-Gregson et al., 2013); being separated, divorced, or widowed; high psychological distress (Adeyemo et al., 2015; Rossi et al., 2012); and poor work conditions (Bhutani et al., 2012), have been found to be associated with BO (Jackson, Barnett, & Stajich, 1993). Finally, high psychological distress (Adeyemo et al., 2015), female gender (Rossi et al., 2012), and holding a qualification in psychiatry or social work (Rossi et al., 2012), have been found to be associated with STS.

Although the existing research on postretired university teachers’ ProQOL is limited, we believe that it is important to investigate this variable in order to determine the quality of the work environment in the postretirement period, which is defined in the Cambridge Dictionary (2016) as the time after someone has left their job and stopped working because they have reached a particular age. We hypothesized that a good organizational climate would predict higher CS, lower STS, and lower BO, and we investigated this by examining ProQOL and organizational climate in a sample of postretired university academics in Thailand.

Method

Participants and Procedure

Among the 278 academics that we contacted, 122 agreed to participate (response rate = 43.9%) in this study. Of the participants, 59.9% had a master’s degree and 40.1% had a doctoral qualification; 63.5% were aged 60–65 years and 36.5% were aged 66–84 years; and 75.4% were women and 24.6% were men. Most were working full-time (73.8%) and 26.2% worked part-time; 44.3% were working in the same workplace as they had before they retired and the rest were not; and 61.5% were nurses or allied health professionals, whereas 38.5% were doctors, dentists, or pharmacists.

The sample was randomly selected from 19 universities across all four regions in Thailand. They responded to a mail-administered, cross-sectional survey after giving informed consent. The study protocol was approved by the Mahidol University ethics committee.

Measures

The English version of the ProQOL (Stamm, 2010) was translated into Thai by one independent bilingual translator, and then another bilingual translator, who had no knowledge of the original instrument, back-translated the Thai version into English to ensure equivalence in meaning. The ProQOL is a 30-item scale that is used to measure positive and negative experiences in relation to quality of life in a professional context (response options range from 1 = never to 5 = very often). It is made up of three subscales: CS, BO, and STS, and, after scores are calculated, participants are categorized into low, average, and high ProQOL groups. In this study, Cronbach’s alpha was .83 for CS, .59 for BO, and .78 for STS, respectively.

We used the Thai version of the Work Ability Index (WAI; Kaewboonchoo & Ratanasiripong, 2015) to evaluate participants’ health status, work abilities, and their perceptions of the mental and physical demands of their work (De Zwart, Frings-Dresen, & Van Duivenbooden, 2002; Gould, Ilmarinen, Järvisalo, & Koskinen, 2008). The index has various response formats, e.g., work ability is rated from 0 = completely unable to work to 10 = able to work at optimum levels, whereas responses to a list of diseases or injuries are 0 = no, 1 = physician’s diagnosis of yes, and 2 = own opinion is yes. The WAI score is achieved by adding up all single scores for each item, with the final figure falling into one of the following four categories: poor (7–27), moderate (28–36), good (37–43), or excellent (44–49; Gould et al., 2008). In this study, Cronbach’s alpha was .65.

The Thai version (Pethtang, Kaewpan, Kalampakorn, & Sillabutra, 2014) of Litwin and Stringer’s (1968) Organizational Climate Questionnaire (LSOCQ) was used to measure organizational climate in the workplace. This scale includes nine subconstructs: structure (four items, e.g., “Does your organization have flexible rules?”), responsibility (two items, e.g., “Is work appropriately assigned?”), reward (four items, e.g., “Do you receive appropriate rewards for your work ability?”), risk (one item: “Do your supervisors have procedures in place to prevent risk at work?”), warmth (four items, e.g., “Do you have high-quality relationships in your workplace?”), support (four items, e.g., “Do you receive help from coworkers?”), standards (one item: “Does your organization have implicit and explicit goals and performance standards?”), conflict (two items, e.g., “Do you get problems out in the open?”), and identity (four items, e.g., “Do you feel that you belong in your workplace?”). Responses are made on a 4-point Likert scale ranging from 1 = strongly disagree to 4 = strongly agree (Gray, 2007). The scale’s Cronbach’s alpha was .92 in this study.

The Thai version of the 30-item General Health Questionnaire was used to measure psychological morbidity (Goldberg, 1972; Nilchaikovit, Sukying, & Silpakit, 1996), with responses made on a 4-point Likert scale ranging from 0= not at all to 3 = much more than usual. The results are evaluated using the two-step (0–0–1–1) assessment method. Scores of 3 or more classify respondents as having psychological distress (Nilchaikovit et al., 1996). Cronbach’s alpha was .84 in this study.

Data Analysis

Frequencies, means, and standard deviations were calculated to describe the sample, and differences in proportion were analyzed using Pearson’s chi-square and Spearman’s rho correlations. Associations among CS, BO, and STS were identified using linear regression analyses. SPSS version 22 for Windows was used to conduct all analyses.

Results

The mean score for CS was 42.4, for BO was 29.7, and for STS was 20.3, whereas the proportions of high levels of CS, BO, and STS were as follows: 21.3%, 28.7%, and 16.4%. Considering the mean values, having excellent work ability, not having psychological distress, and all nine LSOCQ–Thai version subscales were correlated with CS, and considering the high cutoff values, more male than female employees, those that stayed in the same workplace they had been employed at preretirement, and responsibility, reward, risk, warmth, support, and work standards components of the LSOCQ–Thai version were correlated with CS. Further, lack of responsibility was correlated with BO in terms of both mean and frequency evaluations, and, lack of structure and lack of conflict resolution were correlated with the frequency evaluation of BO. Finally, being single, separated, divorced, or widowed; having a poor WAI score; and the lack of responsibility and poor conflict resolution subscales of the LSOCQ–Thai version, were correlated with STS.

Multiple linear regression results showed that being a younger age (60–65 years), WAI score, and perceived warmth and work standards components of the LSOCQ–Thai version were associated with CS. Further, having no psychological distress, and having a lack of responsibility as rated on the LSOCQ–Thai version were associated with BO, and lack of responsibility as rated on the LSOCQ–Thai version was associated with STS (see Table 1).

Table 1. Multiple Linear Regression Predicting Compassion Satisfaction, Burnout, and Secondary Traumatic Stress

Table/Figure

Note. CI = confidence interval. * p < .05, ** p < .01, *** p < .001.

Discussion

We investigated the associations among risk and protective factors and components of retired health sciences instructors’ ProQOL in terms of CS, BO, and STS. The mean score for CS found in this study was high compared to those obtained in previous studies (Bhutani et al., 2012; Kim et al., 2015). The BO and STS mean scores were comparable with those obtained in previous studies using samples of helping professionals (e.g., Kim et al., 2015). The proportion of participants with high levels of STS was low in this study compared to that found in a study conducted with therapists from the United Kingdom (Sodeke- Gregson et al., 2013). It is possible that the overall relatively high levels of ProQOL found in this study sample may be attributed to their postretirement status and, thus, having lower levels of direct patient contact than before they retired. Nevertheless, participants experiencing high BO and/or STS may need professional psychological help to assist them in coping with their stress (Musa & Hamid, 2008).

We found that compared with the participants aged 66 to 84 years, those aged 60 to 65 years had higher CS. In a previous study conducted with adult mental health professionals, CS was found to increase with age (Sodeke-Gregson et al., 2013). Unlike some previous researchers (e.g., Rossi et al., 2012), we did not find other sociodemographic factors to be related to CS, BO, or STS. In terms of risk factors investigated, excellent work ability was found to be associated with CS and psychological distress was inversely associated with BO. Previous researchers (Adeyemo et al., 2015; Musa & Hamid, 2008; Rossi et al., 2012) have found mixed results in terms of the relationship between psychological distress and BO.

Organizational climate, as measured in terms of warmth and standards, was found in this study to be associated with CS. Further, having a position of responsibility was found to be a protective factor against developing BO and STS. These findings support those obtained in previous studies (Bhutani et al., 2012; Ray et al., 2013; Sodeke-Gregson et al., 2013), showing that a positive work environment promotes CS and reduces BO. Therefore, university managers should create employment conditions for postretired academics that provide greater job responsibility, and promote early identification and management of STS and BO.

Study limitations include the small sample size, the cross-sectional nature of the study design, and the fact that specific measures, such as assessing whether participants had a history of traumatic events, were not included. To address these limitations, a longitudinal study with a larger sample and additional measures should be conducted. Further, the collectivist cultural orientation of Thai participants might limit the generalizability of the findings; thus, studies in other countries with an individualistic cultural orientation should be conducted.

References

Adeyemo, S., Omoaregba, J., Aroyewun, B., Modebe, V., James, B., Uteh, B., & Ezemokwe, C. (2015). Experiences of violence, compassion fatigue and compassion satisfaction on the professional quality of life of mental health professionals at a tertiary psychiatric facility in Nigeria. Open Science Journal of Clinical Medicine, 3, 69–73.

Aseem, S. M., & Nazir, N. A. (2008). A study of job burnout among university teachers. Psychology and Developing Societies, 20, 51–64. https://doi.org/dkdfzt

Bhutani, J., Bhutani, S., Balhara, Y. P. S., & Kalra, S. (2012). Compassion fatigue and burnout among clinicians: A medical exploratory study. Indian Journal of Psychological Medicine, 34, 332–337. https://doi.org/bjhq

Cambridge Dictionary. (2016). Meaning of “post-retirement” in the English Dictionary. Retrieved from https://bit.ly/29PsjiB

De Zwart, B. C. H., Frings-Dresen, M. H. W., & Van Duivenbooden, J. C. (2002). Test–retest reliability of the Work Ability Index questionnaire. Occupational Medicine, 52, 177–181. https://doi.org/dzbgqc

Goldberg, D. P. (1972). The detection of psychiatric illness by questionnaire: A technique for the identification and assessment of non-psychotic psychiatric illness. London, UK: Oxford University Press.

Gould, R., Ilmarinen, J., Järvisalo, J., & Koskinen, S. (2008). Dimensions of work ability. Helsinki, Finland: Finnish Institute of Occupational Health.

Gray, R. (2007). A climate of success: Creating the right organizational climate for high performance. Amsterdam, The Netherlands: Elsevier/Butterworth-Heinemann.

Haber, Y., Palgi, Y., Hamama-Raz, Y., Shrira, A., & Ben-Ezra, M. (2013). Predictors of professional quality of life among physicians in a conflict setting: The role of risk and protective factors. Israel Journal of Psychiatry and Related Sciences, 50, 174–180.

Jackson, R. A., Barnett, C., & Stajich, G. (1993). An analysis of burnout among school of pharmacy faculty. American Journal of Pharmaceutical Education, 57, 9–17.

Kaewboonchoo, O., & Ratanasiripong, P. (2015). Psychometric properties of the Thai version of the Work Ability Index (Thai WAI). Occupational Health, 57, 371–377. https://doi.org/bjj4

Kim, K., Han, Y., & Kim, J.-S. (2015). Korean nurses’ ethical dilemmas, professional values and professional quality of life. Nursing Ethics, 22, 467–478. https://doi.org/bjj5

Litwin, G. H., & Stringer, R. A. (1968). Motivation and organizational climate. Boston, MA: Harvard Business Press.

Musa, S. A., & Hamid, A. A. R. M. (2008). Psychological problems among AID workers operating in Darfur. Social Behavior and Personality: An international journal, 36, 407–416. https://doi.org/dcxznk

Nilchaikovit, T., Sukying, C., & Silpakit, C. (1996). Reliability and validity of the Thai version of the General Health Questionnaire. Journal of the Psychiatric Association of Thailand, 41, 2–17.

Pethtang, S., Kaewpan, W., Kalampakorn, S., & Sillabutra, J. (2014). Factors related to quality of work life of nurses working in primary health care units in the central region of Thailand [In Thai]. Journal of Public Health Nursing, 28, 29–42.

Ray, S. L., Wong, C., White, D., & Heaslip, K. (2013). Compassion satisfaction, compassion fatigue, work life conditions, and burnout among frontline mental health care professionals. Traumatology, 19, 255–267. https://doi.org/bjj6

Rossi, A., Cetrano, G., Pertile, R., Rabbi, L., Donisi, V., Grigoletti, L., … Amaddeo, F. (2012). Burnout, compassion fatigue, and compassion satisfaction among staff in community-based mental health services. Psychiatry Research, 200, 933–938. https://doi.org/bjj7

Sodeke-Gregson, E. A., Holttum, S., & Billings, J. (2013). Compassion satisfaction, burnout, and secondary traumatic stress in UK therapists who work with adult trauma clients. European Journal of Psychotraumatology, 4. https://doi.org/bjj8

Stamm, B. H. (2010). The concise ProQOL manual (2nd ed.). Pocatello, ID: ProQOL.org.
Yoder, A. E. (2010). Compassion fatigue in nurses. Applied Nursing Research, 23, 191–197. https://doi.org/fb3n7z

Adeyemo, S., Omoaregba, J., Aroyewun, B., Modebe, V., James, B., Uteh, B., & Ezemokwe, C. (2015). Experiences of violence, compassion fatigue and compassion satisfaction on the professional quality of life of mental health professionals at a tertiary psychiatric facility in Nigeria. Open Science Journal of Clinical Medicine, 3, 69–73.

Aseem, S. M., & Nazir, N. A. (2008). A study of job burnout among university teachers. Psychology and Developing Societies, 20, 51–64. https://doi.org/dkdfzt

Bhutani, J., Bhutani, S., Balhara, Y. P. S., & Kalra, S. (2012). Compassion fatigue and burnout among clinicians: A medical exploratory study. Indian Journal of Psychological Medicine, 34, 332–337. https://doi.org/bjhq

Cambridge Dictionary. (2016). Meaning of “post-retirement” in the English Dictionary. Retrieved from https://bit.ly/29PsjiB

De Zwart, B. C. H., Frings-Dresen, M. H. W., & Van Duivenbooden, J. C. (2002). Test–retest reliability of the Work Ability Index questionnaire. Occupational Medicine, 52, 177–181. https://doi.org/dzbgqc

Goldberg, D. P. (1972). The detection of psychiatric illness by questionnaire: A technique for the identification and assessment of non-psychotic psychiatric illness. London, UK: Oxford University Press.

Gould, R., Ilmarinen, J., Järvisalo, J., & Koskinen, S. (2008). Dimensions of work ability. Helsinki, Finland: Finnish Institute of Occupational Health.

Gray, R. (2007). A climate of success: Creating the right organizational climate for high performance. Amsterdam, The Netherlands: Elsevier/Butterworth-Heinemann.

Haber, Y., Palgi, Y., Hamama-Raz, Y., Shrira, A., & Ben-Ezra, M. (2013). Predictors of professional quality of life among physicians in a conflict setting: The role of risk and protective factors. Israel Journal of Psychiatry and Related Sciences, 50, 174–180.

Jackson, R. A., Barnett, C., & Stajich, G. (1993). An analysis of burnout among school of pharmacy faculty. American Journal of Pharmaceutical Education, 57, 9–17.

Kaewboonchoo, O., & Ratanasiripong, P. (2015). Psychometric properties of the Thai version of the Work Ability Index (Thai WAI). Occupational Health, 57, 371–377. https://doi.org/bjj4

Kim, K., Han, Y., & Kim, J.-S. (2015). Korean nurses’ ethical dilemmas, professional values and professional quality of life. Nursing Ethics, 22, 467–478. https://doi.org/bjj5

Litwin, G. H., & Stringer, R. A. (1968). Motivation and organizational climate. Boston, MA: Harvard Business Press.

Musa, S. A., & Hamid, A. A. R. M. (2008). Psychological problems among AID workers operating in Darfur. Social Behavior and Personality: An international journal, 36, 407–416. https://doi.org/dcxznk

Nilchaikovit, T., Sukying, C., & Silpakit, C. (1996). Reliability and validity of the Thai version of the General Health Questionnaire. Journal of the Psychiatric Association of Thailand, 41, 2–17.

Pethtang, S., Kaewpan, W., Kalampakorn, S., & Sillabutra, J. (2014). Factors related to quality of work life of nurses working in primary health care units in the central region of Thailand [In Thai]. Journal of Public Health Nursing, 28, 29–42.

Ray, S. L., Wong, C., White, D., & Heaslip, K. (2013). Compassion satisfaction, compassion fatigue, work life conditions, and burnout among frontline mental health care professionals. Traumatology, 19, 255–267. https://doi.org/bjj6

Rossi, A., Cetrano, G., Pertile, R., Rabbi, L., Donisi, V., Grigoletti, L., … Amaddeo, F. (2012). Burnout, compassion fatigue, and compassion satisfaction among staff in community-based mental health services. Psychiatry Research, 200, 933–938. https://doi.org/bjj7

Sodeke-Gregson, E. A., Holttum, S., & Billings, J. (2013). Compassion satisfaction, burnout, and secondary traumatic stress in UK therapists who work with adult trauma clients. European Journal of Psychotraumatology, 4. https://doi.org/bjj8

Stamm, B. H. (2010). The concise ProQOL manual (2nd ed.). Pocatello, ID: ProQOL.org.
Yoder, A. E. (2010). Compassion fatigue in nurses. Applied Nursing Research, 23, 191–197. https://doi.org/fb3n7z

Table 1. Multiple Linear Regression Predicting Compassion Satisfaction, Burnout, and Secondary Traumatic Stress

Table/Figure

Note. CI = confidence interval. * p < .05, ** p < .01, *** p < .001.


Karl Peltzer is currently at the University of the Free State. This research was supported by Mahidol University.

Karl Peltzer, HIV/AIDS, STIs and TB (HAST) Research Programme, Human Sciences Research Council, Private Bag X41, Pretoria 0001, South Africa. Email: [email protected]

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