Factors associated with quality of life among community pharmacists in Lebanon: results of a cross-sectional study
Objective: The objective of this study was to assess the quality of life and the factors associated with it among community pharmacists in Lebanon.
Methods: This cross-sectional study was carried out between March and July 2018, enrolling 435 pharmacists, using a proportionate random sample of community pharmacies from all districts of Lebanon. The validated Arabic translation of the Short-Form 12 (SF12v2) was used to derive 2 summary scores: physical and mental component summaries (PCS and MCS).
Results: Lebanese community pharmacists scored a mean PCS-12 and MCS-12 of 48.9 (SD 7.1) and 48.8 (SD 8.5), respectively. Higher age (Beta= -0.08), having a PhD degree (Beta= -4.54), higher depression score (Beta= -0.25), higher emotional work fatigue (Beta= -0.13) and higher physical work fatigue (Beta=-0.14) were significantly associated with lower physical QoL (lower PCS-12 scores).
Increased stress (Beta= -0.17), higher insomnia (Beta= -0.21), higher depression (Beta= -0.2) and working for over 40 hours per week (Beta= -0.2) were significantly associated with lower mental QoL (lower mental MCS-12 scores).
Conclusions: Our research has found a strong correlation between quality of life and psychological factors, including stress, burnout, insomnia, and depression among community pharmacists.
Kheir N, Emmerton L, Shaw J. Can pharmacists influence the health-related quality of life of patients with asthma?: The New Zealand Pharmaceutical Care experience. J Sci Res Med Sci. 2001;3(2):69-75.
Iskandar K, Hallit S, Raad EB, Droubi F, Layoun N, Salameh P. Community pharmacy in Lebanon: A societal perspective. Pharm Pract (Granada). 2017;15(2):893. https://doi.org/10.18549/PharmPract.2017.02.893
Al-Arifi MN. Patients’ perception, views and satisfaction with pharmacists’ role as health care provider in community pharmacy setting at Riyadh, Saudi Arabia. Saudi Pharm J. 2012;20(4):323-330. https://doi.org/10.1016/j.jsps.2012.05.007
Mott DA, Doucette WR, Gaither CA, Pedersen CA, Schommer JC. Pharmacists' attitudes toward worklife: results from a national survey of pharmacists. J Am Pharm Assoc (2003). 2004;44(3):326-336. https://doi.org/10.1331/154434504323063968
Majd M, Hashemian F, Younesi Sisi F, Jalal M, Majd Z. Quality of Life and Job Satisfaction of Dispensing Pharmacists Practicing in Tehran Private-sector Pharmacies. Iran J Pharm Res. 2012;11(4):1039-1044.
Ahmad A, Khan MU, Elkalmi RM, Jamshed SQ, Nagappa AN, Patel I, Balkrishnan R. Job satisfaction among Indian pharmacists: an exploration of affecting variables and suggestions for improvement in pharmacist role. Indian J Pharm Educ Res. 2016;50(1):9-16. https://doi.org/10.5530/ijper.50.1.2
Balkhi B, Alghamdi A, Alshehri N, Alshehri A. Assessment of job satisfaction among hospital pharmacists in Saudi Arabia. IOSR J Pharm. 2017;7(5):34-40.
Armstrong M. A handbook of human resource management practice. London: Kogan Page Publishers; 2006.
Balayssac D, Pereira B, Virot J, Lambert C, Collin A, Alapini D, Gagnaire JM, Authier N, Cuny D, Vennat B. Work-related stress, associated comorbidities and stress causes in French community pharmacies: a nationwide cross-sectional study. PeerJ. 2017;5:e3973. https://doi.org/10.7717/peerj.3973
Salameh P, Hamdan I. Pharmacy manpower in Lebanon: An exploratory look at work-related satisfaction. Res Social Adm Pharm. 2007;3(3):336-350. https://doi.org/10.1016/j.sapharm.2006.09.003
Antoun RB, Salameh P. [Satisfaction of pharmacists in Lebanon and the prospect for clinical pharmacy]. East Mediterr Health J. 2009;15(6):1553-1563.
Choueiry G, Hallit S, Salameh P. Analysis of Cost and Content of 1326 Medical Prescriptions from the Area of Mount Lebanon. Res Rev. 2017;6(3):10-17.
Hallit S, Zeenny RM, Sili G, Salameh P. Situation analysis of community pharmacy owners in Lebanon. Pharm Pract (Granada). 2017;15(1):853. https://doi.org/10.18549/PharmPract.2017.01.853
McCann L, Hughes CM, Adair CG, Cardwell C. Assessing job satisfaction and stress among pharmacists in Northern Ireland. Pharm World Sci. 2009;31(2):188-194. https://doi.org/10.1007/s11096-008-9277-5
Sabbah I, Drouby N, Sabbah S, Retel-Rude N, Mercier M. Quality of life in rural and urban populations in Lebanon using SF-36 health survey. Health Qual Life Outcomes. 2003;1:30. https://doi.org/10.1186/1477-7525-1-30
Frone MR, Tidwell MO. The meaning and measurement of work fatigue: Development and evaluation of the Three-Dimensional Work Fatigue Inventory (3D-WFI). J Occup Health Psychol. 2015;20(3):273-288. https://doi.org/10.1037/a0038700
Obeid S, Abi Elias Hallit C, Haddad C, Hany Z, Hallit S. Validation of the Hamilton Depression Rating Scale (HDRS) and sociodemographic factors associated with Lebanese depressed patients. Encephale. 2018;44(5):397-402. https://doi.org/10.1016/j.encep.2017.10.010
Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960;23:56-62. https://doi.org/10.1136/jnnp.23.1.56
Barbour B, Saadeh N, Salameh PR. Psychological distress in Lebanese young adults: constructing the screening tool ‘BDS-22’. Int J Cult Mental Health. 2012;5(2):94-108. https://doi.org/10.1080/17542863.2011.563043
Pancorbo G, Laros JA. Validity evidence of the Social and Emotional Nationwide Assessment (SENNA) inventory. Paidéia (Ribeirão Preto). 2017;27(68):339-347. http://doi.org/10.1590/1982-43272768201712
Reilly M, Bracco A, Ricci JF, Santoro J, Stevens T. The validity and accuracy of the Work Productivity and Activity Impairment questionnaire–irritable bowel syndrome version (WPAI: IBS). Aliment Pharmacol Ther. 2004;20(4):459-467. https://doi.org/10.1111/j.1365-2036.2004.02091.x
Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976). 2000;25(24):3186-3191. https://doi.org/10.1097/00007632-200012150-00014
Beaton D, Bombardier C, Guillemin F, Ferraz MB. Recommendations for the cross-cultural adaptation of health status measures. New York: American Academy of Orthopaedic Surgeons. 2002.
Al-Bannay H, Jarus T, Jongbloed L, Yazigi M, Dean E. Culture as a variable in health research: perspectives and caveats. Health Promot Int. 2014;29(3):549-557. https://doi.org/10.1093/heapro/dat002
Antunes B, Daveson B, Ramsenthaler C, Benalia H, Ferreira P, Bausewein C, Higginson IJ. The Palliative care Outcome Scale (POS) Manual for cross-cultural adaptation and psychometric validation. London: Cicely Saunders Institute. 2012.
Weidmer B. Issues and guidelines for translation in cross-cultural research. In: Proceedings of the American Statistical Association, Section on Survey Research Methods. 49th, American Association for Public Opinion Research. Danvers, 1994.
Maneesriwongul W, Dixon JK. Instrument translation process: a methods review. J Adv Nurs. 2004;48(2):175-186. https://doi.org/10.1111/j.1365-2648.2004.03185.x
Nejjari C, El Fakir S, Bendahhou K, El Rhazi K, Abda N, Zidouh A, Benider A, Errihani H, Bekkali R. Translation and validation of European organization for research and treatment of cancer quality of life Questionnaire-C30 into Moroccan version for cancer patients in Morocco. BMC Res Notes. 2014;7:228. https://doi.org/10.1186/1756-0500-7-228
Calgan Z, Aslan D, Yegenoglu S. Community pharmacists' burnout levels and related factors: an example from Turkey. Int J Clin Pharm. 2011;33(1):92-100. https://doi.org/10.1007/s11096-010-9461-2
World Health Organization. Active Ageing: A Policy Framework. Available at: http://whqlibdoc.who.int/hq/2002/who_nmh_nph_02.8.pdf (accessed Jul 4, 2019).
Hunger M, Thorand B, Schunk M, Doring A, Menn P, Peters A, Holle R. Multimorbidity and health-related quality of life in the older population: results from the German KORA-age study. Health Qual Life Outcomes. 2011;9:53. https://doi.org/10.1186/1477-7525-9-53
Parker L, Moran GM, Roberts LM, Calvert M, McCahon D. The burden of common chronic disease on health-related quality of life in an elderly community-dwelling population in the UK. Fam Pract. 2014;31(5):557-563. https://doi.org/10.1093/fampra/cmu035
Low G, Molzahn AE, Schopflocher D. Attitudes to aging mediate the relationship between older peoples' subjective health and quality of life in 20 countries. Health Qual Life Outcomes. 2013;11:146. https://doi.org/10.1186/1477-7525-11-146
Raggi A, Corso B, Minicuci N, Quintas R, Sattin D, De Torres L, et al. Determinants of Quality of Life in Ageing Populations: Results from a Cross-Sectional Study in Finland, Poland and Spain. PLoS One. 2016;11(7):e0159293. https://doi.org/10.1371/journal.pone.0159293
Chia EM, Wang JJ, Rochtchina E, Smith W, Cumming RR, Mitchell P. Impact of bilateral visual impairment on health-related quality of life: the Blue Mountains Eye Study. Invest Ophthalmol Vis Sci. 2004;45(1):71-76. https://doi.org/10.1167/iovs.03-0661
Lopez D, McCaul KA, Hankey GJ, Norman PE, Almeida OP, Dobson AJ, Byles JE, Yeap BB, Flicker L. Falls, injuries from falls, health related quality of life and mortality in older adults with vision and hearing impairment--is there a gender difference? Maturitas. 2011;69(4):359-364. https://doi.org/10.1016/j.maturitas.2011.05.006
Bookwala J. Marital quality as a moderator of the effects of poor vision on quality of life among older adults. J Gerontol B Psychol Sci Soc Sci. 2011;66(5):605-616. https://doi.org/10.1093/geronb/gbr091
Netuveli G, Wiggins RD, Hildon Z, Montgomery SM, Blane D. Quality of life at older ages: evidence from the English longitudinal study of aging (wave 1). J Epidemiol Community Health. 2006;60(4):357-363. https://doi.org/10.1136/jech.2005.040071
Han KT, Park EC, Kim JH, Kim SJ, Park S. Is marital status associated with quality of life? Health Qual Life Outcomes. 2014;12:109. https://doi.org/10.1186/s12955-014-0109-0
Georgellis Y, Tsitsianis N, Yin YP. Personal values as mitigating factors in the link between income and life satisfaction: Evidence from the European Social Survey. Soc Indicators Res. 2009;91(3):329-344. https://doi.org/10.1007/s11205-008-9344-2
Mielck A, Vogelmann M, Leidl R. Health-related quality of life and socioeconomic status: inequalities among adults with a chronic disease. Health Qual Life Outcomes. 2014;12:58. https://doi.org/10.1186/1477-7525-12-58
Skilled for life? Key findings from the Survey of Adult Skills. Paris, France: Organisation for Economic Co-Operation and Development (OECD). Available at: http://skills.oecd.org/documents/SkillsOutlook_2013_KeyFindings.pdf (accessed Jul 4, 2019).
Mayberry KM, Miller LN. Incidence of Self-Reported Depression Among Pharmacy Residents in Tennessee. Am J Pharm Educ. 2017;81(8):5960. https://doi.org/10.5688/ajpe5960
Blekemolen J, Hulshof C, Sluiter J. The prevalence of work-related stress complaints among healthcare workers for the disabled participating in a workers’ health surveillance program. Occup Med Health Aff. 2016;4(256):2.
Gong Y, Han T, Yin X, Yang G, Zhuang R, Chen Y, Lu Z. Prevalence of depressive symptoms and work-related risk factors among nurses in public hospitals in southern China: a cross-sectional study. Sci Rep. 2014;4:7109. https://doi.org/10.1038/srep07109
Craiovan PM. Burnout, depression and quality of life among the Romanian employees working in non-governmental organizations. Procedia-Soc Behav Sci. 2015;187:234-238. https://doi.org/10.1016/j.sbspro.2015.03.044
Swider BW, Zimmerman RD. Born to burnout: A meta-analytic path model of personality, job burnout, and work outcomes. J Vocation Behav. 2010;76(3):487-506. https://doi.org/10.1016/j.jvb.2010.01.003
Verlander LA, Benedict JO, Hanson DP. Stress and sleep patterns of college students. Percept Mot Skills. 1999;88(3 Pt 1):893-898. https://doi.org/10.2466/pms.19126.96.36.1993
Léger D, Guilleminault C, Bader G, Lévy E, Paillard M. Medical and socio-professional impact of insomnia. Sleep. 2002;25(6):625-629.
Lapane K, Hughes C. Job satisfaction and stress among pharmacists in the long-term care sector. Consult Pharm. 2006;21(4):287-292. https://doi.org/10.4140/TCP.n.2006.287
Marshall LL, Allison A, Nykamp D, Lanke S. Perceived stress and quality of life among doctor of pharmacy students. Am J Pharm Educ. 2008;72(6):137. https://doi.org/10.5688/aj7206137
Yong FR, Garcia-Cardenas V, Williams KA, Benrimoj SI. Factors affecting community pharmacist work: A scoping review and thematic synthesis using role theory. Res Social Adm Pharm. 2019 [ahead of print]. https://doi.org/10.1016/j.sapharm.2019.05.001
Gallagher CT, Mehta AN, Selvan R, Mirza IB, Radia P, Bharadia NS, Hitch G. Perceived stress levels among undergraduate pharmacy students in the UK. Curr Pharm Teach Learn. 2014;6(3):437-441. https://doi.org/10.1016/j.cptl.2014.02.004
Balayssac D, Pereira B, Virot J, Collin A, Alapini D, Cuny D, Gagnaire JM, Authier N, Vennat B. Burnout, associated comorbidities and coping strategies in French community pharmacies-BOP study: A nationwide cross-sectional study. PLoS One. 2017;12(8):e0182956. https://doi.org/10.1371/journal.pone.0182956
Kumar A, Bhat PS, Ryali S. Study of quality of life among health workers and psychosocial factors influencing it. Ind Psychiatry J. 2018;27(1):96-102. https://doi.org/10.4103/ipj.ipj_41_18
La Torre G, Sestili C, Mannocci A, Sinopoli A, De Paolis M, De Francesco S, Rapaccini L, Barone M, Iodice V, Lojodice B, Sernia S, De Sio S, Del Cimmuto A, De Giusti M. Association between Work Related Stress and Health Related Quality of Life: The Impact of Socio-Demographic Variables. A Cross Sectional Study in a Region of Central Italy. Int J Environ Res Public Health. 2018;15(1):159. https://doi.org/10.3390/ijerph15010159
Phipps DL, Ashcroft DM. An investigation of occupational subgroups with respect to patient safety culture. Saf Sci. 2012;50(5):1290-1298. https://doi.org/10.1016/j.ssci.2011.12.016
Hermansyah A, Sainsbury E, Krass I. Investigating influences on current community pharmacy practice at micro, meso, and macro levels. Res Social Adm Pharm. 2017;13(4):727-737. https://doi.org/10.1016/j.sapharm.2016.06.007
Gidman W. Increasing community pharmacy workloads in England: causes and consequences. Int J Clin Pharm. 2011;33(3):512-520. https://doi.org/10.1007/s11096-011-9498-x
Harvey J, Avery AJ, Ashcroft D, Boyd M, Phipps DL, Barber N. Exploring safety systems for dispensing in community pharmacies: focusing on how staff relate to organizational components. Res Social Adm Pharm. 2015;11(2):216-227. https://doi.org/10.1016/j.sapharm.2014.06.005
Potter P, Deshields T, Divanbeigi J, Berger J, Cipriano D, Norris L, Olsen S. Compassion fatigue and burnout: prevalence among oncology nurses. Clin J Oncol Nurs. 2010;14(5):E56-E62. https://doi.org/10.1188/10.CJON.E56-E62
AlFahhad N. Prevalence and factors associated with depression among health care workers in National Guard Hospital in Riyadh, KSA. Int J Med Develop Countries. 2018;2(3):92-96. http://doi.org/10.24911/IJMDC.51-1526306040
Pawlina MMC, Schnorr GP. Prevalence of stress in health workers in the context hospital. Psychol Behav Med Open Access J. 2018;0(0):15-21.
Silva NC, Ferreira JVB, Albuquerque TC, Rodrigues MR, Medeiros MF. [Mental health disorders will likely related to working life of nurses: a literature review]. Revista Eletrônica Estácio Saúde 2016; 5(2):107-122.
Antunes M. Brazilian scientific production on psychic suffering and depression of the nursing team in the emergency. . Revista Enfermagem Contemporânea. 2017;6(1):68-72.
Kho BP, Hassali MA, Lim CJ, Saleem F. Challenges in the management of community pharmacies in Malaysia. Pharm Pract (Granada). 2017 Apr-Jun;15(2):933. https://doi.org/10.18549/PharmPract.2017.02.933
Carvajal MJ, Popovici I. Gender, age, and pharmacists' job satisfaction. Pharm Pract (Granada). 2018:16(4):1396. https://doi.org/10.18549/PharmPract.2018.04.1396
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