Sociodemographic factors associated with the quality of work life of adults with physical disabilities

ABSTRACT |

Background:

The quality of work life (QWL) of individuals with physical disabilities is not satisfactory.

Objective:

To investigate the relationship between sociodemographic factors and QWL among individuals with physical disabilities.

Methods:

Cross-sectional study with quantitative approach conducted in 2014 at two institutions that help individuals with disabilities find jobs. A total of 38 subjects who responded a sociodemographic questionnaire and a QWL scale participated in the study. Cronbach’s alpha, χ² and Fisher’s tests were performed using Statistical Package for the Social Sciences (SPSS). The ethical requirements in force were met.

Results:

The internal consistency of the scale used was satisfactory (α=0.792); relative to QWL, 44.7% (n=17) participants reported dissatisfaction. Association was found between QWL and sociodemographic factors income (p=0.010), education (p=0.036) and race (p=0.027).

Conclusion:

The participants’ QWL was not satisfactory and was influenced by sociodemographic factors.

INTRODUCTION

The notion of quality of work life (QWL) has been used in a broad manner, involving well-being and restructuration of the organization of work, encompassing from physical to psychosocial and legislative aspects to contribute for individuals to feel respected and appreciated at the workplace and encourage the production of significant outcomes^1,2,3,4,5.

However, QWL and its possible positive repercussions for both companies and workers notwithstanding, within the Brazilian socioeconomic milieu the labor market is characterized by a context that seldom fails to promote it. This scenario becomes particularly evident when one considers social minorities, such as women, blacks, Indians and individuals with disabilities (IwDs) who are remarkably subjected to unequal treatment^6,7.

However, the actual inclusion of IwDs in the labor market evidences the ability for work of this human group in several jobs. The reason is that their rising educational level and technological transformations increased the number of individuals who are in conditions to produce high-quality work despite the limitations imposed by their disabilities. In many situations the latter do not represent an hindrance to find a job, as it has been shown they can be overcome through institutional adjustment and specific arrangements⁸.

Facing this scenario, and as an attempt to overcome discrimination in regard to salaries or in the criteria for hiring workers with some disability, the 1988 Constitution ensured the right of IwDs to work. As established by Law No. 8,213 from 1991, it is mandatory for companies with 100 or more employees to hire IwDs according to specific ratios - up to 200, 2%; 201 to 500, 3%; 501 to 1,000, 4%; 1,001 or more, 5%^9,10. Still in regard to legislation, Law No. 13,146 from 2015 ensures and promotes the exercise of the fundamental rights and liberties in equal conditions aiming at the social inclusion and citizenship of IwDs¹¹.

Although the advances in policies targeting IwDs point to continuous encouragement of equal inclusion of this population in the labor market without any discrimination, but with respect for individual hindrances, it is believed this is not always the actual case. There are gaps in the development of employment programs, inadequate criteria for labor assessment, and non-inclusive physical and logistic characteristics in workplaces¹², resulting in environments likely to impair QWL.

While it is believed that on a more general level some aspects might impair the QWL of IwDs, as stated above, it is also assumed that some individual sociodemographic characteristics of this population might be correlated - as e.g., sex, age, skin color and income - and thus deserve better investigation and comprehension. In addition to broadening the scope of the discussion on the subject of interest within the field of public health, these aspects might serve to ground the implantation and maintenance of policies, programs and services in several areas.

Based on the considerations above, we sought to investigate associations between sociodemographic factors and the QWL of IwDs.

METHODS

The present cross-sectional, epidemiological and descriptive study with quantitative approach was conducted in 2014 at two institutions that help individuals with disabilities find jobs, located in Campina Grande, Paraíba, Brazil.

The sample comprised 38 IwDs who met the inclusion criteria: age 18 years old or older; having some physical disability; and having formal employment relationship. The exclusion criteria were: having some acute or chronic, mental and/or physical disease impairing the cognitive and/or verbal communication skills and/or incapacity.

Following recruitment, data collection was performed by means of two instruments; one comprised sociodemographic data and was formulated ad hoc for the present study. The other was a validated questionnaire available in the literature designed to assess satisfaction with QWL items¹³, in which questions are responded on a 5-point Likert scale, as follows:

1. (very dissatisfied);

2. (dissatisfied);

3. (neither dissatisfied nor satisfied);

4. (satisfied);

5. (very satisfied).

The collected data were entered in a database using software Statistical Package for the Social Sciences (SPSS) 18.0 and then analyzed by means of descriptive statistics. The data relative to the scale and QWL were first subjected to verification of their international consistency to establish the precision of the instrument. For this purpose Cronbach’s alpha was used; values >0.70 were considered to be satisfactory¹⁴. Next associations were investigated, by means of the χ² and/or Fisher’s test, between sociodemographic factors as independent variables and QWL as dependent variable. The latter was dichotomized as “dissatisfactory” (very dissatisfied, dissatisfied, neither dissatisfied nor satisfied) and “satisfactory” (satisfied and very satisfied). Associations were considered to be statistically significant when p<0.05 with 95% confidence interval.

Due to ethical-legal reasons, the study was subjected for appraisal to the research ethics committee of State University of Paraíba (Universidade Estadual da Paraíba CEP - UEPB) being approved under ruling CAAE no. 31868014.8.0000.5187.

RESULTS

The sociodemographic profile of the analyzed IwDs is described in Table 1, which shows predominance of males (60.5%), individuals having completed secondary school (31.6%) and with income up to the equivalent of the minimum wage (68.5%).

Table 1. Sociodemographic profile of individuals with disabilities. Campina Grande, Paraíba, Brazil, 2014.

Variables	n	%
Sex
Male	23	60.5
Female	15	39.5
Age range (years)
18 to 29	5	13.2
30 to 39	16	42.1
40 to 49	7	18.4
50 to 59	9	23.7
60 to 69	1	2.6
Religious belief
Catholic	29	76.3
Evangelical	2	5.3
Spiritualist	3	7.9
None	4	10.5
Ethnicity/skin color
White	14	36.8
Black	7	18.5
Brown skin	16	42.1
Asian	1	2.6
Educational level
Complete elementary school	5	13.2
Incomplete elementary school	11	28.9
Complete secondary school	12	31.6
Incomplete secondary school	9	23.7
Complete higher education	1	2.6
Marital status
Married	24	63.2
Single	14	36.8
Income (times the equivalent of the minimum wage)*
1	26	68.5
2	11	28.9
≥3	1	25

N=38; *minimum wage: BRL 724.00.

Table 2 describes the results of the analysis of the instrument’s precision, showing satisfactory internal consistency - Cronbach’s alpha: 0.792, indicative of adequate reliability.

Table 2. Quality of Work Life tested by means of Cronbach’s alpha. Campina Grande, Paraíba, Brazil, 2014.

QWL scale items	Total correlation among corrected items	Cronbach’s alpha following item removal	Total Cronbach’s alpha
Salary	0.194	0.795	0.792
Food	0.061	0.805
Transportation voucher	0.144	0.813
Health care aid	0.104	0.797
Working hours	0.383	0.781
Workload	0.471	0.778
Use of equipment that makes work easier	0.424	0.779
Workplace: accessibility/safety	0.720	0.755
Decision-making opportunities	0.563	0.769
Aware of own performance	0.399	0.780
Training courses	0.475	0.775
Professional growth ability	0.396	0.780
Job stability	0.308	0.786
Discrimination	0.019	0.800
Relationships with colleagues and supervisors	0.358	0.783
Receives special assistance when requested	0.501	0.773
Respect for workers’ rights	0.322	0.785
Opportunities to express own opinions	0.674	0.764
Privacy	0.618	0.768
How company treats its employees	0.427	0.779

QWL: quality of work life.

Most participants reported satisfaction with their QWL (n=17; 44.7%). When analyzed per component, as shown in Table 3, the participants reported to be most satisfied with food (63.2%) and transportation voucher (57.8%) and less satisfied with salary (50%) and discrimination (40.5%).

Table 3. Percent distribution of participants according to their perception of items in the quality of work life scale. Campina Grande, Paraíba, Brazil, 2014.

QWL scale items	IwDs’ perception of QWL items*
	1	2	3	4	5
Salary	18.4	18.4	13.2	50	-
Food	2.6	15.8	15.8	63.2	2.6
Transportation voucher	2.6	13.2	5.3	57.8	21.1
Health care aid	15.8	57.9	18.4	5.3	2.6
Working hours	2.6	7.9	7.9	42.1	39.5
Workload	2.6	-	15.8	50	31.6
Use of equipment that makes work easier	2.6	5.3	15.8	52.6	23.7
Workplace: accessibility/safety	7.9	23.7	28.9	26.3	13.2
Decision-making opportunities	10.5	21.1	36.8	31.6	-
Aware of own performance	2.6	28.9	18.4	47.5	2.6
Training courses	10.5	26.3	23.7	39.5	-
Professional growth ability	13.2	26.3	26.3	34.2	-
Job stability	10.5	7.9	23.7	50	7.9
Discrimination	40.5	51.4	5.4	-	2.7
Relationships with colleagues and supervisors	-	2.7	18.9	43.3	35.1
Receives special assistance when requested	7.9	5.3	34.2	42.1	10.5
Respect for workers’ rights	-	10.5	36.8	42.2	10.5
Opportunities to express own opinions	7.9	23.7	34.2	34.2	-
Privacy	5.3	26.3	39.5	28.9	-
How company treats its employees	2.6	-	23.7	39.5	34.2

*1: very dissatisfied (very poor); 2: dissatisfied (poor); 3: neither dissatisfied nor satisfied (average); 4: satisfied (good); 5: very satisfied (excellent); QWL: quality of work life; IwDs: individuals with disabilities.

Finally, as Table 4 shows, association was found between QWL and sociodemographic variables income (p=0.010), educational level (p=0.036) and ethnicity (p=0.027).

Table 4. Association between sociodemographic variables and quality of work life among individuals with disabilities. Campina Grande, Paraíba, Brazil, 2014.

Sociodemographic variables	QWL				PR (95%CI)	χ2**	pd
	Dissatis- factory		Satis- factory
	n	%	n	%
Sex
Male	13	61.9	10	58.8	1.06 (0.58-1.91)	0.037	0.847
Female	8	38.1	7
Age range (years)
<50	17	81	11	64.7	1,51 (0.67-3.43)	1.279	0.258
≥50	4	19	6	35.3
Religion
Yes	19	90.5	15	88.2	1.11 (0.40-3.11)	0.050	0.823
None	2	9.5	2	11.8
Ethnicity/skin color
White	11	52.4	3	17.6	1.88 (1.09)-3.25	4.871	0.027
Non white	10	47.6	14	82.4
Educational level*** (years of formal schooling)
<10	12	57.2	4	23.5	1.83 (1.03-3.26)	4.350	0.036
≥10	9	42.8	13	76.5
Marital status
With partner	15	71.4	9	52.9	1.45 (0.73-2.87)	1.380	0.240
Without partner	6	28.6	8	47.1
Income (times the equivalent of the minimum wage)*
Up to 2	18	85.7	8	47.1	2.77 (1.01-7.63)	6.500	0.010
More than 2	3	14.3	9	52.9

*Dissatisfactory: dissatisfied or average; Satisfactory: satisfied; **When the sample size was less than 5 Fisher’s test was used; ***Dichotomized based on mean value; QWL: quality of work life; PR: prevalence ratio; 95%CI: 95% confidence interval.

DISCUSSION

Demographic analysis of the sample of the IwDs analyzed in the present study evidenced predominance of males over women in quantitative terms. Since the participants met the inclusion criteria of having formal employment relationship, the data point to a higher number of males in this condition compared to females, which does not seem to be a trend given the conflicting data in the Brazilian literature^15,16,17.

Although the data on inclusion of IwDs in the formal labor market are recent, considering the Annual Report of Social Information (Relação Anual de Informações Sociais - RAIS) this population fills less than 1% of job positions in Brazil. This situation falls quite short from the ideal, especially in the case of women, because they fill half the job positions men do¹⁸.

Therefore, we might admit, together with the conclusions of a study that just like ours analyzed QWL among IwDs, that women with disabilities might be exposed to a double source of prejudice: one, resulting from their physical disability, which invariably comes with several orders of hindrances; and second, the stigma associated with the female sex, having in view the historical exclusion of women from the labor market¹⁹.

Although the data on the distribution of jobs per sex diverge from the ones reported in other studies, other sociodemographic data described here, such as age range, educational level and financial aspects, agree with the literature. Indeed, most IwDs who perform some form of work are young adults, who completed secondary school and have low income^17,19,20.

As is known, 29% of IwDs in Brazil earn less than the equivalent of the minimum wage per month²¹. It is safe to assume that there is a substantial relationship between disability and poverty, even when the affected individuals do work, as a function of the joint effect of low salary and high expenses, which might exceed their abilities’ to meet them. This scenario was also described in the United States and European Union countries¹².

In addition to contributing to hinder IwDs from performing their activities correctly, with consequent negative impact on their work and productivity, the influence of low income might extend well beyond the world of work, to interfere with the individuals’ health, for instance. The reason is that some forms of disability often demand special modalities of care delivery, which as a rule must be at least partially paid. And when resources are not available (or sufficient) it is believed that such modalities of care delivery might become seriously jeopardized.

The smallest proportion of the analyzed IwDs reported to be satisfied with the performance of a given job. It is believed that satisfaction with this aspect might be related with a set of multiple and variable aspects, the synergic action of which is indispensable to achieve a minimum degree of satisfaction at work. The financial factor is certainly involved, but paradoxically and as also found in another study¹⁹, it was rated as the least satisfactory.

The fact that the participants rated the financial aspect as the least satisfactory is relevant, because analysis of the factors associated with QWL showed that income - which distribution per salary range evidenced predominance of individuals earning up to the equivalent of the minimum wage - had a statistically significant relationship. This finding agrees with the ones of a study conducted with a similar population from a company in Belo Horizonte, Minas Gerais, Brazil²², in which the participants reported dissatisfaction with their salary.

In addition to income, also variable educational level was associated with QWL in a statistically significant manner. It is believed that low-level or no formal schooling - which is the actual situation of a considerable fraction of IwDs²³ - represents a significant hindrance for the inclusion and maintenance of this population in the labor market. This might account for the fact that IwDs tend to shift to less complex activities, which evidences the difficulties they experience upon hitting against countless barriers in their attempts to find better job positions, especially in the case of the ones that require higher technical specialization. It might further explain how far we are from the alleged process of social inclusion of this population, especially in professional training milieus, such as universities.

Within this context, a study found that, as a rule, workers with disabilities perform operational functions and are hardly appointed to higher positions, like the ones involving leadership. Indeed, the present study found that IwDs are at disadvantage in the labor market due to lack of access to education and training²². Reinforcing these findings, a study showed that in 27 countries working-age individuals with disabilities experienced significant labor market disadvantage and poorer labor market outcomes than working-age individuals without disabilities²⁴.

It is believed that for the overall population, and more especially for IwDs, education, understood as qualification and professional training, is a relevant option for the implementation of policies and programs to help them cope with the barriers that restrict them within the world of work. As mentioned above, lack of such policies and programs increases the disadvantage of this population relative to the individuals without disabilities, for which reason professional growth is difficult, with consequent impact on QWL.

Finally, analysis of ethnicity - which together with variables income and educational level was associated with QWL - showed that non-whites - including self-reported brown skinned and black participants - reported greater satisfaction compared to whites in a statistically significant manner. We believe that this finding might derive from some source of bias in our study, because the literature suggests that non-whites are the main victims of social inequities^25,26,27. The reason is that they have to overcome more difficulties in their access to education, work longer working hours, have worse jobs, lower salaries, higher odds of poverty and restriction to health care services, which factors certainly also have impact on the situation of IwDs.

CONCLUSION

Study of QWL of IwDs points to a population predominantly composed of men, even though women are the majority among these individuals, young adults, with low income, and above all, to low rates of satisfaction with work.

Analysis of the association between sociodemographic aspects and IwDs’ QWL evidenced that income, educational level and ethnicity had statistically significant correlation. Therefore, these represent aspects that need to be taken into account, even as target of public policies, for this population to achieve higher levels of well-being at work, so that their odds to find a job might increase, together with possibilities for professional growth and means to care for their own health.

While the present study contributes to fill a need described as urgent in the literature on public health (performance of studies targeting IwDs) as indicated in the National Agenda of Priorities in Health Research, we believe that further studies are needed for QWL, and other equally relevant aspects, eventually also focusing on variables sex, educational level and income, to be thoroughly investigated, as they relevant, albeit scarcely addressed subjects.

Despite our possible contribution, especially to the promotion of a culture of studies on the QWL of IwDs, we believe that our study has two relevant limitations. The first derives from its cross-sectional design, as many confounding factors which could not be controlled might have made the results fail to reflect the true reality of the facts. The second limitation concerns the sample, which being composed of a selected group of individuals, is considered to be small, which hinders the generalization of the results.