The Impact of Employment Status and Occupation Type on Occupational Stress and General Health of Physically Disabled Employees in Vocational Centers of the State Welfare Organization of Tehran: A Cross-Sectional Study

Objective: Disabled people experience worse situation in respect of the stress, health, and socio-demographic indicators than healthy people. Little knowledge is available about the way in which this disadvantage is patterned by employment status and occupation type, especially in employees with physical disabilities. Few studies have investigated the potential effect of employment status and occupation type on general health and occupational stress in physically disabled employees. This study investigated the role of employment status and occupation type and demographic factors in predicting general health and also, examined the relations between occupational stress and general health while adjusting for demographic factors among employees with physical disabilities in vocational centers of the State Welfare Organization in Tehran City, Iran. Materials & Methods: This was a descriptive-analytical study with a cross-sectional design. The study was performed among 273 people with physical disabilities employed in the productive workrooms of vocational rehabilitation centers of Tehran, which were selected via convenience sampling. Data collection tools were Occupational Stress Index (OSI) developed by Belkic (1991) based upon cognitive ergonomics concept to measure the five key potential work-related stressors, Goldberg’s 28-item General Health Questionnaires (GHQ-28) (1979) to detect psychiatric illness as well as current psychological state in the past month and self-administered demographic form. Data analysis was conducted in SPSS software, using the independent t-test, one-way ANOVA and multiple linear regression. Results: The Mean±SD age of the physically disabled employees was 33.65 (3.76) years. Most of them were aged 30 to 39 years. (55.2%), men (60.4%), married (60.4%), with part-time employment (67%) and engaged in productive affairs (30%). The relationship between general health and occupational stress with gender and marital status was found to be significant (P<0.05). Women and married subjects had more occupational stress. Moreover, there were significant differences in general health and occupational stress subscales regarding employment status (P<0.05). Part-time employees were exposed to more stressful physical conditions and accidents at work than others, causing a higher level of occupational stress. In addition, employees who were engaged in art-related jobs had higher rate of time pressure, problems and decision-making situations in their workplace, hence, overall more occupational stress. Multiple linear regression analyses were then performed on data to identify general health predictors while adjusting for demographic variables. Age had a significant independent direct effect on enhanced somatic symptoms (β=0.16). Disabled women had a higher score of somatic symptoms than men (β=1.97). Furthermore, part-time employment was directly related to somatic and depression symptoms (β=1.26 and 1.51). Productive works were significantly associated with a higher level of somatic symptoms, anxiety, insomnia and depression symptoms (β=1.28, 1.53 and 1.95, respectively). Therefore, being female, employing as a part-time worker and working in productive affairs were significant predictors of somatic and depressive symptoms in physically disabled employees. Moreover, the physical condition of the workplace, workplace problems and decision-making situations were positively related to somatic symptoms (β=0.7, 0.13 and 0.14, respectively). In overall, 49% of the variance in somatic symptoms (the best model fit) could be explained by independent variables. Conclusion: Employment status and occupation type are significantly related to occupational stress, which in turn, causes general health disparities among people with physical disabilities. With respect to the higher level of somatic symptoms and depression in part-time employees, it seems that changing their employment status to full-time, can reduce their stress load and improve their health. In addition, women and married subjects experience more occupational stress and have more somatic symptoms.