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Butcher’s quality of life evaluation with the WHOQOL-bref

Avaliação da qualidade de vida de açougueiros com a utilização do WHOQOL-bref

Julianne Cristine Ferreira; Vivian Urbanejo Romero; Rogério Muniz de Andrade; Eduardo Costa Sá

DOI: 10.5327/Z1679443520170416

ABSTRACT

BACKGROUND: There is a global shortage of individuals for jobs that require special skills and techniques, such as butchers. As a result, the available workers are overloaded, which might impair their quality of life.
OBJECTIVE: To assess the quality of life of butchers working for a network of butcher shops in Sao Paulo.
METHOD: Cross-sectional observational study with a selected group of butchers and a control group, with age ranging from 18 to 45 years old and from both genders. A quality of life questionnaire (World Health Organization Quality of Life, bref — WHOQOL-bref) was applied to a sample of 50 butchers and 50 controls.
RESULTS: The scores for butchers were statistically significantly lower in all quality of life variables, except for self-assessment compared to the controls (p<0.05) even after adjustment for characteristics differing between the groups.
CONCLUSION: The present study provides data poorly investigated in other studies, and suggests that assessment of the perception of the quality of life of butchers should continue.

Keywords: quality of life; occupational medicine; meat industry; workers.

RESUMO

CONTEXTO: Profissões como a de açougueiro, que requerem técnicas e habilidades específicas, estão em déficit no mundo. Consequentemente, há sobrecarga de trabalho para os profissionais existentes no mercado, e isso pode afetar a qualidade de vida desses indivíduos.
OBJETIVO: Avaliar a qualidade de vida de açougueiros de uma rede de casa de carnes da cidade de São Paulo.
Método: Estudo observacional do tipo transversal com um grupo selecionado de açougueiros e um grupo controle, com faixa etária de 18 a 45 anos, de ambos os gêneros. Foram utilizados questionários de Qualidade de Vida (The World Health Organization Quality of Life, bref — WHOQOL-bref) em uma amostra de 50 açougueiros e 50 sujeitos de grupo controle.
RESULTADOS: Foi observado que, em todos os domínios de qualidade de vida avaliados, com exceção da autoavaliação, os escores nos açougueiros foram em média estatisticamente menores que nos controles (p<0,05), mesmo após ajuste das características que foram diferentes entre os grupos.
CONCLUSÃO: Este estudo proporciona dados pouco investigados em outras pesquisas e sugere que a avaliação de açougueiros deve ser continuada quanto à percepção da qualidade vida desses profissionais.

Palavras-chave: qualidade de vida; medicina do trabalho; indústria da carne; trabalhadores.

INTRODUCTION

Butchers are an old professional category which survived to this day. Together with the industrialization of production, the consumption of meat increased, and thus it became less expensive1. The labor market for butchers changed following the establishment of meatpacking facilities, which made butchers lose their older prestige to become a poorly recognized, low social reward occupational category1. The work done is often felt as sacrifice and causes disease and suffering as a function of the organizational and emotional climate at the workplace2.

Currently butchers work under adverse working conditions. They are not only exposed to machines and knives, but also to cold chambers and countertops highly exposed to cold3. These conditions might result in work-related diseases, which are increasing in several areas such as metallurgy, meatpacking, banks, telemarketing and commerce (supermarkets)4. In addition, work-related mental and behavioral disorders are growing among the main causes of leaves across the full range of workers in the productive sector5.

The type of and the conditions under which work is performed might represent a source of pleasure and personal accomplishment, but also of disease6.

According to the considerations above, butchers are a professional category that suffers as a results of the changes undergone by the world of work over time, and thus their quality of life (QoL) might be impaired.

According to the concept adopted by the World Health Organization (WHO) QoL is defined as an individual’s perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns7.

There is increasing interest in make QoL a quantitative measurement, and thus an ever increasing number of instruments, categorized as generic or specific, were developed to measure it8. Generic instruments are used to assess the quality of life of the overall population; these are population-based questionnaires that do not target any disease in particular, but are adequate for epidemiological studies and the planning and assessment of health systems. The 100-question WHO Quality of Life — WHOQOL-100 — is one of the QoL generic questionnaires more widely used around the world.

Publications on WHOQOL-100 provide explanations on its development for the purpose of QoL assessment, as well as on its application, also including a Brazilian version9-14.

However, to make the application of this instrument more practical, a shorter version with satisfactory psychometric properties was developed, named WHOQOL-bref15-17. The quality of the results provided by WHOQOL -bref was shown not to be impaired by comparison to WHOQOL-10013. Therefore, WHOQOLbref was selected in the present study.

 

AIM AND OBJECTIVES

AIM

To assess the quality of life of butchers from a network of butcher shops in São Paulo, Brazil, by means of WHOQOLbref from May through August 2012.

OBJECTIVES

To identify the domains most impaired among butchers by comparison to a control group.

 

METHODS

The present cross-sectional observational study was conducted with a group of butchers from a network of butcher shops and a control group composed of workers from other areas, all of whom residents in the city of São Paulo. Assessment was performed from May through August 2012.

The inclusion criteria were: age 18 to 45 years old; both sexes. The exclusion criterion was: failure to respond the questionnaire applied in the study.

A total of 100 WHOQOL-bref questionnaires were responded, and there was no need to exclude any of them. Therefore the sample comprised 50 butchers and 50 controls.

Data collection was performed during periodical examinations of the participants. They received information on the study aims and agreed to participate by signing an informed consent form.

In addition to the standardized questionnaire, information was also collected on individual clinical and epidemiological profile data, such as: age, sex, body weight, height, body mass index (BMI), specific comorbidities (arterial hypertension, diabetes), smoking, alcohol consumption and physical activity.

A dataset was created with the information gathered from the questionnaires. The data were entered in a Microsoft excel 2003 spreadsheet. Calculation of WHOQOL-bref scores was performed as indicated for WHOQOL-100, except for the calculation of the scores of facets17.

Calculation of the WHOQOL-bref results followed the recommendations by Pedroso et al.17 which demands checking whether all 26 questions were attributed a score from 1 to 5, while the scores of all questions with negative formulation is reversed. The domain scores are calculated by adding the average scores for the “n” questions that compose each domain (for domains with up to 7 questions, calculation is only performed when the number of non-calculated facets is not ≥2; for domains with more than 7 questions, calculation is only performed when the number of noncalculated facets is not ≥3). The result is multiplied times 4 and represented on a scale ranging from 4 to 20. Domain scores are converted into a 0–100 scale. Participants who fail to respond or give incorrect responses to more than 6 questions are excluded from the sample.

WHOQOL-bref comprises two general questions on QOL; all the others represent each of the 24 facets included in the original instrument. Questions are distributed across four domains: physical health, psychological, social relationships and environment15-17.

Only some of the facets of each domain were analyzed, as described below; they were designated by the number of the corresponding question in the questionnaire, from 1 to 26 (Q1 to Q26):

• Domain 1 (physical health):

3. Pain and discomfort;

4. Energy and fatigue;

10. Sleep and rest;

15. Mobility;

16. Activities of daily living;

17. Dependence on medicinal substances and medical aids;

18. Work capacity.

• Domain 2 (psychological):

5. Positive feelings;

6. Thinking, learning, memory and concentration;

7. Self-esteem;

11. Bodily image and appearance;

19. Negative feelings;

26. Spirituality, religion, personal beliefs.

• Domain 3 (social relationships):

20. Personal relationships;

21. Social support;

22. Sexual activity.

• Domain 4 (environment):

8. Freedom, physical safety and security;

9. Home environment;

12. Financial resources;

13. Health and social care: accessibility and quality;

14. Opportunities for acquiring new information and skills;

23. Participation in and opportunities for recreation/ leisure activities;

24. Physical environment (pollution, noise, traffic, climate);

25. Transport.

For each group we described the analyzed qualitative characteristics as absolute and relative frequencies. We also investigated the relationship of these characteristics between the groups by means of the χ2 or Fisher’s exact test — the latter when the sample did not allow for application of χ2 18. Quantitative characteristics and QoL scores were described per group by means of summary measures: mean, standard deviation (SD), median, minimum, maximum, coefficient of variation (CV) and range. Student’s t-test was use to compare the results between groups18. For intergroup comparison, the QoL scores were subjected to linear models adjusted for characteristics exhibiting statistically significant difference between the groups19.

Analysis was performed with software International Business Machines— Statistical Package for the Social Sciences (IBM-SPSS) for Windows version 20.0, and the data were tabulated using Microsoft Excel 2003. The significance level was set to 5%.

 

RESULTS

Personal and clinical characteristics per group and the results of statistical analysis are described in Table 1.

 

 

Table 1 shows that that the butchers’ age and average body weight were higher compared to the controls in a statistically significant manner (p<0.01, p=0.047, respectively). It also shows that the frequency of women and of participants who performed physical activity was higher among the controls compared to the butchers (p<0.001, p=0.001, respectively).

Although variable sex exhibited a relationship between the groups (Table 1) it was not include in the models because all the butchers were male.

QoL scores per group and the results of comparative analysis are described in Table 2.

 

 

Table 2 shows that except for self-assessment, the scores on all the domains were lower among the butchers compared to the controls in a statistically significant manner (p<0.05) ever after adjustment for characteristics that differed between the groups.

 

DISCUSSION

Although the average age of the butchers was older compared to the controls in a statistically significant manner (p<0.001) they can be characterized as young workers. Within the meatpacking setting criteria, young age and lack of experience are possibly not only restricted to the time of hiring20. This fact might have had reflections on in the present study, as the average age of the butchers was 32 years old. This finding might also suggest that younger, less experienced individuals might be fitter to perform the activities inherent to the job position.

The literature points to a predominance of male employees in the meatpacking industry20. This agrees with our findings, since all the butchers were male.

The average body weight of the butchers was higher compared to the controls in a statistically significant manner (p=0.047). This finding agrees with the ones of another study conducted with employees from companies in São Paulo, in which about 56% of the men exhibited excess weight (BMI ≥ 25 kg/m2)21. In addition, that study found that the overall prevalence of arterial hypertension was 30%, being about twice as higher among males compared to females (38.1 versus 18.7)21.

We did not find statistically significant difference in alcohol consumption or smoking between butchers and controls. However, as is known, the working conditions and work-related stressors might contribute to make workers consume alcohol or smoke, or even worsen the consequences of these behaviors22.

The frequency of physical activity was higher among the controls compared to the butchers in a statistically significant manner (p=0.001). This finding might have a relationship with the higher body weight found for the latter, since epidemiological data indicate that physical activity contributes to the control of the body weight23, in addition to keeping the blood pressure within safe levels24 and contributing to the control of diabetes mellitus25.

In regard to the QoL domains, except for self-assessment, the butchers’ scores were lower compared to the controls; this difference was statistically significant (p<0.05).

The butchers’ lower score on the physical health domain might be a reflection of long working hours20 and excessive physical effort, which probably have impact on these workers’ health and physical integrity3.

We might attribute the lower scores of the butchers on the psychological and environment domain to longer working hours involving frequent overtime work, as well as to the fact that low salaries prevail in this sector20.

In regard to domain social relationships, the lower score attributed by the butchers might be associated with frequent overtime work20.

Alternatively, they need to spend more time commuting, which indirectly influences their social relationships.

The results did not evidence any difference in self-assessed QoL between butchers and controls. In the present time, butchers receive poor recognition and low social reward for their work1; the occupations of the control group might have similar effects.

 

CONCLUSION

Analysis of the results allow concluding that, except for self-assessment, the butchers’ scores on QoL domains were lower in a statistically significant manner.

Our study provides information scarcely addressed in other studies and suggests that the assessment of the butchers’ perception of QoL domains should continue.

 

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Recebido em 2 de Fevereiro de 2016.
Aceito em 20 de Julho de 2017.

Trabalho realizado na Faculdade de Medicina, Universidade de São Paulo – São Paulo (SP), Brasil.

Fonte de financiamento: nenhuma


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