|Year : 2017 | Volume
| Issue : 1 | Page : 57-62
Mental health among working women in Tala District, Menoufia Governorate
Mahmoud E Abo Salem1, Aml A Salama2, Noha A Allam Negm MBBCh 1
1 Department of Public Health and Community, Faculty of Medicine, Menoufia University, Menoufia, Egypt
2 Department of Family Medicine, Faculty of Medicine, Menoufia University, Menoufia, Egypt
|Date of Submission||14-Dec-2015|
|Date of Acceptance||18-Oct-2015|
|Date of Web Publication||25-Jul-2017|
Noha A Allam Negm
Internal Medicine Department, Faculty of Medicine, Tanta 31111, El-Garbia
Source of Support: None, Conflict of Interest: None
The aim of the present study was to estimate the impact of work on the mental health status of working women by using the General Health Questionnaire (GHQ)-28 and the efficacy of the stressor factors.
Work can affect the general health status of women. Some personal factors as age and marital status and work factors as night shift, odd working hours, and relation with manager and colleagues have been suggested as possible causes of stress that affect significantly the mental health of working women.
Patients and methods
This cross-sectional study included 600 working women randomly selected from two family health units (Kashtoukh and Zawiatbemam), which were randomly selected from the family health units of Tala District, and from the only family health center in Tala. A sample representing both rural and urban areas of Tala District, Menoufia Governorate, was selected. Working women attended the selected family health units and the center for medical cause or worked with family members during their visits.
Of the 600 participants, 16% had abnormal GHQ-28 scores of greater than or equal to 5. This abnormal general health status was statistically significant with participant age, residence, marital status, husband's education, family size, family income, number of school-going children, and government financial support. As regards work-related factors, night shift, odd working hours, personal relation with colleagues, and presence of conflict constituted significantly affected the mental health status of working women.
Mental health of working women can be affected significantly by some personal and some work-related factors. The present study reported that the abnormal GHQ result was prevalent among the studied working women.
Keywords: General Health Questionnaire, mental health, working women
|How to cite this article:|
Abo Salem ME, Salama AA, Allam Negm NA. Mental health among working women in Tala District, Menoufia Governorate. Menoufia Med J 2017;30:57-62
|How to cite this URL:|
Abo Salem ME, Salama AA, Allam Negm NA. Mental health among working women in Tala District, Menoufia Governorate. Menoufia Med J [serial online] 2017 [cited 2020 Feb 18];30:57-62. Available from: http://www.mmj.eg.net/text.asp?2017/30/1/57/211518
| Introduction|| |
Mental health is one of the most important public health issues as it is a major contributor (14%) to the global burden of diseases worldwide .
It means the ability to respond to diverse experiences of life with flexibility and a sense of purpose . It can be described as a state of balance between an individual and his or her surrounding world, a state of harmony between oneself and others .
Mental health is the foundation for well-being and effective functioning for an individual and for a community. For women, mental health is important both for their own health and for the well-being of their children and families .
The status of women in the society has been changing rapidly because of multiple factors such as urbanization, industrialization, increased level of education, awareness of rights, and media influence. More and more women prefer to be engaged in some kind of employment, so that they can contribute financially to their family .
However, the attitude toward women especially married women and their role in the family has remained the same, as even today taking care of the family and children is considered as their primary responsibility .
Thus, carrying out duties and responsibilities both at home and workplace overstrains a married working woman, thereby leading to various psychological problems like role conflict, job strain, mental fatigue, stress, anxiety, frustration, depression, anger, phobias, and other social and emotional distress. All of these problems can interactively affect the mental well-being of working women, especially of married working women. Studies have shown that working women have poor mental health and higher levels of depression compared with nonworking women .
| Patients and Methods|| |
This cross-sectional study included 600 women randomly selected from regular attendants to two family health units (Kashtoukh and Zawiatbemam), which were randomly selected from the FHUS of Tala District, and the only family health center in Tala. A sample representing both rural and urban areas of the Tala District, Menoufia Governorate, was selected. The working women attended the selected family health units and the center for medical cause or accompanied their family members.
The sample size was estimated at a study power of 85% and confidence interval 95%, taking into consideration the percentage of abnormal General Health Questionnaire (GHQ) symptoms from the previous study as well as the total number of women who registered in the selected healthcare facilities. The sample size was calculated as 600. The sample was selected from women attending the selected family health center/units for primary healthcare services during the period of the study, distributed as 200 from the Tala center and 200 from each urban area.
Participants were selected if they fulfilled the inclusion criteria, which were age from 20 to 45 years and presently working. Those under 20 years and above 45 years of age were excluded from the study to avoid any psychological disturbance and hormonal imbalance in the premenopausal period; in addition, women under any medical treatment were excluded.
Tools of study
Each of these women was interviewed using the GHQ-28 .
GHQ is a self-administered psychiatric screening tool available in a range of versions – from GHQ-12 to GHQ-60.
GHQ is developed to cover all aspect of adjustments and felt distress. These include unhappiness, anxiety, depression, social impairment, and psychological disturbance.
Each questionnaire given used the Likert scoring methods.
On the basis of the coding of the different questions in the questionnaire, at least 74% of the total score was considered to have abnormal GHQ and less than 74% of the total score was considered to have normal GHQ.
Data entry and data analysis using (SPSS Inc., Chicago, Il, USA) took about 2 months.
Results were analyzed using the Statistical Package for Social Sciences (SPSS) version 16. Two types of statistics were carried out.
- Student's t-test was used to compare between two groups of normally distributed data.
- χ2-Test was used to compare between qualitative variables.
- Stepwise regression test was performed to test the association between variables and detection of risk factors.
- A P value of less than or equal to 0.05 was considered statistically significant.
| Results|| |
The mean age of the participants was 32.33 ± 6.28 years, with a range of 19–58 years. Overall, 77.5% had attended intermediate institutes and had university education. Most of the studied women worked as employees (48%), whereas the lowest percent worked in trade/business and professional jobs (7 and 6.7%, respectively).
Married women comprised 67.3% of the studied sample; single and divorced or widowed women comprised 18 and 7.3%, respectively. More than half (56%) of the participants were from families with a size less than five members. Overall, 74.7% of the studied group earned enough income, 9.3% earned more than enough, and 16% earned less than enough income – 69.3% of the women had two sources of income, whereas 26.7% had only one. As regards clinical services, 46.7% of the women depended on private clinics and hospitals, 38% depended on health insurance, 7.3% on general hospitals, and 14% on all of the above [Table 1].
|Table 1 Number and percent distribution of the studied participants regarding their characteristics|
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Abnormal GHQ scores were significantly higher among women with the following characteristics: higher age, rural residence, divorced/widowed state, higher age of husband, being able to read and write, not enough income, and all of the children receiving education (P < 0.05) [Figure 1].
|Figure 1: Distribution of the studied participants regarding their General Health Questionnaire (GHQ) results.|
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Abnormal GHQ results were significantly higher among women with higher age and with higher age of the husband; women living in rural areas had significantly higher rate of abnormal GHQ compared with those living in urban areas (23.1 vs. 8.3%), with an odds ratio of 3.3. Moreover, divorced and widowed women showed a higher rate of abnormal GHQ compared with married women (12.9%) and singles (3.2%).
Abnormal GHQ results were significantly higher among women with husbands with low educational level and nonworking husbands. In addition, it was higher among those with not enough income, big family size (>5), those with all siblings in learning stages, and those renting one of the rooms of the house [Table 2].
|Table 2 Sociodemographic criteria as risk factors for General Health Questionnaire results among the studied group|
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Abnormal GHQ results were significantly higher among women with the following work characteristics: long working hours, night shift, difficulty in commuting, responsibility of a part-time job, stressful relationship with manager and colleagues, any activities concerning work in conflict with those at home such as telephone data time, work-related problems affecting concentration, difficulty with household chores after returning from work, difficulty in managing a combination of work and home-related activities, workplace unsuitable in terms of building and ventilation, and disturbance and not enough lighting at the workplace (P < 0.05) [Table 3] and [Table 4].
|Table 3 Binary logistic regression analysis of the most relevant risk factors of general health questionnaire results|
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|Table 4 Work characteristics as risk factors for General Health Questionnaire results among the studied group|
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| Discussion|| |
Physical and mental health is very important for a woman worker, not only for her personal life but also for the productivity of the industry and the general welfare of the community . There is growing evidence to substantiate that work-related stress is a causal factor in mental health of working women . Thus, this study was conducted to examine the effects of working conditions of women along with the dimensions of certain psychosocial variables.
Most studies using standard questionnaires showed that the abnormal GHQ results were found in 16.0% of the participants . These findings were in agreement with those of a study by Ichfer , who reported abnormal GHQ symptoms in 18.2% of working women included in the study. This is in agreement with the findings of Kessler et al. . However, in an Indian study, Rajendral et al.  found a relatively low percentage (4%) of working women with abnormal GHQ symptoms.
In the present study a logistic regression was performed to ascertain the effects of women's age, residence, marital status, husband's age, husband's education level, income, income sources, number of school-going children, and type of housing on the likelihood that participants may have abnormal GHQ results. This was in agreement with the findings of Goldberg .
In their study, Byrant and Veroff  found that the measures of subjective mental health (unhappiness, strain) were positively and significantly related to age. They also found that factors such as lack of gratification and feelings of vulnerability and uncertainty were negatively related to age. It was also reported in their study that the measures of subjective mental health related to one's educational qualification.
In addition, several studies have shown the overall rates of mental illness to be high among married women. There was a significant association between marital status and mental illness in the present study.
There is growing global concern about the impact of job stress, including issues related to sex, ethnicity, sexual harassment, violence, and mobbing at work, family, and underemployment (WHO) . Job stress is one of the most common work-related health problem in the EU countries. The Second European Survey on Working Conditions indicated that 28% of workers reported that their work causes stress. In Japan, the proportion of workers who report serious anxieties or stress in relation to their working life increased from 53% in 2010 to 63% in 2014. In developing countries, there is an increasing concern regarding the health impact of job stress. For example, an increased risk for work-related illnesses and accidents has been observed in the South-East Asian countries that have experienced rapid industrialization .
The results from this study suggest that work has the potential to play a very important part in influencing mental health . These effects are the greatest under a policy environment that supports and encourages women to balance work and home . Welfare reforms that have rewarded and supported work may also have had a positive influence on mental health because they have promoted changes in attitudes toward parents and work, and may therefore have had an indirect impact on the mental health of working women. However, under a less supportive policy environment, where 'push' rather than 'pull' factors influence women's employment decisions, the mental health benefits of work may be limited, as was the case in the mid-1990s before the welfare reforms .
Recommendations: Work circumstances should be well investigated during history taking, especially for those showing anxiety or psychological symptoms. The organization should assists in preventing mental ill-health by giving women a suitable working environment and a clearly defined job. Regular honest appraisals are important and problems in performance should be discussed when they occur, with an opportunity to follow-up and review progress.
| Conclusion|| |
The study was conducted to estimate the effects of working conditions of women along with the dimensions of certain psychosocial variables like mental health status: it can be said that the abnormal GHQ results were prevalent among the working women; many factors were responsible for that, either in their social life or in the working environment.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3], [Table 4]