A study of psychopathology, personality and job satisfaction and its correlates with work absenteeism

 

Samir Gupte¹, Rajkiran Salunkhe^2*

 

¹Associate Professor, Department of Psychiatry, Bharati Vidyapeeth (Deemed to be university) medical college and hospital Sangli, Maharashtra, INDIA.
²Associate Professor, Department of Psychiatry, Government Medical College, Miraj, Maharashtra, INDIA.

 

Abstract               Context: Absenteeism is defined as “any failure of an employee to report for or to remain at work as scheduled, regardless of the reason”. Absenteeism at workplace cause huge losses to the employer, employee and society at large. Aims: To assess the psychiatric morbidity, personality profile and job satisfaction in Government employees with work absenteeism. Methods and Material: 94 consecutive government employees referred to opine on their work fitness after a period of absenteeism were assessed with Job Descriptive Index, NEO personality inventory and questions pertaining to the aims of study. Results: Majority of sample were class 3/class 4 State Government employee. Mean Duration of leave was 14.9 months. Commonly cited reason for leave was ‘feeling stressed’. Majority of sample had presence of some psychopathology, most common being alcohol use disorders, followed by alcohol dependence, depression & psychosis. Most of the subjects had co morbid psychiatric illnesses though most of them did not consult psychiatrist. It was seen that those who availed leave>6 months were more likely to feel less satisfied with opportunities for promotion. Conclusions: Psychiatric evaluation ought to be done for employees availing sick leave to detect psychopathology so that job absenteeism can be reduced. Government policies towards promotion and performance based incentives can be considered.

Key-words: Work absenteeism, Job Satisfaction, Personality profile.

 

 

INTRODUCTION

Absenteeism is defined as “any failure of an employee to report for or to remain at work as scheduled, regardless of the reason.” To many in the world of work, absenteeism is one of those stubborn problems for which “there is no clear culprit and no easy cure”(Rhodes, 1990). Absenteeism at workplace cause huge losses to the employer, employee and society at large. Not having people at work increases the workload of fellow employees, reduces productivity and increases the cost of contract labour. Work absenteeism has been studied in the past and is affected by a variety of factors. It may be caused by medical problems in employees including psychiatric illnesses and substance abuse, psychological factors like work satisfaction and personality profile and work related issues like group dynamics(Hensing & Wahlström, 2004). Besides the cost implications, absenteeism is influenced by dozens of interrelated factors which make it even more difficult to “quantify, qualify or rectify”(Tylczak, 1990). Employee’s level of job satisfaction in the workplace which is defined as “the degree to which people like their jobs and the different aspects of their jobs”(Spector, 1997). Researchers claim Job dissatisfaction as a primary cause of absenteeism(Steers, Porter, Steers, & Bigley, 1996). However, some studies related to absenteeism and job satisfaction have found mixed results(George & Jones, 2002). Steer et al (1996) found Job satisfaction to be more related to frequency of absences than to number of days lost. Satisfaction with work is influenced by pay, promotions, work atmosphere and relations with subordinates and seniors. The atmosphere at work and cohesiveness with colleagues is related to better attendance (Xie & Johns, 2000).Another factor implicated in absenteeism is personality. Openness to experience, agreeableness, conscientiousness, extroversion and neuroticism are personality traits found to be correlated with work absenteeism (Furnham, Jackson, & Miller, 1999). Mental illnesses and stress also gives rise to loss of work productivity and thereby absenteeism. Though the impact of alcohol use on work absenteeism and performance has been studied, psychiatric morbidity leading to work absenteeism has not been received much research(Hensing & Wahlström, 2004). Employees with large families may attend work irrespective of their satisfaction with work perhaps due to family responsibilities (Zaccaro, Craig, & Quinn, 1991). Additionally, age is directly proportional to sick leave. Women at workplace are more likely to have maternity leave and childrearing as an important cause of availing leave (Tripathi et al., 2010). This is more prominent in India where women even though working, still are prime caretakers of children and tend to avail leaves during their exams as well as child sickness. Though there has been extensive research in Western literature, there is a dearth of research on work absenteeism in Indian context. In India, government is the largest organised sector employer offering good job security and sick leaves benefit and hence we decided to study the phenomenology of work absenteeism and its correlates with psychopathology, personality and job satisfaction in Government employees.

 

AIMS AND OBJECTIVES

1. To assess the psychiatric morbidity, personality profile and job satisfaction in employees with work absenteeism appearing for fitness to a medical board of tertiary level state government hospitals and referred for fitness from psychiatry point of view.
2. To study the phenomenology of work absenteeism.
3. To study the correlates of age, family size, job satisfaction and personality with duration of work absenteeism.

MATERIAL AND METHOD

94 consecutive government employees referred to the Department of Psychiatry by the medical board to opine on their work fitness after a period of absenteeism were included in the study. They were explained the nature of the study and informed consent obtained. They were assessed with a semi-structured Performa containing socio-demographic profile, job related details, substance use history and scale like Job Descriptive Index, NEO personality inventory and questions pertaining to the aims of study. The presence of psychopathology at present and retrospectively at the time of initiating the long leave was assessed by the DSM-IV TR criteria for diagnosis of psychiatric disorders.

INCLUSION CRITERIA

1) State Government employees appearing before standing medical board of tertiary care state government hospital to seek opinion on fitness from psychiatry point of view.

2) Education: 7^th standard pass

3) Language compatibility.

EXCLUSION CRITERIA

1) Subjects unwilling to participate.

2) No information (relative) available to corroborate history.

We included 94 consecutive patients who were referred from the medical board of our institute for mental fitness. These included those who produced a certificate from private psychiatrist, or were reported from the employers to be having alcohol problems or any psychological problem and those who did not having any medical basis for leave.

 

SCALES:

Job Descriptive Index

The JDI devised by Smith, Kendall and Hulin (1969) is a ninety item self-reported questionnaire designed to measure respondent satisfaction with a global scale (Job in General), and five other scales / areas of job:

 (1) Work on present Job (work)

 (2) Present pay (Pay)

 (3) Opportunities for Promotion (Promotions)

 (4) Supervision on present Job (Supervision), and

 (5) People on Your present Job (Co- workers).

 Each scale is composed of single word or phrase descriptors, some of which are intended to be purely descriptive and some of which are affective and evaluative—e.g., under Co-Workers, “ Stimulating”, “Boring, “Slow”, “Fast”, “Easy to Make Enemies”, “Talk too much”. Two scales, Pay and Promotions, consist of 9 items each, while the other scales each have 18 items. Respondents indicate their agreement or disagreement with “Yes” or “No” and “?” if they can’t decide. It is rated on a 0-3 scale where a score of 3 is given for positive item with a Yes response and negative item with a no response. A score of 1 is given for a can’t say (?) response. A score of 0 is given for no response for positive item and yes for negative item. Total score is obtained by summation of the scores. Higher score indicates higher satisfaction (Smith, 1985).

NEO Personality Inventory Revised

The NEO PI-R devised by Lord and Wendy (2007) is a measure of the five major domains of personality as well as the six facets that define each domain. Taken together, the five domain scales and 30 facets scales of the NEO PI-R facilitate a comprehensive and detail assessment of normal adult personality. It is 240 item observer rated scale and is rated on a four point Likert rating where 0 = strongly agree to 3 = strongly disagree. It consists of following five domains of personality:

1. Neuroticism: It defines individuals who are prone to psychological distress and

measures anxiety, anger hostility and depression and Self Consciousness.

 2. Extraversion: It is the quantity and intensity of energy directed outwards into the social world and measures warmth, gregariousness, assertiveness, activity, positive emotion and excitement seeking .

3. Openness to Experience: It is an active seeking and appreciation of experiences for their own sake and measures fantasy, aesthetics, feelings, actions, ideas and values

4. Agreeableness: It is a kind of interactions and individuals prefers from compassion to tough mindedness and measures trust, straightforwardness, altruism, compliance, modesty and tender mindedness.

5.Conscientiousness: It is the degree of organization, persistence, control and motivation in goal directed behaviour and measures competence, order, dutifulness, achievement striving, self-discipline and deliberation (Costa & Mac Crae, 1992).

Data Analysis

Data was analysed with SPSS 17 version for windows and two tailed P value were obtained for all statistical analysis. A value of p less than 0.05 was considered statistically significant. Students t test used to study differences in two groups. Correlations were carried out with Persons rank correlation coefficient and Chi square where appropriate.

RESULT

Our sample consisted of 94 consecutive state government employees referred from standing medical board for fitness from psychiatric point of view. It was seen that majority of sample were male (93.7 %), married (91.5%), with education up to high school (76.5%), Hindu (98 %) and belonging to upper-middle class (79.8%) (Table1. Figure 1, Figure2)

Table 1: Socio demographic profile

socio-demographic profile		Count	%
Gender	Male	88	93.7
	Female	6	6.3
Religion	Hindu	92	98
	Muslim	1	1
	Catholic	1	1
Marital status	Married	86	91.5
	Unmarried	8	8.5

 

     Figure 1: Education profile of sample                        Figure 2: Socioeconomic status              Figure 3: Number of dependent family member

 

Majority were from joint family (68 %) and had 3 -4 dependent family members (61.8). (table 2)

Table 2: Type of family

In our study, we did not found any correlation between number of family members and duration of leave (p= 0.32, r= 0.18). Peter Allebeck et al (2004) found those with large families, having more dependent family members like children are less likely to avail leave. In our study, majority employees were class 4 employees living in joint family and had alternative source of income like rent/ farms or had another working family member who shouldered the household expense. Hence number of dependant family members had no impact on leave availed. In our study majority of sample were class 3 (30%) & class 4(61.5%) government employees (Figure 4). 55.5% of the sample was from Maharashtra Police force. Up to half of the sample (47.9%) had completed more than 20 years of service (Figure 5). 2/3 (67 %) of sample had never been promoted during their course of services and most of the class 4 employee had no scope of promotion and received only fixed yearly increments. More than half of the sample (53.2%) were never been transferred during their course of services.

 

         Figure 4: Class of employee                                Figure 5: Employment duration                                Figure 6: Promotion

 

Figure 7: Transfer year back                                  Figure 8: Duration of leave                                        Figure 9: Reason for leave

In our study of those who were ever transferred in their course of service (46.8%), half (28.8%) of employees were recently transferred in the last 2 years prior to going on leave (figure7). Most of the transferred employees had problems regarding place of posting, new working atmosphere and nature of their work. Most of them were reluctant to do job in remote areas and had problem with staying away from their family. This could have acted as trigger for taking leave from their job.Mean duration of leave was (14.91 months) with a right sided skew as some employees were on leave for many years (Figure 8).

In our study of those who were ever transferred in their course of service (46.8%), half (28.8%) of employees were recently transferred in the last 2 years prior to going on leave (figure7). Most of the transferred employees had problems regarding place of posting, new working atmosphere and nature of their work. Most of them were reluctant to do job in remote areas and had problem with staying away from their family. This could have acted as trigger for taking leave from their job.Mean duration of leave was (14.91 months) with a right sided skew as some employees were on leave for many years (Figure 8).

Table 3: duration of leave

 When asked for reason for availing leaves, 2/3 (66.2%) subjects said that they felt stressed and 14.8% stated that they suffered from mental illness, 17% of sample had family problem. 2 cases had no satisfactory reason for leave (figure 9).

None of the employees took leave through proper channel. In case of most of employees on long leaves (Leave more than six months), daily expenditure was taken care by their family members or they had some alternative sources of income. Now they wanted to rejoin work due to financial constraints.

When all the subjects were assessed for psychopathology according to DSM 4 TR majority of sample had presence of some psychopathology (83 %). No psychopathology was seen in (17%) cases. Most common psychopathology reported was alcohol use (63.8 %). Alcohol dependence was seen in 45.8 % cases, and depression was seen in 40.4 % cases. Psychosis was seen in 14.9 % of sample (Table 4). Most of the subjects had co morbid psychiatric illness & did not receive adequate treatment for illness. Gunnel et al (2004) found alcohol use or alcohol dependence to be major cause of sick leaves irrespective of diagnosis on certificate produced and found alcohol use itself and not the quantity of alcohol use to correlate with leave. We found no significant differences in prevalence of alcohol use disorders amongst those with short or long leave (Leave more than 6 months). Problems with colleagues and work absenteeism are a known factor in alcohol dependence. Long working hours in Police force can further lead to increased conflicts in those policemen in our sample with alcohol dependence and cause further absenteeism. Most of employees now wanted to re-join work due to financial constraints and due to pressure from family and stated that they felt better now. 6 subjects cited they wanted to opt for VRS or were due for retirement and wanted to join only for the purpose of completing formalities so that they can quit the job finally. Lack of motivation to continue their work were contributed by poor or absent promotion opportunities, transferable nature of job, alcohol use disorders and lack of monetary incentives for performance for work. All of them felt that pension would be sufficient alone for financial stability. Gunnel et al (2004) found Psychiatric disorder among the most common diagnostic group reported on certificate for sickness absence and hypothesized that it does not mean that psychiatric disorder per se have increased in working population. This may depend on other factors for example; knowledge about psychiatric diseases has increased while concurrently, the stigma associated with psychiatric condition has decreased (Stansfeld et al., 1995). Such changes influence physician and patient alike. Patient may be more willing to talk about psychiatric problems. Possible resistance by physicians to recommend sick leave for psychiatric diagnosis has decreased. Increase in stress related disorder and psychosocial problems in the work environment, particularly in public sector, are other possible explanation for the increase in psychiatric sickness absence reported (Hensing & Wahlström, 2004).However, in our study though psychopathology was prevalent, only 26.59% (25) took treatment from psychiatrist and amongst them some were irregular with treatment. Many produced certificate from local practitioners or physicians and were on no or inadequate treatment from psychiatry point of view. Psychiatric diagnoses given by certifying non-psychiatrists were depression and mental stress. None had a diagnosis of alcohol use disorders on the private doctor certificates signifying reluctance of employees to have a diagnosis of substance use on their service records as they feared it will adversely affect future promotions or increments.

Table 4: Psychopathology

It was seen that 1/3^rd of the total employees were less satisfied with their promotion and pay. There was no scope of promotions in some class 4 jobs. Additionally there were less chances of promotion due to less number of posts available and less eligible posts which in turn was due to reservation policy. Even though the pays were increased according to the 6^th pay commission some still felt unsatisfied due to inflation which resulted in financial condition remaining same.

PERSONALITY PROFILE

When the personality profile of the sample studied on (neo ac) it was seen most of the sample has low to average score on all the subscale. Most of employees in our study were defensive during subjective test (NEOPI) for personality assessment. Since no corroborative test used like LFK scale of MMPI it was difficult to ascertain if they faked good. Due to time constraint MMPI was not used.

 

         Figure10: Job descriptive index                                               Figure 11: personality profile

 

Correlation of job satisfaction (table 4)

It was seen that work on present job and supervision had significant correlation with age. Younger employees feeling less satisfaction with job and relation with supervision.

Table 4: Correlation of job satisfaction with age

Correlation of duration of leave with personality and job satisfaction (table 5)

No correlation of duration of leave was found with any of the factor like personality profile, job profile, mental illness, alcohol use, any socio demographic profile. Those employees who are on leave more than 6 months are compulsory referred to medical board fitness.

Table 5: Personality profile

Job satisfaction has been noted as one of the factors influencing an employee’s motivation to attend. Some researches that investigated the relationship between job satisfaction and absenteeism have found no correlation between these two variables whereas other studies indicate a weak to moderate relationship between these two variables (Kehinde, 2011). Voluntary absenteeism can be predicted by job satisfaction (Sagie, 1998). The sample was divided into two groups according to the duration of leave availed. A cut off of six months was chosen as most State Government Employees are referred by their authorities for medical board evaluation if duration of leave is more than six months. Thus, two groups obtained were: Group A: Long leave availers (n=45) Group B: Short leave availers (n=49)There is no uniform law for referral of non-gazetted worker for medical board fitness. Shorter duration of leave for non-gazetted workers is granted as per the discretion of authority. Though some authorities (n=14) referred those with short leave with reasons like alcoholism or frequent absenteeism, most (n=35) did not cite any reason for referral. Most of the employees in Group B (availing short leave) expressed that it was unfair and biased on part of the senior to have referred them to Medical Board which is a time-consuming process when they had the authority to sanction the leave. This was reflected in Group B having significantly lower scores of jobs Satisfaction with relation to supervisors (p=0.019, r=+2.395). They might be referred earlier as their boss was not happy with them or the employee was suspected to be alcoholic or had some behavioural problem. It was seen that those who availed leave > 6 months (Group A) were more likely to feel less satisfied with promotion. Dissatisfaction with promotion opportunities could lead employees having less incentive to re-join work and prolong the absence. In our sample, class 4 employees were predominant long leave avails and had poor promotion opportunities. Thus, it is recommended that employers should pay due attention to extrinsic sources of job satisfaction as major practical tools to reducing extent of absenteeism (Kehinde, 2011).We did not find any correlation of Personality with duration of leave. Some researchers found conscientiousness to be associated with less work absenteeism. Some found no such correlation as seen in our study.

Table 6: correlation of duration of leave with supervision

 

Table 7: correlation of duration of leave with promotion.

 

There is dearth of literature on this topic. Most studies were carried out in work sitting i.e. employee who are currently working. This is only study done on employees appearing for fitness test. In a study carried out on employees on long duration leave (>6weeks) it was found that there was only weak effect of age and past history of leave. Similar to our study there was insufficient evidence for an effect of other individual and work related factor on long term sick leaves (Sagie, 1998).There was difficulty in ascertaining cause and condition while going for leave, especially long leaves. It was clearly seen that there is lack of awareness about treatment sought from psychiatrist. Employer should take care of issues like promotions, lack of performance based incentives and ambiguity in laws for leaves. There is a need of designed supervisory staff for monitoring of leaves. Periodic recall should be sent to employee on long leave. The government should fund research looking at the extent of the misuse of alcohol by individuals at work, its effect on the workplace and its cost to the nation. The government could also offer financial incentives to those employers currently offering counselling and other types of employee assistance programmes (EAP) to encourage more workers to come forward and admit their alcohol problems.EAP in western countries which have applied with help of mental health professionals for employees with suspected alcohol problems have yielded positive results and reduced absenteeism. Similar EAP are the need of our government employees where organisation are already short staffed and long duration of leave adds to further woes.As per Maharashtra Civil Services Rule, Mental illness is acknowledged as a ground for availing prolonged sick leave. This could promote employees seeking mental illness as a ground for leave. Interestingly, only two out of fifty police force employee produced certificate from police hospital which caters to police department employee and has a visiting psychiatrist. Only 30% of total sample produced treatment certificate. Psychopathology was prevalent but regular and appropriate treatment was not given in 2/3^rd of cases. In most of cases patients treated by psychiatrist now presented to us in remitted state, making it difficult to comment on past illness and recommend previous leave availed for sickness leave benefit. To avoid ambiguity and so as to treat mental illness to ensure speedy recovery and hence shorter the duration of leave, it is worthwhile to have a regular psychiatric evaluation by government psychiatrist for those availing leaves on psychiatric ground.

CONCLUSION

.Majority of patient referred for fitness has long duration of leave for more than a year. More than three quarters had some kind of psychopathology with alcohol use, alcohol dependence and depression were common diagnosis. -Psychosis was seen in 14.9 % of sample & most of the subjects had co-morbid psychiatric illness & did not receive adequate treatment for illness.(26% received treatment)-2/3 (66.2%) subjects were feeling stressed during job. - Leave >6 months were more likely to feel less satisfied with promotion.-Leave < 6 months more likely to less satisfaction with supervision.- Younger employees were feeling less satisfaction with job and relation with supervision-Openness to experience and conscientiousness had positive correlation with people on present job, with relation to work on present job, pay and relation with supervision-No correlation was found between job satisfaction and absenteeism, and personality and duration of leave.

Implications of study

• Thus, only factor which influence long leave is job satisfaction. Those who were more satisfied with promotion opportunities, join back work earlier. Interestingly 2/3 of our sample had never been promoted; further research is needed to understand the impact of job satisfaction, and studies in the employees who are currently working.
• Government can look into taking steps to improve job satisfaction & scope for promotion and performance based incentives.
•  Government should offer employee assistance programs.
• stress management Programs and awareness programs for manager and seniors to cope with work stress, to spot early stress symptoms in their juniors to cope with stress
• Absence reviews- This is a process which is used when an employee

 returns after any absence. It helps to build up a picture of what is happening,

 whether illnesses are genuine and to spot any patterns within teams or for

 individual. Carrying these out can reduce absence and also provide a format for

 staff to express concerns.

• The psychiatric evaluation should be done for employees to detect psychopathology so that job absenteeism can be reduced and early intervention can prevent long duration of leave and subsequent burden on other employees also.
• Key behavior change sign should be taught to seniors so that early diagnosis and treatment can be done.

 

 REFERENCE