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174]

Original Article
Giridhara R. Babu1,2,
Paulomi M. Sudhir3,
Tanmay Mahapatra2,
Association of quality of life and job stress Aritra Das4,
Mohanbabu
in occupational workforce of India: Findings Rathnaiah5,
Indiresh Anand6,7,
from a cross‑sectional study on software Roger Detels2
1
Public Health

professionals Foundation of India,

3
Department of Clinical
Psychology, NIMHANS,
Bengaluru, Karnataka,
Abstract they enjoyed. It is also possible
4
Bihar Technical Support
that stress might actually be Program, CARE India
Background: There is limited scientific evidence on Solutions for Sustainable
responsible for improvements
the relationship of job stress with quality of life (QoL). Development,
in QoL either directly or through
Purpose: This study aims to explore different domains Patna, Bihar, India,
mediation of variables such as
of job stress affecting IT/ITES professionals and estimate 5
Institute of Mental
personal values and aspirations. Health, University of
the levels of stress that these professionals endure to
“Yerkes‑Dodson law” and stress Nottingham, Jubilee
reach positive levels of QoL given that other determinants
appraisal models of Folkman Campus, Nottingham,
operating between these two variables are accounted
and Lazarus may explain the NG7 2TU, 6Hergest
for. Materials and Methods: We estimated levels of
plausible positive association. Unit, Betsi Cadwaladr
stress that software professionals would have endured to
University Health Board,
reach positive levels of QoL considering that other factors Ysbyty Gwynedd,
operating between these two variables are accounted Key words: Developing
Bangor, North Wales,
for. The study participants comprised 1071 software countries, eustress and distress, 7
Abraham Cowley
professionals who were recruited using a mixed sampling job stress, quality of life Unit, Surrey and
method. Participants answered a self‑administered Borders Partnership
questionnaire containing questions on job stress, QoL, NHS Trust, Chertsey,
INTRODUCTION
and confounders. Results: All the domains (physical, UK, 2Department
psychological, social, and environmental) of QoL of Epidemiology,
Quality of life (QoL) is defined as the University of California
showed statistically significant positive associations
“individuals’ perceptions of their Los Angeles, Los
with increasing stress domains of autonomy, physical
position in life in the context of the Angeles, California,
infrastructure, work environment, and emotional factors.
culture and value systems in which USA
Conclusions: The respondents clearly found the trade‑off
they live and in relation to their
of higher stress to be acceptable for the improved QoL For correspondence:
goals, expectations, standards and
Dr. Giridhar R. Babu,
concerns.” [1,2] Hence, QoL denotes
Public Health
Access this article online subjective contexts of physical, Foundation of India,
Quick Response Code psychological, cultural, social, and IIPH‑H, Bangalore
Website:
environmental perceptions from a Campus, SIHFW
www.ijoem.com
holistic perspective. World Health Premises, Beside
Organization Quality of Life‑BREF Leprosy Hospital,
DOI:
(WHOQOL‑BREF) is a validated and 1st Cross, Magadi Road,
10.4103/0019-5278.197544
Bengaluru - 560 023,
widely used instrument for determining
Karnataka, India.
the impact of several diseases on
This is an open access article distributed under the terms of the E‑mail: giridhar@
Creative Commons Attribution‑NonCommercial‑ShareAlike 3.0
QoL. A limited number of studies iiphh.org
License, which allows others to remix, tweak, and build upon the carried out in India have studied QoL,
work non‑commercially, as long as the author is credited and the new however, none of these have assessed
creations are licensed under the identical terms.
its association with job stress among
professionals working in Information
For reprints contact: reprints@medknow.com
Technology (IT) and Information
Technology Enabled Services (ITES).[3,4]
Cite this article as: Babu GR, Sudhir PM, Mahapatra T, Das A,
Rathnaiah M, Anand I, et al. Association of quality of life and job In common parlance, QoL is perceived
stress in occupational workforce of India: Findings from a cross- as having better access to amenities
sectional study on software professionals. Indian J Occup Environ and services. Based on contextual
Med 2016;20:109-13.
settings, the perceived meaning of QoL

© 2016 Indian Journal of Occupational and Environmental Medicine | Published by Wolters Kluwer - Medknow 109
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Babu, et al.: Quality of Life and job stress among software professionals
and the means of attaining a higher level of QoL may vary. In
the process of attempting to achieve perceived higher levels of
QoL, individuals may be willing to endure/tolerate greater levels
of stress. “Job stressors” are defined as “working conditions
that may lead to acute reactions, or strains in the worker.” It is
plausible that professionals can subject themselves to greater
degrees of stress in their occupational settings in order to
achieve better QoL. There have been no attempts in India,
thus far, to explore the psychosocial determinants (such as the
amount of job stress one is willing to endure) of attaining a higher
level of QoL. This study aims to explore the domains of job stress
among IT/ITES professionals and estimate their associations
with attainment of higher/positive levels of QoL, accounting for
other potential determinants of job stress and QoL.
MATERIALS AND METHODS
We recruited 1071 IT/ITES professionals for the current study
from the IT and ITES sectors. A detailed description of study
methods including sample size and method of recruitment
have been reported elsewhere.[5] In brief, we included workers
from the IT and ITES industry who were 20–59 years old and
had been working for at least 1 year prior to inclusion in the
study. After obtaining informed consent, participants were
requested to complete a self‑administered questionnaire that
contained items on QoL and job stressors.
Measures
Quality of Life
The original version of the QoL instrument, developed by the
WHO, WHOQOL‑100, allows a thorough evaluation of individual
facets related to QoL. The WHOQOL‑BREF is the shorter version
of the same tool that examines domain level profiles. The
WHOQOL‑BREF contains 26 questions in total, consisting of one
item from each of the 24 facets present in the WHOQOL‑100, along
with one item to assess the overall QoL and another to examine
health in general. The WHOQOL‑BREF estimates the overall QoL
through four domain scores. The four domain scores denote an
individual’s perception about his/her QoL in each particular
domain, with higher scores denoting better QoL. The mean score
of items within each domain denotes the score for that particular
domain. The scores are multiplied by 4 to rescale the domain
scores to the level of WHOQOL‑100. For the current study, we
calculated the QoL scores using an SPSS syntax file, obtained
from the WHOQOL SRPB Coordinator, Mental Health: Evidence
and Research, Department of Mental Health and Substance
Dependence, CH‑1211 Geneva 27, Switzerland. The WHO‑QoL,[6]
a generic measure of health‑related quality of life (HRQoL) was
used to assess and classify health status of workers according
to job titles held by them.
Job stress
To estimate job stress we utilized stress domains identified
from a preceding qualitative study.[7] The stress domains
included time pressure, length of experience, shift, income,
110 Indian Journal of Occupational and Environmental Medicine - May-August 2016 - Volume 20 - Issue 2
job control, autonomy, appreciation, physical environment,
work environment, and emotional stressors.
Potential confounders
We adjusted for waist‑to‑hip circumference ratio, past
medical history, gender, age (continuous), socioeconomic
status (continuous), marital status, tobacco use, alcohol, and
regular exercise (for at least 20 minutes/day) as confounders.
A detailed description of measurement of above confounders
is provided in earlier publications.[8,9]
Analysis
Variables were recoded in increasing order of contextual stress and
increasing levels of QoL. Newly coded variables were created in
the dataset for further analysis. The data from the cross‑sectional
survey was analyzed using SAS 9.1.3104.[10] Detailed analysis
plan has been described elsewhere.[8,10] In brief, we employed
ordinal logistic regression for testing associations between the
QoL domains and job stressors. For this purpose, tertiles of stress
domain scores (Y) were used as ordinal categories – namely low,
moderate, and high levels of stress. We did not use polytomous
logistic regression because such an analysis plan would not make
use of the information about ordering of variable categories, and
hence, would be comparatively inefficient. On the other hand,
ordinal logistic regression model, using cumulative probabilities,
takes into account the ordering obtained from contextual stress
domains.[11] The cumulative ordinal logistic model for outcome
having ordinal categories can be employed when the coefficients of
the predictor variables do not depend on i, and it can be assumed
that there is one common parameter bij for each covariate. Based
on above assumption, an example of cumulative odds model will
be [Supplement equation].
This model suggests that the k odds for each cut‑off category
i will differ only with regard to the intercepts ai.
RESULTS
The details of variable selection and data completeness are
provided in our earlier paper.[12] In brief, data from 1071 participants
were included for analyses on the variables of interest. Based
on WHO‑QoL, out of 1071 participants, 55% were found to have
moderate quality of physical life. In the psychological domain
of QoL, nearly 40% belonged to the moderate category, whereas
35% were classified as having poor QoL. Regarding quality of
environmental life, 46% and 40% of the participants had moderate
and poor QoL, respectively. Sixty percent of the participants fell
into category of moderate quality of social life [Table 1].
Being in the “good” category for physical and psychological QoL
was found to be significantly associated with presence of higher
occupational stress related to autonomy in both unadjusted and
adjusted models. In addition, participants with moderate and
good quality of environmental life were more likely to have higher
autonomy related stress – both before and after adjustment of
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Babu, et al.: Quality of Life and job stress among software professionals

confounders. Having moderate and good social QoL was found
to be associated with higher autonomy‑related job stress in the
unadjusted analysis; however, in the adjusted model, only good
category of social QoL showed significant positive association
with higher autonomy related job stress [Table 2].
significantly higher odds of occupational stress related to
work environment [Table 4].
Table 5 depicts the results of crude and adjusted analyses of
associations between QoL and occupational stress related to

In comparison to workers reporting poor QoL, workers having Table 3: Estimates of domains of quality of life and physical
moderate and good physical, psychological, environmental, environment stressors
and social QoL were found to have significantly higher odds Variable Analysis Levels Odds ratio 95% CI P
of occupational stress related to physical environment in both Physical Unadjusted Poor Reference
unadjusted and adjusted models [Table 3]. Moderate 1.50# (1.13-2) 0.01
Good 1.88 (1.26-2.82) 0.00
Adjusted* Poor Reference
Similarly, in both unadjusted and adjusted analyses, except Moderate 1.41 (1.07-1.86) 0.02
for the moderate category of psychological QoL, participants Good 1.69 (1.16-2.49) 0.01
Psychological Unadjusted Poor Reference
belonging to moderate and good category, compared to Moderate 1.39 (1.05-1.85) 0.03
those from poor category, in all four domains of QoL had Good 2.21 (1.56-3.15) <0.0001
Adjusted* Poor Reference
Moderate 1.35 (1.03-1.78) 0.03
Table 1: Descriptive table of domains of quality of life Good 2.14 (1.53-3) <0.0001
Domains of Sample Levels Frequency % 95% Confidence. Environmental Unadjusted Poor Reference
quality of Life size of QoL Interval Moderate 2.13 (1.62-2.8) <0.0001
Good 2.49 (1.63-3.83) <0.0001
Physical 1071 Good 303 28.29 (25.59-31.0) Adjusted* Poor Reference
Moderate 589 55.00 (52.02-57.98) Moderate 2.07 (1.6-2.7) <0.0001
Poor 179 16.71 (14.48-18.96) Good 2.41 (1.6-3.63) <0.0001
Psychological 1071 Good 377 35.20 (32.34-38.07) Social Unadjusted Poor Reference
Moderate 432 40.34 (37.4-43.28) Moderate 1.47 (1.1-1.96) 0.01
Poor 262 24.46 (21.89-27.05) Good 2.24 (1.43-3.51) 0.00
Environmental 1071 Good 432 40.34 (37.4-43.28) Adjusted* Poor Reference
Moderate 496 46.31 (43.33-49.31) Moderate 1.44 (1.1-1.91) 0.01
Poor 143 13.35 (11.32-15.4) Good 2.05 (1.34-3.13) 0.00
Social 1071 Good 280 26.14 (23.51-28.78)
Moderate 643 60.04 (57.1-62.98) *Adjusted estimates obtained after controlling for gender, marital status, ever use of
Poor 148 13.82 (11.75-15.89) tobacco, alcohol drinking, exercise habit, socioeconomic condition, nutritional status,
and family history for chronic illnesses

Table 2: Estimates of domains of quality of life and autonomy Table 4: Estimates of domains of quality of life and work
stressors environment stressors
Variable Analysis Levels Odds ratio 95% CI P Variable Analysis Levels Odds ratio 95% CI P
Physical Unadjusted Poor Reference Physical Unadjusted Poor Reference
Moderate 1.26# (0.95-1.67) 0.11 Moderate 1.54# (1.18-2.02) 0.00
Good 1.45 (1-2.12) 0.05 Good 1.87 (1.3-2.7) 0.00
Adjusted* Poor Reference Adjusted* Poor Reference
Moderate 1.29 (0.99-1.68) 0.07 Moderate 1.50 (1.16-1.95) 0.00
Good 1.50 (1.05-2.15) 0.03 Good 1.83 (1.29-2.6) 0.00
Psychological Unadjusted Poor Reference Psychological Unadjusted Poor Reference
Moderate 1.05 (0.8-1.4) 0.71 Moderate 1.15 (0.88-1.5) 0.33
Good 1.83 (1.33-2.55) 0.00 Good 1.49 (1.09-2.04) 0.01
Adjusted* Poor Reference Adjusted* Poor Reference
Moderate 0.98 (0.76-1.29) 0.90 Moderate 1.04 (0.81-1.35) 0.76
Good 1.67 (1.23-2.29) 0.00 Good 1.34 (1-1.81) 0.06
Environmental Unadjusted Poor Reference Environmental Unadjusted Poor Reference
Moderate 2.06 (1.58-2.69) <0.0001 Moderate 1.88 (1.46-2.43) <0.0001
Good 2.57 (1.73-3.81) <0.0001 Good 2.07 (1.42-3.04) 0.00
Adjusted* Poor Reference Adjusted* Poor Reference
Moderate 1.98 (1.54-2.55) <0.0001 Moderate 1.85 (1.45-2.36) <0.0001
Good 2.54 (1.74-3.7) <0.0001 Good 2.14 (1.49-3.08) <0.0001
Social Unadjusted Poor Reference Social Unadjusted Poor Reference
Moderate 1.39 (1.05-1.84) 0.02 Moderate 1.38 (1.05-1.81) 0.02
Good 1.95 (1.29-2.95) 0.00 Good 2.15 (1.44-3.23) 0.00
Adjusted* Poor Reference Adjusted* Poor Reference
Moderate 1.27 (0.98-1.67) 0.08 Moderate 1.26 (0.98-1.64) 0.08
Good 1.88 (1.27-2.78) 0.00 Good 2.19 (1.49-3.24) <0.0001
*Adjusted estimates obtained after controlling for gender, marital status, ever use of *Adjusted estimates obtained after controlling for gender, marital status, ever use of
tobacco, alcohol drinking, exercise habit, socioeconomic condition, nutritional status, tobacco, alcohol drinking, exercise habit, socioeconomic condition, nutritional status,
and family history for chronic illnesses and family history for chronic illnesses
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Babu, et al.: Quality of Life and job stress among software professionals

emotion. In comparison to workers having poor QoL, those there is an inverted U‑shaped relationship between QoL
with moderate and good score in any of the four QoL domains achieved through efficiency of coping and arousal due to
were found to have higher odds of occupational stress related stress.[18‑21] Deducing from this logic, the peak accomplishment
to emotion in both unadjusted and adjusted models. of QoL probably occurs by stimulus of moderate‑to‑high levels
of job stressors, which facilitate transformation.[18‑21] Further,
DISCUSSION very low levels of job stress might lead to mix‑up of extraneous
and pertinent cues, leading to very little or no change toward
The present study aimed to explore the association between better QoL.[18] The term “eustress” or good stress was coined
QoL and job stress among individuals working in the IT by Hans Selye. “Eustress” or good stress,[22] concept suggests
sector. Various researchers have previously studied the that there may be some common benefits accrued due to stress
association between computer‑centric work environment and until it reaches a certain level. Beyond such cut‑off, stress is
different health parameters. These studies mostly focused likely to have negative effects, turning into “distress.” Second,
on assessing physical and mental health in workplace it is a possibility that workers experiencing highest levels of
settings.[13‑16] However, there is a paucity of published literature stress had to drop out of the study, probably even leave their
on association between job stress and QoL.[17] jobs, and the ensuing survivor bias might have affected the
results. In such a scenario, those who could handle stress well
The results of the present study indicate a significant positive continued to work, got promoted in their jobs, and possibly
association between QoL and increasing stress in the domains reported higher levels of QoL.
of autonomy, physical infrastructure, work environment, and
emotional factors. All the QoL domains (physical, psychological, Further, stress (eustress of distress) may not be a simple
social, and environmental) showed statistically significant consequence of exposure to stressors alone because varying
positive associations with increasing stress in the domains perception of stressors by different individuals plays an
of autonomy, physical infrastructure, work environment, and important role in this phenomena.[23‑25] Stress appraisal models
emotional factors. First, many researchers have suggested by Folkman and Lazarus can be more apt in this context as an
the presence of an inverse relationship between QoL and explanation for the observations.[26,27] These models offer a view
stress. In particular, “Yerkes‑Dodson law” states that “As the based on the perception, coping, and interpersonal attitudes.
difficultness of discrimination is increased the strength of that
stimulus which is most favorable to habit formation approaches Fourth, it is possible that extraneous variables connecting
the threshold.”[18‑21] Interpretation of this law suggests that job stress and QoL might be responsible for the observed
association. The five possible domains that have important
Table 5: Estimates of domains of quality of life and emotional bearing on the determination of QoL are health of the individual,
stressors his/her general level of satisfaction, personal values, income, and
Variable Analysis Levels Odds ratio 95% CI P aspirations. Health of an individual depends on his/her physical,
Physical Unadjusted Poor Reference mental, social, and emotional well‑being. Self‑perceptions of
Moderate 1.55# (1.19-2.03) 0.00 QoL is another important determinant. One may be perfectly
Good 1.61 (1.12-2.31) 0.01
Adjusted* Poor Reference healthy and still may consider him/herself sick because of the
Moderate 1.45 (1.13-1.88) 0.00 inability to appreciate the healthiness of self. In general, the
Good 1.67 (1.18-2.36) 0.00 professionals working in IT/ITES industry appear to be satisfied
Psychological Unadjusted Poor Reference
Moderate 1.36 (1.04-1.78) 0.03 with their life.[28] Personal values and aspirations also play a
Good 1.94 (1.42-2.66) <0.0001 significant role in determining QoL. Professionals who reach
Adjusted* Poor Reference the top or perform well in their filed are often the individuals
Moderate 1.31 (1.02-1.7) 0.04
Good 1.86 (1.38-2.51) <0.0001 who can cope successfully with work pressures. As a result,
Environmental Unadjusted Poor Reference they can be expected to have better QoL in most aspects.
Moderate 1.76 (1.37-2.27) <0.0001 There is evidence suggesting that social support may reduce
Good 1.89 (1.3-2.75) 0.00
Adjusted* Poor Reference
conflict, time pressure, and ambiguity.[29] Parental demands,
Moderate 1.78 (1.4-2.27) <0.0001 satisfaction in marital relations, and family conflicts interact
Good 2.05 (1.44-2.95) <0.0001 with job stressors and influence overall satisfaction with life.[30]
Social Unadjusted Poor Reference
Moderate 1.38 (1.06-1.82) 0.02
Good 1.98 (1.34-2.96) 0.00 CONCLUSIONS
Adjusted* Poor Reference
Moderate 1.34 (1.03-1.74) 0.03 The current study had some major strengths. A large sample
Good 2.00 (1.37-2.93) 0.00
size allowed us to capture the experiences of participants from
*Adjusted estimates obtained after controlling for gender, marital status, ever use of
tobacco, alcohol drinking, exercise habit, socioeconomic condition, nutritional status, different background and to adjust for several confounders
and family history for chronic illnesses simultaneously. Moreover, use of a standardized instrument

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Babu, et al.: Quality of Life and job stress among software professionals
for assessing occupational stress and QoL improves validity
and permits external comparison of study findings.
Nonetheless, few important limitations affected this study.
Because of the cross‑sectional nature of data collection, it is
not possible to rule out temporal ambiguity and as a result
observed positive associations cannot be interpreted as
causal. Moreover, we did not measure coping mechanisms
such as sense of coherence and personality characteristics,
which could be potential mediators in the pathway between
stress and QoL. As with any observational study, we cannot
rule out the presence of selection bias and confounding as well
as their possible role in the reported association.
Notwithstanding the limitations, our research provides
an important insight into a relatively less explored area of
occupational epidemiology. Job stress is reportedly associated
with higher income, higher control job categories that also
pay better. The respondents in this study seemed to find the
trade‑off of higher stress to be acceptable in lieu of corresponding
improvement in their QoL. It is also possible that “eustress” might
actually be responsible for betterment in QoL – either directly
or through mediation of variables such as personal values and
aspirations, personality characteristics, income, and others.
Large‑scale future studies, preferably prospective in design,
can be helpful in providing conclusive evidences in this regard.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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