Our data present values for the eight dimensions and two summary scores of the SF-36 health survey from a random sample of Polish pharmacists. The SF-36 instrument has several advantages, including standard criteria for scoring and transforming the raw responses to ensure accurate group comparisons and it has been found suitable for use in a variety of populations [4, 18, 21, 23]. Our results showed evidence of acceptable validity and internal consistency for the SF-36 in the sample, corresponding with the existing findings [4, 21, 23]. Yet, uneven number of men and women might have made the statistical analysis less valid, however, such proportions are representative for this group of health-care providers in Poland and Europe [24]. The method of enrolling respondents and a low response rate might also lead to self-reporting bias [25]. At the same time, since this is the first study assessing quality of life of Eastern European pharmacists, it presents unique values for the SF-36 survey for a representative sample ideal for future comparative analyses related to for instance, the influence of the ongoing COVID-19 pandemic on HQoL.
No normative published data of the general population could be found for a Polish version of SF-36 [17] and as a result we could not perform any reliable comparative analysis. However, in comparison with other European populations, both summary scores of Polish pharmacists were higher in comparison with, for example, Norwegian [26] and Irish [27] general population normative data. However, in comparison to British normative data, with occupation taken into account, our scores of separate domains were comparable or lower (RP, BP, GH, MH domains). In general, there were no gender differences regarding PCS and MCS, however SF score was significantly different among male pharmacists (Table 4). Thus, our results contrast with the findings of Jenkinson et al, who reported that women had poorer health scores than men in all but the general health dimension [7]. Our analysis revealed that an increasing age was associated with a modest decline in PF and GH domains as well as the PCS score. The lowest median and mean scores for both summary scores and most of the domains (except for V and MH) were noted not for the oldest respondents, but in the age group of 51 to 60 year-olds. We suppose this could be attributed to the fact that the eldest respondents were very close or past the retirement age (60 for females and 65 for males in Poland). Consequently, this group was built up of individuals that had postponed their retirement, possibly due to high HQoL and high job satisfaction. Lau et al. found that both job satisfaction and career satisfaction increased with age, and lower job satisfaction of younger generation of pharmacists might stem from unmet work-balance expectations [28]. This tendency has been reflected in other studies, too [29]. Thus, deterioration of HQoL among older pharmacists might result mainly from physical aging. Yet, it should be noted that our respondents were not asked whether they had been diagnosed with a chronic conditions nor were there any use of medicines at the time of the survey recorded. Instead, we analyzed anthropometric and lifestyle-related variables, including sleep time. Interestingly, sleep duration was negatively correlated, yet very weakly, with SF score only. Both excessive and insufficient sleep duration has been associated with altered HQoL [30] and obesity [31], however the majority of our respondents maintained healthy sleep time routine, i.e., 7–8 hours. And no correlation was found between sleep time and BMI in our sample of pharmacists. BMI is known not only to deteriorate HQoL [32–33] but also to increase risk of chronic non-communicable diseases [34]. Our results showed that obese participants reported significantly worse HQoL in both summary scores of SF-36 and most of the domains (except for RP and RE) compared with normal weight participants. The correlation analysis confirmed an inverse relationship only between PF, GH and PCS scores, which was in accordance with other studies pointing to the significant impact of BMI on the PCS score [35–37]. However, BMI could contribute to HQoL impairment or might be a consequence of diminished HQoL. The physical summary score was also negatively correlated with an increased waist circumference and positively correlated with an increased physical activity, better self-assessed nutrition knowledge and dietary habits. Thus, all strategies seeking to improve dietary and lifestyle habits should have positive impact on pharmacists’ HQoL.
HQoL of health-care providers has been recently subjected to significant analysis, not only due to the ongoing pandemic. Yet, pharmacists, who represent the most accessible and the third largest healthcare professional group in the world [24], have not been so thoroughly analyzed compared to medical doctors or nurses. The SF-36 analysis of Italian doctors, nurses and health technologists, for instance, revealed that respondents differed with general population in most domains. Medical workers prevailed in physical and mental health domains, while having lower scores in vitality, social functioning and role emotional. The authors suggested that high self-perception of physical health might stem from the fact that doctors deal with serious ailments of their patients on daily basis, thus rating their own health more favorably [38]. However, the same mechanism seems inapplicable to pharmacists since general health perception according to SF-36 was relatively low in our sample. Low GH score (the lowest median score of all PCS domains) might indicate low self-perception of physical well-being among sampled pharmacists. Therefore, we believe that limiting pharmacists’ HQoL to psychological factors only, such as job related stress, and neglecting the physical health dimension [11, 39] does not constitute an optimal approach, although the data regarding factors influencing mental well-being of pharmacists have been vastly available. According to American survey 57% of the respondents considered quitting their job at least once per year, and 20% believed that stress imposed by their job affected negatively their mental health, social life, work performance, well-being and physical health [14]. A study of pharmacists from Northern Ireland indicated that as many as 30% percent of communal and 50% of hospital pharmacists reported being often or frequently in stress. Frequent interruptions, shortage of staff and excessive workload were listed as the main stressors [12]. Similarly, a survey of American pharmacists pointed out to the problem of high workload. Authors found correlation between high job satisfaction and self-perceived completeness of patients’ review (treated as a measurement of job performance). They also implied that burnout negatively impacted the efficacy of their work. Although the authors did not examine QoL directly, their findings might suggest that the lower QoL should negatively impact work outcomes of pharmacists [39]. Still, none of the studies have utilized the SF-36 (or any other generic) questionnaire to measure mental well-being among pharmacists. The mental health summary score in our sample was only positively correlated with recreational physical activity and dietary habits. And indeed, physical activity together with healthy eating habits are known to provide mental health benefits [40]. It is also worth mentioning that the highest mental summary score was reported by the eldest respondents, while the lowest median score of the mental health domain was reported by the youngest and 51 to 60 year-old-respondents. Thus, we believe that poorer mental health, especially among younger generations of pharmacists, is an important issue and should be appropriately handled.