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 Table of Contents  
ORIGINAL ARTICLE
Year : 2018  |  Volume : 5  |  Issue : 3  |  Page : 203-207

Stress level of shopkeepers and its relationship with their physical activity and body mass index: A cross-sectional study in a marketplace of Kolkata, West Bengal


Department of Preventive and Social Medicine, All India Institute of Hygiene and Public Health, Kolkata, West Bengal, India

Date of Web Publication17-Jul-2018

Correspondence Address:
Bijit Biswas
Department of Preventive and Social Medicine, All India Institute of Hygiene and Public Health, 110 Chittaranjan Avenue, Kolkata, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/cjhr.cjhr_4_18

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  Abstract 


Background and Objectives: Shopkeepers due to their sedentary lifestyle and lack of physical activity are more likely to suffer from high level of stress which, in turn, may increase the risk of various chronic diseases among them. The study aims to assess the stress level and its associated factors among shopkeepers. Materials and Methods: The study was a cross-sectional community-based study conducted from May to July 2016, among 147 shopkeepers in a permanent marketplace of Kolkata with a structured schedule. Data were analyzed using appropriate statistical methods by the Statistical Package for the Social Sciences, SPSS (version 16). Results: The mean stress score of the study participants was 8.1 ± 2.3. Only 43.7% of them were doing a moderate physical activity (≥600 MET-min/week). There was moderate correlation between stress and physical activity (ρ = 0.374, P = 0.000). Other significant correlates of stress were age (t = 2.132, P = 0.035), tobacco consumption (ρ = 0.167, P = 0.043), body mass index (ρ = 0.299, P = 0.000), and hypertension (ρ = 0.165, P = 0.046). Conclusions: Stress level among the study population was high with only two-fifths of them doing a moderate amount of physical activity. Health education regarding the importance of maintaining a healthy lifestyle, i.e., regular physical activity, weight reduction, and quitting addiction should be given to them regularly to reduce their stress level and reduction of their risk of developing various chronic diseases.

Keywords: Body mass index, physical activity, shopkeepers, stress


How to cite this article:
Biswas B, Dasgupta A, Paul B, Sembiah S. Stress level of shopkeepers and its relationship with their physical activity and body mass index: A cross-sectional study in a marketplace of Kolkata, West Bengal. CHRISMED J Health Res 2018;5:203-7

How to cite this URL:
Biswas B, Dasgupta A, Paul B, Sembiah S. Stress level of shopkeepers and its relationship with their physical activity and body mass index: A cross-sectional study in a marketplace of Kolkata, West Bengal. CHRISMED J Health Res [serial online] 2018 [cited 2019 Oct 21];5:203-7. Available from: http://www.cjhr.org/text.asp?2018/5/3/203/236899




  Introduction Top


India is a country in transition since the inception of liberalization of the economy and retail is one of the fastest growing sectors among all other sectors in the country. There are about 12 million retail outlets spread across India, earning it the epithet of a “nation of shopkeepers.” However, more than 80% of these 12 million outlets are run by small family businesses (Kirana stores).[1],[2]

A shopkeeper is a person who owns or runs a shop. Shopkeepers' work profile includes arriving early at the store to open up and prepare for the day, answering to customers' queries, giving advice about products to customers, catering to customers' needs and requests, handle cash, and maintenance of stock. Hence, they lead a sedentary lifestyle as most of the day they sit/stand in a shop to fulfill their job responsibilities.[3],[4] During discharging their duties, they undergo varying levels of mental stress in the workplace. In addition to their sedentary lifestyle and highly demanding job profile, the other possible sources of mental stress for a shopkeeper may be financial insecurity, competition from low-cost rivals, an argument with a customer, interpersonal relationship with other shopkeepers, etc. The stipulated risk factors of stress at the workplace are age, sex, socioeconomic status, educational level, physical activity, hypertension, body mass index (BMI), etc.[5],[6],[7] Stress can increase the risk of various chronic illnesses (i.e., diabetes, stroke, hypertension, and mental illnesses).[8],[9],[10],[11]

There were very few existent literature regarding stress level of shopkeepers and its attributes. A study of such nature will be helpful to understand the problem of stress level and its associated factors so that appropriate interventions can be initiated for the benefit of such a vulnerable group. With this background, the study was conducted to assess the stress level among the shopkeepers of a permanent marketplace of Kolkata.


  Materials and Methods Top


It was a community-based observational study and cross sectional in design. The study was conducted in a permanent marketplace in Chetla between May and July 2016, after getting necessary permission from the chairperson of Kolkata Improvement Trust (KIT). Persons who are either owner or worker of a shop registered with the market trade union and working for at least 1 year as a shopkeeper were included in the study. Census method of sampling was followed. Those who were unwilling (12 shopkeepers) were excluded from the study. Therefore, out of the total 159 shopkeepers registered with the market trade union, only 147 shopkeepers were included in the study. Informed written consent of study participants was taken before their participation.

Structured schedule (based on demographic, behavioral, PSS-4 scale items, and IPAQ-short form), stethoscope, sphygmomanometer, weighing machine, and nonstretchable measuring tape were used for data collection. Pretesting of the questionnaire was done among thirty shopkeepers in an adjacent marketplace, and the necessary modifications were included in the final questionnaire. Cronbach's alpha of PSS-4 questionnaire was 0.767 indicating an acceptable level of internal consistency. At first, line listing of the shopkeepers was done based on shop number allotted to them by the KIT market trade union. Then, the shopkeepers were asked to come to the club room of KIT market on an appointment basis. In a day, on an average of 8–10 people were interviewed and clinically examined considering only two days in a week and 3–4 hours a day was available for data collection.

Operational definitions used are listed next.

Tobacco consumption

Individuals who were currently smoking or taking tobacco products by any other means were reported as tobacco consumers.

Blood pressure

It was measured in sitting position on the right arm using aneroid sphygmomanometer while the study individuals' leg rests on a flat surface. Three readings were taken 5 min apart, and the mean of last two readings was taken as the final blood pressure (BP) reading. Hypertension was defined in the study as systolic BP of ≥140 mmHg or diastolic BP of ≥90 mmHg.[12]

Height

It was measured while the study individual is standing upright on a flat surface by stadiometer taking the highest point of parietal tuberosity as the upper limit of the body. Participants were asked to stand with feet together, heels against the backboard, and knees straight after removing any footwear and headgear while measuring the height.[12]

Body weight

It was estimated while the study individual is wearing light clothes using a loaded calibrated weighing scale. Participants were asked to step onto the scale with one foot on each side of the scale, stand still, face forward, place arms on the side, and wait until asked to step off after removing any footwear and headgear while measuring the height.[12]

Socioeconomic status

It was assessed by modified B. G. Prasad scale 2016.[13]

Physical activity

[TAG:2]It Was Evaluated by Ipaq[14],[15] and Each Was Classified as Mild/moderate/heavy Based on Physical Activity Status.[/TAG:2]

Perceived stress score

It was assessed using the PSS-4 scale.[16] It is a 4-item scale with five likert's. The perceived score was calculated by addition of scores of individual items of perceived stress scale. The minimum and maximum attainable score were 0 and 16 respectively with higher score indicated higher perceived stress level.

Statistical analysis

Data were analyzed using IBM Statistical Package for the Social Sciences (SPSS) (version 16, Chicago, USA). At first, a bivariate analysis by independent samples t-test was done to ascertain the relationship between socioeconomic, demographic, and lifestyle-related factor variables with stress. Then, Spearman's rho correlation between stress and its attributes was done to find out the strength of association. Statistical significance for all statistical tests was set at P < 0.05.


  Results Top


Among the study participants, 78.9% (n = 116) were males and 21.1% (n = 31) were females. The study participants' age range was from 26 to 75 years with a mean ± standard deviation of 47.8 ± 12.2 years. Majority of the study participants were Hindus (96.6%), married (88.4%), and belonged to nuclear family (63.3%). About 53.7% were educated above secondary level while 25.2% of them had educational qualification of graduation and above. In the addiction profile, 12.9% of them were addicted to alcohol while 47.6% of them were addicted to tobacco using smoking or chewing or by both means. Most of them were involved in the mild physical activity (57.1%). The study revealed that 32.7% of the study participants had hypertension (examined/self-reported) while 43.5% of the study participants were overweight/obese [Table 1].
Table 1: Background characteristics of the study participants (n=147)

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The Mean Perceived Stress Score of the Study Participants Was 8.1 ± 2.3 (Range: 4–12). Perceived Stress Scores of the Study Participants Had Shown Significant Association With Their Age, Tobacco Consumption Habit, Bmi, Physical Activity Level, and Hypertension Status, With Physical Activity (ρ = 0.374) and Bmi (ρ = 0.299) Being the Strongest Correlate of Stress [Table 2] and [Table 3].
Table 2: Association between various background characteristics and perceived stress score of the study participants (n=147)

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Table 3: Spearman rho correlation of perceived stress score with various factors (n=147)

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  Discussion Top


The study was a cross-sectional community-based study to assess the stress level and its associated factors among shopkeepers.

In the present study with the advancement of age, stress level of shopkeepers also increased which was supported by earlier shreds of evidence in this regard.[17],[18] It may be because with the advancement of age, one's ability to cope up with the stress level reduces. Thus it was an obvious finding.

It is a well-known fact that nicotine dependency exacerbates stress.[19] In the present study, those who were addicted to tobacco had a higher level of stress. A study conducted by Cui et al.[20] among rural-urban migrant workers in China reported that migrants with high perceived work stress had a 75% excess likelihood to be current smokers which were concurrent with our findings. An individual participant data meta-analysis by Heikkilä et al.[21] reported that smokers are slightly more likely than nonsmokers to report work-related stress which further concretizes our results as we also found a weak correlation (ρ = 0.167) between tobacco consumption and perceived stress.

Hypertensive had a higher level of stress. The study conducted by Rosenthal and Alter[22] concluded conflicting results regarding the relationship between job strain and blood pressure(BP) compared to our study. On the other hand, Dishman et al.[23] reported that mean arterial BP might be elevated in a person with high perceived stress which supports our findings.

Those who were not overweight/obese had lower stress level than others. It was contrary to the findings of Stewart-Knox et al.[24] which did not find such association. A study conducted by Sethi et al.[25] on computer workers reported a significant incremental effect of BMI on occupation-related stress which was concurrent to our findings.

Those who were doing a moderate amount of physical activity had a lower level of stress compared to others. A longitudinal study conducted by Rueggeberg et al.[26] reported that physical activity could predict a 2-year reduction of perceived stress level which supports our findings. Another longitudinal study conducted by Kouvonen et al.[27] by analyzing the data of Finnish public sector study identified physical inactivity as a risk factor of increased workplace stress level which further solidifies our results, whereas Tonello et al.[28] failed to demonstrate the benefit of physical activity on work-related stress.

Strengths of the study

One of the fewer studies explored stress level and its associated factors among shopkeepers.

Limitations of the study

The study population was tiny. All data were self-reported, so there may be over or under reporting. Chances of social desirability bias cannot be overlooked.


  Conclusions Top


Stress level among the study population was high. Only two-fifths of the study participants were doing moderate physical activity. There was a moderate correlation between stress and physical activity. Other significant correlates of stress were age, tobacco consumption, BMI, and hypertension. Health education regarding the importance of healthy lifestyle, i.e., regular physical activity, weight reduction, and quitting addiction should be given to them regularly to reduce their stress level. At every given opportunity, shopkeepers should be screened for their stress level and intervened at the earliest if found to be raised. Counseling services for at-risk individuals should also be provided.

Acknowledgment

The authors would like to express their gratitude for all the study participants for taking part in the study.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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Oyeyemi AL, Oyeyemi AY, Adegoke BO, Oyetoke FO, Aliyu HN, Aliyu SU, et al. The short international physical activity questionnaire: Cross-cultural adaptation, validation and reliability of the Hausa language version in Nigeria. BMC Med Res Methodol 2011;11:156.  Back to cited text no. 14
    
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Heikkilä K, Nyberg ST, Fransson EI, Alfredsson L, De Bacquer D, Bjorner JB, et al. Job strain and tobacco smoking: An individual-participant data meta-analysis of 166,130 adults in 15 European studies. PLoS One 2012;7:e35463.  Back to cited text no. 21
    
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Rosenthal T, Alter A. Occupational stress and hypertension. J Am Soc Hypertens 2012;6:2-2.  Back to cited text no. 22
    
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Dishman RK, Nakamura Y, Garcia ME, Thompson RW, Dunn AL, Blair SN, et al. Heart rate variability, trait anxiety, and perceived stress among physically fit men and women. Int J Psychophysiol 2000;37:121-33.  Back to cited text no. 23
    
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Stewart-Knox B, E Duffy M, Bunting B, Parr H, Vas de Almeida MD, Gibney M, et al. Associations between obesity (BMI and waist circumference) and socio-demographic factors, physical activity, dietary habits, life events, resilience, mood, perceived stress and hopelessness in healthy older Europeans. BMC Public Health 2012;12:424.  Back to cited text no. 24
    
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Sethi J, Sandhu JS, Imbanathan V. Effect of body mass index on work related musculoskeletal discomfort and occupational stress of computer workers in a developed ergonomic setup. Sports Med Arthrosc Rehabil Ther Technol 2011;3:22.  Back to cited text no. 25
    
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Kouvonen A, Vahtera J, Oksanen T, Pentti J, Väänänen AK, Heponiemi T, et al. Chronic workplace stress and insufficient physical activity: A cohort study. Occup Environ Med 2013;70:3-8.  Back to cited text no. 27
    
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    Tables

  [Table 1], [Table 2], [Table 3]



 

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