# Occupational Hazards, Social Support, and Quality of Working Life in Sub-District Health Promoting Hospitals in Southern Thailand: A Cross-Sectional Study

## TL;DR

This study explores how social support and occupational hazards affect the quality of working life for healthcare workers in Thailand's community-based hospitals.

## Contribution

The study identifies community-embedded social support as a key factor in improving quality of working life in decentralized healthcare systems.

## Key findings

- Social support is the strongest positive predictor of quality of working life (QWL) among healthcare workers.
- Working more than eight hours per day is associated with higher QWL, while longer work experience is linked to lower QWL.
- Most healthcare workers reported moderate hazard exposure and high social support.

## Abstract

Public health relevance—How does this work relate to a public health issue?
This study examines occupational health and quality of working life (QWL) among frontline personnel in Thailand’s community-based primary healthcare system, where healthcare delivery is inherently community-engaged.It explores how community-embedded social support and occupational hazard exposure interact within decentralized sub-district health promoting hospitals (SHPHs).

This study examines occupational health and quality of working life (QWL) among frontline personnel in Thailand’s community-based primary healthcare system, where healthcare delivery is inherently community-engaged.

It explores how community-embedded social support and occupational hazard exposure interact within decentralized sub-district health promoting hospitals (SHPHs).

Public health significance—Why is this work of significance to public health?
Findings demonstrate that social support—extending beyond the workplace to community networks—is the strongest determinant of QWL, highlighting a key mechanism within community-engaged health systems.

Findings demonstrate that social support—extending beyond the workplace to community networks—is the strongest determinant of QWL, highlighting a key mechanism within community-engaged health systems.

Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health?
Practitioners and health systems require a dual approach for increasing organizational social support and systematically mitigating occupational risks—particularly biological and chemical hazards—to ensure a resilient and sustainable community health system.Policy makers and researchers can use this data to optimize working hours and compensation structures, ensuring a sustainable workforce amidst the ongoing transition of health services to local administrative organizations.

Practitioners and health systems require a dual approach for increasing organizational social support and systematically mitigating occupational risks—particularly biological and chemical hazards—to ensure a resilient and sustainable community health system.

Policy makers and researchers can use this data to optimize working hours and compensation structures, ensuring a sustainable workforce amidst the ongoing transition of health services to local administrative organizations.

Healthcare personnel working in sub-district health promoting hospitals (SHPHs) are vital to Thailand’s primary healthcare system but often face occupational, psychosocial, and organizational challenges that may affect their quality of working life (QWL). This study aimed to assess QWL and identify its key predictors among SHPH healthcare personnel in southern Thailand. A cross-sectional survey was conducted among 340 healthcare personnel in Nakhon Si Thammarat Province using stratified random sampling. Data were collected through a structured questionnaire covering socio-demographic characteristics, working conditions, occupational hazard exposures, social support, and QWL measured by the 36-item Thai version of the QWL scale. Descriptive statistics and stepwise multiple linear regression analyses were performed. Participants were predominantly female (80.9%) with a mean age of 34.0 years (SD = 9.2), and one-third (33.2%) worked more than eight hours per day. Most participants (75.6%) had moderate hazard exposure, while 73.2% reported high social support. Overall, 51.2% of respondents had good QWL, with safe and healthy working conditions and social relevance of work life rated highest. Regression analysis identified social support (β = 0.790, p < 0.001) and working hours per day (β = 0.109, p = 0.001) as positive predictors, while work experience (β = −0.064, p = 0.049) was a negative predictor (R2 = 0.655). These findings emphasize the need for organizational strategies that strengthen social support and effectively manage working conditions, including the organization of working hours, to promote sustainable quality of working life among healthcare personnel in Thailand’s primary healthcare system.