The Effect of Ramadan and COVID-19 on the Relationship between Physical Activity and Burnout among Teachers

The objective of this study was to explore the effect of COVID-19 and Ramadan on physical activity (PA) and burnout in teachers and the relationship between them. A total of 57 secondary school teachers from public education centers participated in the present study. They were aged between 29 and 52 years. To determine the effect of Ramadan and COVID-19 on PA and burnout, participants completed the online questionnaires before COVID-19, one week before Ramadan and during the second week of Ramadan. The International Physical Activity Questionnaire-BREF and the Maslach Burnout Inventory-Human Services Survey were used to assess PA intensities and burnout, respectively. The data revealed that total PA (p < 0.001, p < 0.05, respectively) vigorous metabolic equivalent of task (MET) (p < 0.001, p < 0.05, respectively), moderate MET (p < 0.001, p < 0.01, respectively) were higher before COVID-19 and before Ramadan than during Ramadan. Regarding burnout subscales, emotional exhaustion (p < 0.001, p < 0.01, respectively) was higher before Ramadan than before COVID-19 and during Ramadan. A lower personal accomplishment was reported before Ramadan than before COVID-19 and during Ramadan (both p < 0.05). In addition, low to high correlations were observed between PA intensities and burnout subscales, except for the correlation between depersonalization and all PA intensities. In conclusion, Ramadan intermittent fasting along with PA was highly recommended for teachers and the general population to improve positive emotions and general health.

Process Evaluation in Occupational Stress Management Programs: A Systematic Review

Objective.

To conduct a systematic review of workplace stress management intervention studies that have incorporated process evaluation.

Data Source.

Electronic databases such as PsycINFO and MEDline were searched.

Study Inclusion Criteria.

The inclusion criteria included interventions published in the English language that were focused on either individual- or organizational-level stress management interventions at the workplace, with an outcome evaluation.

Data Extraction.

Each article was coded on key process-relevant variables, including context, recruitment, reach, dose delivered, dose received, fidelity, implementation, and participant's attitudes toward the intervention. Studies that reported on at least one of these process variables were also coded on the following study characteristics: Participants, setting, evaluation design, intervention content, intervention format, and study outcomes.

Data Synthesis.

Statistical Package for the Social Science was used to analyze the data with descriptive statistics.

Results.

Of the 84 studies identified that met the study inclusion criteria, 52 (61.9%) reported findings on at least one of the key relevant process-relevant variables. Variables most frequently included were recruitment (30%), intervention dose received (22%), participants' attitudes toward intervention (19%), and program reach (13%). Fewer than half of the studies presented any findings linking process evaluation and outcome evaluation.

Conclusions.

The incomplete reporting of information relevant to process evaluation makes it difficult to identify reliable determinants of effective intervention implementation or outcomes.

A web-based training program using cognitive behavioral therapy to alleviate psychological distress among employees: randomized controlled pilot trial

Background

A number of psychoeducational programs based on cognitive behavioral therapy (CBT) to alleviate psychological distress have been developed for implementation in clinical settings. However, while these programs are considered critical components of stress management education in a workplace setting, they are required to be brief and simple to implement, which can hinder development.

Objective

The intent of the study was to examine the effects of a brief training program based on CBT in alleviating psychological distress among employees and facilitating self-evaluation of stress management skills, including improving the ability to recognize dysfunctional thinking patterns, transform dysfunctional thoughts to functional ones, cope with stress, and solve problems.

Methods

Of the 187 employees at an information technology company in Tokyo, Japan, 168 consented to participate in our non-blinded randomized controlled study. The training group received CBT group education by a qualified CBT expert and 1 month of follow-up Web-based CBT homework. The effects of this educational program on the psychological distress and stress management skills of employees were examined immediately after completion of training and then again after 6 months.

Results

Although the training group did exhibit lower mean scores on the Kessler-6 (K6) scale for psychological distress after 6 months, the difference from the control group was not significant. However, the ability of training group participants to recognize dysfunctional thinking was significantly improved both immediately after training completion and after 6 months. While the ability of participants to cope with stress was not significantly improved immediately after training, improvement was noted after 6 months in the training group. No notable improvements were observed in the ability of participants to transform thoughts from dysfunctional to functional or in problem-solving skills. A sub-analysis of participants who initially exhibited clinically significant psychological distress (K6 score ≥5) showed that the mean K6 score was significantly improved immediately after training completion for the training group compared to the control group (−2.50 vs −0.07; mean difference 2.43, 95% CI 0.55-4.31; d=0.61), with this effect remaining even after 6 months (−3.49 vs −0.50; mean difference 2.99, 95% CI 0.70-5.29; d=0.60).

Conclusions

Our results suggest that a brief stress management program that combines group CBT education with Web-based CBT homework moderately alleviates the distress of employees with clinically significant psychological distress. In addition, the program might help improve employees’ ability to evaluate their own stress management skills.

An examination of stress in college students over the course of a semester

The purpose of this study was to determine whether differing stress reduction interventions could alter stress levels experienced by male and female college students from the beginning to the end of a semester. Components of stress examined included overall perceived stress, test anxiety, and personal burnout. Participants (N = 531) were part of courses that during the course of a 16-week semester focused specifically on cognitive-behavioral stress management, cardiovascular fitness, generalized physical activity, or a control with no intervention. In addition to gender differences, both the stress management and physical activity groups had significantly lower levels of perceived stress, test anxiety, and personal burnout at the end of the semester. The fitness group scored significantly lower on perceived stress and personal burnout, but there was no difference in scores for test anxiety. The important ramifications of reducing stress in college students are discussed, including the pros and cons of implementing differing physical and psychological intervention modalities.

Emotional exhaustion, absenteeism, and turnover intentions in childcare teachers: examining the impact of physical activity behaviors

Drawing on Salmon's (2001) unifying theory of the beneficial effects of physical exercise, we examined physical activity behaviors as an important, but understudied, buffer against experiences of emotional exhaustion, absenteeism, and turnover intentions in 189 childcare teachers. Structural equation modeling revealed that workplace and leisure-time physical activity were negatively related to emotional exhaustion, which in turn, was positively related to teacher migration and attrition intentions. Post-hoc analyses revealed indirect (mediated) effects between physical activity behaviors and teacher turnover intentions via emotional exhaustion. This theoretically driven model fit the data better than an alternative model whereby emotional exhaustion predicts physical activity behaviors.

Teacher stress and coping strategies used to reduce stress

This pilot study investigated teachers' symptoms of stress and their coping strategies. Measurements of 'stress levels' and 'coping strategies' used were acquired by constructing a questionnaire made up of four individual standardized questionnaires. The data were analysed by a series of correlational analyses that highlighted significant relationships between ways of coping and levels of distress. Differences between the stress-related areas were measured using the Friedman test and Wilcoxon signed rank test for hierarchy. The findings implied that 'escape avoidance', 'accepting responsibility' and 'uncontrolled aggression' were used as negative coping strategies and only one strategy, 'exercise', was indicated to be an effective way of coping. The teachers' strategies were examined for similarities and differences with those recommended by occupational therapists. This pilot study was limited to two schools and it is recommended that it be extended to better generalize the results. Furthermore, ways of coping, as measured by psychological measures, do not seem to reduce stress so it is possible that the activity-based Stress Management Questionnaire, as advocated by Stein et al. (2003), might be more advantageous.

Relations among exercise, coping, disordered eating, and psychological health among college students

Researchers have long been interested in the coping styles of individuals who display disordered eating characteristics. Recently, exercise has been recognized as both a behavior and coping strategy that might be present among individuals with disordered eating. The present study evaluates the role of exercise as both a coping mechanism and as a health behavior in relation to eating pathology and other measures of psychological health in a nonclinical university population. Female (n=235) and male (n=86) undergraduate students completed questionnaires that assessed exercise behavior, coping strategies, eating attitudes, self-esteem, life satisfaction, affect, depression, and anxiety. The results indicate that the relations among exercise, coping, and eating pathology is complex. Exercise was related to positive psychological health in males, whereas exercise in females was associated with both positive and negative psychological health. For women with high Eating Attitudes Test (EAT-26) scores, exercise was significantly associated with negative affect, and a trend existed in this group such that exercise was associated with higher levels of depression and anxiety. Conversely, for women with low EAT scores, exercise was associated with positive affect. This suggests that exercise might be differentially associated with mental health based on the presence or absence of eating pathology.

The benefits of interventions for work-related stress

OBJECTIVES

This quantitative meta-analysis sought to determine the effectiveness of occupational stress-reducing interventions and the populations for which such interventions are most beneficial.

METHODS

Forty-eight experimental studies (n = 3736) were included in the analysis. Four intervention types were distinguished: cognitive-behavioral interventions, relaxation techniques, multimodal programs, and organization-focused interventions.

RESULTS

A small but significant overall effect was found. A moderate effect was found for cognitive-behavioral interventions and multimodal interventions, and a small effect was found for relaxation techniques. The effect size for organization-focused interventions was nonsignificant. Effects were most pronounced on the following outcome categories: complaints, psychologic resources and responses, and perceived quality of work life.

CONCLUSIONS

Stress management interventions are effective. Cognitive-behavioral interventions are more effective than the other intervention types.

Stress management in work settings: a critical review of the health effects

PURPOSE

To review critically the research literature on the health effects of worksite stress-management interventions.

SEARCH METHODS

Stress-management interventions were defined as techniques that are designed to help employees modify their appraisal of stressful situations or deal more effectively with the symptoms of stress. Stress-management studies that were worksite based, assessed a health outcome, and were published in the peer-reviewed literature were included in this review. The main search method was the one described in the lead article to this special issue of the JOURNAL, but supplementary sources included prior reviews of the research literature and expert contacts. Sixty-four studies met the criteria for inclusion in this review.

SUMMARY OF FINDINGS

A variety of stress-management techniques was used in worksite studies, including muscle relaxation, meditation, biofeedback, cognitive-behavioral skills, and combinations of these techniques. The most common techniques used were muscle relaxation, cognitive-behavioral skills, and combinations of two or more techniques. Outcome measures to evaluate the success of stress interventions included physiologic and psychologic measurements, somatic complaints, and job-related measures. Nearly three-fourths of the studies offered the training to all workers and did not specifically recruit high-stress employees. Over half the studies were randomized control trials, but only 30% conducted posttraining follow-up evaluations. The effectiveness of stress interventions varied according to the health-outcome measure used; some techniques were more effective for psychologic outcomes (e.g., cognitive-behavioral skills), whereas others were more effective for physiologic outcomes (e.g., muscle relaxation). Biofeedback was the least frequent technique used in work settings and also seemed to be the least effective technique. Meditation produced the most consistent results across outcome measures but was used in only six studies. In general, studies using a combination of techniques (e.g., muscle relaxation plus cognitive-behavioral skills) seemed to be more effective across outcome measures than single techniques.

CONCLUSIONS

The large number of different stress-management techniques coupled with the wide range of health outcome measures used in stress intervention studies makes it difficult to draw firm conclusions about the efficacy of each technique and each outcome. Also, the quality of the methodology varied substantially among studies. Nevertheless, the most positive results across the various health outcomes were obtained with a combination of two or more techniques. None of the stress interventions was consistently effective in producing effects on job/organization-relevant outcomes, such as absenteeism or job satisfaction. To produce changes on these types of measures, stress interventions will need to alter or modify the sources of stress in the work environment. It can be said that stress management in work settings can be effective in enhancing worker physical and psychologic health, but the choice of which stress-management technique to use should be based on the specific health outcomes that are targeted for change.

Effects of aerobic and nonaerobic exercise on anxiety, absenteeism, and job satisfaction

The effects of aerobic and nonaerobic exercise on employee state and trait anxiety levels, absenteeism, job satisfaction, and resting heart rate were investigated within a worksite setting. Results indicated that aerobic subjects significantly reduced their state anxiety levels over a single exercise session. Post-exercise state anxiety decreased over the 8 weeks for both groups. Aerobic subjects who were not previous exercisers decreased their trait anxiety. No changes in job satisfaction, absenteeism, or resting heart rate were evident. These results support past findings that concluded that aerobic exercise is superior to nonaerobic exercise for anxiety reduction. Tentative evidence was found to oppose the hypothesis that cardiovascular conditioning is the mechanism responsible for the psychological benefits because no significant cardiovascular changes occurred.