Job strain and sense of coherence: Associations with stress-related outcomes among teachers

Estimating the causal effects of work-related and non-work-related stressors on perceived stress level: A fixed effects approach using population-based panel data

OBJECTIVES

Prolonged or excessive stress can have a negative impact on health and well-being, and stress therefore constitutes a major public health issue. A central question is what are the main sources of stress in contemporary societies? This study examines the effects of work-related and non-work-related stressors and perceived social support on perceived stress within a causal framework.

METHODS

Panel data were drawn from two waves (2013 and 2017) of the population-based health survey "How are you?" conducted in the Central Denmark Region. The analytical sample comprised 9,194 subjects who had responded to both surveys. Work-related and non-work-related stressors included major life events, chronic stressors, daily hassles and lack of social support. Perceived stress was measured with the 10-item Perceived Stress Scale (PSS). Data were analysed using fixed effects regression in a fully balanced design.

RESULTS

The largest effects on PSS were seen in own disease, work situation and lack of social support. Other stressors affecting the perceived stress level were financial circumstances, relationship with partner, relationship with family and friends, and disease among close relatives. Most variables had a symmetrical effect on PSS.

CONCLUSIONS

The results point to the need for comprehensive policies to promote mental health that span life domains and include both the individual and the group as well as organizational and societal levels. The study indicates that there are multiple potential entry points for stress prevention and stress management. However, it also shows that disease, work situation and social support weigh heavily in the overall picture. This points to the healthcare system and workplace as key institutional venues for action.

Psychometric evaluation of the depression, anxiety, and stress scale-21 (DASS-21) among Chinese primary and middle school teachers

BACKGROUND

Teachers in high-stress roles face increasing psychological distress such as anxiety and depression, underscoring the need for validated assessment instruments. Given the current absence of a comprehensive, designated, and time-efficient scale capable of evaluating depression, anxiety, and stress among the teacher population, the Depression, Anxiety, and Stress Scale-21 (DASS-21) presents itself as a promising alternative. Despite the widespread application of the DASS-21 for assessing psychological distress across various populations, its validity among teachers, along with questions about its factor structure and its potential property of time equivalence, remain unverified. This study endeavors to address these considerations by investigating the psychometric properties of the DASS-21 specifically within the population of Chinese primary and middle school teachers.

METHODS

Cross-sectional (n = 9,030) and longitudinal surveys (n = 1,642) were conducted using a non-probability sampling method. In addition to the DASS-21, the Chinese version of Chinese Teachers' Job Burnout Questionnaire (CTJBO) was utilized to evaluate the criterion validity of this scale. Three different approaches, namely confirmatory factor analysis, Rasch analysis, and network analysis, were employed to evaluate internal reliability, construct validity, as well as time invariance of the DASS-21.

RESULTS

The DASS-21 demonstrated a high degree of internal consistency (Cronbach's α > 0.85) as well as excellent convergent validity, despite poor discriminant validity as determined by average variance extracted. Confirmatory factor analysis and network analysis further supported convergent validity. The three-factor structure outperformed one- and two-factor alternatives, establishing time invariance. Rasch analysis at the item level identified six inappropriate items within the anxiety and stress subscales, which were subsequently removed. Network analysis presented a better revised network. Regression analysis with emotional exhaustion as the criterion provided logical and accurate results.

CONCLUSION

The DASS-21 was found to be a reliable and valid tool for measuring the mental health of teachers over time. To assess the instrument's psychometric properties, a combination of confirmatory factor analysis, Rasch analysis, and network analysis was utilized, which proved effective and is recommended for evaluating contentious instruments. Based on the results of the study, researchers and healthcare professionals are recommended to use the DASS-21 for assessing teachers' psychological distress. However, certain items identified in the study may need to be removed to enhance the instrument's appropriateness for this specific population.

Self-rated health (SRH), recovery from work, fatigue, and insomnia among commercial pilots concerning occupational and non-occupational factors

Background

This study investigated associations of self-rated health (SRH), recovery from work, fatigue, and insomnia with working conditions, the psychosocial work environment, lifestyle, and sense of coherence (SOC) among commercial pilots.

Methods

A standardized questionnaire was sent to all pilots in an airline company, of whom 354 (61%) responded. Associations were analyzed via ordinal and logistic regression with mutual adjustment.

Results

Overall, 21.8% of participants reported low SRH, 13.0% reported not recovering from work during their free time, 61.9% experienced fatigue, and 70.6% experienced insomnia symptoms. A high level of demand at work was associated with poor SRH and more fatigue, and low social support at work was associated with insomnia and poorer recovery from work. Habits surrounding exercise and BMI were associated with SRH. Part-time pilots and captains reported experiencing better recovery from work than their counterparts, while female pilots and younger pilots reported less fatigue. Amount of free time after work and the type of airplane operated were associated with experience of insomnia symptoms. Finally, having a strong sense of coherence was protectively associated with all health outcomes.

Conclusion

The psychosocial environment at work is essential for the health of pilots, and a strong sense of coherence can be protective. Occupational conditions may influence recovery from work, fatigue, and insomnia. Moreover, engaging in exercise, maintaining a healthy weight, working part-time, and having more free time after the working day could improve pilots' health.

Promoting health literacy and sense of coherence in primary care patients with long-term impaired work ability-a pilot study

OBJECTIVE

Evaluate feasibility, partnerships, and study design of intervention to minimise sick leave.

DESIGN AND SETTING

The design was a pilot single arm intervention study in primary health care. Outcome measures at follow-ups for each participant were compared with baseline data for the same person.

SUBJECTS

Twenty primary health care patients with recurrent or long-term sick leave or health-related unemployment.

INTERVENTION

Patient education through interactive study groups that met half a day a week for eight subsequent weeks. Groups were led by experienced but not medically trained facilitators. The intervention was designed to improve participant health literacy, sense of coherence, health-related quality of life, and patient involvement in healthcare.

MAIN OUTCOME MEASURES

Primary outcome was the level of sick leave. Sick leave data were obtained from medical records when available, otherwise patient reported. Secondary outcomes regarding health literacy, sense of coherence, and health-related quality of life were measured with validated questionnaires at baseline and follow-ups.

RESULTS

Level of sick leave decreased significantly and participation in work preparatory activities increased during follow-up. Health literacy, sense of coherence (subscale sense of meaningfulness), and health-related quality of life (subscale social functioning) showed statistically significant improvement. Intervention, partnerships, and study design were feasible.

CONCLUSION

An educational programme, conducted in cooperation between primary health care and partners outside the healthcare system, was feasible and showed an impact on sick leave, health literacy, sense of coherence, and health-related quality of life.KEY FINDINGSA pilot study to evaluate an educational programme with study groups conducted in cooperation between primary health care and partners outside the healthcare system showed good feasibility.Sick leave decreased significantly six months after baseline.Health literacy, sense of coherence (subscale sense of meaningfulness), and health-related quality of life (subscale social function) improved significantly 6 months after baseline.

Stress, Burnout, Anxiety and Depression among Teachers: A Scoping Review

BACKGROUND

Worldwide, stress and burnout continue to be a problem among teachers, leading to anxiety and depression. Burnout may adversely affect teachers' health and is a risk factor for poor physical and mental well-being. Determining the prevalence and correlates of stress, burnout, anxiety, and depression among teachers is essential for addressing this public health concern.

OBJECTIVE

To determine the extent of the current literature on the prevalence and correlates of stress, burnout, anxiety, and depression among teachers.

METHOD

This scoping review was performed using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). Relevant search terms were used to determine the prevalence and correlates of teachers' stress, burnout, anxiety, and depression. Articles were identified using MEDLINE (Medical Literature Analysis and Retrieval System Online), EMBASE (Excerpta Medica Data Base), APA PsycINFO, CINAHL Plus (Cumulative Index of Nursing and Allied Health Literature), Scopus Elsevier and ERIC (Education Resources Information Center). The articles were extracted, reviewed, collated, and thematically analyzed, and the results were summarized and reported.

RESULTS

When only clinically meaningful (moderate to severe) psychological conditions among teachers were considered, the prevalence of burnout ranged from 25.12% to 74%, stress ranged from 8.3% to 87.1%, anxiety ranged from 38% to 41.2% and depression ranged from 4% to 77%. The correlates of stress, burnout, anxiety, and depression identified in this review include socio-demographic factors such as sex, age, marital status, and school (organizational) and work-related factors including the years of teaching, class size, job satisfaction, and the subject taught.

CONCLUSION

Teaching is challenging and yet one of the most rewarding professions, but several factors correlate with stress, burnout, anxiety, and depression among teachers. Highlighting these factors is the first step in recognizing the magnitude of the issues encountered by those in the teaching profession. Implementation of a school-based awareness and intervention program is crucial to resolve the early signs of teacher stress and burnout to avoid future deterioration.

Small business managers and Covid-19-The role of a sense of coherence and general resistance resources in coping with stressors

BACKGROUND

The response of small business managers to an external event such as the pandemic can have a profound effect on the work environment, health and well-being for themselves and their employees. Previous research on small business managers during the pandemic has mainly focused on traditional pathogenic effects, and there is a lack of studies looking at the issue from a salutogenic health promotion perspective. The aim of this study is to explore whether a sense of coherence and general resistance resources were experienced by small business managers in Sweden and Norway during the Covid-19 pandemic.

METHODS

A qualitative design was applied through exploratory interviews with 16 managers of small businesses in Sweden and Norway. A content analysis of the interviews was conducted using the sense of coherence concept by Aaron Antonovsky, with the three main components of comprehensibility, meaningfulness and manageability acting as a conceptual framework for the analysis process.

RESULTS

Within the three main sense-of-coherence categories, six general resistance resources were identified as being important for the managers to handle uncertainty during the pandemic. These were understanding rules and regulations, social support, optimism, proactivity, problem-solving and flexibility and cooperation.

CONCLUSIONS

The small business managers handled the pandemic in a way that worked well in their contexts, and the pandemic generally did not have a negative effect on their businesses or themselves. A salutogenic approach, through which the managers focused on identifying and using resources, was an important factor for managing stressors and adversity during the pandemic. Hence, the concept of salutogenesis may be used as an intervention to foster better health in small businesses, both at a personal and organisational level in order to handle future challenges effectively.