Teacher Stress and Burnout: Implications for School Health Personnel

Philip A. Belcastro, Robert S. Gold

ABSTRACT Recent literature indicates teachers experience considerable stress in the

workplace, and that such stress is associated with an increased frequency of physical illnesses and somatic complaints. This study was conducted to identify the relationship between reported levels of stress and somatic complaints and selected illnesses. The Maslach Burnout Inventory and the Teacher Somatic Complaints and Illness Inventory were distributed to 428 teachers in public tchools in Southern Illinois. The MBI yields data allowing classification of teachers into two groups according to degrees of work related stress. A discriminant analysis was performed to examine the ability to discriminate between these groups based on their reported patterns of somatic complaints and illnesses. More than 1 I % of those responding to the study were clarsified as burned out according to conservative criteria for classification. The conclusion that burnout represents a health risk to teachers in this study has implications for school health personnel. Since school health personnel have experience in educating people about physiological and psychological factors that threaten health, and have experience in motivating individuals to take positive action regarding their health, they can provide teachers with information and skills to cope with occupational stress.

Historically, school health personnel have been con- cerned with the many factors that have an impact upon their students’ health. The school health program is, in itself, a complex network of professionals in various disciplines laboring to maintain and improve the health of students. However, during the past few years there has been growing concern about the effects of the teaching environment on the quality of teachers’ health. A review of the literature has indicated that teachers are experiencing stress, anxiety, job dissatisfaction, physi- cal illness, mental illness and emotional exhaustion. With this in mind, one may ask whether the profession of education entails significant health risks to teachers.

Since the early 1970’s there has been a great deal of concern in academia about the prevalence and potential- ly detrimental effects of stress. It was Selye,’ with his articulation of stress as a “general adaptation syn- drome” who was responsible for the popularization of the term stress. Selye‘ theorized that the body’s psycho- logical response to a stimulus is specific to that stimulus. However, Selye speculated there is a constant physio- logical response by the body that remains the same to all stimuli. He called this constant physiological response to varied stimuli, stress.

Selye’s description does not, however, represent a consensus among researchers. There are other widely

accepted views that also should be considered. Some view stress as the stimuli or external force acting on an individual, while others interpret stress in multivariable environmental terms. The latter view of stress is a broader term, encompassing the range of interdepend- ent factors that include not only stimuli and response, but also the intervening psychological and experimental factors that ultimately determine stimulus-response relationships.

BURNOUT Whether stress is variously defined to mean a re-

action, force or combination of environmental factors, burnout is more specifically interpreted to mean a manifestation of stress. Burnout is often characterized by a lack of enthusiasm for one’s job, apathy, aliena- tion and dissatisfaction. The terms stress and burnout often are used interchangeably, although we see stress as a more general term and burnout as evidence of work- related stress.

Maslach’ defined burnout as the “loss of concern for the people with whom one is working,” while Cherniss6 suggests that burnout is defined as the psychological withdrawal from work in response to related excessive stress or dissatisfaction. Burnout, then, is characterized by lack of enthusiasm and drive in one’s work.

Regardless of speculation concerning the etiology of burnout, there are three major elements that school health personnel can single out. First, the primary causal factor of burnout is hypothesized to be the inherent stress of one’s job. Second, burnout decreases the capacity of an educator to perform. Third, burnout is thought to produce various somatic complaints, physical illnesses and emotional problems in profes- sionals.

Related to these three major elements, there is an in- creasingly large body of literature that suggests teachers are experiencing greater and more potent doses of

The purpose of the current study was to:

404 JOSH September 1983, Vol. 53, No. 7

I ) identify the extent of burnout among teachers; and 2) examine the degree of association between burnout and teachers’ somatic complaints and illnesses.

PROCEDURES

Study Sample The data reported in the current study are based on a

sample of convenience that consisted of about 84% of the participants at an areawide institute for public school teachers in Southern Illinois. The institute was an annual event for the school district. The district’s teachers were not aware they would be asked to participate in the present study until they arrived at the institute’s site. The respondents represented approximately 75% of all the teachers employed in that school district.

In all, there were 428 respondents. Since the current study was concerned with teachers whose primary responsibility was classroom instruction, 69 response sets were removed from analysis because only part of their time was spent teaching. The 359 remaining respondents reported that 65% or more of their responsibility involved direct classroom instruction. This final study sample represented approximately 63.9% of the teachers in that district.

instrumentation Maslach Burnout Inventory (MBI) - The MBI was

used as the criterion measure for the identification of teachers who were burned out (BOT) and those who were not burned out (NBOT). The MBI is a 25-item instrument with four theoretical subscales: emotional exhaustion (9 items); depersonalization ( 5 times); personal accomplishment (8 items): and personal involvement (3 items). The first three factors (22 items) are used for classification purposes. High degrees of burnout are reflected in high mean scores on the emotional exhaustion and depersonalization scales and low mean scores on the personal accomplishment scale. The fourth subscale does not contribute significantly to the ability of the MBI to provide a valid criterion measure of burnout.

MaslachI2 estimated the internal consistency of the MBI by Cronbach’s Alpha. Reliability coefficients of .76 (frequency) and .81 (intensity) were found for the subset of 22 items used as the criterion measure.

Teacher Somatic Complaint and Illness Inventory (TSCII) was designed to measure the frequency and intensity of somatic complaints and the presence or absence of illness in teachers. An initial reivew of the

literature was used to identify those somatic complaints and illnesses most frequently associated with burnout and/or teacher stress. Subsequently, all somatic complaints and illnesses believed to be associated with burnout were incorporated into the TSCII.” During its development, Cronbach’s Alpha was computed for the TSCII as an index of internal consistency for a population of Ohio parochial school teachers and yield- ed an estimated reliability coefficient of 39 . A post hoc assessment of reliability based on the current data yielded a coefficient of .91.

RESULTS

Characteristics of the Study Group Classification of the 359 teachers into one of the two

burnout categories was accomplished by computing mean scores for each teacher on the three subscales of the MBI and comparing these means to the standards established by Maslach for the instrument. Teachers who scored above the normative mean on the emotional exhaustion (?i = 3.33, SD = 1.51) and depersonaliza- tion (Sr = 2.13, SD = 1.52) MBI subscales and below the mean on the personal accomplishment (W = 5.02, SD = 1.12) MBI subscale were placed in the burned-out teachers (BOT) group. Teachers who failed to score above the normative mean on either or both of the emotional exhaustion and depersonalization MBI sub- scales and/or below the mean on the personal accom- plishment MBI subscale were placed in the nonburned- out teachers (NBOT) group.

Based upon these criteria, 246 (68.5%) of the teachers were placed in the nonburned-out group (NBOT), and 40 (1 1.1 Vo) in the burned-out group (BOT). The remain- ing 73 teachers (20.3%) could not be classified because of missing data in the MBI.

The mean scores for the full set of respondents among those surveyed on the emotional exhaustion (x = 2.44, SD = 1.16), depersonalization (x = 1.61, SD = 1.15), and personal accomplishment ( x = 4.39, SD = .96) MBI subscales were lower than those in Maslach’s norming population. Based upon the MBI constructs, the 40 burned-out teachers appear to represent a con- servative estimate of the extent of actual burnout among the study sample.

Illnesses Teachers who were and were not burned out were

compared for the presence of 12 illnesses, including cardiovascular disorders, ulcers, hypertension, colitis, kidney disorders, both benign and malignant tumors,

JOSH September 1983, Vol. 53, No. 7 405

hypertension, gall bladder disorders, gastroenteritis, migraine headaches and depression. Teachers were asked to indicate if they had ever been diagnosed as having a particular illness, and if so, whether it had developed before or after they became a teacher. They were instructed to indicate the presence of an illness only i f i t had been diagnosed by a physician.

Based on the data collected, there were no significant differences in the patterns of illness between the two groups, however, the pattern of responses concerning diagnosed depression was borderline (x2 = 5.96, 2 df, p e .051).

Discriminant Analysis The data on the frequency and intensity of somatic

complaints were subjected to a stepwise discriminant analysis procedure to test their ability to distinguish between the two teacher groups (NBOT and BOT). Table 1 contains a review of the results of classification of the subjects using the discriminant function pro- duced. The total discriminant analysis (36 steps) resulted in a canonical correlation coefficient of .65 and a level of significance beyond the ,001 level, and with it, 90.9% of the grouped cases in the study sample could be correctly classified (Table 1). A canonical correlation of .65 indicates that 42.3% of the variance was shared between the patterns of somatic compIaints and the MBI constructs of burnout. The strength of this rela- tionship indicates that these results would be obtained consistently over time. The first eight somatic com- plaints that entered the stepwise classification were responsible for 30% of the shared variance between the study variables. These somatics complaints were tightening of muscles, bowel difficulties, tinnitus, warts, allergic reaction to something in the air, loss of voice, allergic reaction to food and difficulty breathing.

Table 1 Discriminant Analysis Classification Results of Groups

(Stepwise Variable Selection)

I P r r ~ ~ . n t o t "Grouped" Cases Correctly Classified: 90.9%

DI SC U SSI O N The primary purpose of the present study was to

examine patterns of somatic complaints reported by teachers and to identify any that might have been associated with the burn-out syndrome. The first eight somatic complaints of the discriminant analysis accounted for the majority of shared variance between teachers' pattern of somatic complaints and the MBI constructs of burnout. In each case, the data indicated that the burnout group suffered these somatic com- pIaints at either a greater frequency, or with greater intensity than did the group of teachers who were not burned out.

With knowledge of these and other significant dis- criminating variables, 95.1 To of nonburned-out teachers could be correctly identified. At the same time, 65.0% of the burned-out teachers could be identified solely on the basis of their responses concerning the significant somatic complaints. With an overall accuracy of predic- tion of group membership of 90.9%, it appears these somatic complaints are indeed significant discriminating variables between burned-out teachers and teachers who are not burned out.

This paper's second major purpose was to examine the relationship between burnout and the occurrence of some specified diagnosed illnesses. In this case, only depression approached levels indicating significant dif- ferences in observed patterns between teachers who were and were not burned out, A more thorough test of this construct might include the corresponding adminis- tration of the Maslach Burnout Inventory and a stand- ardized measure of depression.

Overall, it can be reported that more than 1 1 Yo of the teachers in the current study were burned out according to conservative guidelines. Among the burned-out public school teachers there was a greater frequency and/or intensity of several reported somatic complaints. One may conclude that teacher burnout represents a condition associated with some potential health risks to the teachers studied. I t appears much of the current concern is warranted, not only because of the numbers of teachers who may be involved, but also because of the potential impact of burnout on these teachers' physiological and psychological well-being. The impli- cations for school health personnel should be apparent.

School health personnel can play a key role in developing, implementing and evaluating early detec- tion and prevention in in-service programs regarding teacher stress and burnout. Their expertise also can be an invaluable asset to the re-evaluation of teacher preparation programs in universities and colleges. School health personnel also can play a supporting role

~~ ~~

406 JOSH September 1983, Vol. 53, No. 7

for the teachers experiencing high levels of stress on the job.

Establishing an interdisciplinary approach for the remediation of teacher stress seems to be the most promising approach to addressing this health concern, successfully. School health personnels’ professional preparation and expertise provide several advantages for the remediation of teacher stress. Specifically, these professionals are trained in detecting and educating individuals about the physiological and psychological factors that threaten and enhance one’s overall health. In addition, they have skills in motivating individuals to take positive action toward those variables that improve their well-being and quality of life. Finally, some school health personnel have been trained as teachers and therefore have additional insights into the dynamics of teaching and teacher stress.

One must keep in mind that the detection and treat- ment of teacher stress is by no means as straight forward as some of our more blatant organic diseases. The con- structs of burnout are based in fragile theoretical frameworks that await empirical support. Given the present level of knowledge, it seems that the labeling and rehabilitation of what both lay and professional people have termed burned-out teachers is a risky endeavor. It seems that prior to running educators through a collection of burnout workshops, significant- ly more research is required to first test the theoretical constructs of this condition dubbed burnout and then test the efficacy of various stress remediation techniques.

This is not to say that school health professionals 5hould not address job related stress and its impact upon workers. Clearly the literature supports the notion that occupational stress is a potential health risk to employees. There are scores of diseases that science pro- vides no cure, such as herpes or shingles. This, however, does not release health professionals from their obliga- tion to educate, research and observe the etiology of these maladies. Stress is no exception.

Thus, school health personnel can approach this health concern by: 1) taking a professional responsibil- i ty for addressing occupational stress; 2) assisting con- cerned individuals in achieving some degree of clarity regarding stress; and 3) constructing a network of

social personnel who experience high levels of occupa- tional stress.

The mobilization of school health personnel in addressing teacher stress may indirectly emphasize to school systems and communities the essential role of the school health program. By school health personnel addressing teacher stress the role of the school health program will be reaffirmed as a service dedicated to the students, school personnel and the community in which they reside. To these ends, it seems teacher stress and burnout are worthy of school health personnel’s atten- tion.

References

I . Belcastro PA: Burnout and its relationship 10 teachers’ \ornalic

2. Justice B, Gold RS, Klein JP: Life events and burnout: Ps-vch

3 . Selye H: Thestress of life. New York. McGraw-Hill. 1956. 4. Selye H: Stress without distress. New York, Lippencott. 1974. 5. Maslach C: Burned-out. Hum Beh 5:16-22. 1976. 6. Cherniss C: Staff burnout: Job stress in the hutnan .services.

7. Dunham J et al: Stressin schools. Heme1 Hempstead: National

8. Kyriacou C. Sutcliffe J : Teacher stress and Satisfaction: Ed Re7

9. Sylwester R: Stress and the classroom teacher: Educ Digesl 42:14-17. 1977.

10. Simpson CJ: A study of teacher stress in adventist schools: (Doctoral dissertation, University of Oregon, 1980). Dissertatron A bstracis International, 2026-A.

I I . Truch S : Teacher burnout and what t o do about I ! . New York, Academic Therapy Publications, 1980.

12. Maslach C, Jackson S: Maslach burnout inwnrorv resuarch edifion. California Consulting Psychologists. Press, 1981.

13. Belcastro PA: The relationship between comatic complaint\ and illnesses of burned out and non-burned out teachers in secondarv Catholic schools: (Doctoral dissertation, The Ohio State University, 1980). Dissertation Abstracts International. 41:2948-A, 1981.

complaints and illnesses: Psych Rep 50, 1045-1046, 1982.

108, 219-226, 1981.

Beverly Hills, Sage Publication, 1980.

Association of School Masters, 1976.

21189-96, 1979.

Philip A . Belcastro, PhD, Assistant Professor and Robert S . Gold, PhD, DrPH, Professor, Department of Health Education, Southern Illinois University, Carbondale, IL 62901.

JOSH September 1983, Vol. 53, No. 7 407