Tatiane Isabela de Araújo Leite1; João Paulo Costa Fernandes2; Fernanda Letícia da Costa Araújo1; Xiankarla de Brito Fernandes Pereira1; Dulcian Medeiros de Azevedo3; Eudes Euler Souza Lucena4
BACKGROUND: Burnout is one of the main examples of health disorders directly related to work. This is a psychological syndrome that results from exposure to stressors in the workplace and represents a considerable psychosocial problem.
OBJECTIVE: To establish the prevalence of and factors associated with burnout among professors at public and private universities.
METHODS: We administered two self-report questionnaires—one for sociodemographic, psychosocial, occupational and health-related data, and the other based on the Maslach Burnout Inventory-Educators Survey—to professors at four public and private universities in Caicó, Rio Grande do Norte, Brazil. We subjected the data to univariate and bivariate analysis and also fitted a logistic regression model.
RESULTS: About 60% of the participants were categorized as in the earliest stage of burnout syndrome. Having a chronic disease and teaching a large number of courses were the only variables significantly associated with burnout. The average score on domain depersonalization was significantly higher among the participants who had a second job, those who reported to need professional updating and the ones who taught a large number of courses. The average score on domain emotional exhaustion was higher among the participants with some chronic disease and those with high blood pressure.
CONCLUSION: The prevalence of burnout was high in the analyzed sample of university professors. Early detection of burnout symptoms might favor early treatment.
Keywords: Burnout, psychological; prevalence; teaching; education, higher.
INTRODUÇÃO: A síndrome de Burnout é um dos principais exemplos de distúrbio relacionado diretamente ao trabalho. Caracteriza-se como uma síndrome psicológica resultante da exposição a estressores presentes no contexto laboral e constitui relevante problema psicossocial.
OBJETIVOS: A pesquisa propôs identificar a prevalência e os fatores associados da síndrome de Burnout em docentes de universidades públicas e privadas.
MÉTODO: Foram utilizados dois instrumentos autoaplicados: um com questões sociodemográficas, psicossociais, ocupacionais e de aspectos relativos à saúde e outro baseado no Maslach Burnout Inventory Educators Survey em professores de quatro instituições públicas e privadas do município de Caicó, Rio Grande do Norte, Brasil. Foram feitas as análises univariada e bivariada, bem como criado um modelo de regressão logística.
RESULTADOS: Observou-se que 61,6% dos docentes encontravam-se na fase inicial da síndrome. A presença de doenças de base e o elevado número de disciplinas foram as únicas variáveis associadas significativamente com a ocorrência de Burnout. As médias dos escores de despersonalização foram significativamente maiores em docentes que tinham outra ocupação, que relataram necessidade de atualização profissional e com número elevado de disciplinas. As médias dos escores de exaustão foram maiores nos professores com doença prévia e hipertensos.
CONCLUSÕES: Este estudo demonstrou que a prevalência da síndrome de Burnout nos professores universitários no município de Caicó, Rio Grande do Norte, é relativamente alta. A detecção precoce de níveis sintomáticos de Burnout pode ser um bom indicador de possíveis tratamentos precoces.
Palavras-chave: Burnout; prevalência; docência; ensino superior.
Data gathered by the Brazilian National Institute of Social Security indicate that mental and behavioral disorders were the third leading cause of incapacity for work in the country, with a total of 668,927 cases in the period from 2012 to 2016. In addition, these conditions represented about 9% of the total number of granted sick pay and disability retirement benefits1. Stress, characterized as a state of tension that causes serious imbalance in the body, is one of the most common problems for human beings. Due to its consequences, occupational stress is a subject of discussion in the academic milieu, governmental agencies, organizations and trade unions2.
Stress is part of the set of health problems which affect several occupational groups, including university professors. It arises from increased tension at work, in turn derived from violence in classrooms, physical exhaustion, poor working conditions and lack of material resources, in association with increasing responsibilities3. Indeed, professors have little time to perform their tasks, additional training, leisure activities and social life4. Given the nature and context of the professors’ job, when stressors persist they are likely to cause burnout.
Burnout syndrome is defined as a set of signs and symptoms related to chronic occupational stress and corresponding to three aspects: emotional exhaustion, depersonalization and reduced personal accomplishment5. This is an individual and long-lasting process that might extend over many years, even decades, with gradual increase in severity. Affected individuals often do not perceive their condition, but on the contrary, they refuse to believe they have fallen to burnout.
Occurrence of burnout among healthcare and social science workers is one of the main focus of interest for researchers, while several studies clearly indicate that teaching is one of the occupations most exposed to burnout. As a result, more studies are needed to establish the impact of burnout on this population, as well as the teachers’ personal characteristics associated with this syndrome6.
As of lately, university professors are not only required to deliver classroom lectures, but they also have many other duties, including research activities, organizing workshops and seminars and supervising trainees and other programs for development7.
Based on the notion of burnout and the current conditions of the teaching profession in Brazil, our aims in the present study were to establish the prevalence of and factors associated with burnout among professors at public and private universities and to analyze the relationship of burnout domains with sociodemographic, psychosocial, occupational and health-related variables.
The present cross-sectional, descriptive and quantitative study was conducted at four universities (two public and two private) in Caicó, Rio Grande do Norte, Brazil. The study population consisted of tenured and non-tenured professors who performed their tasks on a regular basis. Professors in training, sabbatical or maternity leave were excluded.
Data collection was performed through an ad hoc self-report questionnaire with four sections:
demographic data: sex, age, marital status, number of children;
occupational variables: academic degrees, length in the profession, length in the current job, approximate number of students with daily interaction, single job, teaching as main occupation and residing in the same municipality as the university premises;
psychosocial variables: need for professional updating, administrative tasks, multiple roles, teaching a large number of courses, availability of specialized medical follow-up, adequate and large classrooms, sufficient audiovisual resources, incentives for additional training, inclusivity and accessibility;
general health: family history, chronic diseases (yes/no and which — cardiovascular diseases and/or diabetes).
We also administered a self-report questionnaire based on the Maslach Burnout Inventory-Educators Survey (MBI-ES), developed by Christina Maslach to analyze burnout among educators. This questionnaire comprises 22 questions with five response options (Likert scale, 1 to 5) distributed across the three domains of burnout: emotional exhaustion, depersonalization and reduced personal accomplishment8.
The sample size was calculated based on an estimated prevalence of burnout, namely the proportion of individuals with this condition (50%). For a population of 150 professors, error margin of 15% and non-response rate of 20%, the calculated sample size was 79 participants. Participants were recruited by convenience sampling.
A database was developed with software STATA 10.0 (Stata-Corp College Station, Texas, USA) and the consistency of the entered data was verified. We subjected the data relative to sociodemographic, occupational, psychosocial and health-related variables to descriptive (univariate) analysis.
The association between average scores on burnout domains and sociodemographic, occupational, psychosocial and health-related variables was analyzed by means of Student’s t-test. In all cases, the significance level was set to 5%. The association between burnout and sociodemographic, occupational, psychosocial and health-related variables was analyzed by means of the χ2 test (bivariate analysis). Burnout was defined as present when the global score was ≥56 (median) and represented the primary analyzed outcome.
Multivariate analysis involved fitting a logistic regression model by means of hierarchical analysis to estimate prevalence ratios adjusted for the following variables: having a chronic disease, number of students with daily interaction, single job and teaching a large number of courses. The independent variables were entered individually and hierarchically, considering p=0.07 as cut-off point. Permanence of variables in the model was established according to the results of the likelihood, multicollinearity and Hosmer-Lemeshow tests. In all the cases the significance level was set to 5%.
The study was approved by the research ethics committee of State University of Rio Grande do Norte, Brazil, ruling no. 725,711. The participants manifested agreement to participate by signing an informed consent form. The participants’ ethical rights were safeguarded as required by the National Health Council Resolution no. 466/129.
The sample comprised 100 professors from four (public and private) universities in Caicó, 50.5% of whom were female. The participants’ age ranged from 23 to 59 years old; women predominated within age range ≤37 years old, and men within age range ≥38 years old. The largest proportion of participants had a master’s degree (39.2%). The participants had 12 years, on average, of experience in the profession, and six years, on average, in the current job. About 59.8% of the participants worked full time, teaching was the main occupation for 80.4%, they interacted daily with about 37 students, on average, and 56.7% resided in the same municipality as the university premises.
About 92.8% of the participants reported needing professional updating, 63.9% had multiple roles and 22.7% taught a large number of courses. Most of the sample (70.1%) described their institution as inclusive, however, with limited accessibility (61.9%). According to the participants, classrooms were large and adequate (70.1%), audiovisual resources were sufficient (69.1%) and they received incentives for further training (66.0%). Yet 73.2% of the sample observed there was not specialized medical follow-up available to them. Most participants did not report any chronic disease (75.3%), 50.5% reported family history of high blood pressure, 34.0% of cardiovascular diseases and 30.9% of diabetes.
According to the scores on the burnout domains, 61.6% of the participants were categorized as in early stages of burnout, 35.3% as at syndrome onset and 2.1% as with possible burnout, while only 1.0% did not exhibit any indication of burnout. Average scores were: emotional exhaustion — 17.00, depersonalization — 5.00 and reduced personal accomplishment — 32.00 (Table 1).
The average score on domain depersonalization was significantly higher among the participants who reported that teaching was not their main occupation (p=0.33), to require updating (p=0.016) and who taught a large number of courses (p=0.40). The average score on domain emotional exhaustion was significantly higher among the participants with some chronic disease (p=0.049) and high blood pressure (p=0.024) (Table 2).
Burnout was defined as present when the global score was ≥56 (median) and represented the primary outcome on bivariate and multivariate analysis. Variables number of students in the classroom and single job were significantly associated with burnout (p=0.042 and p=0.067, respectively). Number of courses taught exhibited weak association with burnout (p=0.065). In turn, having some chronic illness (diabetes or cardiovascular disease) was significantly associated with burnout (p=0.039) (Table 3).
Upon including the aforementioned sociodemographic, occupational, psychosocial and health-related variables into the multivariate model, only having some chronic disease (p=0.019) and teaching a large number of courses (p=0.042) were significantly associated with the outcome, being that burnout was independently more frequent among the participants with some chronic disease and teaching a large number of courses (Table 4).
Stress is part of the life of most people as a function of their daily work routine and commitments, and may manifest variably, e.g. as cardiovascular problems, psychiatric disorders or behavioral changes10. Among university professors, burnout is a complex and multidimensional phenomenon that results from the interaction of individual aspects with the work environment11. The participants in the present study exhibited high levels of burnout (total score 41 to 60) — indicative of the early stage of this syndrome.
In addition, the domain scores indicate that the participants could, indeed, feel distress in relation to their daily task of caring for others, since they were compelled to work in a state of physical and mental exhaustion. Acknowledging this situation is necessary for institutions to identify and tackle the determinants of burnout before it develops12.
Similar findings were reported by Gonçalves et al.13, who analyzed the prevalence of burnout among professors teaching first to fourth year courses at the undergraduate medical program of State University of Pará, Brazil, in 2011. According to these authors, the prevalence of burnout varies considerably among studies as a function of the population assessed and the cut-off points selected. A study with university professors in João Pessoa, Paraíba, Brazil, reported relevant findings: 43.4% of the participants exhibited poor levels of personal accomplishment14, which rate agrees with that found in the present study.
Most participants had a master’s degree. According to Wang et al.11, there is no clear reason to assume that burnout might be related to academic degrees. One possible reason for burnout to appear at the onset of an institutional career is the inability of subjects to deal with difficulties15. As a rule, young professionals still need to learn how to cope with the work demands and to develop skills and relational maturity16.
None of the analyzed sociodemographic variables was associated with the primary outcome. When present, sex differences might be due to three reasons: family duties, type of occupation and the influence of sex on socialization, and the largest participation of women in household chores and child care and their concern with the wellbeing of others15.
Burnout was more frequent among the participants who taught a large number of courses. The job demands grow together with the number of students, with consequent increase of the susceptibility to burnout. Long daily working hours, teaching large numbers of courses and students, pressure to provide high-quality teaching (since the sample was of university professors) and intensive student/professor interaction contribute to cause exhaustion, which in turn may trigger burnout15.
Most professors in Brazil have a double burden, work long hours and have more than one job, which situation characterizes work overload3. In the course of the teaching career, long daily working hours contribute to cause exhaustion and consequent burnout. Work overload might be due to lack of skills, even though high workloads are not unusual in the present time5.
Depersonalization is the result of negative, sometimes indifferent and cynical feelings and attitudes toward individuals within the work environment. While it behaves as a protective factor, depersonalization might lead to dehumanization, and represents the interpersonal aspect of burnout. The average score on domain depersonalization was higher among the participants for whom teaching was not the main occupation, reported need for updating or taught a large number of courses.
Having some chronic disease was significantly associated with burnout. In a study of the determinants of the health/disease process among primary school teachers in São Paulo, Brazil, Santos17 found that long years in the teaching profession, excessive number of students, exhausting working hours, additional responsibilities transferred to schools, reduced capacity for work and professional undervaluation contributed to cause illnesses among teachers, high blood pressure in particular.
Emotional exhaustion is characterized by a strong feeling of emotional tension, which causes a feeling of exhaustion, of lack of energy and of lack of emotional resources to cope with the work routine. It represents the individual aspect of burnout and is the first to manifest. In the present study, the participants with some chronic disease or high blood pressure exhibited the highest average scores on this domain.
Identifying the profile and early signs of burnout is crucial to implement preventive interventions11. Avoiding work-related diseases and deaths is possible, and thus one cannot passively admit work as a cause of disease, with consequent impact on the duration and quality of life18.
University staffs should be aware of stressors and their impact on performance to establish adequate measures to minimize them and reorganize their actions19. The tasks of university professors include teaching as such, administration and research, which are valued differently and at times represent sources of conflict, given that teaching does not always receive the due recognition20.
Additional studies should be conducted in Brazil to further the knowledge on the influence of individual and environmental variables on phenomena which interfere with the health of workers.
The results of the present study evidence that the prevalence of burnout among the analyzed university professors in Caicó was high. Variables teaching a large number of courses and having some chronic disease were significantly associated with burnout. Teaching not being the main occupation, need for professional updating and teaching a large number of courses were associated with the highest average scores on domain depersonalization. In turn, having a chronic disease and high blood pressure were associated with the highest average scores on domain emotional exhaustion.
Early detection of burnout symptoms might be an accurate indicator of possible problems, thus enabling preventive interventions and the implementation of coping measures.
We thank all four higher education institutions involved in the present study.
1. Brasil. Ministério da Fazenda. 1º Boletim Quadrimestral sobre benefícios por Incapacidade. Adoecimento Mental e Trabalho: A concessão de benefícios por incapacidade relacionados a transtornos mentais e comportamentais entre 2012 e 2016 [Internet]. Brasília: Ministério da Fazenda; 2017 [acessed on Dec. 17, 2018]. Available at: http://sa.previdencia.gov.br/site/2017/04/1%C2%BAboletim-quadrimestral.pdf
2. Borsoi ICF. Trabalho e produtivismo: saúde e modo de vida de docentes de instituições públicas de Ensino Superior. Cad Psicol Social Trabalho. 2012;15(1):81-100. http://doi.org/10.11606/issn.1981-0490.v15i1p81-100
3. Carlotto MS. Síndrome de Burnout em Professores: Prevalência e Fatores Associados. Psic Teor Pesq. 2011;27(4):403-10. http://dx.doi.org/10.1590/S0102-37722011000400003
4. Tabeleão VP, Tomasi E, Neves SF. Qualidade de vida e esgotamento profissional entre docentes da rede pública de Ensino Médio e Fundamental no Sul do Brasil. Cad Saúde Pública. 2011;27(12):2401-8. http://dx.doi.org/10.1590/S0102-311X2011001200011
5. Maslach C. Understanding Job Burnout. In: Rossi AM, Perrewe PL, Sauter SL. Stress and quality of working life. Current perspectives in Occupational Health Psychology. Greenwich, Connecticut: Age Publishing; 2006. p. 37-51.
6. Llorent VJ, Ruiz-Calzado I. Burnout and its relation to sociodemographic variables among education professionals working with people with disabilities in Córdoba (Spain). Ciênc Saúde Coletiva. 2016;21(10):3287- 95. http://dx.doi.org/10.1590/1413-812320152110.00732015
7. Rajak R, Chandra B. Exploring Predictors of Burnout and Work Engagement among Teachers - A Review on Higher Educational Institutions of India. JIAAP. 2017;43(1):145-56.
8. Maslach C, Jackson SE, Leiter MP. Maslach burnout inventory manual. 3rd ed. Palo Alto, California: Consulting Psychologists Press; 1996.
9. Brasil. Ministério da Saúde. Resolução nº 466/12, sobre pesquisa envolvendo seres humanos. Conselho Nacional de Saúde. Brasília; 2012.
10. Lima CRC, Sepúlveda JLM, Lopes PHTNP, Farjado HSR, de Sousa MM, Ferreira Júnior MC, et al. Prevalence of burnout syndrome among military physicians at a public hospital in Rio de Janeiro, Brazil. Rev Bras Med Trab. 2018;16(3):287-96. http://dx.doi.org/10.5327/Z1679443520180297
11. Wang Y, Ramos A, Wu H, Liu L, Yang X, Wang J, et al. Relationship between occupational stress and burnout among Chinese teachers: a cross-sectional survey in Liaoning, China. Int Arch Occup Environ Health. 2015;88(5):589-97. http://dx.doi.org/10.1007/s00420-014-0987-9
12. Sobral RC, Stephan C, Bedin-Zanatta A, De-Lucca SB. Burnout and work organization in Nursing. Rev Bras Med Trab. 2018;16(1):44- 52. http://dx.doi.org/10.5327/Z1679443520180127
13. Gonçalves TB, Leitão AKR, Botelho BS, Marques RHCC, Hosoume VSN, Neder PRB. Prevalence of burnout syndrome in physicians professors of a Brazilian public university. Rev Bras Med Trab. 2011;9(2):85-9.
14. Batista JBV, Carlotto MS, Coutinho AS, Augusto LGS. Prevalência da Síndrome de Burnout e fatores sociodemográficos e laborais. Rev Bras Epidemiol. 2010;13(3):502-12. http://dx.doi.org/10.1590/S1415-790X2010000300013
15. Costa LST, Gil-Monte PR, Possobon RF, Ambrosano GMB. Prevalência da síndrome de Burnout em uma amostra de professores universitários brasileiros. Psicol Reflex Crít. 2013;26(4):636-42. http://dx.doi.org/10.1590/S0102-79722013000400003
16. Gavish B, Friedman IA. Novice teachers’ experience of teaching: A dynamic aspect of burnout. Soc Psychol Educ. 2010;13(2):141-67. http://dx.doi.org/10.1007/s11218-009-9108-0
17. Santos R. O professor e a produção do conhecimento numa sociedade em transformação. Rev Espaço Académico. 2004;35:28-36.
18. Andrade PS, Cardoso TAO. Prazer e Dor na Docência: revisão bibliográfica sobre a Síndrome de Burnout. Saúde Soc. 2012;21(1):129-40. http://dx.doi.org/10.1590/S0104-12902012000100013
19. Yusoff R, Khan F. Stress and Burnout in the Higher Education Sector in Pakistan: a Systematic Review of Literature. Res J Recent Sci. 2013;2(11):90-8.
20. Rodríguez-García AM, Sola-Martínez T, Fernández-Cruz M. Impacto del Burnout en el desarrolo professional del profesorado universitario. Una revisión de la investigación. Rev Elect Interuniversitaria Formación Profesorado. 2017;20(3):161-78. http://dx.doi.org/10.6018/reifop.20.3.275121
30 de Janeiro de 2019.
Aceito em 10 de Junho de 2019.
Fonte de financiamento: nenhuma