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Occupational burnout is a multidimensional phenomenon that consists of three dimensions: emotional exhaustion (EE), depersonalisation/cynicism (DP), and a feeling of low personal accomplishment (PA) (1, 2, 3). Guseva Canu et al. (1), who have studied this phenomenon for many years, define it as “physical and emotional […] exhaustion due to prolonged exposure to work-related problems”. In fact, occupational burnout has been included in the 11th revision of the International Classification of Diseases (ICD-11) as a syndrome resulting from chronic workplace stress that has not been successfully managed (4). Even though it has been recognised as occupational disease in many countries of the European Union (5), there is still some controversy about whether it is an occupational disease (6).

Controversy or not, occupational burnout has many consequences on individual mental and physical health, work performance (7), and on economy in general (6, 8). Various authors have investigated this phenomenon in a wide range of occupations, and the first research in teacher population began in the 1980s and 90s (9, 10, 11). Teaching is often associated with high emotional demands and stress associated with heavy workload, poor working environment and pupil/ student behaviour, long working hours, covering for teacher shortages and absences, pressure of programme targets and inspections, workplace physical and mental violence or bullying by students, parents, or colleagues, which greatly contributes to the burnout syndrome (12, 13, 14, 15). Consequences include frequent presenteeism and/or absenteeism and/ or disrupted teacher-student rapport, which can have consequences on students’ mental health and academic achievements (16, 17).

The prevalence of occupational burnout in teachers varies between countries (18). In Lithuania, high emotional exhaustion was reported in 25.6 %, high depersonalisation in 10.6 %, and a feeling of low personal accomplishment in 33.7 % of teachers (19) In Sweden these percentages were 36 %, 11 %, and 21 %, respectively (20), and in Italy 19.5 %, 3.7 %, and as high as 55.3 %, respectively among primary school teachers (21). In contrast, in the Republic of Srpska (Bosnia and Herzegovina) the prevalence of occupational burnout seems much lower: 5.1 %, 3.8 %, and 22.3 %, respectively (22).

We noticed, however, that the study conducted in Bosnia and Herzegovina took place at the beginning of the school year (22), whereas other studies took place at the end or during the school year (9, 19, 23). Considering the lower prevalence of occupational burnout in the Bosnian study, we decided to test the hypothesis that occupational burnout varies as the school year progresses toward the end, and that differences in timing might account for some differences in findings between studies. We therefore repeated the survey with a new group of teachers from the same district at the end of the school year 2018/2019 and compared with the results of a previous group from the beginning of the same school year (22). Another aim of this study was to stratify occupational burnout by socio-demographic and occupational characteristics for both time points (beginning and end of school year).

Participants and methods

Participants and methods used in the study conducted at the beginning of school year 2018/2019 have already been described in our earlier article (22). Briefly, the study included 952 primary and secondary school teachers. However, that earlier study also included responses from 96 teachers (response rate 91.43 %) from the district of Bijeljina (group 1), whose results were not published, and we wanted to run the second study in as close a sample as possible, considering that we could not repeat it with the same participants, as they were anonymous. We therefore randomly selected primary and secondary schools from the same Bijeljina district that participated in the first run, distributed the questionnaires to school principals, who then distributed them to teachers to fill in at school premises. Of 272 questionnaires distributed, 231 were completed (response rate 84.92 %).

All study procedures followed the ethical standards of the Institute for Occupational and Sports Medicine of the Republic of Srpska, Bosnia and Herzegovina (No. 01-24/18, 20/11/2018) and the 1964 Helsinki declaration with its later amendments. The study was approved by school principals and relevant Ministry. All participants received a leaflet with detailed information on study goals and were informed that the study was completely anonymous. Since participation in the study was voluntary and the questionnaire did not include any personal data, we felt that there was no need for signing an informed consent.

Data collection

For this research we designed a special questionnaire to include standard sociodemographic data (gender, age, marital status, number of children), job description (teaching in primary and/ or secondary school, length of service, and overtime hours), and the Serbian version of the standardised and validated questionnaire Maslach Burnout Inventory-Human Service Survey, which consists of 22 questions and measures three dimensions of occupational burnout: emotional exhaustion (9 items), cynicism/depersonalisation (5 items), and personal accomplishment (8 items). Each of the 22 items asks respondents to rate their feelings on a 7-point Likert-type scale, ranging from never having (0 points) to having those feelings several times a week (6 points). Overall scores of each respondent were obtained by summing them up using a specific key for each of the three dimensions. The threshold for high emotional exhaustion is 27 or more points, for moderate exhaustion 17–26 points, and for low exhaustion 0–16 points. High depersonalisation starts at 13 points, moderate ranges between 7 and 12 points, and low between 0 and 6 points. Personal accomplishment is high at 39 and more points, moderate at 32–38 points, and low at 0–31 (24).

Statistical analysis

All our results are expressed as arithmetic means and medians and standard deviation or relative numbers. The MBI-HSS questionnaire is presented through the three continuous dimension scales. The Kolmogorov-Smirnov and the Shapiro-Wilk test did not confirm normality of the distribution (p<0.05).

Differences in the distribution of independent variables between different categories of outcome variables were tested using the Mann-Whitney U test, and the Kruskal-Wallis test was applied to variables with more than two modalities. Categorical variables were presented by the number of observations and percentage. Frequencies between the groups were compared with the chi-squared test or Fisher’s exact test. All statistical analyses were run with IBM SPSS Statistics for Windows, version 25.0. (IBM, Armonk, NY, USA).

Results
Sociodemographic characteristics of the study groups

The first survey round at the beginning of school year 2018/2019 included 96 teachers (group 1), and the second at the end of the school year 231 teachers (group 2). The two groups significantly differ in gender, age, marital status, and length of service (p<0.05) (Table 1).

Sociodemographic and job characteristics by respondent groups

Socio-demographic characteristics All Group 1 (beginning of the school year 2018/19) Group 2 (end of the school year 2018/19)
             N (%) N (%) N (%) p
Gender
            Female 187 (57.2) 27 (28.1) 160 (69.3) .000
            Male 140 (42.8) 69 (71.9) 71 (30.7)
Age (years)
            <35 82 (25.1) 35 (36.5) 47 (20.3) .000
            36–45 123 (37.6) 35 (36.5) 88 (38.1)
            46–55 111 (33.9) 15 (15.5) 96 (41.6)
            >56 11 (3.4) 11 (11.5) 0
Marital status
            Married/cohabiting 170 (52.0) 25 (26.0) 145 (62.8) .000
            Single 133 (40.7) 65 (67.7) 68 (29.4)
            Divorced/Widowed 24 (7.3) 6 (6.3) 18 (7.8)
Children
            Yes 218 (66.7) 62 (64.6) 156 (67.5) .699
            No 109 (33.3) 34 (35.4) 75 (32.5)
Workplace
            Primary school 179 (54.7) 43 (44.8) 136 (58.9) .054
            Secondary school 144 (44.0) 51 (53.1) 93 (40.3)
            Combined 4 (1.2) 2 (2.1) 2 (0.8)
Years of work
            <10 113 (34.6) 47 (49.0) 66 (28.6) .001
            11–20 125 (38.2) 34 (35.4) 91 (39.4)
            >20 89 (27.2) 15 (15.6) 74 (32.0)
Overtime hours per week
            Never 221 (67.6) 60 (62.5) 161 (69.7) .170
            to 10 h 99 (30.3) 32 (33.3) 67 (29.0)
            >10 h 7 (2.1) 4 (4.2) 3 (1.3)
Occupational burnout

The prevalence of occupational burnout in teachers at the beginning of the school year was low, as expected, and in line with our published report for the rest of the Republic of Srpska entity of Bosnia and Herzegovina. Surprisingly, however, it remained low in the second round of investigation at the end of the school year, even though the two samples do not match in sociodemographic characteristics.

The two groups do, however, differ in depersonalisation scale (p<0.001), as moderate and high level of depersonalisation was reported more often in the group surveyed at the beginning of the school year (7.3 %) than in the group surveyed at the end (0 %) (Table 2).

Occupational burnout (MBI-HSS)

Occupational burnout Group 1 (beginning of the school year 2018/19) Group 2 (end of the school year 2018/19) p
N (%) N (%)
Emotional exhaustion
            Low 87 (90.6) 217 (93.9) .396
            Moderate 6 (6.2) 7 (3.0)
            High 3 (3.1) 7 (2.1)
Depersonalisation
            Low 89 (92.7) 231 (100) .000
            Moderate 4 (4.2) 0
            High 3 (3.1) 0
Personal accomplishment
            Low 16 (16.7) 57 (24.7) .284
            Moderate 28 (29.2) 60 (26.0)
            High 52 (54.1) 114 (49.4)

What is more in line with our expectations and perhaps more indicative, considering the demographic differences between the two groups of respondents, is a significant rise in the scores of emotional exhaustion and depersonalisation score and a non- significant drop in personal accomplishment score in respondents who took the survey at the end of the school year (Table 3).

Occupational burnout scores by dimension (MBI-HSS)

Occupational burnout scale scores Group 1 (beginning of the school year 2018/19) Group 2 (end of the school year 2018/19) p
Mean (SD) Median (min–max) Mean (SD) Median (min–max)
Emotional exhaustion 7.98 (6.96) 6.00 (0–34) 13.17 (10.59) 10.00 (0–54) .000
Depersonalisation 2.05 (4.76) 1.00 (0–40) 2.87 (4.50) 1.00 (0–30) .038
Personal accomplishment 38.18 (8.07) 39.00 (0–48) 36.41 (9.46) 38.00 (0–48) .210

Table 4 compares the prevalences (number and the percentage) of low, moderate, and high occupational burnout by dimensions and sociodemographic and job characteristics for either respondent group. The group taking the survey at the beginning of the school year showed a significant correlation between emotional exhaustion and overtime and between depersonalisation and work in the secondary school (p<0.05).

Differences in dimension scores (Table 5) additionally point to significant correlations between emotional exhaustion and work in the secondary school, years of work, and overtime (p<0.05) in the group surveyed at the beginning of school year and between emotional exhaustion and overtime in the group surveyed at the end of the year. Depersonalisation significantly correlates with having children in the first and position in high school in the second group (p<0.05). Personal accomplishment significantly correlates with the female gender in the group surveyed at the end of the school year (p<0.05).

Prevalence (number and percentage) of low, moderate, and occupational burnout by dimensions and sociodemographic and job characteristics

Enotional exhaustion Depersonalisation Personal accomplishment
Sociodemographic Group 1 Group 2 Group 1 Group 2 Group 1 Group 2
and occupational characteristics Low N (%) Moderate N (%) High N (%) P Low N (%) Moderate N (%) High N (%) p Low N (%) Moderate N (%) High N p (%) Low N (%) Moderate N (%) High N (%) p Low N (%) Moderate N (%) High N (%) P Low N (%) Moderate N (%) High N (%) P
Gender
Female 24 (27.6) 1 (16.7) 2 (44.7) .272 151 (69.6) 5 (71.4) 4 (57.1) .775 25 (28.1) 1 (25.0) 1 .971 (33.3) 160 (69.3) 3 3 / 4 (31.2) 8 (28.0) 14 (20.2) .943 34 (52.0) 41 (68.3) 85 (74.0) .135
Male 63 (72.4) 5 (83.3) 1 (33.3) 66 (30.4) 2 (28.6) 3 (42.9) 64 (71.9) 3 (75.0) 2 (66.7) 71 (30.7) 3 3 11 (68.8) 20 (71.4) 38 (70.1) 23 (40.4) 19 (01.7) 29 (25.4)
Age (years)
<35 (34 39.1) (16.1 7) 3 .186 (20.745 ) (141 -3) (141 .3) .860 (3733 .1) (251 -0) .683 (20.347 ) 3 3 / (376 -5) (42.912 ) (32.717 ) .809 _(159 -8) (2616 -7) (1922 .3) .422
36-45 28 (32.2) 4 (66-7) 3 (100) 81 (37.3) 4 (57.1) 3 (42.9) 31 (34-8) 3 (8.6) 88 (38.1) 3 3 6 (37-5) 9 (31.1) 20 _(38-5) 26 _(45-6)_ 22 (36-7) 40 (35.1)
46-55 14 (16.1) 1 (16-7) 0 91 (41.9) 2 (28-6) 3 (42.9) 14 (15-7) 0 96 (41.6) 3 3 1 (6-2) 4 (14-3) 10 (19.2) 22(38-6) 2 (38-6) 52 (45.6)
>56 (12.611 ) 3 0 3 3 0 11(12-4) 0 3 3 3 (18.33 ) (103 .7) (9.65 ) 0 0 0
Marital status
Married/Cohabiting (24 27.6) 3 (33.31 ) .507 _(62135 -2) (715 -4) 5(71.4) .854 (25 28.1) 0 0 .169 __(145 62-8) 3 3 / (315 .2) ( 25.07 ) (2513 .0) .987 (64.937 ) ( 55.033 ) (6575 -8) .708
Single 57 (65.5) 6 (100) 2 (66.7) 64 (29.5) 2 (28-6) 2 (28-6) _( 59 66-3)_ 4 (100) 2 (66-7)___________ 68 (29.4) 3 3 10 (62-5) 19 (67-9) 36 (69-2) 16 (28.1) 21 (35-0) 31 (27.2)
Divorced/Widowed 5 (6.9) 0 3 18(8.3) 3 0 5 (5.6) 0 1 (33.3) 18 (7.8) 3 3 1 (6-2) ( 2 7.1) 3 (5.8) 4 6 (10.0) 8 (7.0)
Children
Yes 55 (63.2) 5 (83.3) 2 (66.7) .607 146 (67.3) 5 (71.4) 5 (71.4) .950 55 (61.8) 4 (100.) 3 (100) .126 156 (67.5) 0 0 / 11 (68.8) 18 (64.3) .927 39 (68.4) 41 (68.3) 76 (66.7)
No 32 (36.8) 1 (16.7) 1 (33.3) 71 (32.7) 2 (28.6) 2 (28.6) 34 (38.2) 0 0 75 (32.5) 0 0 5 (31.2) 10 (35.7) 18 (31.6) 19 (31.7) 38 (33.3)
Workplace
Primary school (41 47.1) (161 -7) (33.31 ) .609 (125 57-6)_ (715 -4) (856 -7) .605 _( 4339 -8) (1004 ) 0 .000 (136 58-8) 3 3 / (376 -5) (39.311 ) (5026 .0) .460 (5431 -2) ( 54.232 ) (64.673 ) .285
Secondary school 44 (50.6) 4 (83.3) 2 (66-7) 90 _(41-5) 2 (28-6) 1 (143) 49 (55.l) 0 2 (66-7)___________ 93(40.3) 3 3 9 (56-2) ( 16 57.1) 26 (50.0) 26 (45.l) 27 (45.8 40 ) (35-4)
Combined (2 2.3) 3 3 (02 -9) 2 0 1 (1.1) 0 (33.31 ) (0,2 9) 3 3 (61 -2) ( 3.61 ) 0 (0.72 ) 0 0
Years of work
<10 44 (50-6) 1 (16-7) 2 (66-7) .125 61 (28.1) 3 (42.9) 2 (28-6)_ .860 45 (5.6) 1 (25-0) 1 772 (33.3) 66 (28-6)_ 3 3 8 (50-0) 13 (46.4) 26 (50.0) .974 15(26.3) 17 (28.3) 34 (29.8) .939
11-20 28 (32.2) 5 (83.3) 1 (33.3) 85 (39.2) 3 (42.9) 0 (42.9) 31 (34-8) 2 (50-0) 1 (33.3) 91 (39-4)_ 3 3 5 (31.2) ( 10 35.7) 19 (36-5) 25 _(43-9) 24 (40.0) 42 (36-8)
>20 15 (17.2) 3 3 71 (32.7) 1 (14.3) 2 (28.6) 13 1 (25-0) 1 (33.3 74 (32.0) 3 3 3 (18.8) 5 (17.9) 7 -(13-5) 17 (29.8) 19 (31.7) 38 (33.3)
Over time hours per week
Never 58 (66-7) 1 (16-7) 1 (33.3) .000 153 (70-5) 3 (42.9) 5 (71.4) .573 58 (65.2) 1 (25-0) 1 123 (33.3) 161 __(69-7) 3 3 / 9 (56-2) 14 (50-0) 37 (71-2) .375 36 _(63-2) 42 (70.0) 83 (72.8) .372
<10 h 27 (31.0) 5 (83.3) 3 61 (28.1) 4 (57.1) 5 (71.4) _( 28 31-5) 2 (50-0) 2 (66-7) 67 (29.0) 3 3 6 (37-5) 13 (46.4) 13 (25.0) 19 (33.3) 18 (30.0) 30 (33.3)
>10 h 2 (2.3) 3 2 (66-7) 3 P-4) 0 0 3 (3-4)_ 1 (25-0) 3 3 P-3) 3 3 1 (6.3) ( 1 3.6) 2 (3-8) 2 (3-5) / 1 (0-9)

Group 1 - respondents taking the survey at the beginning of the school year 2018/19; Group 2 - respondents taking the survey at the end of the school year 2018/19

Occupational burnout scores by dimension and sociodemographic and job characteristics

Emotional exhaustion Depersonalisation Personal accomplishment
Sociodemographic and job characteristies Group 1 Group 2 Group 1 Group 2 Group 1 Group 2
Median (min—max) p Median (min—max) P Median (min—max) P Median (min—max) p Median (min—max) P Median (min—max) P
Gender
Female (5.00 0-34) .922 11.00 (0-47) .705 (0.00 0-14) .845 (01.0 -20) .076 (39.00 12-48) .648 40.00 (7-48) .020
Male 7.00 (0-32) 9.0 (0-54) 1.00 (0-40) 1.0 (0-30) 40.00 (0-48) 36.00 (0-48)
Age (years)
<35 (7.00 0-20) .461 (9.00 0-43) .664 (0.00 0-40) .144 (1.00 0-15) .671 38.00 (0-48) .902 (37.00 12-47) .309
36-45 6.00 (0-34) 10.00 (0-54) 1.00 (0-14) 1.00 (0-30) 40.00 (20-48) 36.50 (0-48)
46-55 8.00 (0-20) 12.00 (0-47) 0.00 (0-14) 1.00 (0-20) 41.00 (25-47) 39.50 (13-48)
>56 5.00 (0-14) 0.0 34.00 (12-47)
Marital status
Married/Cohabiting (5.00 0-34) .467 11.00 (0-54) .407 0.00 (0-6) .148 (01.0 -30) .599 (39.00 26-48) .575 39.00 (0-48) .788
Single 7.00 (0-32) 9.50 (0-43) 1.00 (0-40) 1.00 (0-21) 40.00 (0-48) 38.00 (12-48)
Divorced/ Widowed 7.00 (0-14) 9.50 (0-26) 1.00 (0-14) 2.00 (0-12) 37.50 (30-42) 37.00 (17-48)
Children
Yes (6.50 0-32) .377 11.00 (0-54) .402 (1.00 0-40) .010 (1.00 0-30) .360 39.00 (0-48) .339 38.00 (0-48) .893
No 5.00 (0-34) 10.00 (0-43) 0.00 (0-6) 1.00 (0-21) 40.00 (26-48) 39.00 (12-48)
Workplace
Primary school (5.00 0-34) .014 10.00 (0-54) .386 (0.00 0-10) .602 (1.00 0-30) .028 (41.00 23-48) .122 40.50 (0-48) .149
Secondary school 8.00 (0-32) 10.00 (0-44) 1.00 (0-14) 2.00 (0-19) 39.00 (12-48) 37.00 (12-48)
Combined 2.50 (2-3) 20.00 (19-21) 20.00 (0-40) ( 3.00 1-5) 18.50 (0-37) 37.00 (34-40)
Years of work
<10 (8.00 0-34) 049 (8.00 0-43) .511 (1.00 0-40) .908 (1.00 0-11) .960 (039.00 -4487) .526 39.50 (0-47) .539
11-20 7.50 (0-324) 10.00 (0-54) 1.00 (0-30) 1.00 (0-30) 40.50 (20-48) 37.00 (5-48)
>20 5.00 (0-14) 9.00 (0-47) 1.00 (0-16) 0.00 (0-16) 37.00 (12-47) 39.00 (13-48)
Overtime hours per week
Never (5.00 0-27) .012 (9.00 0-54) .010 (0.00 0-40) .483 (1.00 0-30) .016 41.00 (0-48) .186 39.00 (0-48) .266
<10 h 7.50 (0-24) 17.00 (0-47) 1.00 (0-14) 2.00 (0-20) 37.50 (20-48) 37.00 (7-48)
>10 h 21.50 (9-34) 7.00 (0-21) 2.00 (0-8) 0.00 38.00 (28-41) 25.00 (21-42)

Group 1 - respondents taking the survey at the beginning of the school year 2018/19; Group 2 - respondents taking the survey at the end of the school year 2018/19

Discussion

This is the first study that aimed at comparing occupational burnout in teachers at the beginning and end of the school year and has showed that, in general, burnout remained low at either time point. Our findings therefore do not confirm our hypothesis that burnout will be higher by the end of the school year. However, scores on the emotional exhaustion and depersonalisation scales shifted towards higher values in the group surveyed at the end of the year and point to work in secondary school, years of work, and overtime as significantly associated with the risk of occupational burnout.

What can be considered a limitation of our study design are demographic differences between the two groups, as they poorly match in the number of respondents (in fact, group 1 is too small), gender, age, marital status, and years of work, whereas an ideal design would have been to follow up the same group of participants across the school year, which can be addressed by future studies. Yet even with these differences between the groups, our results point to low burnout in both groups. We can only assume that differences in emotional exhaustion and depersonalisation between the two groups may be owed to the observed demographic differences, such as those between genders in these two dimensions (male teachers being more prone to depersonalisation and female to emotional exhaustion, see Table 3) reported elsewhere (20, 25, 26, 27). However, gender, age, marital status, and years of work do not seem to have influenced the reporting of emotional exhaustion and depersonalisation in either group (see Tables 4 and 5), which suggests that sociodemographic differences between our groups may not be as great a limitation as feared. This assumption is supported by the results of our previous research, which found little or no association between sociodemographic characteristics and occupational burnout (22).

We did not find a similar study that would address seasonal differences in occupational burnout among teachers, but some studies in athletes point to significantly reduced sense of accomplishment by the end of the sporting season and to the burnout syndrome as a chronic process (28). Other studies show that exposure of social educators to violence or bullying at the workplace increases occupational burnout within 12 months (29) or even shorter intervals, with long-term cumulative effects (30).

Conclusions

This is the first randomised study to investigate the seasonal nature of occupational burnout among teachers using a standardised and validated instrument, most often used to assess occupational burnout.

Although the distribution of occupational burnout classifications (low, moderate, high) was not different between the school teachers studied at the beginning and the end of the school year, our results have shown higher scores of emotional exhaustion and depersonalisation and lower levels of personal accomplishment at the end of the school year. These findings invite further research of occupational burnout seasonality in schoolteachers, preferably by following up cohorts which would be controlled for sociodemographic and work-related variables.

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