Association between workplace violence and burnout syndrome among schoolteachers: A systematic review

Abstract

Introduction: This review aimed to examine systematically the epidemiological evidence linking occupational exposure to violence with risk of burnout syndrome (BOS) among schoolteachers. Methods: A systematic review of literature used five primary databases: PsycINFO; Web of Science; PubMed Medline; Scopus; Cochrane; and keywords related to (a) workplace violence (WV), bullying, harassment, lateral violence, pupil misconduct, physical assault, teacher victimization; (b) schoolteachers, teachers, schools, pre-primary, kindergarten, primary, secondary; (c) burnout, emotional exhaustion, depersonalization, to identify relevant articles. Articles included featured occupational violence and burnout among schoolteachers. Results of the studies were analysed qualitatively. Results: Of 1,472 peer-reviewed articles initially identified, 13 articles were included. All of them were published from 2005 to 2021 and had a quantitative approach. Type of violence against teachers ranged from workplace bullying or mobbing (n = 4), psychological violence (n = 4), to a combination of physical and psychological violence (n = 5). Most of the (verbal and physical) violence was perpetrated by students (n = 9). All grade and levels of schoolteachers were involved. In all cross-sectional studies (n = 10), WV was found to be correlated or associated with BOS (n = 5), the dimensions of EE and DP (n = 4) or the only dimension of EE (n = 2). Longitudinal studies showed that depersonalization was a significant predictor of workplace bullying (n = 1) and WV was indirectly a predictor of BOS (n = 2). Discussion and Conclusions: The reviewed studies consistently indicate an association between WV and BOS in schoolteachers. Further longitudinal studies are needed to provide most evidence on this relationship. There is need of legislative interventions for implementing mandatory occupational health programs and voluntary workplace health promotion programs. These solutions may protect and promote teachers’ mental well-being and give more education and emotional support to students and their families. Journal of Health and Social Sciences 2021; 6,2:187-208 The Italian Journal for Interdisciplinary Health and Social Development 188 INTRODUCTION Teaching is a highly demanding and stressful occupation [1]. Teacher stress has been defined as a teacher’s experience of unpleasant, negative emotions resulting from some aspects of their work [2]. Burnout syndrome (BOS) has been described in ICD-11 as an occupational syndrome resulting from poorly managed chronic workplace stress, which is characterized by emotional exhaustion (i.e. feelings of energy depletion), depersonalization or cynism (i.e. increased mental distance from one’s job or feelings of negativism or cynism related to one’s job), and reduced professional efficacy [3]. BOS has been described in a variety of human service professions [4– 6] and is considered an occupational hazard in helping professions [7] referred to a state of emotional, attitudinal and physical exhaustion that follows from a prolonged exposure to chronic stress [8–17]. However, many questions on BOS still remain unanswered. For instance, although there is a substantial overlap between BOS and depression [18], BOS should be better conceptualized as a breakdown in the relationship between workers and their work or clients [19]. Indeed, this syndrome is strictly related to occupational setting, and, therefore, BOS and depression should be considered two different concepts [20]. Furthermore, antecedents of work-related stress disorders and antecedents of BOS may be different [21]. Work-related stress is a risk factor that refers to aspects of the design and management of work and its social and organisational contexts that have the potential for causing psychological or physical harm [22], BOS has been described as a peculiar and distinctive psychosocial risk factor in helping professions including teachers, because it is closely associated with high emotional load and emotional demands [8, 23, 24]. According to the Job Demand Resources model [25, 26], occupational antecedents, also termed ‘stressors’ [25] or ‘job demands’ [26] of teacher burnout include job characteristics such as heavy workload, relationships with colleagues and management, poor working Competing interests none declared. Copyright © 2021 Francesco Chirico et al. Edizioni FS Publishers This is an open access article distributed under the Creative Commons Attribution (CC BY 4.0) License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. See http:www.creativecommons.org/licenses/by/4.0/. Cite this article as: Chirico F, Capitanelli I, Bollo M, Ferrari G, Acquadro Maran D. Association of workplace violence and burnout syndrome among schoolteachers: A systematic review. J Health Soc Sci. 2021;6(2):187-208 Author Contributions: Conceptualization, study design, methodology, formal analysis, writingoriginal draft, writingreview & editing: FC. Data collection, writingreview & editing: IC and MB. Resources, supervision: GF. Supervision, formal analysis, writingreview & editing: DAM. TAKE-HOME MESSAGE This systematic review showed a close association between workplace violence and burnout syndrome among schoolteachers. Further longitudinal studies are needed to explain this relationship. Received: 20/05/2021 Accepted: 01/06/2021 Published Online: 06/06/2021 DOI 10.19204/2021/ssct6 Journal of Health and Social Sciences 2021; 6,2:187-208 The Italian Journal for Interdisciplinary Health and Social Development 189 environment, pupil behaviour, long working hours, providing cover for teacher shortages and absences, pressure of school targets and inspections, coping with change and administrative duties [25–28]. On the opposite, positive relations with colleagues and the school administration as well as the feeling of doing a meaningful job are positive aspects of the job, termed as ‘job resources’, which may predict positive outcomes such as teacher motivation and well-being and prevent from the onset of teacher stress and burnout [29–32]. Workplace violence (WV) is another psycho-social risk factor, which is specifically regulated in European workplaces. WV can be physical, psychological and/or emotive, and people who are violent towards or harass an employee could be customers, clients, patients, students or pupils of this person [33]. Psychological and emotive violence can vary trough an ideal continuum in terms of intensity, frequency, and severity, ranging from workplace incivility o bullying, passing through lateral violence [34]. Lateral violence is a type of psychological harassment that can be isolated or sporadic and results in hostility. Psychological harassment include sexual harassment (unwanted sexual attention), verbal abuses, threats, humiliations, intimidations, criticism, innuendo, social and professional exclusion, discouragement, disinterest, and denied access to information [35]. Workplace bullying is a type of harassment described as an enduring offensive and insulting behavior, which is worsened by an intimidating, malicious, and insulting pattern [34, 36]. In Europe, bullying is usually termed as ‘mobbing’ [37] and occurs among peers, towards superiors or subordinates (vertical or hierarchical violence) [38, 39]. Bullying is a kind of deliberate and repetitive behavior able to affect negatively the health and economic wellness of the victim. Workplace incivility differs from (physical or verbal) WV for its ambiguity in the intent to damage the victim [40]. Teachers are exposed to physical (e.g., objects thrown, physical attacks, property damages), verbal (e.g., harassment, verbal threats) and social or relational (e.g., gossiping, refusing collaboration or sabotaging teacher’s work by using electronic devices and modern technology) violence, which is often perpetrated by students and their parents, or by colleagues as well [41, 42]. Scholars found a relationship between poor social interrelations with both pupils and colleagues or destructive friction within the professional community due to interpersonal conflicts and pupil misconduct, and an increased risk of developing BOS symptoms among schoolteachers [43–49]. A meta-analysis showed the existence of a relationship between pupils’ misconduct and teacher burnout [43]. Studies conducted in literature [50–53] showed that WV and BOS are associated in nurses and healthcare workers. Also, in teachers this relationship was found. Mościcka-Teske and colleagues [54], for example, in an investigation that involved more than 1,200 teachers, showed that those who were victims of harassment or bullying were more prone to report burnout symptoms than non-victims. Geissler [55] found a correlation between victimization, emotional exhaustion and depersonalization in this population. Similar data were found by Koga and colleagues [56] (verbal violence was associated with emotional exhaustion) and by Melanda and colleagues [57] (violence had a direct effect on emotional exhaustion and depersonalization). Likewise, teachers who regularly witness aggression also present a higher risk of emotional exhaustion although this might be less pronounced than their victimized colleagues [58, 59]. In addition, exposure to a globally high level of several types of aggression (combining witnessing and victimization) might impact teachers more severely than exposure to any specific type of aggression [58]. Physical assaults among education workers is a relevant problem worldwide, which is defined as being ‘hit, slapped, kicked, pushed, choked, grabbed, sexually assaulted, or otherwise subjected to physical contact intended to injure or harm’ [60]. Physical violence has a significant impact on teachers’ job satisfaction and health-related quality of life [61]. But, in general, school-related violence prediJournal of Health and Social Sciences 2021; 6,2:1