Teachers are at high risk of stress-related disorders. This longitudinal study aimed to (a) identify which occupational, sociodemographic and life-style factors and self-efficacy at baseline that were of importance for burnout, (b) explore associations between changes in the studied factors versus changes in burnout, and (c) by interviews increase the understanding of perceived job demands among teachers. A cohort of 310 Swedish teachers in school-years 4–9 responded to a questionnaire of occupational, sociodemographic and life-style factors, self-efficacy and burnout, at baseline and at follow-up (mean 30 months later). A combined measure with four levels of burnout was crafted, based on exhaustion, cynicism and professional efficacy (Maslach Burnout Inventory-General Survey). Quantitative data were analysed with multiple ordinal regression, and qualitative data were analysed with content analysis of interview responses from a subgroup of the teachers (n = 81). The occurrence of high burnout (level 2 and 3 combined) were similar at baseline and follow-up (14% vs. 15%). However, many teachers fluctuated between the levels of burnout (28% increased and 24% decreased). Burnout at baseline was of importance for change of work or being off duty at follow up. In the multi-exposure model, low self-efficacy [OR 0.42; CI 0.26–0.68] and high job demands [OR 1.97; CI 1.02–3.8] were the strongest explanatory variables. Low self-efficacy remained as the strongest explanatory factor after adjustment for burnout at baseline. Increased job demands during follow-up was associated with an increased level of burnout [OR 3.41; CI 1.73–6.69], whereas increased decision latitude was associated with a decreased level of burnout [OR 0.51; CI 0.30–0.87]. Two major categories of demands emerged in the qualitative analysis; i.e. too high workload and a sense of inadequacy. A substantial proportion of teachers showed signs of burnout at both occasions. Low self-efficacy and high job demands was of importance for burnout, and changes in burnout was further associated with changes in decision latitude. The results points to the need of actions on individual, organizational and a societal levels.
14 September 2019 in Scandinavian Journal of Occupational Therapy
Background: Occupational balance is fundamental to occupational therapy and occupational science. Therefore, the Occupational Balance Questionnaire (OBQ) was developed and has previously been found psychometrically valid according to classical test theory. Aim: To investigate the internal construct validity of the OBQ using Rasch measurement theory. Material and methods: Data from two general population samples were used to investigate the psychometric properties of the OBQ according to Rasch measurement theory. Results: The analyses identified problems with the current response scale and multidimensionality of two items. As a result, a revised version, the OBQ11, was suggested and exhibited response categories that worked properly, good reliability (0.92), model fit and measurement invariance across age and gender groups. The hierarchical item ordering was in agreement with previous research. Conclusion: The new OBQ11 satisfies the measurement criteria defined by the Rasch model. However, further studies of additional samples are needed to validate its generic properties. Significance: The purpose of the OBQ11 is to measure occupational balance of individuals or groups, and to identify aspects of occupational balance in need of improvement. Our observations suggest that the OBQ11 is a valid and promising complement to other instruments.
Teachers are at high risk of stress-related disorders. This study aimed to examine the occurrence of burnout in a sample of Swedish school-teachers, to test a combined measure of three burnout dimensions on the individual level, to characterize associations between burnout and factors encountered during work and leisure time, and to explore any differences between the genders. A questionnaire of occupational, sociodemographic and life-style factors was answered by 490 teachers in school years 4–9. Outcome measures were (a) the single burnout dimensions of exhaustion, cynicism and professional efficacy (Maslach Burnout Inventory-General Survey), and (b) a combined measure based on high or low values in the three dimensions. The combined measure was used to stratify the study population into four levels (0–3) of burnout. Multivariable Poisson regression was applied on level 2 + 3 vs. level 0 + 1, for variables that we considered as relevant risk factors for burn out. Half of the teachers reported low values in all three dimensions (level 0), whereas 15 were classified as having high burnout in at least two out of the three dimensions (level 2 + 3), and 4 % in all three dimensions (level 3). Almost all psychosocial factors were incrementally more unfavourably reported through the rising levels of burnout, and so were dissatisfaction with the computer workstation, pain, sleep problems and lack of personal recovery. There was no association between gender and rising levels of overall burnout (p > 0.30). Low self-efficacy, poor leadership, high job demands and teaching in higher grades were the variables most clearly associated with burnout in multivariable Poisson regression. Even if circa 50 % of the teachers appear do well with respect to burnout, the results points to the need of implementing multifaceted countermeasures that may serve to reduce burnout.
2 October 2019 in Scandinavian Journal of Occupational Therapy
Background: Occupational balance (OB) is an important concept in occupational therapy and is considered as an essential component of health and well-being. Aim: The aim of this study was to investigate the validity and reliability of the Turkish version of the Occupational Balance Questionnaire-11 (OBQ11-T). Materials and methods: The OBQ11-T was administered to 116 individuals for construct validity analysis and to 58 individuals for reliability analysis. Validity was determined using explanatory and confirmatory factor analysis. In confirmatory factor analysis, RMSEA (root mean square error of approximation) value, comparative fit index (CFI), and Chi-square to degrees of freedom ratio (CMIN/DF) were analysed. The test–retest method and Cronbach’s alpha coefficient were used to assess the reliability and internal consistency of the OBQ11-T, respectively. Results: The model fit the data according to the indices of relative fit (RMSEA = 0.076, CMIN/DF = 1.661, and CFI = 0.875). The correlation coefficient between test and retest OBQ11-T total scores was 0.922. Total scores showed a significant statistical relationship (p < 0.01), indicating good reliability. Cronbach’s alpha for OBQ11-T total score was 0.785, indicating acceptable internal consistency. Conclusions and significance: The current study demonstrates that the OBQ11-T is a valid and reliable tool for measuring the self-rated OB of healthy individuals.
There is growing interest in developing a conceptual understanding of the experience of balance in everyday life, from an occupational perspective. The purpose of this study was to gain insights about balance in the everyday lives of women with stress‐related disorders. Data were gathered from 19 women who were past the first phase of recovery from a stress‐related disorder and participated in one of five focus groups. Analysis revealed that the participants experienced a continuum between imbalance and balance in everyday life. The themes that emerged were image of occupational self, strategies to manage and control everyday life, occupational repertoire, and occupational experience. Balance in everyday life was achieved through a dynamic interaction between these themes, which the women characterised as respecting their own values, needs, and resources; having strategies to manage and control everyday life; having a harmonious occupational repertoire; and engaging in personally meaningful occupation. Engagement in personally meaningful occupation appears to be a mechanism that enables people to achieve balance in everyday life by enabling them to develop a successful occupational self‐image, manageability, control, and a harmonious occupational repertoire. Well‐being seems to be the outcome of balance in everyday life, and lack of balance is experienced as overload.