[A questionnaire assessing knowledge level concerning occupational asthma]. / Questionnaire d'évaluation du niveau de connaissances sur l'asthme professionnel.

INTRODUCTION: Screening for occupational asthma is should still be promoted. In order to improve the efficiency of any educational intervention we need to evaluate the patient's knowledge of the disease. OBJECTIVES: The aims were to evaluate objectively the knowledge level of Tunisian asthmatic patients concerning occupational asthma using a self-questionnaire in Arabic Tunisian dialect, then to conduct a validation process of the questionnaire. METHODS: We followed De Vellis's rules during all stages of redaction of the self-questionnaire. It contained 18 items allocated in 4 dimensions: knowledge about asthma; knowledge about occupational asthma; prognosis of occupational asthma; prevention of occupational asthma. A pre-test was conducted on 18 asthmatic patients to assess the clarity and comprehensibility of all the questions. The questionnaire was then applied to 107 asthmatic patients. RESULTS: The statistical analysis proved the discrimination value in 14 of the 18 items. The internal consistency of the questionnaire was demonstrated by a KR20 index of 0.731. Factorial analysis of the principal components showed the reliability of the questionnaire and of its uni-dimensional structure. The statistical findings proved the positive correlation between the mean scores of all its dimensions. CONCLUSIONS: Using this questionnaire in daily practice should inform health care providers about the level of knowledge of occupational asthma in the targeted population and improve the effectiveness of any further educational intervention.

[Stress and burnout among Tunisian teachers]. / Stress et épuisement professionnel des enseignants tunisiens.

INTRODUCTION: Burnout, or professional exhaustion syndrome, is defined as a state of emotional, mental and physical exhaustion caused by excessive and prolonged stress at work. Despite the fact that it is not a recognized disorder in the DSM-IV, burnout has been widely described among medical and paramedical staff. In Tunisia, all the studies about this syndrome have only considered populations of doctors. However, professional exhaustion syndrome is not only limited to the medical sector, but can also be seen in any profession involving a relation of help. Thus, the teaching profession seems to be concerned with this syndrome. In fact, in our clinical practice, we are increasingly confronted with teachers' suffering. The latter face increasing difficulties in their work and moreover some of them can no longer resist and thus become vulnerable to the professional exhaustion syndrome. OBJECTIVE: The aim of this study was to evaluate burnout among a population of Tunisian teachers and to examine the professional stressors associated with teachers' burnout. METHODS: Our study was a transversal study conducted over five months (from October 2009 to February 2010) and it concerned teachers working in the public high schools of Manouba (Tunisia). The participants completed a self-questionnaire dealing with professional stressors. Five types of professional stressors were identified in the literature: bad working conditions, work overload, administrative difficulties, organizational factors and difficulties with pupils and their relatives. They were also explored by the scale of the burnout: the Maslach Burnout Inventory (MBI), which is the best-studied measurement of burnout in the literature. We used the French version of the MBI adapted to educational settings. It is a scale composed of 22 items and three dimensions: emotional exhaustion (nine items), dehumanization (five items) and reduced personal accomplishment (eight items). In our study, we considered a teacher was suffering from burnout when at least two among the three dimensions of this scale were pathological. RESULTS: From the total number of teachers working in public high schools of Manouba (n=876), only 398 teachers filled in our questionnaires. Hence the rate of participation was 45.4%. The mean age of those participants was 40.04 years. 52.3% of them were women (sex ratio=0.91) and the great majority was married (81.8%). The burnout syndrome was found in 21% of those teachers: Moderate professional exhaustion was found in 16.4% of cases and severe professional exhaustion was found in 4.6%. A high emotional exhaustion was found in 27.4% of cases. A percentage of 16.1 of participants had a high dehumanization and 45.5% of them were susceptible to reduced personal accomplishment. The majority of teachers (66.4%) declared being stressed at work. The professional stressors reported by the teachers were in decreasing order of rate: bad working conditions (80.3%), overload work (75.2%), administrative difficulties (70.4%), difficulties with pupils and their relatives (64.4%) and finally organizational factors (57.1%). In our study, we found a strong association between burnout syndrome among teachers and three types of professional stressors which were: bad working conditions (p=0.0017), administrative difficulties (p=0.005) and difficulties with pupils and their relatives (p=0.005). The organizational factors and the work overload were not associated with the burnout syndrome. CONCLUSION: The job of teaching accumulates many difficulties. Some Tunisian teachers cannot tolerate this professional stress and develop a burnout. This syndrome leads to a teachers' psychological distress with the risk of an increase in absenteeism at work. So, we hope that this study will give rise to future research on stress, coping and burnout among Tunisian teachers, with theoretical aims as well as practical applications to prevent and reduce the risk of this problem.