Working time reduction, mental health, and early retirement among part-time teachers at German upper secondary schools - a cross-sectional study.

Objective: Many secondary school teachers work part-time in order to cope with the high workload and to remain as healthy as possible until regular retirement. However, due to the acute shortage of teachers, the increase in the teaching obligation for part-time teachers (PTT) has become a topic of discussion in Germany. Whether a reduction in teaching hours is associated with benefits for mental health has not yet become evident. Therefore, this study investigated the relationship between the real working hours of PTT and their mental health as well as individual pension prognosis. Methods: The cross-sectional study included 5,905 PTT at German upper secondary schools (female proportion: 81%, average age: 44 ± 9 years) who logged their working hours over four weeks. Four part-time groups (PTG) were formed based on the proportion of a full-time position worked: maximum (<100-90% = PTGmax - reference group - 17%), high (<90-75% = PTGhigh - 34%), medium (<75-50% = PTGmed - 40%) and low (<50% = PTGlow - 9%) teaching commitment. These groups were compared in terms of their average weekly working hours, mental health (inability to recover, risk of burnout) and predicted retirement age. Results: The contractually agreed working time is exceeded to a relevant extent for PTT. The extent of unpaid overtime increases significantly the lower the teaching obligation is and lies on average between -0.4 (PTGmax) and 7.3 (PTGlow) hours/week. A reduction in teaching hours is neither related to the mental health of teachers nor to their decision to retire early (42%) or regularly (58%). However, predicted retirement is mainly explained by mental health status, gender and age (variance explanation: 24%, OR of predictors: maximum 2.1). One third of PTT reported inability to recover, 47% burnout symptoms and 3% a burnout syndrome. Conclusion: Mental health is also a risk for PTT; reducing teaching hours alone does not improve it. However, good mental health increases the chance of regular retirement. Therefore, instead of a legal obligation, PTT should be encouraged to increase the number of teaching hours voluntarily in order to counteract the general shortage of teachers.

Psychosocial Work Stress and Health Risks - A Cross-Sectional Study of Shift Workers From the Hotel and Catering Industry and the Food Industry.

Purpose: Psychosocial work stress, and shift and night work are considered risk indicators for impaired health. Using the effort-reward (ER) model, it was possible to examine which relationships exist for shift workers between clusters (CL) of different levels of psychosocial work stress and overcommitment (OC) and cardiovascular or psychological health indicators, and which predictive value is evident in individual health indicators to explain the clusters. Methods: The data were collected as part of an occupational health prevention program. The analysis sample consisted of 199 shift workers from alternating shift systems with and without night work (43%) (average age: 40 ± 12 years, men: 47%). Psychosocial work stress was recorded using the ER imbalance (ERI) questionnaire. To determine the clusters, ERI and OC were entered into a cluster analysis. Blood pressure, body mass index, waist-hip ratio, PROCAM score (risk of a heart attack within the next 10 years), sporting activity, and smoking were included as cardiovascular indicators, psychological wellbeing (GHQ-12) and inability to recovery (IR) (FABA) as psychological health indicators. Shift system, sex, and age were entered into the statistical analyses as control variables. Multinomial logistic regression models were used to identify health-related predictors to explain the ER-OC clusters. Results: Three different ER-OC clusters emerged: low-stress: 36%, normal: 44%, risk: 20%. While normal psychosocial work stress is present in the low-stress and the normal CL, in the risk CL 28% of the shift workers show a health-endangering ERI and 48% show an excessive OC. No significant cluster-specific differences were determined for the cardiovascular health indicators. Rather, the known sex and age effects were confirmed and the shift system had no significant effect. Significantly more shift workers in the risk CL had impaired psychological health (18 vs. 1/6%) and an IR (52 vs. 0/12%) than in the low-stress and normal CL. IR turned out to be the strongest predictor of the explanation for the ER-OC clusters (49%). Conclusion: IR could be assigned an independent diagnostic value for the assessment of psychosocial work stresses and discussed as a new component of occupational health screening concepts for shift workers. Independently of this, the health indicators signal an urgent need for occupational health prevention and care.

Gender-Specific Aspects of Teachers Regarding Working Behavior and Early Retirement.

Worldwide, a significant proportion of teachers retires prematurely for health reasons or at their own request. The study examines whether male and female teachers differ in terms of working conditions and coping with high work demands as well as individual factors that promote early retirement. A cross-sectional study was conducted to collect data from 6,109 full-time teachers in high schools (56% women). Weekly working hours from a four-week working time record and psychosocial work stress (effort-reward model, ER ratio) were used as workloads. In addition, emotional exhaustion (Maslach Burnout Inventory) and coping strategies that endangered health were recorded in the form of overcommitment and inability to recover. Also, the teachers gave a prediction and reasons for early retirement and made their own suggestions on how to prevent this. The results show that both workloads and emotional exhaustion are comparable between the genders, but women have a greater tendency than men to overcommit and be unable to recover. As ER ratio and emotional exhaustion increase, the chances for both genders to reach the regular retirement age decrease significantly; for health-endangering coping strategies, the relationship is somewhat weaker. The majority of male and female teachers (79%) indicates excessive workloads as the main reason for leaving the profession early. In order to protect teachers from high workloads, measures at the organizational, social, and individual level are necessary. Proposals for schools and policy makers are critically discussed on the basis of teacher recommendations.

Teachers' working time as a risk factor for their mental health - findings from a cross-sectional study at German upper-level secondary schools.

BACKGROUND: The work of teachers has changed due to an increase in the range of tasks. However, there is a lack of current information on working hours, task distribution and the possible health effects. METHODS: For the first time for Germany as a whole, a cross-sectional survey determined how long teachers at upper-level secondary schools work per week, what influences their working hours and how different recording methods affect the total working hours. To this end, 6,109 full-time teachers estimated their working hours based on twelve categories and then documented these daily over 4 weeks. Afterwards, the effects of long working hours on teachers' ability to recover and emotional exhaustion were analysed. RESULTS: The article shows the large interindividual variance in the working hours of teachers and a significant influence of sex, age, and subject profile. Self-reported working hours varied substantially by method used to record working time with work time reported via daily diaries totaling 2 h per week more than hours recorded by a single estimation. A substantial proportion of the teachers (36%) work longer per week than European guidelines allow (> 48 h); 15% work even more than 55 h per week. Teachers who work more than 45 h per week suffer more often from inability to recover (46%) and emotional exhaustion (32%) than teachers who work less than 40 h per week (26% and 22% respectively). CONCLUSIONS: Taking professional experience and teaching subjects into account could in future contribute to a fairer distribution of workload among teachers. This could protect individual teachers from long working hours, ensure sufficient recovery and also reduce the risk of emotional exhaustion. In order to identify teachers whose health is at risk at an early stage, voluntary preventive care offers would be considerably helpful.

Influence of Work-Related and Personal Characteristics on the Burnout Risk among Full- and Part-Time Teachers.

Teachers are at increased risk of stress-related illnesses and burnout symptoms. Thus, a cross-sectional study involving 6109 full-time and 5905 part-time teachers at upper-level secondary schools examined the influence of presumed work-related and personal characteristics on burnout risk between January and April 2018. Burnout was recorded using the Maslach Burnout Inventory-General Survey (MBI-GS). Work-related characteristics were weekly working hours and work stress, operationalized with the effort-reward imbalance (ERI) model. Overcommitment and the inability to recover were determined as personal characteristics. Multiple linear regression analyses were performed, adjusted for age and gender. Overall, 47% of the teachers reported burnout symptoms and 3% had an indication of burnout. Full-time and part-time teachers did not differ in their risk of burnout. ERI, overcommitment, and inability to recover were identified as predictors of burnout risk (explained variance: 29%), whereby the inability to recover was the strongest predictor. In contrast, weekly working hours, extent of employment, gender and age were not related to the burnout risk. ERI was found in 33%, inability to recover in 36% and overcommitment in 39% of all the teachers studied. In particular, the inability to recover should be taken into account as an early indicator of burnout.

Cardiovascular recovery after workload in German shift workers in the hotel and catering industry: results of 24-hour-ambulatory monitoring of heart rate and blood pressure.

PURPOSE: Shift work is associated with an impairment of sleep-wake cycles that can affect cardiovascular recovery (CR) negatively. The aim of this study was to examine CR of shift and day workers in the hotel and catering industry (HCI) and identify predictors of CR. METHODS: The sample consisted of 64 alternating and 96 day workers in the HCI. Monitoring of blood pressure (BP) and heart rate (HR) was conducted for 24 hours per working day during work, leisure and sleep. The CR process was examined for differences between work and leisure, work and sleep regarding a reduction in BP and HR. Lifestyle (physical activity, smoking, drinking) was assessed through questionnaires, BP over a four-day, self-assessment period (38% hypertensives). Participants taking BP medication (n = 12) were excluded from analyses. RESULTS: Shift workers had significantly higher BP (Ø 146/87 vs. Ø 140/84 mmHg; p = 0.034-0.044) and HR (Ø 86 vs. 82 bpm; p = 0.032) during their work phase verses day workers. There were no differences found for the CR between work and leisure nor work and sleep. As predictors of the CR, classic cardiovascular indicators (blood pressure status, smoking, age, physical activity, sex) were found which explains between 14% (HR) and 30% (BP) of the variance. Shift work was not a predictor for CR. CONCLUSIONS: Employees in the HCI show that their CR is mainly determined by the known cardiovascular indicators and less by shift work. This effect needs to be discussed in relation to the job requirements and the cardiovascular health of the employees.

Early Detection of Undiagnosed Hypertension Based on Occupational Screening in the Hotel and Restaurant Industry.

Blood pressure is the most important, modifiable risk factor for cardiovascular diseases. Lifestyle factors and also workload are the main, potential risk factors for the development of hypertension. This study focused on the early detection of unknown hypertension by screening employees in the hotel and restaurant industry (HRI). 148 HRI employees without hypertension (mean age: 34 years, men: 45%) self-measured their blood pressure during rest and for 24 hours of a normal workday. Individuals with a resting blood pressure ≥ 135/85 mmHg were classified as hypertensive. A further analysis investigated whether the currently applicable thresholds for hypertension during work, leisure, and sleep were exceeded on a working day. At rest, 36% of the study participants suffered from hypertension, which increased to 70% under workload and 46% during leisure time and dropped to 8% during sleep. Normal nocturnal dipping (10-20%) occurred only in 18% of cases; 78% were extreme dippers (>20%). Occupational hypertension screening is a suitable component of preventive healthcare. Resting blood pressure measurement alone is insufficient for the early detection of risk individuals and should be supplemented by 24-hour ambulatory blood pressure monitoring under working conditions. The impact of workload on blood pressure needs to be given more attention in the guidelines.

Health status of long-term sick leave and working female teachers in Germany: A cross-sectional study.

OBJECTIVES: Limited research on the health situation of teachers on long-term sick leave is available. The aim of this study has been to describe the health status of female teachers on long-term sick leave (LSFT) in comparison to working female teachers (WFT) and to determine predictors for their state of mental health (MH) and cardiovascular fitness (CF). MATERIAL AND METHODS: Twenty-eight LSFT and 300 WFT (average age: 53±5 years old) participated in a screening diagnostic inventory. Mental health, CF, blood pressure (BP), body mass index (BMI), body fat mass (BFM), health behavior (smoking, alcohol intake, physical activity) and disease burden (DB - number of medical diagnoses) were analyzed for the purpose of characterization of the health status. The multiple linear regression analysis was performed to identify predictors for the state of MH and CF. RESULTS: Adverse values for the MH but also for CF, BFM and the DB (median of medical diagnoses: LSFT: 5; WFT: 2) among the LSFT in comparison to the WFT were confirmed. Additionally, the part of smokers among LSFT (25%) was higher (WFT: 8%). In contrast, the WFT (61%) were much more affected by an elevated BP (LSFT: 26%). Disease burden proved as the strongest predictor for MH of the female teachers. Age, BMI and DB proved as predictors for CF. CONCLUSIONS: Health-related differences between long-term sick leave and working teachers were particularized and a link between physical and mental health among teachers was quantified. Therefore, health-related concepts for teachers should equally focus on physical and psychological aspects. The relevance of regular well-structured occupational health check-ups should be brought to the attention of the profession to prevent diseases and early retirements. Int J Occup Med Environ Health 2018;31(2):227-242.

German version of the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ): translation and validation.

BACKGROUND: Musculoskeletal disorders are a public health problem with significant effects on work ability. In the context of the promotion and prevention of work-related health, there is a need for valid, simple, time-saving and universally applicable methods for the assessment of musculoskeletal pain and complaints. The aim of this study was the translation of the English Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) into German and the validation of the German version. METHODS: The linguistic and cultural adaption of the CMDQ into German (D-CMDQ) followed international guidelines. The adapted pre-version was initially tested in terms of comprehensibility on 44 persons with different educational and occupational backgrounds. The questionnaire was validated further on 68 employees with the reference of an 11-point Numeric Rating Scale (Cohen's Kappa and Spearman's rank correlation coefficients). Finally, reliability (Cohen's Kappa) and internal consistency (Cronbach's alpha) were verified. RESULTS: The D-CMDQ meets the requirements for comprehensibility and demonstrated good validity: The values of Cohen's Kappa and Spearman's rank correlation coefficient obtained substantial to excellent agreement, with one exception. The Kappa values for the test-retest reliability were mainly in the moderate to substantial range whilst taking the prevalence effect into account. The internal consistency was proven satisfactory. CONCLUSIONS: The D-CMDQ meets the psychometric requirements for questionnaires. A clear one-sided presentation of body areas enables the time-saving assessment of musculoskeletal complaints and their effects on work ability. As a result, a broad application in the German-speaking world for different occupational groups seems possible, whether performing physical, manually repetitive or sedentary work.

Effort-Reward Imbalance and Mental Health Problems in 1074 German Teachers, Compared with Those in the General Population.

High degrees of premature retirement among teachers warrant investigating the occupational burden and the mental health status of this profession. A sample of 1074 German teachers participated in this study. Two samples of the general population (N = 824 and N = 792) were used as comparison groups. Work distress was assessed with the Effort-Reward-Imbalance questionnaire, and mental health problems were measured with the General Health Questionnaire (GHQ-12). Teachers reported more effort-reward imbalance (M = 0.64) compared with the general population (M = 0.57), and they perceived more mental health problems (GHQ: M = 12.1) than the comparison group (M = 9.5). School type was not associated with work stress and mental health. Teachers with leading functions perceived high degrees of effort and reward, resulting in a moderate effort-reward ratio and no heightened mental health problems. Teachers working full time reported more effort than teachers working part time, but the reward mean values of both groups were similar. This results in a somewhat unfavourable effort-reward ratio of teachers working full time. Moreover, teachers working full time reported more mental health problems. The results support the appropriateness of the effort-reward conception, applied to the profession of teachers. The higher degree of effort-reward imbalance and the level of mental health problems warrant preventive measures. Copyright © 2014 John Wiley & Sons, Ltd.

Teachers' Health.

BACKGROUND: Almost 800,000 teachers were working in Germany in the 2012-13 school year. A determination of the most common medical problems in this large occupational group serves as the basis for measures that help maintain teachers' health and their ability to work in their profession. METHODS: We present our own research findings, a selective review of the literature, and data derived from the German statutory health insurance scheme concerning medical disability, long-term illness, and inability to work among teachers. RESULTS: Compared to the general population, teachers have a more healthful lifestyle and a lower frequency of cardiovascular risk factors (except hypertension). Like non-teachers, they commonly suffer from musculoskeletal and cardiovascular diseases. Mental and psychosomatic diseases are more common in teachers than in non-teachers, as are nonspecific complaints such as exhaustion, fatigue, headache, and tension. It is commonly said that 3-5% of teachers suffer from "burnout," but reliable data on this topic are lacking, among other reasons because the term has no standard definition. The percentage of teachers on sick leave is generally lower than the overall percentage among statutory insurees; it is higher in the former East Germany than in the former West Germany. The number of teachers taking early retirement because of illness has steadily declined from over 60% in 2001 and currently stands at 19%, with an average age of 58 years, among tenured teachers taking early retirement. The main reasons for early retirement are mental and psychosomatic illnesses, which together account for 32-50% of cases. CONCLUSION: Although German law mandates the medical care of persons in the teaching professions by occupational physicians, this requirement is implemented to varying extents in the different German federal states. Teachers need qualified, interdisciplinary occupational health care with the involvement of their treating physicians.

Predictors of mental health in female teachers.

OBJECTIVE: Teaching profession is characterised by an above-average rate of psychosomatic and mental health impairment due to work-related stress. The aim of the study was to identify predictors of mental health in female teachers. MATERIAL AND METHODS: A sample of 630 female teachers (average age 47 ± 7 years) participated in a screening diagnostic inventory. Mental health was surveyed with the General Health Questionnaire GHQ-12. The following parameters were measured: specific work conditions (teacher-specific occupational history), scales of the Effort-Reward-Imbalance (ERI) Questionnaire as well as cardiovascular risk factors, physical complaints (BFB) and personal factors such as inability to recover (FABA), sense of coherence (SOC) and health behaviour. RESULTS: First, mentally fit (MH(+)) and mentally impaired teachers (MH(-)) were differentiated based on the GHQ-12 sum score (MH(+): < 5; MH(-): ≥ 5); 18% of the teachers showed evidence of mental impairment. There were no differences concerning work-related and cardiovascular risk factors as well as health behaviour between MH(+) and MH(-). Binary logistic regressions identified 4 predictors that showed a significant effect on mental health. The effort-reward-ratio proved to be the most relevant predictor, while physical complaints as well as inability to recover and sense of coherence were identified as advanced predictors (explanation of variance: 23%). CONCLUSION: Contrary to the expectations, classic work-related factors can hardly contribute to the explanation of mental health. Additionally, cardiovascular risk factors and health behaviour have no relevant influence. However, effort-reward-ratio, physical complaints and personal factors are of considerable influence on mental health in teachers. These relevant predictors should become a part of preventive arrangements for the conservation of teachers' health in the future.

Working conditions of female part-time and full-time teachers in relation to health status.

PURPOSE: Teacher's volume of employment and health status are controversially discussed in the current literature. This study focused on female teachers with part-time versus full-time jobs in association with working conditions and health status depending on age. METHOD: A sample of 263 part-time and 367 full-time female teachers (average age 46.7 ± 7.8 vs. 46.0 ± 6.3) participated in an occupational health screening. Specific work conditions, stressors (job history-questionnaire) and effort-reward-imbalance ratio (ERI-Q) were measured and their relationships to mental and physical health were analysed. Health status was quantified by complaints (BFB questionnaire), general mental health status (GHQ-12) and cardiovascular risk factors. RESULTS: On average, teachers in part-time positions reported 36 and in full-time positions 42 h per week. The effort-reward ratios were significantly associated with the volume of employment. Teachers in part-time jobs had only a slightly lower ERI-ratio. There were no differences between full-time and part-time teachers regarding health status. Eighteen percentage of both groups reported impaired mental health (GHQ ≥ 5), 48% of part-time teachers and 53% of full-time teachers suffered from high blood pressure. Low physical fitness was observed in 12% of part-time and 6% of full-time teachers. In this study, neither the volume of employment nor working conditions were found to be significantly correlated with health status. CONCLUSION: Part-time and full-time employment status did not appear to influence health in the teaching profession. Although there are differences in quantitative working demands, while the health status does not differ between both teacher groups.

Working conditions, adverse events and mental health problems in a sample of 949 German teachers.

OBJECTIVES: The aim of this study was (1) to explore in detail the working load of teachers, (2) to analyse the extent of negative or threatening school-related events teachers are confronted with, and (3) to evaluate mental health strain by applying the general health questionnaire (GHQ). METHODS: A sample of 949 teachers in 10 grammar schools (German: Gymnasien) and 79 secondary modern schools (German: Hauptschulen) was investigated applying (1) a questionnaire covering different aspects of the occupational burden and threatening school-associated events and (2) the general health questionnaire (GHQ-12). RESULTS: Based on what teachers indicated in the questionnaire, full-time teachers work more than 51 h weekly. More than 42% of our sample indicated verbal insults, almost 7% deliberate damage of personal belongings, and 4.4% threat of violence by pupils during the past 12 months. When applying the GHQ-12, we found that 29.8% of the sample report significant mental health problems. With respect to school types, teachers in secondary modern schools indicated more of such problems, while no effects regarding age, gender, or full/part-time teaching were observed. CONCLUSIONS: To be a teacher is a hard work and requires coping of considerable amount of adverse events. Based on the GHQ, nearly 30% of teachers suffer from significant mental health problems.

Burnout and effort-reward-imbalance in a sample of 949 German teachers.

OBJECTIVES: High rates of teachers' premature retirement initiated a research investigating their occupational burden. The aim of this study was to elaborate on and extend previous investigations exploring (1) teacher burnout and (2) the relationship between teachers' efforts and their rewards. METHODS: A sample of 949 German teachers in 10 Gymnasien (grammar schools) and 79 Hauptschulen (secondary modern schools) was investigated applying the Maslach Burnout Inventory (MBI-D) and the Effort Reward Imbalance Inventory (ERI). RESULTS: Compared with other studies investigating burnout in employees, we found high rates of burnout symptoms such as emotional exhaustion, depersonalisation, and low personal accomplishment. Male teachers showed significantly lower personal accomplishment and more depersonalization than female teachers. With respect to school types, teachers in Hauptschulen were more often affected by emotional exhaustion and showed more depersonalization. Part-time teachers felt less personal accomplishment than full-time teachers. The ERI cut off was exceeded by 21.6% of all teachers indicating that this subgroup is affected by an imbalance between too much effort and too little reward. With respect to the ERI, significant differences were found for school types, with a higher proportion of Hauptschulen teachers being above this cut off. CONCLUSIONS: At present, the working situation of teachers appears to be characterized by a perceived imbalance of effort and reward and is associated with a high risk of developing burnout symptoms.

Temporal stability of psychophysiological response patterns: concepts and statistical tools.

The specificity or patterning of psychophysiological responses to behavioral stimuli is of importance for basic and applied psychophysiological research. However, the statistical tools used to describe specificity are heterogenious and the attempts to describe temporal stability or reliability of such response profiles are even more complicated. The aim of this paper is to present an approach designed to clarify the relationships between different measures of temporal stability of specificity. This is done with a compilation of statistical measures based on variance components. This approach incorporates features of response specificity and reliability. Individual, situational and motivational response specificity are defined in a uniform way with respect to temporal stability. The use of the formulae is demonstrated with an empirical example. As is found in the research on single parameters, the profile reliability of level scores is higher than that of change scores. Furthermore, the stability of individual response patterns is dependent upon the question of whether the data is aggregated across situations or not. Situational response patterns are stable when the data is aggregated across subjects, whereas the stability is low without such aggregation. Issues of inconsistencies of variance estimates are addressed, and the relationships between temporal stability, consistency and covariation of physiological variables are discussed.