Physiological and Psychological Strain in Elementary School Teacher

Study Overview
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Brief Summary
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Survey will enquire the physical and psychological conditions in primary school teachers in Upper Austria. All primary teachers of the 553 Upper Austrian elementary schools (approximately 5105 persons) will be interviewed between November 2018 and April 2019. The main outcomes will be Musculoskeletal pains in nine body regions, the physical activity and the psychological stress with the Work-related Behaviour and Experience Patterns and big five personality traits.

Detailed Description
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Background: Musculoskeletal disorders (MSD) are the leading cause of pain and loss of function, and are complex complaints of high prevalence, resulting in high costs and the psychosocial disadvantages of these patients. The prevalence of work-related physical stress in primary school teachers worldwide depending on the region ranges from 32% to 67%. Schoolteachers also represent an occupation group among which there appears to be a high prevalence of MSD. Many studies have shown that musculoskeletal pain (MSP) impairs quality of life (QoL) to a varying extent. For working populations, musculoskeletal disorders (MSDs) are considered as being responsible for a substantial impact on QoL and incurring a major economic burden in compensation costs and lost wages. Since being a reason for seeking healthcare, MSDs decrease productivity at work, cause absence due to sickness and even to early retirement. Musculoskeletal pains top the list of the most common work-related ailments in Austria. In 2018, they were the third-leading cause for taking sick leave. MSD is one of the leading causes of ill-health retirement among schoolteachers. Gender, age, length of employment and awkward posture are found to be associated with higher MSD prevalence rates among teachers. Primary School teachers spend 25% of time in squatting, kneeling, or sitting position on the floor. An additional 26% of their time was spent sitting on small, child-sized furniture. 18% of teachers' activities were involved in flexing at the trunk greater than 20°. Classroom is configured for primary school pupils. The intensity and frequency correlated with ergonomic factors in the work environment. Beside physical pressures in teachers work, the occupational engagement and individual coping capacity are very important. Schaarschmidt and Kieschke found four types of work-related coping behaviours. These types include psychological aspects of the health. Particular attention is paid to the question of personality factors that facilitate a health-promoting approach to the demands of the profession. The picture for teachers is quite problematic. The teaching profession appears to be associated with higher health risks than other fields of employment. Furthermore, striking gender differences were observed. Female teachers apparently suffer from greater stress than their male colleagues. On the other hand, there are hardly any school-specific or regional differences. Personality traits that prove beneficial for the teaching profession are, in particular, conscientiousness, extraversion and psychological stability. Increased neuroticism is a risk factor for experiencing professional stress and burnout. A low level of neuroticism is a favorable personal disposition in the teaching profession, since everyday teaching is characterized by diverse and permanent social interactions. Therefore, teachers should be expressive, enjoy communicating, be confident, and assertive in socio-communicative situations. In addition, appreciative behavior, friendliness and empathy, team and problem-solving skills are advantageous for teachers. Schaarschmidt was able to show by coping patterns that in the context of school in Germany and Austria there is a critical distribution of these coping patterns regardless of the type of school. In all school types, at least 50% of the teachers are in the risk patterns (overload, burn-out) and just under 20% are in the healthy pattern, in which there is sufficient positive experience of work, commitment and resilience to the challenges of the profession. This picture becomes even more problematic when one compares the pattern distribution between female and male teachers. A shift to the disadvantage of female teachers is evident in all school types. Both, musculoskeletal pains and psychological stress, has a great influence on the health and quality of life of primary school teachers. Aim: The primary aim of this observational study is to enquire the physical and psychological conditions in primary school teachers in Upper Austria. The second goal is to evaluate the influence of physical activity and personal factors on physical and mental health. The personal feedback will evaluate qualitatively in the sense of a holistic view. The authors hope that the results will provide new insights into the factors influencing the works of primary school teachers. Methods: The survey will conduct by an online questionnaire using the Questback Enterprise Feedback Suite tool. The questionnaire included four sections. After the introduction page, followed the physical stress examination with the Nordic Musculoskeletal Questionnaire (NMQ). The second part will survey the psychological stress with the 11 item short test with the Work-related Behaviour and Experience Patterns (AVEM) and Big5 personality questionnaire (TIPI G). At third sections, the physical activity level will enquiry with the Short-Version of the International Physical Activity Questionnaire (IPAQ). The demographic characteristics (gender and age) and the risk factors (smoker/non-smoker, teaching profile, Job category and anthropometric parameter) will collect finally.

Official Title
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Physiological and Psychological Strain in Elementary School Teacher

Conditions
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Work-Related Musculoskeletal Disorders, Work-Related Stress Disorders

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All primary schoolteachers in active service at elementary schools in Upper Austria will be included Exclusion Criteria: on maternity leave ill-health retirement

Ages Eligible for Study
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Minimum Age: 21 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Level of physical activity | The physical activity (PA) of the participants was assessed through the German version of the International Physical Activity Questionnaire -Short Form (IPAQ-SF), which includes 6 questions searching the frequency (days per week) and duration (hours) of walking, as well as the intensity of physical activity in the last seven days. The IPAQ calculates the metabolic equivalent (MET) score by asking participants the days and minutes exercised in three categories of intensity (vigorous, moderate, and walking) during the previous one week. The following formula is used to calculate the MET: MET = 8 (vigorous activity)*(minutes) + 4 (moderate activity)*(minutes) +3.3 (walking activity)*(minutes). | at one point (baseline) | 
| Measure stress-related work behaviour | Work-related Behaviour and Experience Patterns (Arbeitsbezogenes Verhaltens- und Erlebensmuster - AVEM) short test using a five-point answer scale to measure the three Dimensions Engagement, Resilience and Emotions. The 5-point Likert scales ranging from 1 (strongly disagree) to 5 (strongly agree). The points if the three Dimensions are assigned to the 2 patterns G (Health) and S (Unambitious) or the risk pattern A (Overexertion) and B (Burnout). The higher percentage distribution on the patterns G and S is better, more points for the risk patterns A and B shows a poorer mental health. | at one point (baseline) | 
| Prevalence of pain in nine region of the body with the Nordic Musculoskeletal Questionnaire (NMQ) | The Questionnaire evaluating the prevalence of pain (dichotomous scale, yes or no) in the neck, shoulders, upper back, elbows, lower back, wrists/hands, hips/thighs, knees and ankles/feet at the last week and at the last 12 months. The prevalence can reach from 0% (no participant answered yes) to 100% (all participants answered yes). | at one point (baseline) | 
| Intensity of pain in nine region of the body with the Visual Analogue Scale (VAS) | Subjects will report their pain intensity in the neck, shoulders, upper back, elbows, lower back, wrists/hands, hips/thighs, knees and ankles/feet at the last week and at the last 12 months by means of VAS. The VAS used for this study ranges from 0 (no pain) to 10 (heavy pain) points. | at one point (baseline) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Big Five personality traits | The openness, conscientiousness, extraversion, agreeableness and neuroticism will survey at the Trier Integrated Personality Inventory (TIPI). A ten-item measure of the Big Five personality dimensions - 2 items for each of the 5 dimensions. Each item is rated on a 7-point scale that ranges from 1 (disagree strongly) to 7 (agree strongly). The result shows the personal distribution of the personal Big 5 personality traits. | at one point (baseline) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Musculoskeletal Pain, Psychological Stress, Primary School teachers