BURNOUT SYNDROME AMONG EDUCATORS IN PRE-SCHOOL INSTITUTIONS.

INTRODUCTION: The occurrence of burnout syndrome (BS) has been recognized in many professions (pilots, firefighters, police officers, doctors…) that during their work are subjected to high levels of stress. For educators in preschool institutions stress level is very high thus creating the possibility of developing BS.
MATERIAL AND METHODS: For this research is selected preschool institution - kindergarten "Radost" (Joy) in Split, in which by use of questionnaires (modified scale by Freudenberger and modified scales by Girdin, Everly and Dusek) during 2014 among educators (100 respondents) is conducted a survey regarding the frequency of burnout syndrome. RESEARCH
RESULTS: According to questionnaires by Girdin, Everly and Dusek there is no statistically significant difference between the number of educators who feel good and those that are under significant stress (χ2=1.04; p=0.307). According to questionnaire by Freudenberg educators are classified into 3 categories and distribution of educators by the groups is almost uniform (χ2=2.76; p=0.250), which means that one third of a teacher is in good condition, a third is in the risk area for burn-out syndrome, while one third are candidates for development of this syndrome. Comparing a teacher in good condition compared to other (at risk and those who are candidates for the burn-out syndrome) is up to 1.5 times higher in those who are at risk and the candidates for development of this syndrome than in others (χ2=4.5; p=0.033).
CONCLUSION: The occurrence of burnout syndrome is very high for the group of educators (half of the educators!) in pre-school institutions which should be taken into account by the institutions management. For this purpose, it is necessary to organize regular medical check-ups with particular reference to burnout syndrome with signs of the syndrome to prevent its further development.

1. INTRODUCTION

The concept of “burnout syndrome” (BS) was first described in 1970 as a reaction to interpersonal stressors at the workplace (1). Many professions are in constant uncertainty due to the global economic crisis, fear for their jobs, frustrations and pressures at work by business owners or supervisors, because of increased efficiency and, consequently, higher earnings. This consequently leads to an increase in the number of those exposed to BS, that is because of its frequency by the WHO declared as global epidemic. In short, the BS indicates the simultaneous presence of multiple stressors at work and long-term exposure to them, consequently, leads to burnout syndrome. BS is often associated with the appearance of symptoms of anxiety and depression among workers. Today, the stress associated with the job is the most common trigger in which, work factors interact with the worker by hanging its psychological and physiological state and start the disease. Basically this occurs due to the mismatch between the demands of the working environment (owner of the company or superiors) and the real employee’s possibilities. Those exposed to BS are in constant vicious circle: soul-stress-job-environment- body, permanent exposure which final result is the collapse of psychophysical strength and sinking into depression or occurrence of organic diseases (2-8).

In summary, today’s pace of life and work of employees “as at the production line”, exposure to stress and frustration in the workplace, disturbed interpersonal relationships, mobbing at work will eventually lead to physical-mental exhaustion of the organism, described as BS. Burn-out syndrome is particularly acute in the professions with high physical-mental strain, especially in doctors, nurses, educators, firefighters, pilots, police officers and a number of other professions that are exposed to everyday stress and frustrations (9). By definition (Girdin, Everly and Dusek, 1996), burn-out syndrome is “a state of mental and/or physical exhaustion caused by excessive and prolonged stress” (10). These authors distinguish three levels of burnout:

I level - the initial stage, the tension stress

II level - reactive compensation to stress with the conservation of energy

III level – level of burnout

In the initial stage, the tension stress causes the psychological and physiological reactions: constant irritability, anxiety, periods with high blood pressure, teeth grinding during sleep, insomnia, forgetfulness, heart palpitations, abnormal arrhythmia, concentration problems, digestive problems and acute gastrointestinal symptoms. In this stage a person does not perceive its work no longer as a pleasure. In most cases the first phase is not recognized, masked by a complex job requirement, threatened people and the environment and is not recognized as the beginning of the BS. However, with the occurrence of at least two of these symptoms, with great certainty we can say that this is the first stage of exposure to stress.

In the second phase person saves energy to compensate for stress, coming late for work, delaying operations and is reluctant to accept new tasks, lengthening work breaks, have decreased sexual desire, feelings of fatigue and isolation from friends and family, with increased cynicism, bitterness, excessive smoking, drinking coffee, and often alcohol drinking, person is trying to solve problems by taking drugs and psychoactive substances, until the appearance of apathy. This phase is characterized by the need of the person to retreat, calm and conserve energy as much as possible. Environment observes changes in behavior and functioning and ignoring symptoms which leads to the third stage. The appearance of any two of the pervious symptoms indicating the existence of the burnout syndrome second stage.

In the third stage of exhaustion majority of people can see that there is something wrong. Work is being seen as a load, appears chronic depression, decrease resistance to permanent morbidity, chronic stomach and intestinal disorders, chronic mental and physical fatigue, chronic headaches or migraines, the desire to escape from society and going from family, leaving friends and frequent suicidal afterthoughts. The emergence of any two of these symptoms is a certain sign of the third phase of BS (11,12). In addition to these studies, there are is number of other research in this area and numerous scales that in a practical way can help vulnerable working populations, in order to forestall the BS on time (13). Some of these scales are primarily components of the measurement of mental status, others have prevailing physical components in the scale. It seems that the combination of physical-mental component scale for scoring is closest to the exact definition of the of burnout syndrome degree (14-17).

1.1. Exposure to stress of preschool teachers

By definition, educator/teacher is the qualified person who carried out the educational program of the preschool children, independently creates the educational process in its education group (18). He/she timely plan the program and evaluate educational work in all stages of its execution. Teacher obtains, creates and maintains resources for work with children, taking care of the aesthetic and functional arrangement of space to perform different activities. It estimates does each child follows mental and physical development, creates individual development tasks and encourages the development of each child according to its abilities. Neatly keep all supporting documents for children and work and meet professional requirements in organizing and improving the educational process. Teacher works closely with parents, professionals and professional team, with the director of the kindergarten as well as other participants in the upbringing and education of preschool children in the local community. Teacher is responsible for the implementation of the program of work with children as well as for equipment and teaching aids used (19). Pre-school teachers working in kindergartens in jobs care, upbringing and education, social and health protection and care of children from the first year of life, and to enrolling in primary school. In addition to a regular program of education and other care for preschool children in kindergartens and special exercise programs for children with special needs, for gifted children and children of ethnic and national communities and minorities, as well as special programs of learning foreign languages and other programs artistic, cultural, religious and sports facilities. The specific programs also include the so-called pre-school programs. In this respect, children are usually divided into nursery population (by the end of the third year of life) and kindergarten population (from three years to pre-primary school), within which still differ younger and older groups. In accordance with the development opportunities specific groups of children, educators perform the following tasks: train children for self-fulfillment of basic needs in terms of dressing, using eating utensils, personal hygiene and similar habits; organize and conduct with the children proper physical exercise (sports and playgrounds) in order to develop their functional physical ability and health condition; organize receptive and creative games that develop certain cognitive skills and in which is especially pronounced for children creativity; organize activities in which children are exposed to certain aesthetic experiences, for example, art workshops, theater games, music activities, etc.; take children to get to know the environment, with special emphasis on the development of environmental awareness and the development of environmental practices; organize and encourage social activities and games in which children develop their own identity and also develop as social beings; participate in shaping the overall material space in which children in kindergarten live, so that they can satisfy their individual needs in the physical, cognitive, creative, emotional and social development. With close cooperation with other experts in kindergarten (nurse, psychologist, pedagogue, doctor, etc.), a very important segment of the pre-school teachers job is active cooperation with parents, while the parents participate in the selection and implementation of the educational work with children. This cooperation comes to the fore when preparing children over kindergarten age to go to school. In this regard, the cooperation with the primary school in which the children move from kindergarten would be very helpful to many children already in kindergarten meet their future teachers. Pre-school teachers developed and manage prescribed instructional documentation. Based on the annual plan and program of kindergarten, elaborated quarterly and micro-programs for smaller periods and keep diaries of work in which the allegations of planned incentives are recorded and realized activities at individual and group level. At the end of the educational period prepare relevant reports and perform other administrative tasks (20).

Work in the institution of preschool education is a very complex, sensitive and responsible, requires maximum engagement with intensive physical and mental strain, and also the teachers are exposed more to infectious diseases, diseases of the musculoskeletal system and speech organs. Because every day psychological stress, frustration at work, fear for the children entrusted to them for safekeeping, with (not) rare misunderstandings with the environment, parents, sometimes with colleagues at work, BS is common among employees in preschool institutions (21-28).

2. MATERIAL AND METHODS

During the 2014 is carried out a survey of 100 educators from kindergarten „Radost”, out of which 88, aged from 20 to 65 years, adequately filled out the survey. Also performed is the research of work experience and absenteeism among teachers, as well as indirect indicators of stress.

In order to assess the level of stress was used modified scale by Girdin, Everly and Dusek.

1.2. Assessment of stress: a) almost always - 4 points; b) often - 3 points; c) rarely - 2 points; d) almost never -1 point (enter the number next to the answer)

Because of the daily obligations you have too little time for rest and entertainment?

Do you feel that you have enough support and help at work?

Do you lack time to effectively finish your work?

Do you have trouble sleeping because of the excess problem?

Many people simply expect too much from you?

Do you have a sense of devastation?

Do you notice that you are forgetful and undecided because you are overworked?

Do you feel that you are under a lot of pressure?

Do you feel that you have too many responsibilities?

Do you feel worn down at the end of the day?

To study the level of burnout syndrome is used modified scale by Freudenberger.

1.3. Assessment of BS level

Assessment: Scale: 1 to 5! (Insert number of next to the question)

Do you getting tired easily and you feel exhausted?

You’re upset when someone tells you that lately you do not look good?

Are you working more and more, and you feel that you have not done anything?

Is that why you are sarcastic and more disappointed with the world around you?

Do you feel sad and do not know why?

Do you forgetting, do not go to the agreed or visit often lose something?

Are you grumpy, explosive, you get tired of people that surround you?

Do you spend less time with friends and family?

You have no time for common needs (phone, PC, letter etc.).

Do you feel always ill or permanently sick?

Do you feel distracted at the end of the day?

Do you have difficulty in achieving a sense of happiness and satisfaction?

Are you able to laugh at or joke at your expense?

Are you burdened more with marriage and have more problems than usual?

Do you feel that you have very little to say to people?

Assessment of test results was performed as follows:

Girdin, Everly and Dusek, 1996, test

Evaluation: a) almost always - 4 points: a) often - 3 points: c) rarely - 2 points: d) almost never -1 point

The total number of points from 25-40 points imply high levels of stress that can cause mental and physical exhaustion.

15 questions drawn up by Freudenberg scale of burnout, where each answer is scored according to the strength of feeling in a scale from 1 to 5 points

3. RESULTS

During the 2014 years was carried out a survey of 100 educators from institution „Radost” of which 88, aged from 20 to 65 years, duly filled out the survey. The one respondent at age of 20 years is joined to the category of 31-40 years in which there were 23 (26%) of respondents. In the category of 41-50 years there was 18 (20.5%) of respondents. In the category of 51-60 years was 39 (44%) and in the category of 61-65 years were 8 (9.1%) subjects, which in the further analysis, because of the small sample, will be joined to the group of 51-65 years.

Classification of teachers according to age

Also, in order to evaluate the health status are examined absenteeism educators:

The table shows that older population is particularly vulnerable of which 58, or 50%, was on sick leave. It is expected regarding the age group educators, high morbidity and threat of burnout syndrome. In the women’s team is usually more frequent sick leave an employee because of pregnancy, maternity and sick children.

Also evaluated is the teacher’s age:

Burn-out syndrome in teachers

By Girdin, Everly and Dusek arithmetic mean of the score is 25.11±5.0 (median: 25; min-max: 11-42).

According to Freudenberger scale mean of scores is 30.35±2.10 (median: 29; min-max: 15-60).

Pearson correlation coefficient was r=0.605 (p<0.001).

By Girdin, Everly and Dusek there is no statistically significant difference between the number of educators who feel good and those that are under significant level of stress (χ2=1.04; p=0.307).

By Freudenberg educators are classified into 3 categories and distribution of educators by the groups is almost uniform (χ2=2.76; p=0.250). This means that a third teacher in good condition, a third is in the area of risk of burn-out syndrome, while a third candidate for this syndrome. If we compare the educators in good condition compared to other (at risk and those who are candidates for the burn-out syndrome) we get that to 1.5 times those at risk and candidates for this syndrome than the healthy (χ2=4.5; p=0.033).

4. DISCUSSION

Teacher job is extremely stressful, and according to the literature data, after doctors, firefighters, police officers, teachers are among the top people at risk of burnout syndrome (9,21-28). For this reason, we have also examined indirect indicators of BS, the rate of absenteeism (sick leave) and work experience. It is evident that teachers, because of the specifics of the job having the highest rate of sick leave, compared to other groups of workers in pre-school institutions, with a relatively lower length of service and younger age.

Regarding the burnout syndrome, there are many scales which determine its intensity, especially the psychological characteristics (e.g. Maslach scale) or the intensity of stress (Girdin, Everly and Dusek), and final measurement of the level of burnout syndrome (scale according to Freudenberg).

In this case, in our study we used two scales by using data from the questionnaire, scale by Girdin, Everly and Dusek and scale by Freudenberg, which have their specific features. Both scales taken into account more components which by summing produce results which were scored on a scale.

As for the results of our study, they are very similar to the results of other authors indicating that the teacher’s job is extremely stressful, because many years of work in kindergartens, with constant exposure glitter, without preventing BS (periodic examinations of workers to specific, leading to burnout syndrome (9, 12-28).

According to our study and the scale of Girdin, Everly and Duseksman sum of scores is 25.11±5.0 (median: 25; min-max: 11-42), and by the Freudenberg scale mean of the sum of scores is 30.35±2.10 (median: 29; min-max: 15-60). Pearson correlation coefficient is r=0.605; p<0.001.

Thus, according to the results of the first scale, by Girdin, Everly and Dusek there is no statistically significant difference between the number of teachers who feel good and those that are under significant levels of stress, in other words half of the educators has signs of burnout syndrome (χ2=1.04; p=0.307).

According to Freudenberger teachers are classified into 3 categories, and distribution of teachers by the groups is almost uniform (χ2=2.76; p=0.250). This means that a third of teacher is in good condition, a third under the risk of burn-out syndrome, while a third are the candidates for the syndrome. If we compare the educators in good condition compared to other (that are at risk and those who are candidates for the burn-out syndrome) we get that 1.5 times more risk and a candidate for burnout syndrome than in healthy (χ2=4.5; p=0.033). This confirms the hypothesis that the work nursery school teacher one of the most stressful because of the great responsibility and everyday frustrations at work. It also confirms that the communication patterns within the internal public, within the kindergarten, hampered mainly because almost half (on a scale Girdin, Everly and Dusek and scale by Freudenberger) teachers are predisposed to burnout syndrome.

5. CONCLUSION

According to this study, the appearance of signs of burnout syndrome is very high for the group of educators in pre-school and is located in approximately half of the educators. About BS should take into account administration institutions, regarding its prevention. For this purpose, it is necessary to organize regular medical check-ups with particular reference to BS and signs of the syndrome to prevent its further development.

Table 1

Sick leave of employees during 2013/2014.

Table 2

Overview of age and work age of employees by type of work

Table 3

Overview of the number (%) of respondents by scores on different scales.