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Prevalence of exhaustion symptoms and associations with school level, length of work experience and gender: a nationwide cross-sectional study of Swedish principals

Persson, Roger LU ; Leo, Ulf ; Arvidsson, Inger LU ; Håkansson, Carita LU ; Nilsson, Kerstin LU and Österberg, Kai LU (2021) In BMC Public Health 21(1).
Abstract

BACKGROUND: While poor mental health and psychiatric disorders attributed to stressful work conditions are a public health concern in many countries, the health consequences of the occupational stress experienced by school principals is an understudied issue. Although current data is lacking, some research suggests that principals have a stressful work situation that eventually may lead to burnout and exhaustion disorder, thus negatively affecting the ability of principals to function as leaders. To gauge the situation in Sweden, and as a basis for future preventive actions, we examined to what extent principals displayed signs of exhaustion and whether the prevalence rates of exhaustion differed across school levels, length of work... (More)

BACKGROUND: While poor mental health and psychiatric disorders attributed to stressful work conditions are a public health concern in many countries, the health consequences of the occupational stress experienced by school principals is an understudied issue. Although current data is lacking, some research suggests that principals have a stressful work situation that eventually may lead to burnout and exhaustion disorder, thus negatively affecting the ability of principals to function as leaders. To gauge the situation in Sweden, and as a basis for future preventive actions, we examined to what extent principals displayed signs of exhaustion and whether the prevalence rates of exhaustion differed across school levels, length of work experience as a principal, and gender.

METHODS: Principals (N = 2219; mean age 49 years [SD 7 years]; 78% women) working at least 50% in pre-schools, compulsory schools, upper secondary schools or adult education completed a cross-sectional web survey entailing two validated inventories: The Karolinska Exhaustion Disorder Scale (KEDS) and the Lund University Checklist for Incipient Exhaustion (LUCIE). Data was analysed using traditional non-parametric methods. Gender stratification achieved covariate balance when analysing school level and length of work experience.

RESULTS: Altogether, 29.0% of the principals met the exhaustion criteria in KEDS. The prevalence rates for the four LUCIE-steps of increasing signs of exhaustion were: no signs of stress, 48.8%; weak signs of stress, 25.6%; clear signs of stress but no exhaustion, 15.4%; possible exhaustion disorder, 10.2%. Compared with male principals, female principals reported more signs of possible exhaustion disorder in both LUCIE and KEDS. School level was not associated with reports of exhaustion symptoms in neither LUCIE nor KEDS. Among male principals, length of work experience was associated with exhaustion symptoms in KEDS.

CONCLUSIONS: A large group of Swedish principals working in pre-schools, compulsory schools, upper secondary schools or adult education displayed a symptomatology of signs of exhaustion that if sustained might lead to poor health. This observation suggests that education authorities, or other relevant stakeholders, ought to take some form of preventive action. However, effective combinations of individual, group, organisational, and/or societal preventive activities remain to be identified and tested.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Exhaustion, KEDS, LUCIE, School leaders, Self-rated health, Stress, Wellbeing, Work
in
BMC Public Health
volume
21
issue
1
article number
331
publisher
BioMed Central (BMC)
external identifiers
  • pmid:33568106
  • scopus:85100981085
ISSN
1471-2458
DOI
10.1186/s12889-021-10317-7
project
Skolledares arbetsmiljö: Ett projekt om organisatoriska förutsättningar, stressrelaterad psykisk ohälsa, personalrörlighet och förbättringspotential
language
English
LU publication?
yes
id
1662cc52-14a5-4f3c-9649-152ccf2e0493
date added to LUP
2021-02-12 09:22:49
date last changed
2021-06-08 04:41:58
@article{1662cc52-14a5-4f3c-9649-152ccf2e0493,
  abstract     = {<p>BACKGROUND: While poor mental health and psychiatric disorders attributed to stressful work conditions are a public health concern in many countries, the health consequences of the occupational stress experienced by school principals is an understudied issue. Although current data is lacking, some research suggests that principals have a stressful work situation that eventually may lead to burnout and exhaustion disorder, thus negatively affecting the ability of principals to function as leaders. To gauge the situation in Sweden, and as a basis for future preventive actions, we examined to what extent principals displayed signs of exhaustion and whether the prevalence rates of exhaustion differed across school levels, length of work experience as a principal, and gender.</p><p>METHODS: Principals (N = 2219; mean age 49 years [SD 7 years]; 78% women) working at least 50% in pre-schools, compulsory schools, upper secondary schools or adult education completed a cross-sectional web survey entailing two validated inventories: The Karolinska Exhaustion Disorder Scale (KEDS) and the Lund University Checklist for Incipient Exhaustion (LUCIE). Data was analysed using traditional non-parametric methods. Gender stratification achieved covariate balance when analysing school level and length of work experience.</p><p>RESULTS: Altogether, 29.0% of the principals met the exhaustion criteria in KEDS. The prevalence rates for the four LUCIE-steps of increasing signs of exhaustion were: no signs of stress, 48.8%; weak signs of stress, 25.6%; clear signs of stress but no exhaustion, 15.4%; possible exhaustion disorder, 10.2%. Compared with male principals, female principals reported more signs of possible exhaustion disorder in both LUCIE and KEDS. School level was not associated with reports of exhaustion symptoms in neither LUCIE nor KEDS. Among male principals, length of work experience was associated with exhaustion symptoms in KEDS.</p><p>CONCLUSIONS: A large group of Swedish principals working in pre-schools, compulsory schools, upper secondary schools or adult education displayed a symptomatology of signs of exhaustion that if sustained might lead to poor health. This observation suggests that education authorities, or other relevant stakeholders, ought to take some form of preventive action. However, effective combinations of individual, group, organisational, and/or societal preventive activities remain to be identified and tested.</p>},
  author       = {Persson, Roger and Leo, Ulf and Arvidsson, Inger and Håkansson, Carita and Nilsson, Kerstin and Österberg, Kai},
  issn         = {1471-2458},
  language     = {eng},
  month        = {02},
  number       = {1},
  publisher    = {BioMed Central (BMC)},
  series       = {BMC Public Health},
  title        = {Prevalence of exhaustion symptoms and associations with school level, length of work experience and gender: a nationwide cross-sectional study of Swedish principals},
  url          = {http://dx.doi.org/10.1186/s12889-021-10317-7},
  doi          = {10.1186/s12889-021-10317-7},
  volume       = {21},
  year         = {2021},
}