Assessment of Stress, Depressive, and Anxiety Symptoms in Teachers in the Public Education Network

Research Article

Ann Depress Anxiety. 2015;2(3): 1051.

Assessment of Stress, Depressive, and Anxiety Symptoms in Teachers in the Public Education Network

Gonçalves GB¹, Cesário ACM¹, Fernandes MR²,Beijo LA³, Magalhães VF4 and Marques LAM4*

¹Academic of Pharmaceutical Sciences, Federal University of Alfenas, Brazil

²Department of Psychiatry, University of Alfenas, Brazil

³Department of Mathematics, Federal University of Alfenas, Brazil

4Pharmaceutical practice, Federal University of Alfenas,Brazil

*Corresponding author: Luciene Alves Moreira Marques, Pharmaceutical Sciences Faculty of Federal University of Alfenas, Brazil

Received: May 13, 2015; Accepted: June 11, 2015; Published: June 18, 2015

Abstract

Stress events and depressive and anxiety symptoms present in public education network teachers involve factors that may affect the good performance of themselves and of their students. The objective of this study was to evaluate the levels of anxiety, depression, and stress, and compare the data from elementary schools with high school and refers the subject to psychiatric service, when required. The research instruments were applied to 139 teachers from public schools in Alfenas-MG. After application, a lecture at each school was given to enlighten the teachers and give feedback about their condition, and affected individuals were referred for care and treatment. Data were analyzed using Bioestat 5.0 software through short steps. The results showed that levels of stress, depression, and anxiety symptoms of teachers in the public education network are high.

Keywords: Stress; Education; Teachers; Depression

Introduction

Stress and symptoms of depression and anxiety in the workplace arise through lack of good work space structure, moodiness of people who interact in this period and pressure from superiors demanding improvements for effective work, according to a survey carried out by the newspaper O Globo (The Globe) on 22 September 2012 [1].

Stress is considered a challenge to workers, making them vulnerable, causing illness and lower productivity, lack of motivation, and insecurity in what they do [2]. Teachers are people who suffer from these consequences and can have a direct impact on the education of those who depend on this professional.

Accompanying this stimulus response to external and internal actions are anxiety and depressive symptoms that affect the mental health of teachers, since wear and fatigue are not offset by compensation and moral gratification. The burnout concept [3] justifies such causes as burnout, impacting on emotional, psychological and physical [4] aspects.

It is known that at the present time the teacher’s role has expanded; in addition to fulfilling their study plan in the classroom they have to maintain the link between the community and the students/school. In addition to the teacher exercising their role as educators, they must attend school management planning. It is noted that the teacher, beyond their duties in the workspace, also involves participation from families and the community [5], which often causes a lot of stress, anxiety and depression due to overloading.

There are several studies that aim to assess the health of teachers [6-8]. However, none of them aimed at the inclusion of some level of intervention.

Studies in other countries indicate that there is a direct relationship between increased stress at work and high levels of fatigue sleep disturbance, depressive problems and consumption of medication [9]. In addition, currently more is demanded of the teacher’s responsibilities, they are less valued and are often subjected to violence that has built up over the years in their work environment.

In Brazil, teachers of elementary and secondary education has faced and a double shift or triple work, situations of disrespect and violence in schools reported by major media outlets. So the elementary and high school teachers were chosen as the object of study of this research.

Thus, this study aims to assess levels of stress; anxiety and depression present in public school teachers, compare the results obtained in elementary school teachers with those of high school, and provide guidance on the subject and refer those affected to psychiatric service.

Materials and Methods

Study location and data collection period

Research was conducted in state and municipal public schools in the city of Alfenas-MG. The field of research through data collection was developed in the period from January to November 2013.

Inclusion and exclusion criteria

All teachers of state and municipal public schools in Alfenas operating in the elementary and high school levels of public education were included in the research. Those teachers who were not present on the interview day, after two attempts, were excluded and also those who declined to participate.

Procedure

This was an observational cross-sectional study. Teachers received a statement about the research objectives through the management of schools and were invited to participate. Those who accepted were instructed on how to fill out the forms after signing the free and informed consent terms. Teachers received a questionnaire with socio-demographic data and questions about their working lives, the Beck anxiety and depression inventory and the work stress scale. They were instructed on how to complete the documents in their homes or at another appropriate time and to deliver the questionnaires to the school board after 3 days, for collection by the researchers.

After collecting the questionnaires, a lecture on depression, anxiety and quality of life was scheduled that was given by one of the researchers and lasted approximately two hours. This lecture was given at the school on a date previously scheduled with the board. The purpose of this lecture was to provide guidance on depression, anxiety and stress and also on pharmacological and non-pharmacological treatment. On the same day each teacher received feedback about their screening, conducted through questionnaires. Although the scales may not be used as a diagnostic tool, they give us evidence of which people/patients need to be referred to the health facility for evaluation and if necessary, treatment. In this case, the subject would be forwarded to the municipal psychiatric service.

Research instruments used

Beck depression and anxiety inventory: The Beck Depression Inventory (BDI) is a scale of economic self-assessment because it requires less time of the mental health team. However it has obvious disadvantages: its reliability is difficult to analyze and its use assumes patients have some degree of education, are cooperative and have no serious psychopathology. In addition, many patients find it difficult to assess the severity of their symptoms [10].

Still, the Beck depression inventory is a self-assessment scale most widely used both in research and in the clinic, and has been translated into several languages and validated in different countries [11].

The original scale consists of 21 items, including symptoms and attitudes whose intensity varies from 0 to 3. The items refer to sadness, pessimism, sense of failure, lack of satisfaction, guilt, feelings of punishment, self-deprecation, self-accusation, suicidal thoughts, crying spells, irritability, social withdrawal, indecision, body image distortion, inhibition to work, sleep disturbance, fatigue, loss of appetite, weight loss, somatic concern, and decreased libido.

The competitive validity of the BDI with respect to other clinical depression assessments such as the scales of Hamilton and of Zung, are high for psychiatric patients (0.72 and 0.76), respectively [11].

The BDI has been extensively validated in Brazilian clinical and population samples by Cunha and colleagues, who found the following points for different intensities of depressive symptoms: minimal (0-11), mild (12-19), moderate (20-35) and severe (36-63).

The Beck anxiety scale (BAS) was developed to assess the severity of anxiety symptoms in depressed patients. The scale consists of 21 items describing common symptoms of anxiety. The summed items result in a score which can range from 0-63, and the cut-off points are the same as those of the BDI.

The average score for each subject and for the groups (elementary and high school) was calculated.

Work Stress Scale (WSS): The WSS proposal by Paschoal & Tamayo (2004) [12] has satisfactory psychometric characteristics and can contribute both to research on the subject and to diagnose the organizational environment, completing information resulting from other instruments. Commonly, tools used to evaluate occupational stress consider a range of stressors or a range of reactions and, when considering the two, do not establish a link between them. The WSS avoids making two separate reviews and considers the individual’s perception in line with the criticism relating to approaches that focus on stressors or reactions alone, and thus fills in some gaps in occupational stress assessment tools.

This scale consists of 23 items answered in a rating scale from 1 to 5, with 1 being the minimum stress and 5 being the maximum stress. The average score for each subject and for the groups (elementary and high school) was calculated. The higher the score, the higher the stress level. When the average value is equal to or greater than 2.50 it is to be understood as a considerable stress indicator [12].

Ethical aspects

This study was approved by the Ethics Committee of the Federal University of Alfenas (UNIFAL-MG) under number: 183.256.

Statistical analysis

Data were analyzed using summary measures (mean, standard deviation and percentage frequency). Bioestat 5.0 software used in the research.

Results

In this study 139 teachers were interviewed, with an average age of 39.30 years (±10.70 years), 78.40% (n = 109) were female and 20.10% (n = 28) male, and 1.40% (n = 2) did not identify.

Regarding education, 0.72% (n = 1) of the respondents have technical/high school, 46.76% (n = 65) have higher education, 49.64% (n = 69) have specialisms and 1.44 % (n = 2) have a master’s degree, and 1, 44% (n=2) did not answered.

Evaluating the duration of work in the profession, 15.10% (n = 21) have worked less than two years, 11.51% (n = 16) between two and five years, 22.31% (n = 31) between five and ten years, 17, 99% (n = 25) between ten and fifteen years and 32.37% (n = 45) worked more than fifteen years, and 0.72 (n=1) did not answered.

Of the respondents, 52.52% (n = 73) work in more than one school, 15.10% (n = 21) have more than one activity at the same school and 67.63% (n = 94) work in more than one work shift.

Teachers who reported having been humiliated in the workplace total 46.76% (n = 65) of all respondents, and many have already been humiliated by more than one individual. The biggest offenders are students (38.80% of teachers have been assaulted), followed by directors or supervisors (19.41%), professional colleagues (17.32%), parents of students (15.31 %) and others (8.23%).

Of the professionals interviewed, a very significant number, 63.31% (n = 88) reported ever having been verbally or physically abused by students. Among these, 13, 63% (n = 12) had to move away to recover, 27.27% (n = 24) required some medication and 10.22% (n = 9) required therapy with a psychologist.

The percentage of teachers who have at least one diagnosed illness was 31.00% and, using some type of medication was 31.71%. Additionally, 33.81% reported having used some medication to sleep.

With regard to leisure, 7.22% stated that they do not engage in any leisure activity.

Analyzing the Beck anxiety inventory, the percentage of teachers who received some degree of anxiety above normal was 43.84% (Figure 1).