High workload is related to lower quality of life in public school teachers: A cross-sectional study

Abstract

BACKGROUND:

People with long work hours, as evidenced by teachers, were more likely to present health problems that impact their quality of life (QoL). The reduced physical activity (PA) level or higher sedentary behavior in public school teachers was related to obesity. Although PA seems to improve the QoL in other professions, assessing whether the PA level could influence the relationship between workload and QoL in public school teachers is necessary.

OBJECTIVE:

To analyze whether the high workload was related to worse QoL in teachers considered less active and more active.

METHODS:

Two hundred forty-three teachers from public schools participated in this study. The domains of QoL and PA levels were assessed by SF-36 and Baecke questionnaires, respectively. Workload perception was assessed by a Likert scale. Binary logistic regression analyzed the association between high workload and QoL domains in teachers considering the PA level in a model adjusted by confounding factors (i.e., sex, age, and socioeconomic condition).

RESULTS:

Heavy workload was associated with less chances of having better physical limitation domain of both less and more physically active teachers. Less active teachers with heavy workloads were 53%, 61%, and 56% less likely to have better vitality, social functioning, and mental health, respectively. No such associations were observed in the more physically active teachers.

CONCLUSION:

Less active teachers with a heavy workload demonstrate lower QoL. Although the PA practice eliminated this relationship, both active and less active teachers with a heavy workload demonstrated lower QoL in physical limitation domain.

Keywords

Teaching physical activity exercise quality of life mental health adults workload

1 Introduction

One of the world’s most important and oldest professions refers to the act of teaching exercised by teachers. Nowadays, is common in many parts of the world for teachers to have a significant number of hours with a high workload [1, 2]. Teachers can spend up to 55 hours per week in the classroom during the term and a lot of hours in extracurricular activities (e.g., school coordinator and grade level chairmanship) [2, 3]. Thus, this is an important issue to consider since the high workload can cause teachers a series of health problems.

A high workload negatively impacts physical and mental/emotional health and well-being [4, 5]. Previous studies evidenced that teachers with a high level of workload can present sleep problems, burnout, stress and. pain in different body regions in women from different professions (including teachers) [6 –9]. Due to the need to work in the evenings and at weekends [4], some teachers have time for leisure and practice physical activity (PA) reduced, which affects their physical and mental health. The reduced PA or higher sedentary behavior in public school teachers was related to abdominal obesity [10]. On the other hand, high sedentary breaks were associated with better dietary habits, lower chance of high blood pressure, and high levels of PA among teachers [10, 11]. These findings show that the high workload in teachers can greatly influence their health and quality of life (QoL).

QoL is a subjective and multidimensional parameter that involves the perception of health and well-being considering physical, emotional, and social aspects and the individual’s perception of their position in relation to their goals, standards, and concerns [12, 13]. Teachers from Brazil demonstrates impaired QoL, psychological well-being, and the meaning in life [14]. It should be highlighted that the performance of the teachers in their functions was affected by the decrease in the satisfaction of QoL [15]. An important tool to increase QoL in different population is the PA practice [16].

PA is one lifestyle habit that can help support workload and improve QoL. PA was positively associated with several domains of QoL such as body pain, vitality, and mental health [16] The practice of PA was related to a better QoL in office workers at a university [17]. Similar findings were observed after investigating the relationship between PA and QoL in a supermarket cashier [18]. Considering teachers, few studies have evaluated the possible effects on QoL, especially considering the workload. Metri et al. observed that a six-week yoga intervention improved pain and mental health scores in female teachers with chronic musculoskeletal pain [19]. However, it is necessary to assess whether the level of PA could influence the relationship between workload and QoL in public school teachers.

Therefore, the aim of this study was to analyze whether the high workload was related to worse QoL in teachers considered less active and more active and whether such relationships would be independent of possible confounding variables (i.e., sex, age, and socioeconomic status). We expected that the relationship between self-perception of high workload and lower QoL is less incident in more active teachers.

2 Methods

The present observational study has a cross-sectional design. All procedures of this study were approved by the research ethics committee at São Paulo State University (CAAE: 72191717.9.0000.5402). All participants were informed about the procedures and objectives of the research and those who agreed to participate signed the statement of consent before their participation.

2.1 Sample selection, inclusion, and exclusion criteria

Our study was conducted in the city of Presidente Prudente (∼207,625 inhabitants) located in the Southeast region of Brazil. There are approximately 650 teachers distributed in 23 public schools according to the Presidente Prudente Education Department. The sample size calculation considering a confidence interval of 95%, a power of the test of 80%, and a maximum tolerable error of 5%, provided a minimum sample of 242 teachers. For the sample selection, all 23 schools in the five regions (i.e., north, south, east, west, and central area) in the city were visited and invited to participate in the research. However, only 13 schools allowed the collection of data, and all these schools were assessed. The details of the study were communicated by the coordinator to the teachers at least one week in advance and the following inclusion criteria were defined: i) be an effective teacher at the school, and ii) answer all items of the questionnaires.

The following exclusion criteria were considered: i) not answering all questions in the applied questionnaires; ii) refusing to take anthropometric measurements.

2.2 Data collection and analysis

The data collection was performed during the collective pedagogical work class, at the time when all teachers were present, on a previously scheduled date, in the work environment of the teachers. This was planned to not interfere with the pedagogical activities of the schools. Trained researchers performed the data collection in face-to-face household interviews in specific rooms provided by the management of the schools participating in the study.

The domains of QoL were assessed by The Medical Outcomes Study SF-36-Item Short Form Health Survey (SF-36). SF-36 is a questionnaire constituted of 36 items that investigate the following domains of QoL: physical limitation, general health status, vitality, social functioning, mental health, bodily pain, functional capacity, and role-emotional. Each domain has a score ranging from 0 to 100, from the worst to the best QoL, respectively [20].

The perception of workload was assessed by a Likert scale (very low, low, regular, high, and very high). The teachers were classified as having a ‘heavy workload’ those who reported high and very high perception of workload, and ‘regular workload’ those participants whose perceptions were very low, low, and regular workload.

Habitual practice of physical activity was assessed by Baecke questionnaire [21, 22]. The questionnaire is composed of questions about the frequency, duration, and intensity of physical activities performed in the domains of leisure time/commuting, occupation, and sports practice (i.e., three domains). A dimensionless score ranging from 1 to 5 for each assessed domain and the sum of three domains corresponds to the total physical activity score provided by the Baecke questionnaire. Individuals were classified as ‘high active’ those who were in the fourth quartile (i.e., highest quartile), and ‘less active’ those participants located in the first quartile of the Baecke score.

Sex, age, and socioeconomic score were considered as covariates in the study analysis. The socioeconomic score was calculated according to Brazilian Criteria for Economic Classification [23], which considers educational level and the number of specific rooms and consumer goods at home. This instrument provides a specific score that classified the individuals into the following economic classes: “high class” (A1, A2), “medium class” (B1, B2, C1), and “low class” (C2, and D) [23].

2.3 Statistical analysis

Statistical analyses were performed by the software SPSS 15.0 (SPSS Inc., Chicago, IL, USA). The significance level was maintained as 0.05. The prevalence of different domains of QoL according to self-perception of heavy workload was analyzed by Qui-Squared test. Binary logistic regression analyzed the association between high workload and QoL domains in teachers considering the level of physical activity practice in model adjusted by confounding factors (i.e., sex, age, and socioeconomic condition).

3 Results

Table 1 presents the sample characterization information (n = 243) according to self-perception of workload. It is observed that teachers with normal self-perception of workload had higher QoL scores in the domains of physical limitations, social functioning, and role-emotional when compared to teachers with high self-perception of workload.

Table 1
Sample characteristics according to self-perception of workload (n = 243)

Normal workload High workload P-value

Mean (SD) Mean (SD)

Age, years 45.44 (11.41) 44.95 (9.55) 0.707

Weight, kg 75.55 (17.38) 73.25 (16.32) 0.288

Height, cm 164.34 (8.75) 164.38 (8.41) 0.974

Physical limitation, 0–100 score 81.92 (30.97) 64.48 (38.38) <0.001

General health status, 0–100 score 66.95 (30.97) 64.80 (38.39) 0.466

Vitality, 0–100 score 54.52 (24.80) 50.90 (20.25) 0.217

Social functioning, 0–100 score 78.91 (20.98) 71.32 (21.25) 0.006

Mental health, 0–100 score 63.83 (26.10) 60.41 (22.07) 0.270

Bodily pain, 0–100 score 42.36 (10.74) 42.40 (9.15) 0.974

Functional capacity, 0–100 score 75.57 (28.01) 73.20 (27.91) 0.512

Role-Emotional, 0–100 score 80.96 (33,13) 71.16 (41.41) 0.044

	Normal workload	High workload	P-value
Age, years	45.44 (11.41)	44.95 (9.55)	0.707
Weight, kg	75.55 (17.38)	73.25 (16.32)	0.288
Height, cm	164.34 (8.75)	164.38 (8.41)	0.974
Physical limitation, 0–100 score	81.92 (30.97)	64.48 (38.38)	<0.001
General health status, 0–100 score	66.95 (30.97)	64.80 (38.39)	0.466
Vitality, 0–100 score	54.52 (24.80)	50.90 (20.25)	0.217
Social functioning, 0–100 score	78.91 (20.98)	71.32 (21.25)	0.006
Mental health, 0–100 score	63.83 (26.10)	60.41 (22.07)	0.270
Bodily pain, 0–100 score	42.36 (10.74)	42.40 (9.15)	0.974
Functional capacity, 0–100 score	75.57 (28.01)	73.20 (27.91)	0.512
Role-Emotional, 0–100 score	80.96 (33,13)	71.16 (41.41)	0.044

SD: Standard deviation.

The prevalence of high quality of different QoL domains in participants with self-perception of heavy workload according to the level of PA is shown in Fig. 1. It is generally observed that the prevalence of better scores of QoL domains is higher in more active participants, mainly considering the domains of vitality, mental health, functional capacity, and role-emotional.

Fig. 1

Prevalence of different domains of quality of life according to self-perception of heavy workload.

Table 2 shows the associations between self-perception of heavy workload and high QoL. The self-perception of heavy workload was associated with less chances of having QoL in the domain of physical limitation both in less active and more physically active participants. Considering the domain vitality, less active participants with a self-perceived heavy workload were 53% less likely to have high QoL. No significant associations were observed in the most active teachers. Less active teachers with a self-perceived heavy workload were 61% and 56% less likely to have better social functioning and mental health, respectively. No such associations were observed in the more active teachers. No associations were observed between self-perception of heavy workload and the domains of general health status, bodily pain, functional capacity, and role-emotional.

Table 2

Association between high self-perception of workload and quality of life

	Less active			More active
	OR	95% CI	P-value	OR	95% CI	P-value
Physical limitation	0.39	0.21–0.74	0.004	0.32	0.10–0.99	0.048
General health status	0.59	0.30–1.16	0.131	0.70	0.24–2.01	0.510
Vitality	0.47	0.23–0.97	0.038	0.89	0.31–2.52	0.824
Social functioning	0.39	0.19–0.81	0.012	0.51	0.17–1.51	0.229
Mental health	0.44	0.21–0.94	0.033	0.74	0.26–2.06	0.563
Bodily pain	1.17	0.62–2.21	0.619	0.88	0.29–2.64	0.821
Functional capacity	0.63	0.31–1.24	0.182	0.48	0.17–1.37	0.173
Role-Emotional	0.79	0.41–1.51	0.483	0.40	0.10–1.59	0.194

Adjusted by sex, age, and socioeconomic status.

4 Discussion

The study aimed to analyze whether the high workload was related to worse QoL in public school teachers considering the physical activity level. As expected, we observed that less active teachers with a high workload were less likely to have a better QoL in the domains of functional capacity, vitality, social functioning, and mental health. Thus, PA practice may decrease, at least in parts (i.e., some domains), the deleterious effect of heavy workload in QoL in public school teachers. In the more active teachers, the heavy workload was only related to lower chances of having better functional capacity.

In our sample, 52% of teachers reported having a high workload, which could be related to lower QoL. Hojo [7] in a study with Japanese teachers observed that the average workload of hours in the classroom was 54 hours. Nowadays, is a worldly phenomenon of teachers reporting to have a significant number of hours at work [1, 2]. Teachers can spend up more than 55 hours per week in the classroom and in others extracurricular activities [1, 2], which decrease the time for leisure and PA practice [4], and lead to physical and emotional problems [7 –9]. Similar to our study with teachers, it was observed that excessive workload during COVID-19 in nurses was associated with lower QoL [24]. In a study with homecare Works in Sweden, Sjöberg et al. (2020) observed that high workloads had a lower QoL than personnel with a normal workload [25]. Comparing our study sample with the studies by Ebrahimi et al. [24] (with nurses) and Sjöberg et al. [25] (home care workers), keeping due proportions, are professions with a high demand for stress and where physical and mental wear tends to be higher.

Moreover, considering the specificity of our sample, teachers have some peculiarities such as the long-standing time or the fact of having to bend down and be in a bent posture to assist children in kindergarten, for example. Such aspects could contribute to a decrease in functional capacity, in addition to an increase in musculoskeletal pain in teachers [26]. It is also noteworthy that the pain caused by prolonged standing, poor posture, and often linked to excessive workload could be related to a decrease in mental health, such as depression [27].

Although heavy workload impact negatively the QoL in teachers, the practice of PA may decrease this negative influence. Our results indicated that when stratified by PA levels, the excessive workload was related to lower QoL in four domains (i.e., functional capacity, vitality, social functioning, and mental health) for less active teachers, while such relationships were observed only with functional capacity in more active teachers. One of the possible reasons is that the practice of PA would help maintain physical fitness and subsequently, the body could be better prepared for the workload, also contributing to vitality [28, 29]. Regarding social functioning, PA performed in groups can often help to strengthen relationships, which would provide positive outcomes in social relationships by increasing the circle of friends [30].

Despite the relationship between a heavy workload and worse QoL in less active participants, this relationship was not observed in the more active ones. Inadequate time of PA or higher sedentary behavior was related to abdominal obesity in public school teachers [10]. On the other hand, high sedentary breaks were associated with high levels of PA among teachers [10, 11]. Previous cohort study observed that PA was associated with mental health in adults [31]. The practice of PA would be linked to a series of beneficial neurotransmitters that would cause a feeling of well-being, such as endorphins and serotonin [32] which would contribute to improvements in mental health.

As limitations of this study, we point out the subjective measure of PA, which makes it difficult to better explore the different intensities. However, the Baecke questionnaire seems to be a reliable and valid measurement of habitual PA levels in adults [22], Also, it should be highlighted the difficulty of evaluating a large number of participants with accelerometry in epidemiological studies. Another aspect is the cross-sectional nature of the study, which makes it impossible to analyze cause-and-effect relationships. Although these limitations, our study advances the knowledge by evidencing the positive influence of the PA practice in the QoL in teachers with a heavy workload that live in a middle-income country (i.e., Brazil). Thus, our results could contribute to public policies for improving QoL through PA practice in a population with a high workload such as teachers at public schools.

5 Conclusion

Less active teachers with a heavy workload demonstrates lower QoL such as vitality, social functioning, and mental health domains. Although the practice of PA eliminated this relationship, both active and less active teachers with a heavy workload demonstrated lower QoL in the physical limitation domain. Thus, the PA practice seems to be an important tool for public policies that can be developed based on consistent epidemiological data.

Ethical approval

The study was approved by the Ethics Research Committee at Sao Paulo State University (CAAE: 72191717.9.0000.5402 –08/11/2017).

Informed consent

Informed consent was obtained in writing from all individual participants included in the study.

Conflicts of interest

The authors declare that they have no relevant conflict of interest.

Footnotes

Acknowledgments

The authors would like to thank all volunteers who agreed to participate in this research, as well as all members of the Physical Activity and Health Scientific Research Group (GEAFS)— UNESP/ Brazil who assisted with data collection sampling and logistics.

Funding

VSB was financed by São Paulo State University (UNESP) (Edital 13/2022/PROPe). LDD was supported by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Capes) (Finance code 001). DGDC holds a Productivity Fellowship from the National Council for Scientific and Technological Development (Grant number: 305886/2022-3).

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