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

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 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.

Supportive and demanding managerial circumstances and associations with excellent workability: a cross-sectional study of Swedish school principals

“…From this perspective, it is conspicuous that the Swedish Work Environment Authority, which in 2009 and 2010 inspected the working conditions of principals in 52 municipalities in Western Sweden, observed problems with turnover, work overload, and performance, and that only approximately 10% of the visited school units paid sufficient attention to the principals' working environment [13]. It is similarly conspicuous that we observed in a recent study that circa 25-30% of Swedish principals' displayed signs of exhaustion [14], and that national data for the 2011/12, 2012/13 and 2014/15 semesters, showed that 29%, 22% and 27% of the principals changed school units, respectively [15]. Even if turnover rates may affect schools differently, and differ between age groups, school level, and the type of municipality (e.g., urban or rural) [15,16], the high turnover rates and the high prevalence of exhaustion signs raise questions regarding the principals' organisational preconditions.…”

“…The participants in the present study are identical to the participants in our previous study that examined the prevalence rates of signs of exhaustion [14]. In brief, 9900 principals were invited via e-mail.…”

Guest editorial: Leadership in school health promotion. The multiple perspectives of a neglected research area

“…health-oriented leadership requires more research that examines the working conditions and their links with health related outcomes. So far, we know little about the health and well-being of leaders, and only a few studies focus on the health and well-being of formal leadership positions such as school principals (Persson et al, 2021;Philips et al, 2008). The same is true for follower-directed leadership, with only very few studies examining the relationship between formal leadership styles and actions and well-being and health of school staff (Harazd and van Ophuysen, 2011;Konu et al, 2010).…”

Should I Stay or Should I Go? Associations between Occupational Factors, Signs of Exhaustion, and the Intention to Change Workplace among Swedish Principals

“…While work environment factors and stress-related health among teachers have gained a large interest among researchers [ 16 , 17 , 18 , 19 , 20 ], less scientific studies have focused on the work environment and health among principals [ 13 , 21 , 22 ]. Anyhow, evidence has been provided of an association between principals’ satisfaction with their work characteristics and their mental health status [ 12 ].…”

“…The association between burnout and high job demands and low job control also applied to Swedish teachers [ 19 , 20 ]. In a previous study of the present study population [ 22 ], 29% of the principals and assistant principals in compulsory school met the exhaustion criteria according to Karolinska Exhaustion Disorder Scale (KEDS) [ 27 ]. This prevalence rate is almost twice as large as the prevalence rate observed in a highly educated but occupationally diverse study sample [ 28 ].…”