A systematic review and meta-analysis of the effectiveness of individual-level interventions to reduce occupational stress perceptions among teachers

Abstract

Teachers are largely affected by OS, during their most productive years, leading to catastrophic physical, psychological, and economic burden on themselves, families and society by large. Teachers are responsible for producing the workforce of any nation, and thus have a major impact indirectly on the economy and health of a nation. There are several individual-level interventions conducted to reduce occupational stress (OS) among teachers. This study was conducted to systematically review and conduct a meta-analysis of the effectiveness of individual-level interventions to reduce occupational stress among teachers. This review was registered in the International Prospective Register of Systematic Reviews (PROSPERO; Registration ID: CRD42020149277) and followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed, Scopus, Cochrane, PsycInfo, and Web of Science databases were searched using predefined search strategies covering the eligibility criteria. Studies were selected in four rounds. Risk of bias assessments were conducted with GRADE recommendations and ROBINS-I criteria for randomized and non-randomized interventions, respectively. Study selection, data extraction and bias assessments were performed independ ently by two reviewers with a third reviewer to resolve conflicts. Narrative synthesis of the findings were also performed. Clinical, methodological, and statistical heterogeneity assessments were conduct ed. Meta-analyses were performed with Review Manager 5.3 software using the "generic inverse variance method" with mean difference as the pooled estimate. Sensitivity analyses of the findings was also performed. At the initial search, 293 articles were identified and 29 subsequently selected for synthesis of findings. The findings of the meta-analysis indicated that Cognitive Behavioral Therapy (CBT) and relaxation interventions significantly reduced OS among teachers with an effect size of 6.2 (p < 0.001). Effect size was highest for combined CBT and relaxation interventions which was 6.57 (p < 0.001). Relaxation interventions only and CBT interventions only had effect sizes of 3.35 (p < 0.001) and 3.12 (p = 0.002) respectively. In sensitivity analysis, after removing low-quality studies, CBT interventions only, combined CBT and relaxation interventions and overall effect size were 6.31 (p < 0.00001), 17.36 (p < 0.00001), and 14.55 (p < 0.00001), respectively, ie, substantially greater than with low-quality studies included. Inconclusion, CBT and relaxation interventions reduce OS among teachers and it's most effective when those individual-level interventions are conducted together.

Keywords:

• Cognitive‐behavioral
• effectiveness of individual-level interventions
• reduce occupational stress
• teachers

Acknowledgments

The authors would like to acknowledge Dr. Chandrani Kuruppu, Dr. P.K. Buddhika Mahesh, Dr. Sameera Jayan Senanayake and Dr. Yasaswi Walpita for helping to search research articles.

Authors’ contributions

BD, DS, NG and MD conceptualized the review. DS, NG and MD supervised and guided the overall review. BD, DS, NG, MD and contributed in developing the protocol. BD obtained the registration of the review. BD and DS conducted the study search. BD, DS and NG contributed in study selection and risk of bias assessments. BD, DS and NG contributed in the data extraction. BD conducted the meta-analysis. DS, NG and MD did the overall coordination of the review. All authors contributed in drafting of the initial manuscript. BD, DS, NG, and MD were involved in revising the manuscript. All authors read and approved the final manuscript. BD, DS, and NG preformed the statistical analysis and wrote the first draft of the manuscript. All authors contributed to interpretation of the data, substantively revised the manuscript and approved the final version.

Competing interests

The authors declare that they have no competing interests.

Ethics declarations

Ethical approval was obtained from the Ethical Review Committee, Faculty of Medicine, University of Colombo, Sri Lanka.

Correction statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.