Burnout Among Primary School Teachers in the Wazzane Region in Morocco: Prevalence and Risk Factors

Article history: Received: 09 August, 2020 Accepted: 16 September, 2020 Online: 24 November, 2020 Introduction: Burnout is a real malaise that affects the mental health of teachers. The objective is to determine the prevalence of burnout among primary school teachers in the Wazzane region and to look for associated risk factors. Methods: Descriptive crosssectional study conducted in 20172018 with a sample of 330 teachers. Socio-demographic and work-related data were assessed by a self-administered questionnaire and the Karasek Job Content Questionnaire (JCQ) the Karasek, the burnout by the Maslach Burnout Inventory (MBI). Results: 330 teachers participated in the study with a male predominance of 62.4% and an average age of 38.4 (SD = 8.9). The average scores for emotional exhaustion, depersonalization and personal accomplishment were (21.8 ± 9.2); (14.1 ± 9.9) and (15.1 ± 8.4) respectively. Pathologically, emotional exhaustion was high in 23.9%, depersonalization was high in 24.2% and personal accomplishment was low in 26.1% of participants. 46.6% were victims of burnout, of which 23.9% had a low level; 14.2% had a moderate level and 8.5% had severe burnout. Logistic regression analysis showed that the predictors of burnout were female gender (p<0.01), Problems of equipment didactic (p<0.01), student demotivation (p<0.05), conflict with colleagues (p<0.05), work overload (p<0.01) and low decision-making autonomy (p<0.01).Conclusion: These results justify the interest of a prevention program and intervention at different levels to protect teachers.


Introduction
Burnout is a negative psychic experience experienced by an individual; it is related to chronic emotional stress caused by working to help people [1]. Maslach and Jackson [2] identified three characteristics of the burnout syndrome: Emotional exhaustion: It refers to the feeling of being drained of one's emotional and physical resources and leads to difficulties in regarding to the emotions of the other. It represents the basic response to stress.
Depersonalization: It represents a negative or excessively detached response towards other people who are considered as objects.
Loss of personal accomplishment: It refers to feelings of incompetence and inefficiency, lack of success and productivity at work. Teachers are part of at-isk populations of workers who may be exposed to the burnout syndrome [3]. Indeed, Maslach and Travers have identified several socio-demographic and occupational risk factors for teacher burnout [4,5]. In our context, no study has been carried out among primary school teachers. For this reason, we aim to determine the prevalence and risk factors of burnout among a population of primary school teachers in the Wazzane district (Morocco).
For burnout, a score was calculated and a severity rating (low, moderate, and high) was assigned for each dimension. Emotional exhaustion was considered pathological for a score above 29, depersonalization for a score above 22, and personal accomplishment was considered low for a score below 11. The number of dimensions affected characterizes the degree of severity of burnout, so a single affected dimension determines low burnout, two affected dimensions determine moderate burnout, and three affected dimensions determine severe burnout (high emotional exhaustion and depersonalization scores, low personal accomplishment score). Statistical analysis was realized using SPSS version 21. Frequencies and percentages were calculated for the categorical variables, and the chi-square test (X 2 ) was used to evaluate the differences between these variables. Continuous numerical data were summarized as mean and standard deviation. Logistic regression was used to determine the predictors of burnout; a p-value<was considered statistically significant.

Results
For the 330 participants who completed the data sheet, the average age was 38.4±8.9 years, with a minimum age of 24 and a maximum age of 59. The sex ratio was 1.7 in favor of males. The average years of service was 16.3±8.9 years. 46.7% are between the ages of 35 and 49; 62.4% are male; 52.4% are married and 48.5% have years of service between 11 and 24.
In terms of work-related characteristics, 40% managed multigrade classes; 61.5% had problems due to student demotivation; 54.5% had problems due to equipment didactic; 19.1% reported conflicts with colleagues; 12.4% with administration; workload was high for 57.5%; decision-making autonomy was low for 42.7%, and social support was low for 45.2% of participants (Table 1). Pathologically, emotional exhaustion was high for 23.9%; depersonalization was high for 24.2% and personal accomplishment was low for 27.6% of participants (table 2).
Regarding sociodemographic risk factors, the chi-square test showed that age and years of service were not significantly associated with burnout, while gender was found to be significantly associated with burnout (p<0.01). Marital status was also significantly associated with burnout: married were more burned out than unmarried (p<0.001) ( Table 3).

N=330
For work-related risk factors, the chi square test showed that burnout was significantly related to the management multigrade classes (p<0.001), the student demotivation (p<0.001), the problems of equipment didactic (p<0.01), the conflicts with colleagues (p<0.001), the conflicts with administration (p<0.01), the work overload (p<0.01), the low decision-making autonomy (p<0.001) and the low social support (p<0.01) ( Table 4).
Logistic regression analysis showed that gender was the only sociodemographic variable that predicted burnout; while the workrelated variables that predicted it were: Problems of equipment didactic, student demotivation, conflicts with colleagues, work overload and Low Decisionmaking autonomy (Table 5).
These results show the importance of knowing certain stress factors specific to the teaching profession. Thus, problems of didactic equipment, student demotivation, work overload and low decision-making autonomy are risk factors that threaten the psychological health of the Moroccan teacher. Table 4: Association of burnout with work-related risk factors among primary school teachers (n = 330) in Wazzane, 2017/2018. These results show the importance of knowing certain stress factors specific to the teaching profession. Thus, problems of didactic equipment, student demotivation, work overload and low decision-making autonomy are risk factors that threaten the psychological health of the Moroccan teacher.

Discussion
The objective of our study was to evaluate burnout and determine its prevalence and risk factors among a sample of Moroccan primary school teachers.
In Morocco, no study had yet been carried out among primary school teachers. Most of the studies on burnout concerned the health care professions. However, the teacher may also be exposed to this pathology, as confirmed by many of foreign studies [8,9,10]. The prevalence of burnout found in our study is 46.6%, which is higher than that found in the studies of some Arab countries, for example 21% in Tunisia [11], 24.5% in Iraq [12]. However, it remains lower than that found in a Moroccan study conducted among university teachers where it exceeds 60% [13] and that found in some Asian countries where it can reach 50 to 70% [5]. The difference in the prevalence of burnout between studies can be explained by variations in assessment tools and methods, socio-cultural factors, the timing of data collection and teachers' coping strategies to deal with stress. In this study, age and years of service were not associated with burnout, which is consistent with the study by Van Der Doef and Maes [14]. However, in a meta-analysis involving 5 to 35 studies and 1,092 to 10,818 subjects, the association between burnout and age, and burnout and experience was demonstrated, the older and more experienced subjects had lower burnout levels [15].
For gender, it was significantly related to burnout, and women were more exhausted than men, which is consistent with other studies that have reported that female teachers experienced burnout more than teachers [16,17], and a meta-analysis that looked at the effect of gender on burnout reported significantly higher overall burnout scores for women [18].
With regard to teacher burnout, the literature has clearly objectified the link between work-related risk factors and the development of burnout [5]. The main stressors described in the international literature include poor material conditions, work overload, organizational factors, but also administrative difficulties and role conflicts [9,19,20]. In our study, logistic regression revealed that the work-related risk factors that predict burnout were work overload (p<0.01); low decision-making autonomy (p<0.01); the Problems of equipment didactic (p<0, 01); work overload (p<0.01); student demotivation (p<0.05) and conflicts with colleagues (p<0.05).
For work overload and low decision-making autonomy, the results found are consistent with a study that looked at associations between work demands (workload) and resources (autonomy, degree of control) and burnout. Positive correlations were found for work demands and negative correlations were found for perceived resources [21]. In the same vein, a metaanalysis of one hundred and seventy-nine articles, representing 186,440 topics treating the associations between burnout and perceived work demands and resources, showed that there are positive correlations with cognitive workload at work and negative correlations with the "Resources" category: autonomy, support from colleagues, knowledge, management style, and feeling of security [22]. For other work-related factors, our work revealed a significant link between burnout and the Problems of equipment didactic, which is consistent with several studies that have found that the material conditions of the school environment play a significant role in teacher distress and dissatisfaction [8,23]. Addition, student demotivation also represents a risk factor for the development of burnout in this study, and the literature has widely reported the association of burnout with relationship problems with students. Thus, a study, which involved 2558 teachers in France, showed a significant association between difficulties with students and the three pathological dimensions of burnout [24].

Conclusion
The Moroccan educational context is affected by a plethora of risk factors that can affect the psychological health of teachers. It is necessary to carry out serious studies on the quality of life at work, teacher satisfaction and psychological health in order to establish a prevention program at different levels and protect this true wealth of Morocco.