Sickness , colleagues ’ harassment in teachers ’ work and emotional exhaustion

The aim of this study was to assess the relationship among colleagues’ harassment, emotional exhaustion, and sickness absence with a sample of teachers. Material and methods. The sample consisted of 351 teachers from 8 secondary schools in Kaunas. Instruments used in the study included the Work Harassment Scale (WHS) developed by Björkqvist and Österman (1992), the Emotional Exhaustion Scale (the MBI-ES) by Maslach et al. (1996), and a questionnaire of demographic information. Results. Data analysis indicated that a higher level of work harassment was related to higher emotional exhaustion. Regression analysis findings indicated that a higher level of emotional exhaustion was related to higher levels of disruption, humiliation, alienation, and indignity. Teachers who observed harassment reported higher levels of emotional exhaustion. Respondents who missed work due to illness reported higher levels of disruption on the WHS. Conclusions. The study indicated that work harassment could be an important aspect in teacher’s health. The seriousness of the work harassment phenomenon may be supported by the results showing that teachers who witnessed others being harassed experienced a higher level of emotional exhaustion. The phenomenon appears to be an area that requires additional research. Medicina (Kaunas) 2010;46(9):628-34


Introduction
Work consumes a large portion of our lives and can impact our health as well as emotional predisposition.It was reported by the World Health Organization that health issues and mental health problems are the result of a complex interplay among biological, psychological, and environmental factors.There is increasing evidence that both the content and context of work can play a role in the development of mental health and physical problems in the workplace (1).Work and health are closely connected.Presently, researchers are more concerned with health-and workrelated variables such as job strain and work-related stress (2).
Findings of previous research have identified the connection among health problems, work productivity, absenteeism, and mental health (1,3).Although there are many possible reasons for increased absenteeism in schools and other organizations, some investigators believe that workplace harassment by colleagues may provide some clarity related to teachers' sick leave and health issues (4).Initial studies examining workplace harassment (or psychological terror, mobbing) began in the early 1980s.The primal studies focused on work harassment and psychological stress (4).After several decades of research, there continues to be confusion as to the meaning of the term of workplace harassment.Researchers have used such terms as mobbing, bullying, hostile behavior, victimization, and psychological abuse to describe this phenomenon (5).Though not all may agree, the description of harassment in the workplace, proposed by Björkqvist et al., seems to encompass much of the meaning in the studies that follow.They describe work harassment as "repeated activities, with the aim of bringing mental (but sometimes also physical) pain, and directed toward one or more individuals who, for one reason or another, are not able to defend themselves" (6).They further specify that work harassment may include different forms of aggressive behavior of which they named direct and indirect aggression.Indirect aggression may be described by two other subforms: rational-appearing aggression (being criticized, reduced opportunities to express oneself, etc.) and social manipulation (insinuative negative glances, spreading of false rumors, etc.) (7).
Results of earlier studies indicated statistically significant findings relating harassment to absenteeism and sick leave (8,9), mental health, stress, sleeplessness, depression, anxiety, fatigue, anger, cardiovascular disease, and in some extreme cases, suicide (4,(8)(9)(10)(11)(12).Several studies have indicated the impact of the contagion effect where observers of others being harassed reported lower job satisfaction (13,14).This, in general, proves the negative effect of work harassment on work environment.
Some researchers also propose that workplace harassment may be more common in certain career fields.They claim that employees in educational settings ranging from elementary schools to universities are at higher risk of becoming victims of psychological abuse by their colleagues (4)(5)(6)(15)(16)(17).
An outcome of work harassment has resulted in a form of job burnout referred to as emotional exhaustion and has been documented in several studies (18)(19)(20)(21)(22)(23).Emotional exhaustion is one of the tripartite variables related to job burnout.According to Maslach et al., "Burnout is a syndrome of emotional exhaustion, depersonalization, and reduced personal accomplishment that can occur among individuals who work with people in some capacity" (24).People who feel burned out are usually emotionally exhausted.Emotional exhaustion may well be an important construct related to health such as physical exhaustion and insomnia (24).Emotional exhaustion is described as "the tired and fatigued feeling that leads to low physical energy.When this feeling become chronic, educators find they can no longer give of themselves to students as they once could" (24).
In summary, previous researches conducted on work harassment show that this phenomenon might be the cause of employee's emotional exhaustion and sickness absence.Despite the mounting evidence related to harassment, emotional exhaustion, job burnout, and health issues, to date there are few studies that have addressed work harassment with a Lithuanian sample (11,17).Briefly, these studies indicated that respondents reported higher levels of stress, anxiety, depression, and cardiovascular problems (11,17).However, there are no studies to date that address the three organizational dynamics of work harassment, emotional exhaustion, and sick leave issues in a teachers' population.Therefore, the purpose of the study was to address the interrelatedness of the variables of work harassment, absenteeism, and emotional exhaustion with a sample of teachers.
We hypothesized that a higher level of perceived work harassment is related to a higher level of emotional exhaustion.We further hypothesized that teachers who reported sick leave during the last year will report a higher level of work harassment.

Material and methods
The sample included 351 teachers (310 women and 31 men, and 10 subjects who failed to indicate gender) in 8 secondary schools from city of Kaunas, Lithuania.The mean age of the respondents was 45.2 (SD, 10.01) years.Teachers' mean length of work experience was 22.53 (SD, 10.56) years.Characteristics of the study population are presented in Table 1.
As the above Table indicates, the sample was spread among the four qualifications of teacher categories in the school system.The majority of the teachers were of qualification level of senior teacher and teacher methodologist.The majority of respondents Sickness, colleagues' harassment in teachers' work and emotional exhaustion did not have other work.There was a greater proportion of teachers who supervised the class.In addition to that, more teachers teach upper classes (from 5th to 12th grade).The majority of teachers had a partner or were married.The mean number of teachers' lessons per week was 21.5 (SD, 5.1).
The schools for the study were chosen using a convenient sampling method.The data collection process was implemented in November 2008 and completed in February 2009.Each school administrator was contacted and informed about the purpose of the research, confidentiality issues, and reporting of results.Data were gathered in two ways.
A total of 142 inventories and questionnaires were administered to teachers and collected on the same day.All of 142 respondents agreed to participate in the study.Researchers were present during the administration and collected the materials in sealed envelopes.Assessment time averaged 30 minutes per group.
The other 232 respondents received the inventories and questionnaires and were requested to return the packets in a sealed envelope in a one week.A total of 209 respondents returned the completed materials; 23 respondents did not return the materials.

Instruments
The Work Harassment Scale (WHS) by Björkqvist and Österman (1992) was used to assess the variable of work harassment (6,7).Originally, the WHS was developed for research with educators; therefore, it seemed as the most suitable instrument for our research.The scale consists of 24 items (6, 7).The items are evaluated by marking the alternative that comes closest to one's experience: never, seldom, occasionally, often, and very often.
The research team conducted a factor analysis study on the instrument and identified factors based on the Lithuanian sample.Using a varimax rotation, four factors were identified.Each factor was examined, and the descriptors, which best fit the factors, were selected.The factors were named as follows: disruption, humiliation, alienation, and indignity.
The disruption factor included 11 forms of harassment by colleagues: being unduly disrupted, being shouted at loudly, being unduly criticized, belittling of one's opinions, refusal to hear a person, words aimed at hurting a person, giving meaningless tasks, giving insulting tasks, being ridiculed in front of others, judging ones work in an incorrect or insulting manner, having sense of judgment questioned.This harassment form might be partly compared with rational-appearing aggression according to Björkqvist et al. (6,7).
The humiliation factor reflected behavior of spreading false rumors and criticism related to work tasks.Behaviors included in this factor would be as follows: lies told to others, being shouted at loudly, accusations, criticism, spreading malicious rumors, insinuative glances/negative gestures, shouting, or direct threats.
The alienation factor included behaviors and comments that influence the individual's social relations at work.More specifically, it might include actions by colleagues to isolate the victim and use interpersonal behaviors of ignoring the presence of the victim in social settings and cutting off any forms of interpersonal communication with the teacher/victim.The exact forms of this factor are isolation, insinuative glances/negative gestures, sneering, refusal to speak, treating a person as nonexistent, words aimed at hurting a person.
The final factor of indignity consisted of colleagues' revealing the sensitive details of a person's life, isolating or insulting the victim via comments on personal life, being given insulting tasks.
Assessment of the internal consistency of the scales (Cronbach α) indicated that the scales yielded moderate to high correlations: general evaluation of work harassment, 0.92; disruption scale, 0.88; humiliation scale, 0.86; alienation scale, 0.82; and indignity scale, 0.71.
The Emotional Exhaustion Scale for educators (MBI-ES) created by Maslach et al. in 1996 was used to assess the variable of emotional exhaustion.The scale includes 9 items (24).The items are evaluated related by marking the alternative that comes closest to one's experience: never, a few times a year or less, once a month or less, a few times a month, once a week, a few times a week, and every day.
Internal consistency of the scale (Cronbach α) was 0.93.Permission to use the scale was received from the authors, and in 2008, the scale was back-forward translated employing the same format as was used with the WHS.
Sick leave was assessed by requesting teachers to respond to a question from the demographic survey, "How many workdays did you spend because of sick leave during the last year?"Observation of work harassment was assessed by requesting teachers to respond to a question, "Have you seen someone who experienced work harassment at your present workplace?"Factor analysis, logistic regression analysis, and Mann-Whitney criterion were the statistical procedures employed in the data analysis.Logistic regression analysis was used to assess relationships between different work harassment factors and emotional exhaustion.The Mann-Whitney criterion was used because the data did not meet the requirements of the normal distribution.

Relation between work harassment and emotional exhaustion.
To analyze the emotional exhaustion scores, the teachers' sample was divided into two groups of high scores and low scores.The groups were divided depending on the mean score of emotional exhaustion.The mean score of emotional exhaustion was 21.94 (11.27).The Group 1 was composed of individuals with the mean scores less than and equal to 22.The Group 2 included individuals with the mean scores of emotional exhaustion of more than 22.To assess the relationship between work harassment and emotional exhaustion, the nonparametric two-independent sample Mann-Whitney criterion was used.Fig. 1 indicates that higher work harassment is related to higher emotional exhaustion among teachers.
Logistic regression analysis was used for the assessment of harassment and emotional exhaustion.In order to analyze possible relationships between and among emotional exhaustion and other aspects, which are not work harassment factors, we added several other variables to the logistic regression analysis.
Emotional exhaustion was a dependent variable, and the independent variables addressed the aspects of work harassment (disruption, humiliation, alienation, indignity) and demographic variables as well as work characteristics, such as work experience, workload, marital status, other employment, gender, qualification category, taught classes, and age.
Table 2 shows the model of logistic regression analysis, which indicates that higher emotional exhaustion was related to higher level of disruption, humiliation, indignity, and alienation.Results also revealed that higher emotional exhaustion was related to lower qualification category (teachers and senior teachers).
For the assessment of emotional exhaustion among teachers who had witnessed and who had not witnessed colleagues' harassment, we used the Mann-Whitney criterion.The results in Fig. 2 show that teachers who had witnessed harassment at work felt more emotionally exhausted than respondents who had not witnessed this negative phenomenon.Relation between work harassment and sickness absence.The Mann-Whitney criterion was applied to assess the relationship between work harassment and reported sickness during the school year.The results are presented in Table 3.The findings show that teachers missing work related to sick leave reported a higher level of disruption than their colleagues who did not miss any workdays.

Discussion
Earlier studies have highlighted the significant associations among health, work harassment, and emotional exhaustion (18)(19)(20)(21)(22).Our investigation showed similar results.The findings support the impact of work harassment and emotional exhaustion on teachers in the workplace setting.Higher emotional exhaustion was related to four aspects of work harassment: disruption, humiliation, alienation, and indignity.
The relation between teachers' reported emotional exhaustion and witnessing of others being harassed was an important finding.Analysis of the data indicated that teachers who witnessed work harassment were more emotionally exhausted.This finding adds to the body of research on this topic.To date, we were not able to identify any study that reflects findings related to witnessed harassment and emotional exhaustion.However, there were several studies conducted on job satisfaction and employees' witnessing of work harassment.These studies indicated that people who observed work harassment were more dissatisfied with their job (13,14).Results of previous studies as well as our results appear to show that harassment creates hostile and unhealthy atmosphere not only for its direct targets, but also for the observers of the process.This phenomenon needs to be explored further with different samples coupled with different instruments and qualitative research methodology.
Additional results revealed that teachers who missed work due to illness felt higher levels of disruption.Earlier studies carried out on harassment relations to sick leave show similar results (8,9).Researchers state that "victims of workplace harassment are more likely to have chronic diseases such as asthma, rheumatoid arthritis, osteoarthritis, sciatica, diabetes, or cardiovascular disease" (8).Psychosomatic complains, such as stomachache, chest pain, dizziness, were also related to harassment at work (8).Our study data show that disruptive behavior, which is directed toward work tasks and achievements, might also have a serious and important impact on teachers' physical and psychological health.However, relatedness among work harassment, health issues, and sick leave needs to be examined more precisely.This needs to be made in order to understand what health issues are related to work harassment among Lithuanian workers.
We propose that the findings of this study could be important information for people who work in health care settings.We hope that our study will encourage others to examine the impact of harassment, emotional exhaustion, and health issues more closely.Most of all we hope that this study will gain the attention of health care practitioners who may be in

Conclusions
The study showed a connection between sickness, work harassment, and emotional exhaustion among teachers.The importance and seriousness of the harassment phenomenon seems to take more meaning with our findings related to days absent due to illness and the fact that teachers who witnessed negative acts in the workplace reported higher levels of emotional exhaustion.

Fig. 2 .
Fig. 2. Emotional exhaustion in groups of teachers who had and who had not witnessed harassment incidents at work (Z=-2.73,P=0.006) not witnessed work harassment (N=252) teachers who witnessed work harassment (N=179) Milda Astrauskaitė, Aidas Perminas, Roy M. Kern positions to design prevention and intervention health programs in schools and other institutions.Based on our research, work harassment does have serious consequences on people's health and well-being.

Table 1 .
Sample characteristics

Table 3 .
Comparison of harassment (and its aspects) in groups of teachers regarding absence from work due to sickness 1 Z, standard score; 2 Asymp.sig., asymptotic significance.