Psychosocial Factors and Hypertension in Teachers: A Research Proposal

Introduction to Psychosocial Factors and Workplace Well-Being

A feeling of workplace well-being serves as a key component of employee strategy. Of late, there has been considerable focus on this element, particularly in the healthcare sector and among healthcare workers. In western countries, the combination of an unappealing workplace atmosphere, work-linked stress, a shortage of practitioners, and an increasingly elderly population underscores the necessity of updated studies in this area. The concept of well-being is a summative one, encompassing physical, societal, and emotional facets both within and external to the organization. Further, it is a key factor determining productivity — psychosocial and organizational climate, which encompasses work climate, social support, and work recognition, is believed to have a significant influence on workplace well-being. Psychosocial elements make up factors like job satisfaction, physical workload, and social support on the job (Goetz, Berger, Gavartina, Zaroti, & Szecsenyi, 2015).

Psychosocial elements denote interactions between workplace conditions, atmosphere, and content, as well as employee capability, requirements, culture, and extra-work-related personal aspects that might, based on experience and perception, have an impact on personnel health, workplace performance, and satisfaction. Evaluating these facets may therefore prove vital to preventing occupational ailments and fostering employee health.

Psychosocial Factors and Health Problems

Psychosocial elements such as stress, job control, resentment, depression, and despair appear to be linked to physical well-being, especially heart ailment. Adverse risk profiles relating to psychosocial factors tend to cluster with broader social disadvantage. Owing to this, the "psychosocial hypothesis" proposes that psychosocial components constitute a major source of health inequities. Such components include various psychological characteristics, states, or social-environmental conditions with negative connotations (Macleod & Smith, 2003).

One important consideration is the way "psychosocial adversity" may contribute to physical illness. It likely has the potential to promote unhealthy behaviors such as smoking, or may directly result in neuroendocrine disturbances that affect illness risk. It is useful here to distinguish between basic and contingent sources (termed, elsewhere, as sufficient and probabilistic grounds respectively). The relationship between a contingent source and a healthcare outcome depends on that source's association with a more fundamental cause. Hence, psychosocial adversity may result in greater illness risk in scenarios where it is positively linked to behaviors such as smoking. These relationships are not, however, automatic (Macleod & Smith, 2003).

Karasek's Demand-Control Model

Karasek developed an influential Demand-Control model that examines factors associated with psychosocial workplace attributes. The model regards occupational stress as the product of discrepancies between work conditions and the reaction capability of employees carrying out workplace tasks, as well as the degree of control available to them for fulfilling those demands (Fernandes & Rocha, 2009).

Karasek's (1981) model emphasizes two key psychosocial work dimensions: control over work and the mental demands of occupational tasks. Control relates to skill development and application — for instance, the need to learn new practices, opportunities for innovation, the level of task repetition, development of unique skills, and task variety. Psychological demands encompass the conditions employees face during their activities, including variables measuring volume, pace, task performance time, and the presence of conflicting demands.

A combination of lower and higher levels across these two dimensions produces four distinct work characteristic profiles. These include low demand (high control at low mental demand), high work demand (low control but high demand), active work (high control and high demand), and passive work (low control and low demand). Some of these scenarios may be considered risk factors likely to contribute to the development of physical and psychological pathology among working individuals (Fernandes & Rocha, 2009).

Hypertension Among Teachers: The Problem

The chosen work environment for this study is educational institutions, with teachers and educators as the target population. Educators are increasingly confronted with major occupational health issues. They are routinely assigned growing numbers of tasks that surpass those traditionally associated with their role — tasks that largely determine student outcomes, whether success or failure. Teachers encounter overcrowded classrooms, unhealthy working conditions, and structural and institutional inadequacy. Combined with their tremendous workload, these factors leave many feeling dysfunctional and stressed. A key contributor is inadequate or absent rest breaks, which plays a part in high absenteeism and turnover rates. Psychosocial factors and the workplace climate have been identified as the main contributors to educator health issues (Fernandes & Rocha, 2009).

Occupational health issues among educators are recognized as widespread (Jardim & Pereira, 2016; Leka & Jain, 2010), leading to high rates of work absence whose repercussions are both individual and institutional (Cladellas & Castelló, 2011). Many researchers have highlighted the importance of work-linked psychosocial risk (PR) factors in this context. However, integrating findings across studies is difficult, possibly because most research in this area focuses either on Burnout Syndrome or school teachers in isolation, with only a small number of studies examining an integrative link between psychosocial determinants (Kinman, 2001).

These problems stem from educators' stressful working conditions, which include large class sizes, low salaries, and insufficient instructional resources (Zamri, Moy, & Hoe, 2017). Psychosocial occupational determinants can gravely affect personnel health and well-being at both the physical and psychological levels. Psychosocial influences may manifest as insomnia, anxiety, depression, and irritability (Eatough, Way, & Chang, 2012).

The present study addresses hypertension (HT) as it relates to psychosocial factors among school teachers. HT refers to a temporary or chronic elevation of arterial blood pressure, with arbitrary systolic measures above 160 mmHg and diastolic measures over 90 mmHg. It is a widespread condition, with over 25 percent of adults globally diagnosed with it — approximately 333 million in industrialized nations and 639 million in unindustrialized ones. It is a key preventable risk factor for disability and premature death. In particular, it constitutes a significant risk factor for cardiovascular diseases (CVDs) such as coronary artery disease (CAD), hypertensive heart disease, chronic kidney disease, stroke, cerebrovascular illness, aortic aneurysm, and peripheral artery disease (Mucci et al., 2016).

Workplace stress is a contributing factor in HT development, with a consistent body of research examining commonly cited workplace elements such as job insecurity, control and strain (i.e., job quality), pay, satisfaction, perceived dissatisfaction, and work hours. Studies have revealed that stress may result in blood pressure fluctuations, elevated cholesterol levels, increased triglyceride levels, hematocrit growth, changes in blood fluidity, and fibrinogen growth. Psychological stress may also result in abnormal sympathetic nervous system (SNS) activation, triggering hormonal cascades that interfere with blood pressure regulation, increase platelet activity, and promote coagulation — factors that can act as triggers for cerebrovascular events (Mucci et al., 2016).

References

Cladellas, R., & Castelló, A. (2011). University professors' stress and perceived state of health in relation to teaching schedules. Electronic Journal of Research in Educational Psychology, 9(23), 217–240.

Eatough, E., Way, J., & Chang, C. (2012). Understanding the link between psychosocial work stressors and work-related musculoskeletal complaints. Applied Ergonomics, 43(3), 554–563. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/21944295

Fernandes, M., & Rocha, M. (2009). Impact of the psychosocial aspects of work on the quality of life of teachers. Brazilian Journal of Psychiatry, 31(1). Retrieved from http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462009000100005

Goetz, K., Berger, S., Gavartina, A., Zaroti, S., & Szecsenyi, J. (2015). How psychosocial factors affect wellbeing of practice assistants at work in general medical care? — a questionnaire survey. BMC Family Practice, 16, 166. DOI: 10.1186/s12875-015-0366-y

Himmelfarb Health Sciences Library. (2019). Case-control study. Retrieved from https://himmelfarb.gwu.edu/tutorials/studydesign101/casecontrols.cfm

Jardim, J., & Pereira, A. (2016). Perceived impact of lifelong training in teachers. Interacções, 31(42), 22–31.

Karasek, R., Baker, D., Marxer, F., Ahlbom, A., & Theorell, T. (1981). Job decision latitude, job demands, and cardiovascular disease: a prospective study of Swedish men. American Journal of Public Health, 71(7), 694–705.

Kessler, R. C., Andrews, G., Colpe, L. J., Hiripi, E., Mroczek, D. K., Normand, S. L. T., … Zaslavsky, A. M. (2002). Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychological Medicine, 32(6), 959–976. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12214795

Kinman, G. (2001). Pressure points: A review of research on stressors and strains in UK academics. Educational Psychology, 21(4), 473–492. https://doi.org/10.1080/01443410120090849

Kristensen, T. S., Hannerz, H., Høgh, A., & Borg, V. (2005). The Copenhagen Psychosocial Questionnaire — a tool for the assessment and improvement of the psychosocial work environment. Scandinavian Journal of Work, Environment & Health, 31(6), 438–449. https://doi.org/10.5271/sjweh.948

Leka, S., & Jain, A. (2010). Health impact of psychosocial hazards at work: An overview. Geneva.

Macleod, J., & Smith, G. (2003). Psychosocial factors and public health: a suitable case for treatment? Journal of Epidemiology & Community Health, 57, 565–570. Retrieved from https://jech.bmj.com/content/jech/57/8/565.full.pdf

Mucci, N., Giorgi, G., Ceratti, S., Fiz-Perez, J., Mucci, F., & Arcangeli, G. (2016). Anxiety, stress-related factors, and blood pressure in young adults. Frontiers in Psychology. Retrieved from https://www.frontiersin.org/articles/10.3389/fpsyg.2016.01682/full

World Health Organization. (2015). WHO STEPS surveillance manual: The WHO STEPwise approach to chronic disease risk-factor surveillance. Retrieved from http://apps.who.int/iris/handle/10665/43376

Zamri, E., Moy, F., & Hoe, V. (2017). Association of psychological distress and work psychosocial factors with self-reported musculoskeletal pain among secondary school teachers in Malaysia. PLoS One, 12(2).