Journal of Psychosocial Nursing and Mental Health Services

CNE Article 

Positive Mental Health and Prevalence of Psychological Ill-Being in University Nursing Professors in Catalonia, Spain

Barbara Hurtado-Pardos; Carmen Moreno-Arroyo, PhD; Irma Casas, PhD, MD; Teresa Lluch-Canut, PhD; Mar Lleixà-Fortuño, PhD; Mariona Farrés-Tarafa; Juan Roldán-Merino, PhD

Abstract

The aim of the current study was to examine the prevalence of psychological ill-being among university nursing professors in Spain and determine their grade of positive mental health. A cross-sectional study was conducted from June 2013 to December 2013 with a sample of 263 university nursing professors. Sociodemographic and occupational variables, as well as variables related to daily habits and lifestyle, were collected. Psychological ill-being was measured using the General Health Questionnaire (GHQ-12) and positive mental health was evaluated with the Positive Mental Health Questionnaire (PMHQ). Prevalence of psychological ill-being (GHQ-12 score >2) among the sample was 27% (range = 21.8% to 32.6%), with a higher prevalence in teachers from first and second cycles (Bachelor's degree and Master's degree, respectively) and a lower prevalence in those having very satisfactory social relationships. Significant differences were found in relation to consumption of tranquilizer drugs and Bach flower remedies. PMHQ scores were lower among teachers with a GHQ-12 score >2. Participants presented a good level of positive mental health. Preventive policies should be applied with the aim of reducing psychological ill-being among professors and potentiating positive mental health. [Journal of Psychosocial Nursing and Mental Health Services, 55(7), 38–48.]

Do you want to Participate in the CNE activity?

Abstract

The aim of the current study was to examine the prevalence of psychological ill-being among university nursing professors in Spain and determine their grade of positive mental health. A cross-sectional study was conducted from June 2013 to December 2013 with a sample of 263 university nursing professors. Sociodemographic and occupational variables, as well as variables related to daily habits and lifestyle, were collected. Psychological ill-being was measured using the General Health Questionnaire (GHQ-12) and positive mental health was evaluated with the Positive Mental Health Questionnaire (PMHQ). Prevalence of psychological ill-being (GHQ-12 score >2) among the sample was 27% (range = 21.8% to 32.6%), with a higher prevalence in teachers from first and second cycles (Bachelor's degree and Master's degree, respectively) and a lower prevalence in those having very satisfactory social relationships. Significant differences were found in relation to consumption of tranquilizer drugs and Bach flower remedies. PMHQ scores were lower among teachers with a GHQ-12 score >2. Participants presented a good level of positive mental health. Preventive policies should be applied with the aim of reducing psychological ill-being among professors and potentiating positive mental health. [Journal of Psychosocial Nursing and Mental Health Services, 55(7), 38–48.]

Do you want to Participate in the CNE activity?

In 2016, the International Labour Organization defined psychosocial risk factors (or psychosocial hazards) as “those aspects of the design and management of work and its social and organizational contexts which have the potential for causing psychological or physical harm” (p. 3). This definition is a benchmark of how job conditions can influence the development of work and health of workers.

Although the terms psychosocial risk factors and psychosocial risks are interchangeable in the literature, they can be considered as two different concepts. The concept of psychosocial risk is the “likelihood or probability that a person will be harmed or experience adverse health effects if exposed to a psychosocial hazard” (International Labour Organization, 2016, p. 3). Psychosocial risks at both a national (in Spain) and international level have acquired great relevance in the job setting due to the repercussions that these risks may have on worker health and quality of life (Moncada et al., 2014; World Health Organization [WHO], 2010). This greater relevance has led to new action policies that prioritize evaluation and control and prevention strategies against these risks, particularly those related to stress at work (European Agency for Safety and Health at Work, 2013; Fishta & Backé, 2015; WHO, 2010).

In relation to teaching professionals, there are two important lines of investigation on work and mental health: the search for explanatory models of teaching professional well-/ill-being (Archibong & Bassey, 2010; Ferrel, Thomas, Solano, Redondo, & Ferrel, 2014; Mahan et al., 2010), and the study of their consequences, including stress and burnout (Arvidsson, Håkansson, Karlson, Björk, & Persson, 2016). Many of these studies were developed from a negative perspective or that of psychological ill-being. The General Health Questionnaire (GHQ) is one of the instruments most commonly used to measure this concept (Goldberg, 1978). This questionnaire has several versions, with the GHQ-12 being one of the most used to measure psychological ill-being (Goldberg & Willians, 1988; Goldberg et al., 1997), and it has been used in different settings (Kataoka et al., 2015; Seibt, Matz, Hegewald, & Spitzer, 2012; Unterbrink et al., 2014). From a positive approach, most studies use terms such as well-being or satisfaction (Doménech-Betoret, Lloret-Segura, & Gómez-Artiga, 2015; Yin, Huang, & Wang, 2016), but few have explored the positive mental health construct and its dimensions. The multifactorial model by Lluch-Canut (2003) is a conceptual approach that is gaining application, especially from the perspective of the promotion of health. This multifactorial model comprises six factors that define positive mental health: personal satisfaction, prosocial attitude, self-control, autonomy, problem solving and self-actualization, and interpersonal relationship skills (Lluch-Canut, 2003). This model has become operative as a measurement tool.

Spanish university teaching has recently undergone the greatest educational reform of the past decade (i.e., adaptation to the European Higher Education Area). This change has generated new challenges for teaching professionals who have had to meet new work demands, which may have repercussions on their occupational well-/ill-being (Avargues & Borda, 2010). These changes were made to implement the European Credit Transfer System to promote the mobility of students and teachers and to adopt new teaching methodologies. Thus, in addition to coping with these changes, university nursing professors in Spain have had to face specific particularities, which may have had an even greater effect on their occupational well-/ill-being. Some of these particularities include the need to change their nursing diploma to a nursing degree or implementation of a third cycle (i.e., obtaining a doctorate degree).

It is important to note that repercussions on occupational well-/ill-being among nursing teachers may affect their teaching and lead to less focus on their teaching skills, a reduction in work performance, and impaired interaction between students and teachers.

The aim of the current study was to examine the prevalence of psychological ill-being among university nursing professors in Catalonia (Spain) and determine their grade of positive mental health.

Method

Study Design and Participants

A cross-sectional study was conducted from June 2013 to December 2013. The study population included 1,500 university nursing professors in Catalonia (Spain) who were active during the study period and voluntarily accepted to participate. Sample size was calculated based on an estimated prevalence of psychological ill-being of 15% (Martínez, Pujazón, & Jiménez, 2014), with an accuracy of 4% and an alpha risk of 5%. Accordingly, it was estimated that the minimum sample size necessary was 255 university nursing professors.

Variables and Instruments

Psychological ill-being was measured using the GHQ-12, which has been validated in the Spanish language (Sánchez-López & Dresch, 2008). This questionnaire evaluates state of ill-being in the previous 4 weeks. The GHQ-12 comprises 12 items, with six positive and six negative statements. It is measured using a Likert scale with four possible responses (0–1–2–3) that can be transformed into a score of 0–0–1–1 called the GHQ score. This allows a total score of 12, with a score >2 being interpreted as possible psychological ill-being. According to different studies, internal consistency has shown Cronbach's alpha values ranging from 0.82 to 0.86. The results of validation studies performed in 15 countries showed an area under the curve in receiver operating characteristic curves between 0.83 and 0.85 (Goldberg et al., 1997). Internal consistency and reliability of the GHQ in the current study was 0.84.

Positive mental health was evaluated using the Positive Mental Health Questionnaire (PMHQ) by Lluch-Canut (2003). This questionnaire includes 39 items grouped into six factors: personal satisfaction, prosocial attitude, self-control, autonomy, problem solving and self-actualization, and interpersonal relationship skills. Each item is formulated as positive or negative statements with four options for responding: always or almost always, quite often, sometimes, and never or rarely. Total scores range from 39 to 159 points, with higher scores signaling better positive mental health. This questionnaire has been used and validated in different populations and in several languages (Mantas et al., 2015; Roldán-Merino et al., 2017; Sequeira et al., 2014). Internal consistency of these studies, measured by Cronbach's alpha, ranged from 0.66 to 0.92, and was 0.88 in the current study.

Sociodemographic and occupational variables (e.g., age, sex, teaching category, years teaching in university, number of courses and teaching shifts), as well as variables related to daily habits and lifestyle (e.g., coffee intake; smoking; physical exercise; degree of satisfaction with social relationships and friends; use of antidepressant, tranquilizer, and analgesic agents; and Bach flower remedies) were measured. Bach flowers are a series of natural scents extracted from wild flowers. These remedies are used to treat different emotional situations, such as fear, stress, anxiety, or depression. All professors were asked whether they experienced any stressful life events during the past year, such as the loss of a family member or loved one, separation/divorce, or important changes in the family economic situation.

Data were collected using an anonymous online questionnaire designed to facilitate completion via https://www.encuestafacil.com. Each center sent the questionnaire to participants by e-mail. The e-mail included a letter of presentation with information regarding the study proposals. Before gaining access to the questionnaire, participants first had to voluntarily provide informed consent accepting to participate in the study. All data obtained remained anonymous and confidential. Participants were sent a reminder about the questionnaire 1 month after initiation of the study.

Ethical Considerations

The Clinical Investigation Ethics and Research Committee of the Sant Joan de Déu Foundation approved the study. Participants were informed that only aggregate data would be used in presenting results.

Statistical Analysis

Descriptive analysis was conducted for all variables. Frequencies and percentages were calculated for categorical variables, with means and standard deviations for quantitative variables. Prevalence of psychological ill-being was estimated with 95% confidence intervals (CIs).

To compare the scores of the different factors of the PMHQ, mean scores for each factor were divided by the number of items comprising each factor. Associations between variables and the GHQ-12 (scores ≤ 2 and >2) were calculated using chi-square tests. Student's t test or analysis of variance were used for the PMHQ. Data analyses were performed using SPSS version 22. A bilateral p value <0.05 was accepted to detect statistically significant differences. Bonferroni correction was used for multiple comparisons.

Results

A total of 263 questionnaires were collected. Mean age of participants was 47.8 years (SD = 9.9 years, range = 27 to 67 years); 79.1% were women, 50.6% were full-time professors, 32.3% of the sample had <5 years teaching experience in the university, and 53.2% taught morning and afternoon classes. Regarding habits and lifestyle, 93.9% of participants reported feeling satisfactory or very satisfactory about their social relationships and friends, 23.6% did not play any sports or exercise, 60.5% always or almost always drank coffee, and only 16.3% were active smokers. Approximately 10% of participants normally took antidepressant, tranquilizer, analgesic, or anti-inflammatory agents or Bach flower remedies. Approximately one third of participants experienced a stressful situation during the past year (Table 1).

Participants' Sociodemographic and Occupational Habits and Lifestyle Characteristics (N = 263)Participants' Sociodemographic and Occupational Habits and Lifestyle Characteristics (N = 263)

Table 1:

Participants' Sociodemographic and Occupational Habits and Lifestyle Characteristics (N = 263)

Prevalence of psychological ill-being (GHQ-12 score >2) among participants was 27% (95% CI [21.8, 32.6]). The prevalence was higher in young teachers (≤40 years), women, and full-time professors who taught morning and afternoon classes, although the differences were not statistically significant. The prevalence was also higher in teachers of first and second cycles (Bachelor's degree and Master's degree, respectively) (35.4%, p = 0.022), but lower in those having very satisfactory social relationships and friends (17.3%, p = 0.012) (Table 2). Regarding consumption of pharmacological agents or Bach flower remedies, the prevalence was higher in all participants who took them on a usual basis. Significant differences were only found in relation to consumption of tranquilizer drugs and Bach flower remedies (p = 0.046 and 0.033, respectively) (Table 3).

Prevalence of Psychological Ill-Being in the Sample (N = 263)Prevalence of Psychological Ill-Being in the Sample (N = 263)

Table 2:

Prevalence of Psychological Ill-Being in the Sample (N = 263)

Prevalence of Psychological Ill-Being According to Use of Pharmacological Agents

Table 3:

Prevalence of Psychological Ill-Being According to Use of Pharmacological Agents

Total mean score of the PMHQ was 114.8 (SD = 12, range = 77 to 148). Scores were higher in the factors of problem solving and self-actualization (mean = 3.33), interpersonal relationships skills (mean = 3.07), and self-control (mean = 3.06). The lowest score was found in the factor of autonomy. Table 4 shows the scores for each factor of the PMHQ.

Positive Mental Health Questionnaire (PMHQ) Scoresa

Table 4:

Positive Mental Health Questionnaire (PMHQ) Scores

After comparing positive mental health with sociodemographic and occupational factors, statistically significant differences were only found in the teaching category, grade of satisfaction with social relationships, and physical activity. Mean PMHQ score was higher in full-time university professors and teachers who reported having unsatisfactory social relationships (p = 0.01 and 0.001, respectively) (Table 5). Mean PMHQ score increased with an increase in the number of hours of weekly physical activity (p = 0.041).

Mean Total Scores of the Positive Mental Health Questionnairea According to Sociodemographic Variables (N = 263)Mean Total Scores of the Positive Mental Health Questionnairea According to Sociodemographic Variables (N = 263)

Table 5:

Mean Total Scores of the Positive Mental Health Questionnaire According to Sociodemographic Variables (N = 263)

Statistically significant differences were found in the personal satisfaction, problem solving, and interpersonal relationship skills factors after analyzing the relationship between the PMHQ and GHQ-12. PMHQ scores for these factors and the total score were lower among teachers with a GHQ-12 score >2 (Table 6).

Relationship Between General Health Questionnaire-12 (GHQ-12) and Positive Mental Health Questionnaire (PMHQ) Scoresa

Table 6:

Relationship Between General Health Questionnaire-12 (GHQ-12) and Positive Mental Health Questionnaire (PMHQ) Scores

Discussion

The lines of action of most national and international organizations related to health and work include the evaluation and prevention of psychosocial risk in workers (Moncada et al., 2014; WHO, 2010). Within this line of action, few studies exist on the work sector of university teachers and even fewer on professors of nursing. In the past decade in Spain, this sector has undergone important changes as a consequence of the adaptation to the European Higher Education Area.

Regarding the general population in the current study's setting, in 2014, a study estimated that 8.5% of the Catalonian population older than 15 had a risk of presenting a mental disorder. With the use of the GHQ-12, they described a prevalence of 6.5% for men and 10.5% for women. This study also reported that the level of mental well-being of the population was satisfactory (Generalitat de Cataluña, 2014).

Prevalence of psychological ill-being in the current sample of nursing professors was 27%, which was higher than that found in the general population of Catalonia. This finding is important because it indicates that this work collective may be exposed to occupational or extra-occupational factors that make them more susceptible to presenting these problems (Archibong & Bassey, 2010; Ferrel et al., 2014; Kataoka, Ozawa, Tomotake, Tanioka, & King, 2014). This prevalence was also higher than that found in most studies performed within the teaching setting using the GHQ-28 or GHQ-12 (Galdeano, Godoy, & Cruz, 2007; Seibt et al., 2012). It should be considered that these studies were performed in non-university teaching populations or other countries and, thus, different cultural or organizational factors may have had an impact on the prevalence reported.

It is important to describe the occupational variables that may act as modulators of possible responses of teachers regarding situations of psychosocial risk. The current results showed that although age and sex did not show significant differences, there was a trend of women and younger teachers presenting higher levels of psychological ill-being. This finding coincides with the results of other studies that found significant differences (Galdeano et al., 2007; Kataoka et al., 2015). Women may present greater psychological ill-being due to the role they play in the community, which often makes it difficult for them to combine work with family life (Barbosa, Pinto, Ribeiro, Moura, & Campos, 2011). Younger teachers have less work experience and, consequently, less experience in controlling the different activities developed within the academic setting.

In relation to habits and lifestyle, the current results showed that few participants played sports or engaged in exercise, which is an important factor in the struggle against depression, anxiety, and stress (Subirats, Vila, & Martínez, 2012). No association was found between exercise and prevalence of psychological ill-being. Nevertheless, teachers who reported not engaging in any type of physical exercise and those who exercised more than 4 hours per week presented a higher prevalence. An association was found between satisfaction in social relationships and friends, with a lower prevalence of psychological ill-being in those having very satisfactory relationships. This finding is important because it is known that social support is a protective factor against stressful situations (Fiorilli et al., 2015; Thoits, 2011).

Another finding of the current study was that the usual consumption of pharmacological agents and other substances was high. Observed percentages were higher than those reported in another study in a sample of the Spanish working population (Colell, Sánchez-Niubò, Domingo-Salvany, Delclós, & Benavides, 2014). These results agree with those of the 2015 report on the consumption of alcohol, smoking, and drugs in Spain (Ministry of Health and Social Affairs, 2015), which described an increase in the use of psychoactive drugs in the Spanish working population as well as the consumption of hypnosedative agents in the teaching and health care sector. A relationship was also found between consumption of tranquilizer drugs, Bach flower remedies, and psychological ill-being in the current study. Few studies have demonstrated a relationship between adverse occupational factors and consumption of tranquilizer drugs (Colell et al., 2014). However, several studies have shown a relationship between occupational factors and mental health problems (Stansfeld et al., 2013; Vives et al., 2013).

No study has used the PMHQ with teaching professionals (Lluch-Canut, Puig-Llobet, Sánchez-Ortega, Roldán-Merino, & Ferré-Grau, 2013; Mantas et al., 2015; Sequeira et al., 2014). Thus, this conceptual approach by Lluch-Canut (2003) is novel in this group of professionals.

In the current study, total mean score of the PMHQ in university nursing professors was 114.8 (range = 77 to 148), with the highest scores in the factors of problem solving and self-actualization, interpersonal relationships skills, and self-control. The current sample presented moderate to high PMHQ scores, with higher scores than those found in mental health nurses (Mantas et al., 2015). However, similar to nursing professionals, teachers of nursing intervene in and perform activities in society that facilitate the learning of problem solving. In addition, skills in interpersonal relationships are potentiated by the relationship between patient help and communication with professionals.

According to the current results, physical activity has a significant effect on PMHQ score. The analysis showed that PMHQ score showed an upward trend with higher levels of physical activity. This finding demonstrates the positive influence physical exercise has on many aspects of health. One paradoxical finding was the association between satisfaction in social relationships and friends, with higher PMHQ scores in those with unsatisfactory relationships. This aspect requires further investigation in future studies.

One interesting result of the current study was the relationship found between psychological ill-being and positive mental health studied in this work collective of nursing professors. This possible association may be bidirectional. It is logical to assume that the presence of a mental health problem or psychological ill-being influences PMHQ scores. Nevertheless, some have suggested that the PMHQ could predict who has the greatest risk of developing a mental illness (Keyes, Dhingra, & Simoes, 2010). More detailed longitudinal studies are required to explore these findings in greater depth.

Limitations

Limitations of the current study should be considered when interpreting the results. This was a cross-sectional study that did not allow a cause–effect relationship to be established among the associations found. The voluntary participation of participants may have produced selection bias. Teachers with the worst state of health, or those who were healthier and more willing to participate, may have responded to the questionnaire. Nevertheless, the results obtained correspond to a sample of university nursing professors in Catalonia with a sociodemographic profile that coincides with the data of the nursing teacher population. Lastly, the results may be affected by the data having been provided by the teachers themselves, although it should be considered that standardized questionnaires were used.

Conclusion

Prevalence of psychological ill-being in university nursing professors is high compared to the general population. Nonetheless, university teachers present a good level of positive mental health.

Preventive policies should be applied with the aim of reducing psychological ill-being among professors and potentiating positive mental health, which acts as a protective factor. The current findings indicate that to improve the mental health of university nursing faculty, it is necessary to make these professionals aware of the benefits of healthy habits and lifestyles. It is also important for these teachers to potentiate social relationships. In addition, support is needed for female and younger teachers, as well as studies to evaluate psychosocial risk factors, which would help design adequate interventions to promote the well-being and positive mental health of university teachers.

References

  • Archibong, I.A. & Bassey, A.O.G. (2010). Occupational stress sources among university academic staff. European Journal of Educational Studies, 2, 217–225.
  • Arvidsson, I., Håkansson, C., Karlson, B., Björk, J. & Persson, R. (2016). Burnout among Swedish school teachers—A cross-sectional analysis. BMC Public Health, 16, 823. doi:10.1186/s12889-016-3498-7 [CrossRef]
  • Avargues, M.L. & Borda, M. (2010). Estrés laboral y síndrome de burnout en la Universidad: análisis descriptivo de la situación actual y revisión de las principales líneas de investigación [article in Spanish]. Annuary of Clinical and Health Psychology, 6, 73–78.
  • Barbosa, M.A., Pinto, M.C., Ribeiro, S., Moura, D. & Campos, P. (2011). Being a nursing teacher, woman and mother: Showing the experience in the light of social phenomenology. Revista Latino-Americana de Enfermagem, 19, 164–170. doi:10.1590/S0104-11692011000100022 [CrossRef]
  • Colell, E., Sánchez-Niubò, A., Domingo-Salvany, A., Delclós, J. & Benavides, F.G. (2014). Prevalence of the use of hypnotics and sedatives among the working population and associated work-related stress factors. Gaceta Sanitaria, 28, 369–375. doi:10.1016/j.gaceta.2014.04.009 [CrossRef]
  • Doménech-Betoret, F., Lloret-Segura, S. & Gómez-Artiga, A. (2015). Teacher support resources, need satisfaction and well-being. Spanish Journal of Psychology, 18, E6. doi:10.1017/sjp.2015.8 [CrossRef]
  • European Agency for Safety and Health at Work. (2013). Priorities for occupational safety and health research in Europe: 2013–2020. Retrieved from https://osha.europa.eu/en/tools-and-publications/publications/reports/priorities-for-occupational-safety-and-health-research-in-europe-2013-2020
  • Ferrel, F., Thomas, J., Solano, A., Redondo, E. & Ferrel, L. (2014). Psychological well-being in a private university faculty of district of Santa Marta. Cultura Educación y Sociedad, 5, 61–76.
  • Fiorilli, C., Gabola, P., Pepe, A., Meylan, N., Curchod-Ruedi, D., Albanese, O. & Doudin, P.-A. (2015). The effect of teachers' emotional intensity and social support on burnout syndrome. A comparison between Italy and Switzerland. European Review of Applied Psychology, 65, 275–283. doi:10.1016/j.erap.2015.10.003 [CrossRef]
  • Fishta, A. & Backé, E.M. (2015). Psychosocial stress at work and cardiovascular diseases: An overview of systematic reviews. International Archives of Occupational and Environmental Health, 88, 997–1014. doi:10.1007/s00420-015-1019-0 [CrossRef]
  • Galdeano, H., Godoy, P. & Cruz, I. (2007). Psychosocial risk factors in secondary school teachers. Archivos de Prevención de Riesgos Laborales, 10, 174–180.
  • Generalitat de Cataluña. (2014). Informe 2014 de l'Enquesta de salut de Catalunya, Barcelona: Departament de Salut [webpage in Spanish.]. Retrieved from http://salutweb.gencat.cat/ca/el_departament/estadistiques_sanitaries/enquestes/esca/resultats_enquesta_salut_catalunya
  • Goldberg, D. (1978). Manual of the general health questionnaire. Slough, UK: NFER Nelson.
  • Goldberg, D.P., Gater, R., Sartorius, N., Ustun, T.B., Piccinelli, M., Gureje, O. & Rutter, C. (1997). The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychological Medicine, 27, 191–197. doi:10.1017/S0033291796004242 [CrossRef]
  • Goldberg, D.P. & Willians, P. (1988). A user's guide to the general health questionnaire. Windsor, UK: NFER Nelson.
  • International Labour Organization. (2016). Work-place stress: A collective challenge. Retrieved from http://www.ilo.org/wcmsp5/groups/public/---ed_protect/---protrav/---safework/documents/publication/wcms_466547.pdf
  • Kataoka, M., Ozawa, K., Tanioka, T., Okuda, K., Chiba, S., Tomotake, M. & King, B. (2015). Gender differences of the influential factors on the mental health condition of teachers in the A university. Journal of Medical Investigation, 62, 56–61. doi:10.2152/jmi.62.56 [CrossRef]
  • Kataoka, M., Ozawa, K., Tomotake, M., Tanioka, T. & King, B. (2014). Occupational stress and its related factors among university teachers in Japan. Health, 6, 299–305. doi:10.4236/health.2014.65043 [CrossRef]
  • Keyes, C.L.M., Dhingra, S.S. & Simoes, E.J. (2010). Change in level of positive mental health as a predictor of future risk of mental illness. American Journal of Public Health, 100, 2366–2371. doi:10.2105/AJPH.2010.192245 [CrossRef]
  • Lluch-Canut, M.T. (2003). Construcción y análisis psicométrico de un cuestionario para evaluar la salud mental positive [article in Spanish]. Psicología Conductual, 11, 61–78.
  • Lluch-Canut, T., Puig-Llobet, M., Sánchez-Ortega, A., Roldán-Merino, J. & Ferré-Grau, C. (2013). Assessing positive mental health in people with chronic physical health problems: Correlations with socio-demographic variables and physical health status. BMC Public Health, 13, 928. doi:10.1186/1471-2458-13-928 [CrossRef]
  • Mahan, P.L., Mahan, M.P., Park, N., Shelton, C., Brown, K. & Weaver, M. (2010). Work environment stressors, social support, anxiety, and depression among secondary school teachers. Workplace Health & Safety, 58, 197–205. doi:10.3928/08910162-20100416-01 [CrossRef]
  • Mantas, S., Juvinyà, D., Bertran, C., Roldán, J., Sequeira, C. & Lluch, T. (2015). Evaluation of positive mental health and sense of coherence in mental health professionals. Revista Portuguesa de Enfermagem de Saúde Mental, 13, 34–42.
  • Martínez, A.C., Pujazón, R.F. & Jiménez, P.L. (2014). Prevalencia de ansiedad y depresión en docents [article in Spanish]. Revista Enfermería del Trabajo, 4, 55–62.
  • Ministry of Health and Social Affairs. (2015). Informe 2015: Alcohol, tabaco y drogas ilegales en España [webpage in Spanish]. Retrieved from http://www.pnsd.msssi.gob.es/profesionales/sistemasInformacion/informesEstadisticas/pdf/INFORME_2015.pdf
  • Moncada, S., Utzet, M., Molinero, E., Llorens, C., Moreno, N., Galtés, A. & Navarro, A. (2014). The Copenhagen psychosocial questionnaire II (COPSOQ II) in Spain—A tool for psychosocial risk assessment at the work-place. American Journal of Industrial Medicine, 57, 97–107. doi:10.1002/ajim.22238 [CrossRef]
  • Roldán-Merino, J., Lluch-Canut, M.T., Casas, I., Sanromà-Ortíz, M., Ferré-Grau, C., Sequeira, C. & Puig-Llobet, M. (2017). Reliability and validity of the Positive Mental Health Questionnaire in a sample of Spanish university students. Journal of Psychiatric and Mental Health Nursing, 24, 123–133. doi:10.1111/jpm.12358 [CrossRef]
  • Sánchez-López, M.D.P. & Dresch, V. (2008). The 12-Item General Health Questionnaire (GHQ-12): Reliability, external validity and factor structure in the Spanish population. Psicothema, 20, 839–843.
  • Seibt, R., Matz, A., Hegewald, J. & Spitzer, S., (2012). Working conditions of female part-time and full-time teachers in relation to health status. International Archives of Occupational and Environmental Health, 85, 675–687. doi:10.1007/s00420-011-0715-7 [CrossRef]
  • Sequeira, C., Carvalho, J.C., Sampaio, F., Sá, S., Lluch-Canut, T. & Roldán-Merino, J. (2014). Avaliação das propriedades psicométricas do Questionário de Saúde Mental Positiva em estudantes portugueses do ensino superior [article in Portuguese]. Revista Portuguesa de Enfermagem de Saúde Mental, 11, 45–53.
  • Stansfeld, S.A., Pike, C., McManus, S., Harris, J., Bebbington, P., Brugha, T. & Clark, C. (2013). Occupations, work characteristics and common mental disorder. Psychological Medicine, 43, 961–973. doi:10.1017/S0033291712001821 [CrossRef]
  • Subirats, E.S., Vila, G.S. & Martínez, I.S. (2012). Exercise prescription: Indications, dosage and side effects. Medicina Clínica, 138, 18–24. doi:10.1016/j.medcli.2010.12.008 [CrossRef]
  • Thoits, P.A. (2011). Mechanisms linking social ties and support to physical and mental health. Journal of Health and Social Behavior, 52, 145–161. doi:10.1177/0022146510395592 [CrossRef]
  • Unterbrink, T., Pfeifer, R., Krippeit, L., Zimmermann, L., Rose, U., Joos, A. & Bauer, J. (2014). A manual-based group program to improve mental health: What kind of teachers are interested and who stands to benefit from this program?International Archives of Occupational and Environmental Health, 87, 21–28. doi:10.1007/s00420-012-0832-y [CrossRef]
  • Vives, A., Amable, M., Ferrer, M., Moncada, S., Llorens, C., Muntaner, C. & Benach, J. (2013). Employment precariousness and poor mental health: Evidence from Spain on a new social determinant of health. Journal of Environmental and Public Health, 2013, 1–10. doi:10.1155/2013/978656 [CrossRef]
  • World Health Organization. (2010). Health impact of psychosocial hazards at work: An overview. Retrieved from http://apps.who.int/iris/bitstream/10665/44428/1/9789241500272_eng.pdf
  • Yin, H., Huang, S. & Wang, W. (2016). Work environment characteristics and teacher well-being: The mediation of emotion regulation strategies. International Journal of Environmental Research and Public Health, 13, 907. doi:10.3390/ijerph13090907 [CrossRef]

Participants' Sociodemographic and Occupational Habits and Lifestyle Characteristics (N = 263)

VariableMean (SD), Range
Age (years)47.8 (9.9), 27 to 67
No. of cigarettes per day (active smokers)11.48 (8.9), 2 to 40
n (%)
Sex
  Female208 (79.1)
  Male55 (20.9)
Teaching category
  Full-time professor133 (50.6)
  Associate professor130 (49.4)
Years teaching in university
  ≤585 (32.3)
  6 to 1567 (25.5)
  16 to 2573 (27.8)
  >2538 (14.5)
Cycles taught by teacher
  First (Bachelor's degree)167 (63.5)
  First and second (Bachelor's and Master's degrees)96 (36.5)
Teaching shifts
  Morning and afternoon140 (53.2)
  Morning or afternoon123 (46.8)
Satisfaction with social relationships and friends
  Satisfactory143 (54.4)
  Very satisfactory104 (39.5)
  Unsatisfactory16 (6.1)
Plays sports/physical exercise
  None62 (23.6)
  1 to 2 hours/week90 (34.2)
  3 to 4 hours/week95 (36.1)
  >4 hours/week16 (6.1)
Variablen (%)
Coffee consumption
  Always or almost always159 (60.5)
  Never or almost never104 (39.5)
Smoking
  Never123 (46.8)
  Ex-smoker97 (36.9)
  Active smoker43 (16.3)
    Smoking habit
      Usually23 (53.5)
      Occasionally20 (46.5)
Antidepressant agent use
  Never225 (85.6)
  Usually33 (12.5)
  Occasionally5 (1.9)
Tranquilizer drug use
  Never210 (79.8)
  Usually35 (13.3)
  Occasionally18 (6.8)
Analgesic drug use
  Never124 (47.1)
  Occasionally115 (43.7)
  Usually24 (9.1)
Anti-inflammatory drug use
  Never144 (54.8)
  Occasionally95 (36.1)
  Usually24 (9.1)
Bach flower remedies
  Never211 (80.2)
  Usually38 (14.4)
  Occasionally14 (5.3)
Stressful life events in past year
  No170 (64.6)
  Yes93 (35.4)

Prevalence of Psychological Ill-Being in the Sample (N = 263)

VariablePrevalenceChi-Squarep Value
n (%)95% CI
GHQ-12 score >271 (27)[21.8, 32.6]
Age (years)
  ≤4025 (36.2)[25.5, 48.0]4.1220.249a
  41 to 4913 (20)[11.6, 31.0]
  50 to 5618 (28.1)[18.1, 40.0]
  >5615 (25)[18.1, 40.0]
Sex
  Female58 (27.9)[22.1, 34.2]0.3980.528a
  Male13 (23.6)[13.8, 36.1]
Teaching category
  Full-time professor41 (30.8)[23.4, 39.0]2.0040.157a
  Associate professor30 (23.1)[16.4, 30.9]
Years teaching in the university
  ≤526 (30.6)[21.5, 40.9]2.6700.445a
  6 to 1516 (23.9)[14.8, 35.1]
  16 to 2522 (30.1)[20.4, 41.3]
  >257 (18.4)[8.43, 33.0]
Teaching cycle
  First (Bachelor's degree)36 (22)[16.1, 28.7]5.6260.022a
  First and second (Bachelor's and Master's degrees)35 (35.4)[26.4, 45.1]
Teaching shifts
  Morning and afternoon43 (30.7)[23.5, 38.7]2.1000.165a
  Morning or afternoon28 (22.8)[16.0, 30.7]
Satisfaction with social relationships and friends
  Satisfactory48 (33.6)[26.1, 41.6]8.5050.012b
  Very satisfactory18 (17.3)[10.9, 25.4]
  Unsatisfactory5 (31.3)[12.4, 56.3]
Plays sports/physical exercise
  None18 (29)[18.7, 41.2]1.7900.622b
  1 to 2 hours/week21 (23.3)[15.4, 32.8]
  3 to 4 hours/week26 (27.4)[19.1, 36.9]
  >4 hours/week6 (37.5)[16.8, 62.3]
Coffee consumption
  Always or almost always42 (26.4)[20.0, 33.6]0.0690.887a
  Never or almost never29 (27.9)[19.9, 37.0]
Smoking
  Never30 (24.4)[17.4, 32.5]5.7760.058a
  Ex-smoker23 (23.7)[16.0, 32.9]
  Active smoker18 (41.9)[27.8, 56.9]
    Smoking habit
      Occasionally9 (45)[25.6, 66.7]0.1510.763a
      Usually9 (39.1)[21.0, 59.8]
Stressful life events in past year
  No44 (25.9)[19.7, 32.8]0.3030.663a
  Yes27 (29)[20.5, 38.8]

Prevalence of Psychological Ill-Being According to Use of Pharmacological Agents

VariablePrevalenceChi-Squarep Value
n (%)95% Confidence Interval
GHQ-12 score >271 (27)[21.8, 32.6]
Antidepressant agent use
  Never55 (24.4)[19.1, 30.3]5.8310.046a
  Usually14 (42.4)[27.3, 59.5]
  Occasionally2 (40)[14.7, 56.9]
Tranquilizer drug use
  Never50 (23.8)[18.4, 29.9]5.8310.046a
  Usually15 (42.9)[27.3, 59.5]
  Occasionally6 (33.3)[14.7, 56.9]
Analgesic drug use
  Never38 (30.6)[23.0, 39.1]4.3720.121b
  Occasionally24 (20.9)[14.1, 29.0]
  Usually9 (37.5)[20.0, 57.7]
Anti-inflammatory drug use
  Never36 (25)[18.4, 32.5]4.7570.102b
  Occasionally24 (25.3)[17.3, 34.7]
  Usually11 (45.8)[26.9, 65.6]
Bach flower remedy use
  Never51 (24.2)[18.7, 30.2]6.6560.033a
  Usually17 (44.7)[29.6, 60.6]
  Occasionally3 (21.4)[5.7, 47.9]

Positive Mental Health Questionnaire (PMHQ) Scoresa

PMHQ FactorMinimumMaximumMedianTotal Mean (SD), Item Meanb
Personal satisfaction (8 items)16312323.1 (3.1), 2.88
Prosocial attitude (5 items)6191514.6 (2.1), 2.92
Self-control (5 items)8201515.3 (2.4), 3.06
Autonomy (5 items)520910.2 (3.7), 2.04
Problem solving and self-actualization (9 items)12363130 (3.7), 3.33
Interpersonal relationship skills (7 items)14282121.5 (3), 3.07
Total77148113114.8 (12)

Mean Total Scores of the Positive Mental Health Questionnairea According to Sociodemographic Variables (N = 263)

VariableMean (SD)F/t Testp Value
Age (years)
  ≤40117 (13.1)1.5440.204b
  41 to 49112.5 (11.3)
  50 to 56114.8 (12.1)
  >56114.8 (10.4)
Sex
  Female114.6 (11.9)−0.6650.502c
  Male115.8 (12.2)
Teaching category
  Full-time professor116.7 (12.1)2.6030.010c
  Associate professor112.9 (11.6)
Years teaching in the university
  ≤5115.9 (13.2)0.7860.503b
  6 to 15114.9 (10.9)
  16 to 25113.1 (12.3)
  >25115.7 (10.2)
Teaching cycle
  First (Bachelor's degree)114.9 (11.8)0.1250.900c
  First and second (Bachelor's and Master's degrees)114.7 (12.3)
Teaching shifts
  Morning and afternoon115.3 (12)−0.7170.474c
  Morning or afternoon114.3 (12)
Satisfaction with social relationships and friends
  Satisfactory114.3 (11.5)6.9460.001b
  Very satisfactory114 (12.1)
  Unsatisfactory125.5 (11.5)
Plays sports/physical exercise
  None111.2 (11.2)2.7990.041b
  1 to 2 hours/week115.2 (9.2)
  3 to 4 hours/week116.6 (12.7)
  >4 hours/week117 (18.1)
Coffee consumption
  Always or almost always114.3 (11.9)0.8490.396c
  Never or almost never115.6 (12.1)
Smoking
  Never115.2 (11.5)2.4470.089b
  Ex-smoker116 (13.2)
  Active smoker111.2 (9.8)
    Smoking habit
      Occasionally111.2 (10.4)−0.0180.986c
      Usually111.3 (9.4)
Stressful life events in past year
  No115.2 (12.1)−0.6330.527c
  Yes114.2 (11.9)

Relationship Between General Health Questionnaire-12 (GHQ-12) and Positive Mental Health Questionnaire (PMHQ) Scoresa

PMHQ FactorGHQ-12 Score ≤2GHQ-12 Score >2p Valueb
Mean (SD)Mean (SD)
Personal satisfaction23.4 (3.2)22.2 (2.7)0.005
Prosocial attitude14.8 (2.3)14.1 (1.6)0.011
Self-control15.4 (2.5)14.9 (2.2)0.120
Autonomy10.3 (3.8)9.7 (3.3)0.249
Problem solving and self-actualization30.4 (3.8)28.8 (3.3)0.003
Interpersonal relationship skills21.9 (3.1)20.2 (2.3)0.0001
Total116.5 (12.5)110.3 (9.2)0.0001
Authors

Ms. Hurtado-Pardos is PhD Student and Professor of Nursing, Dr. Moreno-Arroyo is Professor of Nursing, Dr. Lluch-Canut is Professor of Psychosocial and Mental Health Nursing, Ms. Farrés-Tarafa is Professor of Nursing, and Dr. Roldán-Merino is Professor of Mental Health Nursing, School of Nursing, University of Barcelona; Dr. Casas is Medical Doctor, Servicio de Medicina Preventiva del Hospital Germans Trias i Pujol; Dr. Roldán-Merino is also Associate Professor in Nursing, and Dr. Casas is also Associate Professor, Universitat Autònoma de Barcelona, Barcelona; and Dr. Lleixà-Fortuño is Associate Professor, Universitat Rovira i Virgili, Tarragona, Spain. Dr. Lluch-Canut is also Coordinator, Research Network “Mental Health Nursing and Addictions,” Barcelona, Spain.

The authors have disclosed no potential conflicts of interest, financial or otherwise.

The authors thank all of the nursing teachers who participated.

Address correspondence to Irma Casas, PhD, MD, Medical Doctor, Servicio de Medicina Preventiva del Hospital Germans Trias i Pujol, C/Carretera Del Canyet s/n CP 08916, Badalona, Spain; e-mail: icasas.germanstrias@gencat.cat.

Received: February 14, 2017
Accepted: May 01, 2017

10.3928/02793695-20170619-06

Sign up to receive

Journal E-contents