Journal of Nursing and Practice

ISSN: 2578-7071

Original Research | VOLUME 5 | ISSUE 1 | DOI: 10.36959/545/414 OPEN ACCESS

Emotional Exhaustion of Female Nursing Educators

Nadiah A Baghdadi, PhD, RN

  • Nadiah A Baghdadi 1
  • Assistant Professor, Nursing Management and Education Department, College of Nursing, Princess Nourah bint Abdulrahman University, Saudi Arabia

Baghdadi NA (2022) Emotional Exhaustion of Female Nursing Educators. J Nurs Pract 5(1):417-424.

Accepted: March 26, 2022 | Published Online: March 28, 2022

Emotional Exhaustion of Female Nursing Educators

Abstract


Previous research indicates the prevalence of burnout among nurses and educators. Factors of burnout need to be identified to help prevent its adverse outcomes on work and well-being, especially among women from the Middle East who are underrepresented in burnout studies. Drawing from an online survey among 299 female nurse educators in Saudi Arabia, this study aims to examine personal and work characteristics, task demands, social support and activities outside work as determinants of burnout, which was measured using the Maslach Burnout Inventory (MBI). This cross-sectional study made use of descriptive and bivariate statistics, and hierarchal regression to analyze the data. Findings indicate moderate burnout among the respondents. Younger, Saudi nationals, with only a master's degree and a rank below assistant professor, more years in service and no administrative position demonstrate higher levels of MBI. Work pressure and social support positively predicted MBI, while house of sleep per day was inversely related to MBI. This study provides evidence to inform policies, programs, and other initiatives of nursing education institutions to address faculty members with or at risk for burnout.

Keywords


Burnout, Faculty, Female, Nursing education, Saudi Arabia

Introduction


Burnout is a psychological concept that refers to the experience of emotional exhaustion and depersonalization [1,2]. The global prevalence of burnout among nurses has been estimated at 11.23% [3]. Consequences of burnout among nurses include decreased quality of life, service delivery and organizational outcomes [2]. This current study focuses on nurses working in academia, who are also prone to experiencing burnout [4,5]. Lackritz [6] estimated the level of burnout among nursing educators at 20%. If left underestimated or unchanged, burnout can negatively impact faculty, team, students, teaching, and the nursing program's overall quality. Burnout has been linked to decreased job satisfaction and institutional loyalty, and increased turnover in educational settings [7]. Additionally, job burnout among nursing educators potentially affects the reputation of nursing colleges, commitment to higher education settings, and the learning experience of nursing students [8]. Understanding the facilitators and barriers of burnout among nursing educators may guide higher education institutions in addressing the shortage of academic staff in nursing colleges [5,6]. Addressing potential sources of burnout is specifically salient during this period of "great resignation," wherein workers from different sectors, including healthcare and education, tend to easily decide to leave employment because of stressful work conditions and lack of rewards [9].

Focus on female faculty members and Saudi Arabia

Meta-analytic evidence suggests that the levels and characteristics of teacher burnout vary across countries, and that gender can influence burnout outcomes [10]. Redondo-Florez, et al. [11] demonstrates the significant difference in burnout levels among university professors when grouped according to gender, with females scoring higher compared to their male counterparts. Qualitative evidence demonstrates that while there is increasing empowerment of women educators in Saudi Arabian Society, lack of appreciation and power struggles persist in their work experiences [12]. Given this context, we argue the necessity of conducting a woman-centered study on burnout.

Meanwhile, the current educational landscape of Saudi Arabia is influenced by Vision 2030, which stresses the importance of developing attractive, preferred, and simulant school environments while connecting this with supportive and integrated services systems [13]. This demand is seen in the objectives of the Saudi Transformation Program which includes improving recruitment, training, and development of educators. This would then stimulate creativity and an innovative learning environment. This national strategy can potentially impact expectations from educators, and consequently their demands and burnout. Given these country- and gender-specific contexts, it is necessary and timely to examine burnout and its antecedents, especially in the Middle East region, which is underrepresented in nurse burnout research [3].

Conceptualizing the determinants of burnout

For this study, burnout is operationalized as the state of having high level of emotional exhaustion and depersonalization, and low level of personal achievement in the context of work [2,14]. For the determinants to be examined, this study appeals to the framework by Padilla and Thompson [15] who examined burnout among university doctoral faculty members. In their work, they made use of two theoretical underpinnings. The first is the Job Demand-Control Model [16] which posits that job strain (i.e. burnout) is induced by a mixture of high job demand, low job control and low social support. The second is the concept of work-family conflict, which suggests that poor job performance and overall wellbeing can result, when one's work disrupts one's family and personal life, and vice versa [17]. From these theories, Padilla and Thompson [15] identified three factors of burnout: task demands, social support and activities outside work.

Task demands and burnout: Padilla and Thompson [15] operationalized task demands as the hours spent and pressure received by faculty members in performing the following four tasks: teaching, research, service, and grants. This corroborates with the assertion of a conceptual review that workloads of faculty members, such as working hours, number of students in class, research productivity and other career demands, facilitate burnout [14]. Moreover, Zeng, et al. [2] suggests that quantitative and qualitative job demands also contribute to occupational burnout among nurses. Additional external demands such as meeting accreditation and certification requirements can also compound with internal multiple demands and foster burnout among nurse faculty [5]. Empirical evidence among nursing faculty among Northeastern US suggests that job demand is positively associated with emotional exhaustion and depersonalization dimensions of burnout [18].

Social support and burnout: For this study, social support refers to the support received from peers, the department, and the college [15]. Zeng, et al. [2] considers support from colleagues and the organization as external resources that can protect nurses from occupational burnout. Moreover, Thomas, et al. [5] suggests that collegial support through mentors and civil relationships also decreases risk for burnout. Evidence among Greek nurses suggest that support from friends and significant others [19]. A narrative review of research among educational professions reveals that lack of social support and participation in decision making can facilitate burnout among faculty [20].

Activities outside work and burnout: The activities outside work that were considered in this present study are family, leisure, and sleep [15]. These dimensions of life outside work were also noted by Thomas, et al. [5], which posited that lack of sleep and exercise and poor work/life balance contributed to nursing faculty burnout. Furthermore, Sabagh, et al. [20] suggests that family-related stressors is a determinant of burnout presented in general education literature. Evidence among Canadian nursing faculty linked the ability to accommodate life experiences outside work with decreased emotional exhaustion [21]. Moreover, a study among associate degree nursing program directors noted that sleep problems were linked to burnout, stress and emotional work demands [22].

Personal and work profile, and burnout: Aside from the abovementioned determinants of interest, we also considered contextual factors related to the demographic and work background of the female faculty. Based from a review of education literature, age, years of experience, academic rank, management role and employment status are gradients that affect the likelihood of faculty burnout [20]. Also, because of the increasing population of migrant nursing faculty working in Saudi, we also considered their immigrant status as a potential factor for burnout and other related difficulties as seen in previous research [23].

Materials and Methods


Study design and sampling

The study used descriptive, cross-sectional survey research design, and a multistage sampling design. We obtained a list of nursing education programs in Saudi Arabia that offer Bachelor of Science in Nursing program (BSN) from the ministry of education website. A number was assigned to each program and 4 schools/colleges per region were randomly selected using a computerized random number generator. Then we proceeded to recruit individual faculty members from the selected institutions. The inclusion criteria included female faculty, teaching in BSN programs. The exclusion criteria included BSN faculty who are male, managers with no teaching load, and those teaching graduate courses exclusively. Following randomization, faculty names and email addresses from the selected institutions were obtained from the publicly available online directories of the university websites. Based on a priori sample size G-power analysis (version 3.1), the total sample size needed for the hypothesized model is 167 (f2 = 0.15, power = 0.95, α error probability = 0.05). The total number of qualified respondents who participated in the study is 299.

Instrumentation

Personal and work background characteristics: The first part of our online survey inquired the following details: age, nationality (1 = Saudi local, 0 = non-Saudi), educational attainment (1 = Master's degree, 2 = Doctoral degree), academic ranking (1 = teaching assistant and lecturer, 2 = assistant and associate professor), program level assignment (1 = undergraduate only; 2 = with graduate teaching assignment); years in service, and administrative position (1 = yes, 0 = no).

Task demands, social support and activities outside work: The second section of the online survey measured task demands, social support and activities outside work, based on the tool used in the previous work of Padilla and Thompson [15]. Task demands has two dimensions: work hours and work pressure. For work hours, the respondents were asked to indicate the number of weekly hours they performed the following tasks: teaching, research, service, and grant writing. For work pressure, the respondents were asked to answer the extent to which they feel pressured to perform the four tasks using a 5-point Likert scale (0 = "none", 4 = "a very great deal").

Social support was measured using three items. The respondents were asked to rate the extent of support they received from three sources (peer, department and college) using a 5-point Likert scale (0 = "none" 4 = "a very great deal"). For activities outside work, we inquired about the number of hours the respondents spent on sleep, family and leisure per week. We conducted a pilot study (n = 24) to determine the internal consistency of the tool; the tool yielded an acceptable Cronbach alpha (α = 0.85).

Malsach Burnout Inventory (MBI): The dependent variable of the study is burnout and was measured using the Malsach Burnout Inventory (MBI). MBI is a 22-item scale that measures emotional exhaustion, personal achievement and depersonalization related to work. A sample item is "Feel working too hard on the job." Similar to Padilla & Thompson [15] we measured each item using a 5-point Likert scale (0 = "not at all", 4 = "very often"). Previous studies have estimated the Cronbach alpha of MBI from 0.71 to 0.93 [15]. Our pilot study (n = 22) yielded an acceptable score of 0.91.

Data collection procedure and ethical considerations

Prior to data collection, an ethical approval to conduct the study was obtained from XXX Institutional Review Board (IRB) (log Number: 18-0111). Faculty members from the selected institutions who met the inclusion criteria were invited via email. Before accessing the online survey, a consent statement that provided a full explanation of the study and assurance of their privacy and confidentiality. The participating faculty were then prompted to click agree and complete the online surveys without any incentives. The online survey forms were active from October 2019 to February 2020.

Data analysis procedure

Descriptive statistics (mean and standard deviation for continuous variables, frequency and percentage for categorical variables) were used to determine the distribution of the variables. Bivariate statistics (independent t-test for dichotomous variables, one way ANOVA for multinomial variables, and Pearson R correlation for continuous variables) for categorical were used to identify the significant correlates of overall MBI scores. Significant correlates were included in the hierarchal regression model for MBI. First step included personal and work characteristics, second step included task demands, social support and activities outside work. Bootstrapping using 5,000 replicates was used to address possible non-normality. JASP 0.16 was used for analysis. Significance was set at 0.05 level.

Results


Descriptive results

Table 1 shows the descriptive statistical results of the personal and work back-ground characteristics of the participants. Majority of the female nurse educators are within the 41 to 50-years-old age bracket (n = 146, 48.8%), non-Saudi (n = 202, 67.6%), with doctoral degree (n = 224, 74.9%), in the assistant to associate professor rank (n = 186, 62.2%), teaching only in the undergraduate level (n = 182, 60.9), more than 15 years in service (n = 98, 32.8) and with administrative position (n = 149, 49.8%).

Table 2 shows the mean and standard deviation scores of MBI and its potential predictors. For task demands, the mean work hours per week is 90.4 ± 13.5, with teaching comprising most of the hours (Mean = 23.4 ± 12.9). The overall mean for work pressure is 1.96 ± 0.69, with service pressure as the indicator garnering the highest score (Mean = 2.49 ± 1.01). For social support, the overall mean is 1.51 ± 0.89, with college support as the indicator garnering the highest score (Mean = 1.57 ± 1.01). Under activities outside work, the average number of hours per day for sleep, family and leisure are 5.82 ± 1.14, 3.56 ± 2.39 and 2.39 ± 1.75 respectively.

Table 2 also indicates that the burnout among the female nurse educators is at a moderate level (Mean = 1.92 ± 0.63). As for the specific domains of burnout, emotional exhaustion (Mean = 2.13 ± 0.63), depersonalization (Mean = 2.12 ± 0.50) and personal achievement scores (Mean = 2.38 ± 1.13) are within moderate level as well.

Bivariate results

Table 3 presents the results of the bivariate tests between the potential predictors and burnout. Among the personal and work characteristics, age (F = 154, p < 0.001), nationality (t = -8.11, p < 0.001), educational attainment (t = 2.90, p = 0.004), years in service (F = 17.4, p < 0.001) and administrative position (t = 3.18, p = 0.002) were significantly correlated with MBI. Specifically, younger, Saudi locals with no doctoral degrees, academic ranking of lecturer or less, lesser years in service and without administrative position were observed to have higher burnout scores.

Among the two variables under task demands, work pressure (r = 0.346, p < 0.0001) was significantly positively correlated with MBI. Social support (r = 0.292, P < 0.001) was significantly positively correlated with MBI as well. In terms of activities outside work, sleep (r = -0.219, p < 0.001) was significantly negatively correlated with MBI. Work hours per week, and family and leisure hours per day did not emerge as significant correlates of burnout.

Heirarchal regression results

Table 3 presents the results of the hierarchal regression analyses to identify the significant predictors MBI. The Durbin-Watson statistics for the four models were at 2.303 to 2.404, suggesting no autocorrelation. In step 1, the personal and work variables that were significant correlates were inputted in the model (block 1). The model explained 54.7% of the variance of MBI (F = 43.116, p < 0.001). Being 40-years-old (41-50yo [B = -0.610, p < 0.001], 51 yo+ [B = -0.533, p < 0.001]), a Saudi local (B = 0.455, p < 0.001), in lecturer rank or less (B = -0.380, p < 0.001), with more years of service (6-10 yrs [B = 0.368, p < 0.001], 10-15 yrs [B = 0.481, p < 0.001], +15 yrs [B = 0.281, p = 0.012]) and without administrative position (B = -0.241, p < 0.001) were factors to having higher burnout. Educational attainment did not yield significant results in this model.

In step 2, the other significant correlates were added into the model, including work pressure (task demands), social support, and sleep hours per day (activities outside work). The model explained 59.4% of the variance of MBI (ΔR2 = 0.147, F = 53.999, p < 0.001). In step 2, age (41-50yo [B = -0.453, p < 0.001], 51yo+ [B = -0.369, p < 0.001]), a nationality (B = 0.369, p < 0.001), academic ranking (B = -0.980, p < 0.001), years of service (6-10 yrs [B = 0.547, p < 0.001], 10-150 yrs [B = 0.309, p = 0.001], +150 yrs [B = 0.281, p = 0.007]) and administrative position (B = -.290, p < 0.001) maintained their significant relationship with burnout. Moreover, educational attainment has yielded significant values in step 2 (B = 0.575, p < 0.001).

Work pressure (B = 0.400, p < 0.001) and social support (B = 0.100, p < 0.001) positively predicted MBI. Sleep hours per day negatively predicted MBI (B = -0.076. p < 0.001). The final model suggests that being younger, a Saudi local, with only a Master's degree, a teaching assistant or lecturer rank, more years in service, no administrative position, and having higher work pressure, more social support and less sleep contributed to more burnout among female nurse educators (Table 4).

Discussion


The goal of this present study is to identify the significant determinants of burnout among female nursing educators in Saudi Arabia. Our study extends the literature by determining the prevalence and the factors of burnout in among women faculty from the Middle East, who are underrepresented in burnout research. Our findings indicate moderate burnout among respondents overall and in all three dimensions (emotional exhaustion, depersonalization, and personal achievement). Similarly, previous research has estimated moderate levels of burnout among female Spanish educators, who experienced worse burnout and practiced less stress management activities compared to their male counterparts [11].

All the determinants under the personal and work characteristics of the respondents significantly predicted and explained a substantial amount of variance (54.7%) of MBI. Consistent with previous studies [20,24], younger nursing faculty (below forty years old) reported higher burnout. From a life course perspective, this period of emerging and young adulthood is a time of identity, intimacy, and family building [25], which are activities that can compound with the work stresses they are experiencing, hence causing burnout. In terms of nationality, Saudi locals exhibited higher burnout levels compared to migrant faculty. This present result corroborates with previous research elsewhere demonstrating higher psychological distress among locals versus non-local workers [26]. A possible reason for the lower burnout scores of migrants is because despite the challenges at work, nurses working in Saudi Arabia perceive that employment and income conditions is better compared to their home country [27].

Moreover, our findings suggests that doctoral degree holders report higher burnout compared to their master's degree holder counterparts, which confirms previous evidence which noted that those with lower degrees had higher emotional exhaustion and lower personal accomplishment [28]. In addition, our present study indicates that female nursing educators who rank lower than assistant professor demonstrate higher levels of MBI, which was also noted in earlier evidence of faculty with lower ranks reporting more burnout compared to associate professors or higher [20]. These two findings corroborate as tenure and academic promotion of a faculty member in higher education is tied to advanced educational degrees. Stability of employment and career prospects, which are tied to these variables, have been noted as protective factors against faculty burnout [5].

In terms of years in service, our results indicate higher burnout levels among female nursing faculty with lesser years of service, which confirms earlier research that noted resistance of more tenured educators against emotional exhaustion [28]. Previous reviews have suggested the salience of tenure as a factor that protects against burnout [5,20]. Interestingly, years of service demonstrate an inverse direction with age. It must be noted that majority of the respondents are migrant workers. Evidence has suggested that migrant nurse workers in Saudi Arabia enter the country during their mid-careers [29], hence, restarting their counting for years of service. Finally, under profile variable, our results suggest that having an administrative role predicted lower anxiety among female nursing faculty. Nursing educational administrators may demonstrate more control over their workload, thus improving role conflict and ambiguity which can alleviate burnout [14]. Overall, it must be noted that personal and work characteristics explain a larger extent of the variance of burnout (54.7% out of 69.4%).

As for task demands, our study suggests that higher levels of work pressure are linked with burnout. This runs parallel with the findings of previous research on faculty burnout [2,14,18]. Descriptive findings of the present research shows that the topmost source of work pressure is in the dimension of research, which has also been identified as a salient factor contributing to burnout among university academics [15].

Surprisingly, the results of the present study indicated a significant positive predictive relationship between social support and burnout. This contradicts theoretical assumptions that posit social support as a protective factor against burnout [5]. It must be noted that the current investigation measured sources of support (peer, department, college). A possible explanation for this uncanny finding is that not all types of social support alleviate burnout. For instance, evidence has noted that informational support and appraisal support can facilitate ambiguity in decision making that can lead to work-related stress [30]. Moreover, social interactions may make the educators more aware of the stressful nature of their work [31], hence inducing their burnout.

Lastly, the present study indicates that sleep is inversely related with burnout, which confirms previous evidence among higher education teachers [22]. Burned-out nursing educators who perform high task demands may likely spend more time performing work and other personal tasks, thus decreasing their sleep periods [5]. Moreover, teachers who sleep longer periods have been noted to perform better and have less strained relationships with colleagues and students [32].

The findings must be viewed in the light of its limitation. The current study makes use of a cross-sectional approach. Thus, the relationships established in this study do not readily imply causality. Future research can implement longitudinal designs to enrich the understanding of the links of the explanatory variables with the development of burnout. Moreover, the support variable measured in the study covered more on sources rather than forms or types, which could have added more insights to the uncanny results.

Conclusions


This study provides empirical evidence highlighting the presence of moderate levels of burnout among female nursing educators in Saudi Arabia. Work and profile characteristics of educators contribute significantly to their burnout, such that younger, Saudi locals, with only a master's degree, an academic rank below assistant professor, more years of experience and without administrative position demonstrate higher levels of burnout. Burnout among female nursing educators is also accentuated by greater work pressure, increased social support, and decreased sleep per day.

Recommendations


The salience of profile variables highlights the need for professional and career development programs that may be able to address burnout. Administration should provide incentives for achievement of advanced degrees and other forms of motivation to climb the academic ladder. Administrative duties can be delegated, and positions can be offered in a cyclical fashion, so that every faculty can partake in leadership roles. Nursing colleges and human resource departments can conduct informal sessions wherein faculty members are engaged in conversations about their sense of burnout and its possible causes in their lives, allowing them to voice out their needs. Implementation of initiatives to decrease burnout should also be sensitive on the development and cultural context of the faculty, particularly the young and the Saudi locals. Nursing educational administrators should be mindful of the way they approach the assignment of tasks to faculty. These assignments must be open for negotiations, and goals and deadlines must be flexible, so as not to induce pressure on the faculty. Since social support may cause increased burnout, managers and colleagues of faculty should also respect personal and alone times of each other and provide only the specific social support they need. Lastly, overtimes and working after work hours must be discouraged, and communicating with faculty during evenings must be avoided, to respect the rest and sleep time of the educators, to give them time to rejuvenate and relieve their stress.

Ethical Consideration


Ethical Approval was Obtained and Approved from Princess Nourah bint Abdulrahman University IRB, Registration Number H-01-R-059.

Funding


None.

Acknowledgment


None.

Conflict of Interest


All authors declared no conflict of interest with other person or organization that might influence the work of this study.

References


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  2. Zeng JF, Xiao AX, Ye JR, et al. (2020) Occupational Burnout in nurses: A concept analysis. Frontiers of Nursing 7: 1-8.
  3. Woo T, Ho R, Tang A, et al. (2020) Global prevalence of Burnout symptoms among nurses: A systematic review and meta-analysis. Journal of Psychiatric Research 123: 9-20.
  4. Owens JM (2017) Secondary stress in nurse educators. Teaching and Learning in Nursing 12: 214-215.
  5. Thomas CM, Bantz DL, McIntosh CE (2019) Nurse faculty Burnout and strategies to avoid IT. Teaching and Learning in Nursing 14: 111-116.
  6. Lackritz JR (2004) Exploring Burnout among university faculty: Incidence, performance, and demographic issues. Teaching and Teacher Education 20: 713-729.
  7. Madigan DJ, Kim LE (2021) Does teacher Burnout affect students? A systematic review of its association with academic achievement and student-reported outcomes. International Journal of Educational Research 105: 101714.
  8. Arian M, Soleimani M, Oghazian MB (2018) Job satisfaction and the factors affecting satisfaction in nurse educators: A systematic review. Journal of Professional Nursing 34: 389-399.
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Nursing and Practice Journals


Abstract


Previous research indicates the prevalence of burnout among nurses and educators. Factors of burnout need to be identified to help prevent its adverse outcomes on work and well-being, especially among women from the Middle East who are underrepresented in burnout studies. Drawing from an online survey among 299 female nurse educators in Saudi Arabia, this study aims to examine personal and work characteristics, task demands, social support and activities outside work as determinants of burnout, which was measured using the Maslach Burnout Inventory (MBI). This cross-sectional study made use of descriptive and bivariate statistics, and hierarchal regression to analyze the data. Findings indicate moderate burnout among the respondents. Younger, Saudi nationals, with only a master's degree and a rank below assistant professor, more years in service and no administrative position demonstrate higher levels of MBI. Work pressure and social support positively predicted MBI, while house of sleep per day was inversely related to MBI. This study provides evidence to inform policies, programs, and other initiatives of nursing education institutions to address faculty members with or at risk for burnout.

References

  1. Al-Omari A, Al Mutair A, Shamsan A, et al. (2019) Predicting Burnout factors among healthcare providers at private hospitals in Saudi Arabia and United Arab Emirates: A cross-sectional study. Applied Sciences 10: 157.
  2. Zeng JF, Xiao AX, Ye JR, et al. (2020) Occupational Burnout in nurses: A concept analysis. Frontiers of Nursing 7: 1-8.
  3. Woo T, Ho R, Tang A, et al. (2020) Global prevalence of Burnout symptoms among nurses: A systematic review and meta-analysis. Journal of Psychiatric Research 123: 9-20.
  4. Owens JM (2017) Secondary stress in nurse educators. Teaching and Learning in Nursing 12: 214-215.
  5. Thomas CM, Bantz DL, McIntosh CE (2019) Nurse faculty Burnout and strategies to avoid IT. Teaching and Learning in Nursing 14: 111-116.
  6. Lackritz JR (2004) Exploring Burnout among university faculty: Incidence, performance, and demographic issues. Teaching and Teacher Education 20: 713-729.
  7. Madigan DJ, Kim LE (2021) Does teacher Burnout affect students? A systematic review of its association with academic achievement and student-reported outcomes. International Journal of Educational Research 105: 101714.
  8. Arian M, Soleimani M, Oghazian MB (2018) Job satisfaction and the factors affecting satisfaction in nurse educators: A systematic review. Journal of Professional Nursing 34: 389-399.
  9. Sheather J, Slattery D (2021) The great resignation-how do we support and retain staff already stretched to their limit? BMJ.
  10. García-Arroyo JA, Osca Segovia A, Peiró JM (2019) Meta-analytical review of teacher Burnout across 36 societies: The role of national learning assessments and gender egalitarianism. Psychology & Health 34: 733-753.
  11. Redondo-Flórez L, Tornero-Aguilera JF, Ramos-Campo DJ, et al. (2020) Gender differences in stress- and Burnout-related factors of university professors. BioMed Research International 1-9.
  12. Alabbasi D, DEANZ Biennial Conference, In WhatsApp, agency and education (2016) The case of female Saudi teachers. The University of Waikato: Hamilton New Zealand.
  13. Vision 2030 (2020) Homepage: The progress & achievements of Saudi Arabia.
  14. Khan F, Yusoff RM, Khan A (2014) Job demands, burnout and resources in teaching a conceptual review. World Applied Sciences Journal 30: 20-28.
  15. Padilla M, Thompson, J (2015) Burning out faculty at doctoral research universities. Stress and Health 32: 551-558.
  16. Lesener T, Gusy B, Wolter C (2019) The job demands-resources model: A meta-analytic review of longitudinal studies. Work & Stress 33: 76-103.
  17. Le H, Newman A, Menzies J, et al. (2020) Work-life balance in Asia: A systematic review. Human Resource Management Review 30: 100766.
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