Tools for Assessing Psychological Distress and Dietary Patterns among School Teachers: A Scoping Review
-
Aqilah Hadhirah Hazizi
,
NurZetty Sofia Zainuddin
,
Divya Vanoh
,
Affizal Ahmad
,
Nani Draman
,
Hana Fauziyyah
Abstract
Background: Unhealthy eating habits and behaviours among educators contribute to mental health issues, which profoundly affect both physical health and work-related wellness. The objectives of the review were to identify the prevalence of psychological distress and dietary habits among teachers and the tools used to assess psychological distress and dietary intake or behaviour in this population.
Methods: Three databases which are SCOPUS, PubMed and Web of Science were extensively searched to identify primary articles. Full articles were screened independently based on predefined inclusion and exclusion criteria. Fifteen studies published between 2016 and 2024 were included, following PRISMA-ScR guidelines.
Results: The prevalence of psychological distress ranged from 15% to 50%, with the most commonly used tools being the Patient Health Questionnaire (PHQ-9) and Job Content Questionnaire (JCQ). Regarding dietary behaviour, studies revealed that teachers tend to skip meals and reported moderate to high scores of Healthy Eating Index. The Food Frequency Questionnaire (FFQ) was the most commonly used tool for assessing nutritional intake.
Conclusion: Addressing these issues, interventions that incorporate emotional skills development, coping strategies and social support are required to explore this relationship in greater detail.
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2. Ramón-Arbués E, Gea-Caballero V, Gra-nada-López JM, et al (2020). The preva-lence of depression, anxiety and stress and their associated factors in college students. Int J Environ Res Public Health, 17(19):7001.
3. Ozoemena EL, Agbaje OS, Ogundu L, et al (2021). Psychological distress, burnout, and coping strategies among Nigerian primary school teachers: a school-based cross-sectional study. BMC Public Health, 21(1): 2327.
4. Asaloei SI, Wolomasi AK, Werang BR (2020). Work-related stress and perfor-mance among primary school teachers. Int J Eval & Res in Educ, 9(2):352–358.
5. Koutelidakis A, Argyri K, Almoraie NM (2023). Associations between dietary in-take, physical activity, and obesity among public school teachers in Jed-dah, Saudi Arabia. Front Nutr, 10:1081928.
6. Eng JY, Moy FM, Bulgiba A, et al (2020). Dose–response relationship between western diet and being overweight among teachers in Malaysia. Nutrients, 12(10):3092.
7. Sayih Belay A, Guangul MM, Asmare WN, et al (2021). Prevalence and Associated Factors of Psychological Distress among Nurses in Public Hospitals, Southwest, Ethiopia: A cross-sectional Study. J Health Sci, 31(6):1247.
8. Soria-Saucedo R, Lopez-Ridaura R, Lajous M, et al (2018). The prevalence and cor-relates of severe depression in a cohort of Mexican teachers. J Affect Disord, 234:109–116.
9. Bu F, Mak HW, Fancourt D, et al (2022). Comparing the mental health trajecto-ries of four different types of keywork-ers with non-keyworkers: 12-month fol-low-up observational study of 21 874 adults in England during the COVID-19 pandemic. Br J Psychiatry, 220(5):287–294.
10. Wirth T, Kozak A, Schedlbauer G, et al (2016). Health behaviour, health status and occupational prospects of appren-tice nurses and kindergarten teachers in Germany: a cross-sectional study. J Occup Med Toxicol, 11(1):26.
11. Brütting J, Druschke D, Spitzer S, et al (2018). Health status of long-term sick leave and working female teachers in Germany: A cross-sectional study. Inte J Occup Med Environ Health, 31(2): 227–242.
12. Roberts AM, Gallagher KC, Daro AM, et al (2019). Workforce well-being: Personal and workplace contributions to early educators’ depression across settings. J Appl Dev Psychol, 61:4–12.
13. Schultz NS, Chui KKH, Economos CD, et al (2020). Impact of physical activity, di-et quality and stress on cardiometabolic health in school employees. Prev Med Rep, 20:101243.
14. Sisson SB, Malek-Lasater A, Ford TG, et al (2023). Predictors of Overweight and Obesity in Early Care and Education Teachers during COVID-19. Int J Envi-ron Res Public Health, 20(3): 2763.
15. Johnson AD, Phillips DA, Schochet ON, et al (2021). To Whom Little Is Given, Much Is Expected: ECE Teacher Stress-ors and Supports as Determinants of Classroom Quality. Early Child Res Q, 54:13–30.
16. Peele M, Wolf S (2020). Predictors of anxie-ty and depressive symptoms among teachers in Ghana: Evidence from a randomized controlled trial. Soc Sci Med, 253:112957.
17. de Souza Cunha C, Haikal DS, Silva RRV, et al (2022). Association between lifestyle and emotional aspects of food con-sumption during the COVID-19 pan-demic. Nutr Metab Cardiovasc Dis, 32(3):734–742.
18. Zeng G, Fung S fu, Li J, et al (2022). Evalu-ating the psychometric properties and factor structure of the general self-efficacy scale in China. Curr Psychol, 41(6):3970–3980.
19. Parthasarathy N, Li F, Zhang F, et al (2022). A Cross-Sectional Study Analyzing Pre-dictors of Perceived Stress Among Ele-mentary School Teachers During the COVID-19 Pandemic. Workplace Health Saf,70(4):180–187.
20. Nielsen MG, Ornbol E, Vestergaard M, et al (2016). The construct validity of the Perceived Stress Scale. J Psychosom Res, 84:22–30.
21. Karasek R, Brisson Q, Kawakami N, et al (1998). The Job Content Questionnaire (JCQ): An Instrument for Internationally Comparative Assessments of Psychoso-cial Job Characteristics. J Occup Health Psychol, 3(4):322-55.
22. Martin A, Partika A, Castle S, et al (2022). Both sides of the screen: Predictors of parents’ and teachers’ depression and food insecurity during COVID-19-related distance learning. Early Child Res Q, 60:237–249.
23. Eng JY, Moy FM, Bulgiba A, et al (2018). Consistency and Generalizability of Di-etary Patterns in a Multiethnic Working Population. J Acad Nutr Diet, 118(7):1249-1262.
24. Banudi L, Ino Ischak W, Koro S, et al (2018). Prediction Model of Obesity Among Teachers in Senior High School in Kendari. Belitung Nurs J, 4(4):411-419.
25. Verhavert Y, Deliens T, Van Cauwenberg J, et al (2024). Associations of lifestyle with burnout risk and recovery need in Flem-ish secondary schoolteachers: a cross-sectional study. Sci Rep, 14(1):3268.
26. Bailey RL (2021). Overview of dietary as-sessment methods for measuring intakes of foods, beverages, and dietary sup-plements in research studies. Curr Opin Biotechnol, 70:91–96.
27. Agyapong B, Obuobi-Donkor G, Burback L, et al (2022). Stress, Burnout, Anxiety and Depression among Teachers: A Scoping Review. Int J Environ Res Public Health, 19(17): 10706.
28. Majid NLA, Vanoh D, Zainuddin NZS, et al (2024). Post bariatric surgery compli-cations, nutritional and psychological status. Asia Pac J Clin Nutr, 33(2):162–175.
29. Miller P, Newby D, Walkom E, et al (2021). The performance and accuracy of de-pression screening tools capable of self-administration in primary care: A sys-tematic review and meta-analysis. Eur J Psychiatry, 35(1):1–18.
30. Khalili R, Sirati nir M, Ebadi A, et al (2017). Validity and reliability of the Cohen 10-item Perceived Stress Scale in patients with chronic headache: Persian version. Asian J Psychiatr, 26:136–140.
31. Huang F, Wang H, Wang Z, et al (2020). Psychometric properties of the per-ceived stress scale in a community sam-ple of Chinese. BMC Psychiatry, 20(1):130.
32. Jiang JM, Seng EK, Zimmerman ME, Sli-winski M, et al (2017). Evaluation of the Reliability, Validity, and Predictive Va-lidity of the Subscales of the Perceived Stress Scale in Older Adults. J Alzheimers Dis, 59(3):987–996.
33. Baik SH, Fox RS, Mills SD, et al (2019). Re-liability and validity of the Perceived Stress Scale-10 in Hispanic Americans with English or Spanish language pref-erence. J Health Psychol, 24(5):628–639.
34. Thorsen SV, Pedersen J, Flyvholm MA, et al (2019). Perceived stress and sickness absence: a prospective study of 17,795 employees in Denmark. Int Arch Occup Environ Health, 92(6):821–828.
35. Shahar S, Shahril MR, Abdullah N, et al (2021). Development and relative validi-ty of a semiquantitative food frequency questionnaire to estimate dietary intake among a multi-ethnic population in the malaysian cohort project. Nutrients, 13(4):1163.
36. Schultz NS, Chui KKH, Economos CD, et al (2019). A Qualitative Investigation of Factors that Influence School Employee Health Behaviors: Implications for Wellness Programming. J Sch Health, 89(11):890–898.
37. McAuley EA, MacLaughlin HL, Hannan-Jones MT, et al (2023). Effectiveness of diet quality indices in measuring a change in diet quality over time: a sys-tematic review and meta-analysis of randomized controlled trials. Nutr Rev, 81(4):361–383.
38. Hlaing-hlaing H, Pezdirc K, Tavener M, et al (2020). Diet quality indices used in australian and new zealand adults: A sys-tematic review and critical appraisal. Nutrients, 12(12):3777.
39. Shams-White MM, Pannucci TRE, Lerman JL, et al (2023). Healthy Eating Index-2020: Review and Update Process to Re-flect the Dietary Guidelines for Ameri-cans, 2020-2025. J Acad Nutr Diet, 123(9):1280–1288.
40. English LK, Ard JD, Bailey RL, et al (2021). Evaluation of Dietary Patterns and All-Cause Mortality A Systematic Review. JAMA Netw Open, 4(8):2122277.
41. Kuwato M, Hirano Y (2020). Sense of co-herence, occupational stressors, and mental health among Japanese high school teachers in Nagasaki prefecture: A multiple regression analysis. BMC Pub-lic Health, 20(1):1355.
42. Risal Tawil M, Purbha Sakti B, Ramli A, et al (2023). The Influence of Workload, Demographic Factors and Hardiness on Teachers’ Work Stress. Journal on Educa-tion, 5(4):15631-15636.
43. Cotter EW, Kelly NR (2018). Stress-related eating, mindfulness, and obesity. Health Psychol, 37(6):516–525.
44. Kangalgil M, Yardimci H, Özçelik A (2017). Evaluate the Eating Habits of Teachers Working in Various Primary Schools in Ankara. J Sci Res Rep, 15(5):1–11.
2. Ramón-Arbués E, Gea-Caballero V, Gra-nada-López JM, et al (2020). The preva-lence of depression, anxiety and stress and their associated factors in college students. Int J Environ Res Public Health, 17(19):7001.
3. Ozoemena EL, Agbaje OS, Ogundu L, et al (2021). Psychological distress, burnout, and coping strategies among Nigerian primary school teachers: a school-based cross-sectional study. BMC Public Health, 21(1): 2327.
4. Asaloei SI, Wolomasi AK, Werang BR (2020). Work-related stress and perfor-mance among primary school teachers. Int J Eval & Res in Educ, 9(2):352–358.
5. Koutelidakis A, Argyri K, Almoraie NM (2023). Associations between dietary in-take, physical activity, and obesity among public school teachers in Jed-dah, Saudi Arabia. Front Nutr, 10:1081928.
6. Eng JY, Moy FM, Bulgiba A, et al (2020). Dose–response relationship between western diet and being overweight among teachers in Malaysia. Nutrients, 12(10):3092.
7. Sayih Belay A, Guangul MM, Asmare WN, et al (2021). Prevalence and Associated Factors of Psychological Distress among Nurses in Public Hospitals, Southwest, Ethiopia: A cross-sectional Study. J Health Sci, 31(6):1247.
8. Soria-Saucedo R, Lopez-Ridaura R, Lajous M, et al (2018). The prevalence and cor-relates of severe depression in a cohort of Mexican teachers. J Affect Disord, 234:109–116.
9. Bu F, Mak HW, Fancourt D, et al (2022). Comparing the mental health trajecto-ries of four different types of keywork-ers with non-keyworkers: 12-month fol-low-up observational study of 21 874 adults in England during the COVID-19 pandemic. Br J Psychiatry, 220(5):287–294.
10. Wirth T, Kozak A, Schedlbauer G, et al (2016). Health behaviour, health status and occupational prospects of appren-tice nurses and kindergarten teachers in Germany: a cross-sectional study. J Occup Med Toxicol, 11(1):26.
11. Brütting J, Druschke D, Spitzer S, et al (2018). Health status of long-term sick leave and working female teachers in Germany: A cross-sectional study. Inte J Occup Med Environ Health, 31(2): 227–242.
12. Roberts AM, Gallagher KC, Daro AM, et al (2019). Workforce well-being: Personal and workplace contributions to early educators’ depression across settings. J Appl Dev Psychol, 61:4–12.
13. Schultz NS, Chui KKH, Economos CD, et al (2020). Impact of physical activity, di-et quality and stress on cardiometabolic health in school employees. Prev Med Rep, 20:101243.
14. Sisson SB, Malek-Lasater A, Ford TG, et al (2023). Predictors of Overweight and Obesity in Early Care and Education Teachers during COVID-19. Int J Envi-ron Res Public Health, 20(3): 2763.
15. Johnson AD, Phillips DA, Schochet ON, et al (2021). To Whom Little Is Given, Much Is Expected: ECE Teacher Stress-ors and Supports as Determinants of Classroom Quality. Early Child Res Q, 54:13–30.
16. Peele M, Wolf S (2020). Predictors of anxie-ty and depressive symptoms among teachers in Ghana: Evidence from a randomized controlled trial. Soc Sci Med, 253:112957.
17. de Souza Cunha C, Haikal DS, Silva RRV, et al (2022). Association between lifestyle and emotional aspects of food con-sumption during the COVID-19 pan-demic. Nutr Metab Cardiovasc Dis, 32(3):734–742.
18. Zeng G, Fung S fu, Li J, et al (2022). Evalu-ating the psychometric properties and factor structure of the general self-efficacy scale in China. Curr Psychol, 41(6):3970–3980.
19. Parthasarathy N, Li F, Zhang F, et al (2022). A Cross-Sectional Study Analyzing Pre-dictors of Perceived Stress Among Ele-mentary School Teachers During the COVID-19 Pandemic. Workplace Health Saf,70(4):180–187.
20. Nielsen MG, Ornbol E, Vestergaard M, et al (2016). The construct validity of the Perceived Stress Scale. J Psychosom Res, 84:22–30.
21. Karasek R, Brisson Q, Kawakami N, et al (1998). The Job Content Questionnaire (JCQ): An Instrument for Internationally Comparative Assessments of Psychoso-cial Job Characteristics. J Occup Health Psychol, 3(4):322-55.
22. Martin A, Partika A, Castle S, et al (2022). Both sides of the screen: Predictors of parents’ and teachers’ depression and food insecurity during COVID-19-related distance learning. Early Child Res Q, 60:237–249.
23. Eng JY, Moy FM, Bulgiba A, et al (2018). Consistency and Generalizability of Di-etary Patterns in a Multiethnic Working Population. J Acad Nutr Diet, 118(7):1249-1262.
24. Banudi L, Ino Ischak W, Koro S, et al (2018). Prediction Model of Obesity Among Teachers in Senior High School in Kendari. Belitung Nurs J, 4(4):411-419.
25. Verhavert Y, Deliens T, Van Cauwenberg J, et al (2024). Associations of lifestyle with burnout risk and recovery need in Flem-ish secondary schoolteachers: a cross-sectional study. Sci Rep, 14(1):3268.
26. Bailey RL (2021). Overview of dietary as-sessment methods for measuring intakes of foods, beverages, and dietary sup-plements in research studies. Curr Opin Biotechnol, 70:91–96.
27. Agyapong B, Obuobi-Donkor G, Burback L, et al (2022). Stress, Burnout, Anxiety and Depression among Teachers: A Scoping Review. Int J Environ Res Public Health, 19(17): 10706.
28. Majid NLA, Vanoh D, Zainuddin NZS, et al (2024). Post bariatric surgery compli-cations, nutritional and psychological status. Asia Pac J Clin Nutr, 33(2):162–175.
29. Miller P, Newby D, Walkom E, et al (2021). The performance and accuracy of de-pression screening tools capable of self-administration in primary care: A sys-tematic review and meta-analysis. Eur J Psychiatry, 35(1):1–18.
30. Khalili R, Sirati nir M, Ebadi A, et al (2017). Validity and reliability of the Cohen 10-item Perceived Stress Scale in patients with chronic headache: Persian version. Asian J Psychiatr, 26:136–140.
31. Huang F, Wang H, Wang Z, et al (2020). Psychometric properties of the per-ceived stress scale in a community sam-ple of Chinese. BMC Psychiatry, 20(1):130.
32. Jiang JM, Seng EK, Zimmerman ME, Sli-winski M, et al (2017). Evaluation of the Reliability, Validity, and Predictive Va-lidity of the Subscales of the Perceived Stress Scale in Older Adults. J Alzheimers Dis, 59(3):987–996.
33. Baik SH, Fox RS, Mills SD, et al (2019). Re-liability and validity of the Perceived Stress Scale-10 in Hispanic Americans with English or Spanish language pref-erence. J Health Psychol, 24(5):628–639.
34. Thorsen SV, Pedersen J, Flyvholm MA, et al (2019). Perceived stress and sickness absence: a prospective study of 17,795 employees in Denmark. Int Arch Occup Environ Health, 92(6):821–828.
35. Shahar S, Shahril MR, Abdullah N, et al (2021). Development and relative validi-ty of a semiquantitative food frequency questionnaire to estimate dietary intake among a multi-ethnic population in the malaysian cohort project. Nutrients, 13(4):1163.
36. Schultz NS, Chui KKH, Economos CD, et al (2019). A Qualitative Investigation of Factors that Influence School Employee Health Behaviors: Implications for Wellness Programming. J Sch Health, 89(11):890–898.
37. McAuley EA, MacLaughlin HL, Hannan-Jones MT, et al (2023). Effectiveness of diet quality indices in measuring a change in diet quality over time: a sys-tematic review and meta-analysis of randomized controlled trials. Nutr Rev, 81(4):361–383.
38. Hlaing-hlaing H, Pezdirc K, Tavener M, et al (2020). Diet quality indices used in australian and new zealand adults: A sys-tematic review and critical appraisal. Nutrients, 12(12):3777.
39. Shams-White MM, Pannucci TRE, Lerman JL, et al (2023). Healthy Eating Index-2020: Review and Update Process to Re-flect the Dietary Guidelines for Ameri-cans, 2020-2025. J Acad Nutr Diet, 123(9):1280–1288.
40. English LK, Ard JD, Bailey RL, et al (2021). Evaluation of Dietary Patterns and All-Cause Mortality A Systematic Review. JAMA Netw Open, 4(8):2122277.
41. Kuwato M, Hirano Y (2020). Sense of co-herence, occupational stressors, and mental health among Japanese high school teachers in Nagasaki prefecture: A multiple regression analysis. BMC Pub-lic Health, 20(1):1355.
42. Risal Tawil M, Purbha Sakti B, Ramli A, et al (2023). The Influence of Workload, Demographic Factors and Hardiness on Teachers’ Work Stress. Journal on Educa-tion, 5(4):15631-15636.
43. Cotter EW, Kelly NR (2018). Stress-related eating, mindfulness, and obesity. Health Psychol, 37(6):516–525.
44. Kangalgil M, Yardimci H, Özçelik A (2017). Evaluate the Eating Habits of Teachers Working in Various Primary Schools in Ankara. J Sci Res Rep, 15(5):1–11.
| Files | ||
| Issue | Vol 54 No 8 (2025) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v54i8.19570 | |
| Keywords | ||
| Psychological distress Mental health Dietary habit Nutritional intake School teachers | ||
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How to Cite
1.
Hazizi A, Zainuddin N, Vanoh D, Ahmad A, Draman N, Fauziyyah H. Tools for Assessing Psychological Distress and Dietary Patterns among School Teachers: A Scoping Review. Iran J Public Health. 2025;54(8):1608-1619.
