Weber A, Weltle D, Lederer P
Consulting-Assessment-Evaluation, Erlangen.
Versicherungsmedizin. 2004 Mar 1;56(1):17-24.
School principals on the one hand play an important role in maintaining the performance and health of teachers, but on the other hand often feel over-burdened themselves and suffer from illnesses which not only impair their health-promoting function, but also lead to limitations in their fitness for the occupation. The aim of our study was therefore, using objective parameters and larger numbers of cases, to obtain a differentiated insight into the type and extent of morbidity spectrum and the health-related early retirement of school principals.
In a prospective total assessment (the whole of Bavaria in the period 1997-1999), all the reports about the premature unfitness for work of school directors were evaluated. The analysis included for example socio-demographic/occupational factors, diagnoses, assessment of performance and rehabilitation. The answers given in a standardised, anonymous questionnaire provided the database. Evaluation was carried out by means of descriptive statistics.
The median age of the 408 school principals included in the evaluation (heads and vice-heads, 30% of whom were women) was 58 (min: 41 years old, max: 64 years old). The most frequent workplaces were primary schools (38%) and secondary schools (25%). 84% (n=342) of the headmasters were assessed to be unfit for work. The main reasons for early retirement were psychic/psychosomatic illnesses (F-ICD 10) which made up 45% of the cases. The relative frequency was higher in women than in men. Depressive disorders and exhaustion syndromes (burnout) dominated among the psychiatric diagnoses (proportion: 57%). The most frequent somatic diseases were cardio-vascular diseases (I-ICD10) in 19% of cases, then muscular/skeletal diseases (M-ICD10) in 10% and malignant tumours (C-ICD 10) in 9% of cases. Cardio-vascular diseases, in particular arterial hypertonia and ischaemic heart disease, were, in addition, found in headmasters significantly more frequently than in teachers without a leadership function (p < or = 0.05). 63% (n=257) of the school principals had participated in at least one medical rehabilitation measure before the proceedings for determining unfitness for work were instigated. The performance of 66% (n=226) of those judged unfit for work was assessed to be so severely impaired that no other employment could be expected of them.
The morbidity spectrum of school principals prematurely unfit for work is characterised by stress-associated illnesses. The health disorders objectified are of considerable relevance for public health. Specific measures of prevention and intervention must, therefore, also include this occupational group. Activity should not be limited to the prevention of behavioural problems, but should also take into account important aspects for preventing adverse circumstances arising at the school workplace.
一方面，学校校长在维持教师的工作表现和健康方面发挥着重要作用，但另一方面，他们自身常常感到负担过重，并患有疾病，这些疾病不仅损害了他们促进健康的功能，还导致他们的职业适应性受到限制。因此，我们研究的目的是通过客观参数和大量案例，对学校校长的发病类型和程度范围以及与健康相关的提前退休情况进行差异化洞察。
在一项前瞻性全面评估（1997 - 1999年期间整个巴伐利亚州）中，对所有关于学校校长过早丧失工作能力的报告进行了评估。分析内容包括例如社会人口统计学/职业因素、诊断、工作表现评估和康复情况。一份标准化、匿名问卷给出的答案提供了数据库。通过描述性统计进行评估。
纳入评估的408名学校校长（包括校长和副校长，其中30%为女性）的年龄中位数为58岁（最小：41岁，最大：64岁）。最常见的工作场所是小学（38%）和中学（25%）。84%（n = 342）的校长被评估为不适合工作。提前退休的主要原因是精神/心身疾病（F - ICD 10），占病例的45%。女性的相对发病率高于男性。在精神科诊断中，抑郁症和疲惫综合征（职业倦怠）占主导（比例：57%）。最常见的躯体疾病是心血管疾病（I - ICD10），占病例的19%，其次是肌肉/骨骼疾病（M - ICD10），占10%，恶性肿瘤（C - ICD 10），占9%。此外，心血管疾病，特别是动脉高血压和缺血性心脏病，在校长中被发现的频率明显高于没有领导职务的教师（p≤0.05）。63%（n = 257）的学校校长在启动确定不适合工作的程序之前至少参加过一项医疗康复措施。66%（n = 226）被判定不适合工作的人的工作表现被评估为严重受损，以至于无法期望他们从事其他工作。
过早不适合工作的学校校长的发病谱以与压力相关的疾病为特征。所客观呈现的健康障碍对公共卫生具有相当大的相关性。因此，具体的预防和干预措施也必须包括这个职业群体。活动不应仅限于预防行为问题，还应考虑预防学校工作场所出现不利情况的重要方面。
