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Ann. psychophysiol. 
ISSN 2412-3188 (Online)|2410-1354 (Print) 

APP| Published By AEIRC| https://doi.org/10.29052/2412-3188.v9.i1.2022.17-27 
 

 
Original Article 

Assessment of Burnout Syndrome and 
Physical Activity of the University Teachers 
– A cross-sectional Observational Study 
Qazi Noor Ul Wahab1 , Zia Ud Din1, Muhammad Jahanzeb2, Saleem Ullah3 & 
Muhammad Abbas1 
1Department of Human Nutrition, University of Agriculture, Peshawar-Pakistan 
2Department of Psychology, University of Peshawar, Peshawar-Pakistan 
3Department of Agricultural Chemistry and Biochemistry, University of  
  Agriculture, Peshawar-Pakistan 
 

Abstract 
Background: Burnout and physical activity (PA) are two critical determinants of 
health. The burnout and PA of the university teachers in Pakistan are not well, 
established. The main objective of the present study is to determine the prevalence 
of burnout syndrome and the level of physical activity in university teachers. 
Methodology: The sample of university teachers (n=505) was drawn from 14 
public/private universities in Peshawar using a partly convenient, non-
probabilistic method based on an exhaustive and up-to-date database of all 
universities in Peshawar. Data were collected on these parameters: socio-
demographics, anthropometrics (body weight, height, and body mass index: BMI), 
Burnout using Maslach Burnout Inventory (MBI-ES), and PA level. The global 
Physical Activity Questionnaire developed by WHO (GPAQ-WHO) was used.   
Results: The sample consisted predominantly of males (78%) with a mean (SD) age 
of 37.5 ± 7.9 (Range: 28 – 60). The results demonstrated that 19% of university 
teachers suffered from burnout syndrome, with most of those with job experience 
<10 years. The mean PA for all the respondents was 955.1 MET minutes/week, 
with significant differences in PA levels of male and female teachers from public 
vs. private universities (p, for all trends < 0.05). The proportion of physically active 
university teachers was 63.6% (95%CI 56.6 to 68.2), with a higher proportion of 
university teachers without Burnout Syndrome being physically active than those 
with Burnout Syndrome (73.5% (95%CI 68.1 to 79.3) vs. 21.6% (95%CI 16.5 to 24.6). 
Only a small number of university teachers could achieve the recommended levels 
of PA with differences between genders and university types. 
Conclusion: Work-related burnout is seen in teachers with poor physical activity, 
and females are mostly affected. Public sector universities showed a greater 
burnout rate. The public sector needs to revitalize the staff and train them to 
manage their workload efficiently. 

 

Keywords 
Burnout Syndrome, Physical Activity, University Teachers, Work Stress, 

Occupation. 

 

Citation: Wahab Q, Din Z, Jahanzeb M, 
Ullah S, Abbas M. Assessment of Burnout 
Syndrome and Physical Activity of the 
University Teachers – A cross-sectional 
Observational Study. APP. 2022;9(1):17-27 
 
Corresponding Author Email: 
dr.qazinoor@gmail.com 
 
DOI: 10.29052/2412-3188.v9.i1.2022.17-27 
 
Received 26/03/2022 
 
Accepted 06/04/2022 
 
Published 01/06/2022 
 
Copyright © The Author(s). 2022. This is 
an open-access article distributed under 
the terms of the Creative Commons 
Attribution 4.0 International License, 
which permits unrestricted use, 
distribution, and reproduction in any 
medium, provided the original author and 
source are credited.  
 

 

Funding: The author(s) received no 
specific funding for this work. 

Conflicts of Interests: The authors have 
declared that no competing interests 
exist. 
 

https://doi.org/10.29052/2412-3188.v9.i1.2022.17
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Introduction 
Stress and burnout are common phenomena 
present among university teachers. Burnout 
is a typical form of chronic occupational 
stress characterized by three dimensions, i.e., 
emotional exhaustion, depersonalization (or 
cynicism), and reduced professional 
efficacy1,2. The term 'Burnout,' which can be 
translated as 'emotionally exhausted3, has 
been studied mainly in the health 
professions. There has been an increasing 
trend of investigating the burnout 
phenomena in other occupations, including 
teaching at the university level. 
 
Regular physical activity (PA) is a state of 
health4. In addition to its overall positive 
impact, it is now accepted that health also 
plays an essential role in maintaining regular 
exercise. World Health Organization (WHO) 
recommends 600 or more metabolic 
equivalent tasks (METs) minutes/week as at 
least sufficient to produce health benefits5. 
The forms of movement they suggest are 
walking, swimming, indoor cycling, low-
intensity aerobics, running or jogging (only 
if this was done before pregnancy), 
maintaining a healthy body weight, and 
improving mental health6.   
 
It hypothesizes that regular physical activity 
and exercise may constitute a practical 
approach to reducing burnout in university 
teachers. Physical activity to minimize 
burnout syndrome and its associated 
symptoms include its ease of accessibility, 
lower costs, and positive "side effects," such 
as the reduced risk for cardiovascular 
diseases (CVD)7-9. As teachers in the 
university may face work stress and burnout 
that may affect their PA, it is logical to think 
about the association between burnout and 
low PA. Low PA may further deteriorate the 
state of burnout or vice versa. Therefore, the 
analysis of PA habits of university teachers 

in association with burnout is of great 
importance. The main aim of our study was 
to investigate the prevalence of burnout and 
level of PA in university teachers and the 
frequency, duration, and intensity of PA 
concerning stress and burnout.   
 

Methodology 
Study Design and Subjects’ Characteristics:  
This cross-sectional study considered 
university teachers working at different 
universities of Khyber Pakhtunkhwa (KP) of 
Pakistan, both in the public and private 
sectors. The sampling strategy used for the 
present study was partly convenience, non-
probabilistic, and based on consecutive cases 
that met these inclusion criteria: (1) to be a 
formal institutional employee (university 
teacher/permanent basis), (2) of any age, (3) 
only morning shift, (4) from any 
area/subject of service, (5) serving the 
university at the time of the study (data 
collection) and not on leave, (6) with no 
chronic infectious/non-infectious diseases. 
Rotating personnel, visiting, teachers on 
probation, pregnant/lactating, diabetic 
teachers, etc., were omitted. The sample size 
was calculated using Cochran's equation10. 
Where, n= Sample size; z= z-score 
correspond to the 95% confidence level, i.e. 
1.96; e= Acceptable margin of error assumed 
as 4% or 0.04; p= population proportion 
(assumed to be 50% or 0.5); N=Total teaching 
population = 2818;    Putting the above values 
in the equation (1), the sample size was 
estimated 494. In this way, the required 
sample was 500. However, the sample size 
was increased to 510 to take care of non-
response/dropped out. The university 
teachers were screened initially to ensure 
selection criteria.  
 
Data Collection 
Socio-demographics and Anthropometrics: 
Socio-demographic data were collected in a 



 
 

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pre-designed questionnaire. All methods of 
measurement were standardized, and the 
same persons collected data. 
Anthropometrics were measured for the 
weight (digital scale: Tanita Terraillon, 100g 
precision) and height (stadiometer; SECA 
231, 0.1cm precision). Body mass index 
(BMI) was calculated (weight in kg divided 
by the height in meters squared). Using 
WHO criteria (2020), BMI was categorized as 
average weight (BMI: 18.5 to 24.9), 
overweight (BMI: 25.0-28.0), and obese 
(BMI>28.0). 
 
Burnout Assessment: Maslach Burnout 
Inventory (MBI)– Educators Survey is a well-
known 22-item questionnaire. This includes 
evaluation of three sub-scores: (1) 
"Emotional exhaustion" (EE; including 9 
items with a maximum score of 54 points 
with items 1,3,6,8,13,14,16,20); (2) 
"Depersonalization" (DP), including 5 items 
with a maximum score of 30 points (these are 
items 5,10,11,15,22) and (3) "Personal 
accomplishment" (PA), including 8 items 
with a maximum score of 48 points (items 
4,7,9,12,17–19,21) (Maslach et al., 1996). In 
this manner, the total score for the whole 
scale could have a maximum value of 132. 
The 'EE' subscale assesses aspects of physical 
and/or mental exhaustion and includes 
characteristics like physical wear/tear, 
exhaustion, and loss of strength/energy. The 
'DP' subscale showed negative aspects of the 
responses and attitudes of other individuals 
and main co-workers in a setting. The 'PA' 
subscale displays typical negative responses 
aimed at the respondent and the work itself. 
These responses are related to low morale, 
depression, low productivity, poor self-
esteem .and inability to withstand pressure, 
etc., for the present study. The MBI score was 
dichotomized according to the criteria 
reported by Ramirez et al. (1996) as 'present' 
or 'absent' when considering high scores in 
the dimensions of 'EE' and 'DP' and low 
scores. In 'PAC .'Burnout was defined as: 

high score (>26) for 'EE' and 'DP' (> 9), low 
(< 34) score PAc11. In this way, burnout was 
defined in four levels: 

1. No burnout, when all three 
dimensions are 'negative.' 

2. Mild burnout, when only one of the 
three dimensions is 'positive.' 

3. Moderate burnout, when two out of 
three dimensions are 'positive.' 

4. Severe burnout, when all three 
dimensions are 'positive'12-14. 

A Cronbach's Alpha Coefficient was applied 
for MBI reliability analysis.  
 
Assessment of Physical Activity: Physical 
activity levels of the teachers was evaluated 
by using the 'global physical activity 
questionnaire (GPAQ).' The data collected 
through GPAQ was used to calculate the 
'Metabolic equivalent of Task (METs)' 
score15. "MET is the ratio of 'working 
metabolic rate' relative to the 'resting 
metabolic rate. Briefly, GPAQ has 16 
questions. These are grouped to assess PA in 
3 distinct domains:  

1. Work,  
2. Transport, and  
3. Discretionary activity 

(recreation/leisure).  
The last domain has questions that assess the 
frequency/duration of two different 
categories of PA defined by the energy 
requirement/intensity (vigorous/moderate-
intensity PA). In the transport domain, the 
frequency/duration of all walking/cycling 
is taken. In addition, one question enquires 
explicitly about time spent in sedentary 
activities/week. The data extracted from 
GPAQ defines PA as 'high PA, moderate PA, 
and low PA. The GPAQ questionnaire was 
pre-tested. A pilot study was carried out on 
the university teachers (n=10) to check the 
validity, practicability, and interpretation of 
the responses.   
 
For statistical analysis SPSS version 20.0 was 
used for data analysis. Values were reported 



 
 

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in mean (SD). Means were compared using a 
student's t-test, and a value of p<0.05 was 
considered significant. 
 

Result 
Five hundred-five (505) university teachers 

from different universities in the Khyber 

Pakhtunkhwa (KPK) province of Pakistan 

completed the study. Some of the baseline 

socio-demographic characteristics are 

provided in Table 1. In general, the 

University teachers in the present study 

represent relatively young faculty, mainly 

with ages <35 years. A significant percentage 

of university teachers were male (67.9%). 

The mean family size was fairly large (7.5 ± 

7.0). Lesser than two-thirds (30%) of the 

University teachers demonstrated their 

satisfaction with their monthly income. Most 

(75%) of the teachers from the study sample 

belonged to public sector universities (71%). 

The majority of the university teachers who 

participated in this study were from 

sciences, followed by a decent percentage 

from the Arts subjects. 

 

 

 

Table 1: Summary of demographics variables (N = 467). 

Personal and Socioeconomic Characteristics No./mean % 

Age   

<30 years 167 33.1 

31 - 40 156 30.9 

41-50 115 22.8 

 >50 53 10.5 

Gender   

Male 343 67.9 

Female 162 31.9 

Family Type   

Joint 333 65.9 

Nuclear 171 33.9 

Income Status   

Sufficient 143 28.3 

Partially Sufficient 311 61.6 

Insufficient 51 10.1 
Health status (any type of chronic disease)   

Diabetes (yes) 173 34.3 

Cardiovascular  vascular (yes) 123 24.4 

Any chronic infectious disease (yes) 45 8.9 

Health Status   

Any physical disability (yes) 23 4.6 

Any other long-term health issue (yes) 10 2.0 

Health status (any type of chronic disease) 147 29.1 

Accommodation status   

Rental House 187 37.0 

Own House 107 21.2 

University House 122 24.2 

 



 
 

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Figure 1. Distribution of three dimensions of Burnout 

 

This Venn diagram is based on the number of University Teachers having a high level of these 

dimensions. This diagram has not considered the number with low and moderate levels on these 

dimensions. The numbers for each region represent the number of University Teachers in 

different situations; 97=had all three dimensions common in them; 11=had two dimensions, 

comprising 3 for 'EE' and 'DP,' 5 for 'DP' and 'PA,' and 3 for 'EE' and 'PA .'The number of 

University Teachers who had only high 'EE,' only 'DP,' and only 'Pac' were 6, 5, and 40. 

 

We defined burnout based on high scores on 'EE' (>26) and 'DP' (>9) and a low score on PAC 

(<34). So in this way, positive (higher than the cutoff score of any of the dimensions) number of 

respondents in three dimensions, we divided job burnout into four levels: no burnout (all the 

three dimensions are negative); mild burnout (only one of the three dimensions is positive); 

moderate burnout (arbitrary two of the three dimensions are positive); and severe burnout (all 

the three dimensions are positive). These results are shown in Figure 1. 

 

Table 2 represents PA among the study participants. Information on PA was calculated in three 

domains, i.e., PA while at work, PA while traveling, and PA during recreational activities. Total 

mean PA at work, travel, and recreation was 176.8, 277.6, and 500.8 MET minutes/week, 

respectively. Significant differences were noted in the mean physical activity of males and 

females (p< 0.05). Differences between PA of males and females were also pointed out in the three 

domains of physical activity (p, for all trends<0.05). 

 

 

 

 



 
 

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Table 2: PA among University Teachers. 

 

Physical Activity   Total 
(n=505)  

With Burnout 
 (n-97)  

Without Burnout  
(n=408)  

Mean SD Mean SD Mean SD 
Work Domain Vigorous  

8.9 
21.1 5.4 19.1 12.4 7.9 

Moderate 167.9 26.8 134.7 24.8 201 23.6 

Total activity at work* 176.8 23.5 140.1 21.5 213.4 20.3 
Total Activity during Travel* 277.6 45.3 142.1 43.3 413 42.1 
At Recreation Vigorous 116.6 43.2 34.5 41.2 198.7 40 

Moderate 384.2 54.3 156.7 52.3 611.7 51.1 

Total recreational activity*  500.8 44.8 191.2 46.5 810.4 45.3 

Mean Total PA* 955.1 113.6 473.4 111.3 1436.8 107.7 

*P<0.05  

 

 
Figure 2: Proportion of Active and Inactive University Teachers 

 

According to burnout syndrome, figure 2 showed the proportion of physically active and inactive 

university teachers. The proportion of physically active university teachers in this study was 

36.4% (95%CI 26.6- 44.2), with a higher proportion of university teachers without Burnout 

Syndrome being physically active than university teachers with Burnout Syndrome, 33.9% 

(95%CI 18.1-39.3) vs. 2.6% (95%CI 1.5-4.6). 

  

Table 3 showed the percentages of university teachers who achieved the recommended level of 

physical activity as recommended by WHO. When the study subjects’ PA level was 

disaggregated by the "WHO global recommendation on PA for health," males who achieved the 

recommended level (23.7%) were almost 52.6% lower than those who didn't achieve (76.3%). In 

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Total With Burnout Without Burnout

Physically Active Pysically In Active



 
 

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comparison, the case of a female who reached the recommended PA level (12.7%) was 74.6% 

lower than those who didn't achieve t (87.3%).  

 

Similarly, only 11.2% of university teachers from public universities achieved the recommended 

PA level. A relatively higher percentage of university teachers from private universities (25.2%) 

achieved the recommended PA. In addition, there were comparatively more males than females 

who completed the recommended level of physical activity recommended by WHO (22.7% vs. 

12.7; p<0.05). Similarly, significantly more teachers from private universities than those from 

public universities achieved the recommended level of physical activity as recommended by 

WHO (25.1% vs. 12.2; p<0.05). 

 

Table 3: Distribution of University Teachers who achieved/did not achieve the 'WHO 

recommendations on PA for health*. 

 

 Male n(%) Female n(%) p-value 

A. Distribution by Gender 

Achieved the recommended level 81(23.7) 21(12.7) 0.014 

Didn’t achieve the recommended level 262(76.3) 141(87.3) 0.005 

B. Distribution by university type 

 Public n(%) Private n(%)  

Achieved the recommended level 40(11.2) 38(25.1) 0.0001 

Didn’t achieve the recommended level 313(88.8) 114(74.8) 0.0001 
*Calculations were based on WHO guidelines that adults, 18–64 years, should accumulate at least 600. MET-minutes 

of physical activity per week (2); WHO, World Health Organization; p<0.05 

 

Association between Burnout Syndrome and socio-demographic characteristics 

 

A Chi-square test of independence was performed to examine the relation between Burnout 

Syndrome and socio-demographic characteristics. Table 4 shows an association between Burnout 

Syndrome and some socio-demographic characteristics. The relation between these variables 

were mostly significant, X2 (1, N = 505) = 8.93-31.37). Burnout was present when the global score 

was ≥56 (median) and represented the primary outcome of bivariate and multivariate analysis. 

All other variables except 'gender' was significantly associated with burnout (p, for all trends 

<0.05). The analysis for other than socio-demographic variables shows that except for the 

subscales, 'stress symptoms,' 'good working conditions,' 'social support at work,' and 'promotion 

and development opportunities' were significantly associated with Burnout Syndrome (p, for all 

trends<0.05). A total of 19% subjects were reportedly suffering from burnout syndrome. 

 

 

 

 

 

 

 



 
 

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Table 4: Frequency, χ2 test results, p-value, prevalence ratio, and confidence interval for the 

association between primary outcome and socio-demographic, occupational, psychosocial, and 

health-related variables. 

 

Items Categories Respondents with 
Burnout 

Syndrome. (%) 

X2 p-value 

 Age (yrs) <45  76 9.21 0.0023 

>45  21 
  

Sex  Male 72 1.204 0.272 

Female 25 
  

Family Type Joint 47 9.27 0.0023 

Nuclear 50 
  

University Type Public 61 8.931 0.0027 

Private 36 
  

Field Discipline Sciences 84 32.21 <0.0001 

Humanities/Art
s 

15 
  

Higher Qualification MS/MPhil 70 31.37 <0.0001 

PhD 27 
  

 Position/Job Title 
  
  
  

Lecturer 48 
 

0.0021 

Assistant 
Professor 

22 
  

Associate 
Professor 

17 
  

Professor 10 
  

Job Experience (years) 
  

<10 yrs 61 7.142 0.0079 

>10 years 36   
 Marital Status 
  

Married 15 7.211 0.0064 

Unmarried 31 
  

Stress Symptoms 
  

Yes 72 5.29 0.21 

No 25 
  

Good Working Conditions 
  

Yes 8 0.018 0.89 

No 89 
  

Social Support at Work’ 
  

Yes 6 2.93 0.087 

No 91 
  

Promotion and development 
opportunities 

Yes 11 0.204 0.651 

No 86 
  

Workplace bullying 
  

Yes 82 3.82 0.050 

No 15 
  

Job Satisfaction Yes 5 9.19 0.0024 
No 92 

  

Mental Health 
  

Yes 18 25.79 <0.0000 
No 79 

  

 



 
 

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Discussion 
The present study shows that 19% of 
university teachers were affected by burnout 
syndrome. This is a high percentage 
considering that a relatively strict criterion 
for defining burnout was adopted in the 
present study. Burnout was determined 
based on high scores on 'EE' (>26) and 'DP' 
(>9) and a low score on ‘PAC'(<34). So in this 
way, based on the positive (i.e., higher than 
the cutoff score of any of the three 
dimensions) number of respondents in the 
three dimensions, burnout was divided into 
four levels12-14. According to this criterion, 
19% (n=97) of university teachers had severe 
burnout syndrome, while the rest (n=408) 
were categorized as 'no burnout at all' (24%); 
mild burnout (41%), and 'moderate burnout' 
(16%). This study also demonstrated that the 
university teachers had low physical 
activity: mean (SD) 955.1 (113.6) MET-
minutes/week. Furthermore, the physical 
activity of university teachers with burnout 
syndrome (Mean 473.4 SD 111.3 vs. Mean 
1436.8; SD 107.7 MET-minutes/week) was 
significantly lower than the mean physical 
activity of university teachers without 
burnout syndrome (p,0.05). In addition, 
more females compared to males and more 
university teachers in public universities 
compared to those in private universities 
had physical activity levels much lower than 
the recommendations of WHO.   
 
A teacher at a university is usually regarded 
as a 'low-stress job .'In addition, job security, 
conducive working employment, and a high 
social standard are generally associated with 
teaching at the university level. Teaching at 
the university level is considered a job with 
great promotion opportunities and 
enhanced satisfying level16. However, over 
the past 20 years, perceptions about 
academic careers and the environment have 

changed drastically. For example, Akerlind 
and McAlpine reported the pressures for 
change acting upon academia17. This 
pressure includes substantial growth in 
student numbers/ institutions of higher 
learning, increased emphasis on research, 
concerns for equity and social benefits of 
education, and great emphasis on the job-
training job training. As presented in the 
present work, university teachers with lower 
physical activity are more likely to suffer 
from burnout syndrome. These findings are 
in agreement with other studies7,8. In another 
study by Abos et al. demonstrated that two 
sessions of exercise in a week improved 
satisfaction at work and work-related 
outcomes7. Another study by Sane et al., who 
collected data from 81 university teachers 
from Iran, demonstrated a significant 
inverse correlation between PA and burnout 
syndrome18. In addition, a linear but inverse 
correlation between PA and its components 
with burnout represents the positive role of 
PA in the prevention or reduction of 
burnout. Although the relationship between 
PA and burnout investigated in the present 
study may be casual with no indication of 
whether low PA causes burnout or vice 
versa, the association between the two is 
essential to form from a nutrition and health 
point of view. Future studies should 
investigate the cause-effect relationship 
between the two. 
 
Nevertheless, a high level of burnout is 
associated with substantial losses to 
employees' health and well-being and, 
consequently also, economic losses. 
Employees with burnout show significantly 
reduced self-efficacyabout:blank - B5, poor 
sleep quality, reduced cognitive functioning, 
compromised workability, and are at 
relatively higher risk for developing CVD 
diseases. Employers, too, face the 
consequences such as leave and/or absence 



 
 

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and productivity time loss19. Given the high 
prevalence of burnout and its negative 
consequences, it is valuable to examine 
potential approaches and remedies to reduce 
it20. 
 

Conclusion 
In conclusion, university teachers who were 
physically more active were relatively less 
prone to burnout. PA thus may play an 
important role in enhancing the physical and 
mental health status of university teachers. 
Future studies must explore this (rewrite). 
Findings also showed a significant difference 
between the genders and types of 
universities concerning burnout prevalence 
and physical activity levels. These 
differences may be considered while 
designing rehabilitation programs for 
university teachers.  
 

Acknowledgment  
We are thankful to all academic institutes' 
authorities, participants of the research, and 
our colleagues, for helping in data collection. 
Moreover highly grateful to the authors of 
the scales for providing the scales free of 
cost.  
 

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16. Knight P. Being a teacher in higher 
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