Skip to main content
Medicine logoLink to Medicine
. 2024 Mar 1;103(9):e37174. doi: 10.1097/MD.0000000000037174

Effect of psychological intervention in cushioning work-induced stress among secondary school home economics teachers: Implications for policy and administration

Glory Mmachukwu Nwakpadolu a, Moses Onyemaechi Ede b, Joy Oluchukwu Okoro c, Calister Lebechukwu Nwadi c,*, Florence Ukamaka Akudo d, Grace N Anigbogu b, Amaka Bibian Ezeanwu c, Edith C Edikpa b, Vera Nkiru Nwadinobi e, Joy Obiageli Oneli f
PMCID: PMC10906576  PMID: 38428875

Abstract

Background/Objective:

Work demands in the contemporary Nigerian work environment are a critical concern to many including occupational stress researchers. This informed the current study to investigate the effect of psychological intervention in cushioning teachers’ stress in public secondary schools in Nigeria.

Methods:

A randomized control design was applied. The participants were 80 secondary school home economics teachers. They were randomized into 2 groups, that is, treatment and waitlisted arms. The former was designed as a 12-session cognitive behavior intervention while the latter was waitlisted and the members received theirs at the end of the study. Both group members were evaluated at the pretest, posttest, and follow-up test to understand the baseline of the problem, treatment outcome, and sustainability respectively. Perceived Stress Scale and Teacher irrational belief scale were used as test tools. Data from the 3-time tests were analyzed using multivariate statistic.

Results:

The main effect results showed a significant reduction in teachers’ stress and irrational beliefs due to cognitive behavior intervention. The follow-up test results also indicate that the impactful benefit of cognitive behavioral intervention on job stress reduction was significantly sustained over time. Regarding the influence of gender, the result shows no significant influence of gender on teachers’ job stress in schools.

Conclusion:

This study suggests that cognitive behavior intervention can decrease work-induced stress among secondary school home economics teachers. Therefore, the management of schools is enjoined to deploy the services of cognitive behavior therapists to monitor the mood and mental health of teachers.

Keywords: CBI, home economics teachers, psychological intervention, secondary schools, teachers, work stress

1. Introduction

Home economics education improves the quality of living at home for both people and families.[1] It serves as the basis for the knowledge, attitudes, and skills that influence the daily decisions we make throughout our lives.[2] There are 5 interconnected domains in home economics: human development, food and nutrition, financial management, clothing and textiles, shelter, and housing.[1,2] Since home economics education is a component of home economics, its assistance is focused on resolving issues inside the family. The suffering caused by the family’s failure to participate enough in the domains of activity that characterize the family as the principal social institution is the focus of family problems. Even though this approach to higher education was established over 30 years ago, it is still relevant today—possibly even more so in light of the issues that families continue to face, especially those brought on by strong external forces like corporate capitalism, war and conflict, and climate change. It focuses on achieving optimal and sustainable living for individuals, families, and communities; grounded in the values of justice, compassion, sharing, accountability, introspection, and visionary foresight.[13] Home economics has the potential to have a significant impact on all spheres of society by influencing and changing localized systems of politics, social work, culture, the environment, economics, and technology.[13] These work roles are demanding and stressful and may affect the mental health of home economics teachers.

Issues related to work demands in the contemporary Nigerian work environment are critical concerns to many including occupational stress researchers. Stress is a worry that can be physical, psychological, physiological, and sociological which could emanate from not meeting certain demands at the workplace.[4] Stress decreases employees’ rate of commitment to jobs,[5] increases low morale, and is a source of exposure to high occupational hazards.[6] These are worrisome situations job-related stress could pose to institutional employees. More of these were highlighted in prior research reported that stress heightens heart rate, mental, and physical illness of individuals.[7] Other empirical studies also reported stress leads to emotional pain,[8] depression,[9] anxiety,[10] and zero commitment to duty.[11] Study findings also, reported that teachers with high stress levels could be vulnerable to low productivity, absenteeism, poor work performance, job dissatisfaction, and attrition in the workplace.[1216] This indicates that stress has a very serious adverse effect on individual sense of commitment to duty, and the physical and psychological wellness of individuals including teachers teaching in an inclusive school. If teachers posted to community-based schools are left untreated, their mental health or well-being, school productivity, and national goals on education are at a crossroads.

Drawing references from prior research that documented the prevalence rate of high stress among the teaching staff, it is apparent that it cuts across countries. Among the European countries, Kristensen et al[17] reported that 10% to 40% of teachers are suffering from extreme stress. In Pakistan, above 23% were documented,[18] among the Asian countries, higher stress levels were reported.[19] Among the Canadians, an 8.3% to 87.1% prevalence of chronic stress among teachers was documented.[20] While in England 83% were reported suffering from job-related stress.[21]

In Nigeria, among the teachers teaching primary school pupils, 62% were documented,[22] while other researchers reported extreme stress.[23] In Enugu state Nigeria, for instance, a closer observation of the researchers and reports by some teachers, say that they are experiencing high levels of stress. In line with the above observation and reports, past studies showed teachers in Nigeria, including community-based schoolteachers experience extreme stress in their workplaces (I. B. Agbigwe, Unpublished data, 2023).[23,24] This extreme stress has been reported to be linked to excessive responsibilities (I. B. Agbigwe, Unpublished data, 2023).[24] These include the development of individualized education plans (IEP) for special needs students, teaching and learning, among others.[25,26] All these could be conceived as serious factors treating the output rate of the teachers teaching in inclusive schools (i.e., community secondary schools). Hence, their output is greatly rated as insignificant and incommensurate.

Teachers’ stress could be experienced by either gender male or female. World Health Organization (WHO)[27] defines gender as socially constructed characteristics of women and men such as norms, roles, and relationships of and between groups of men and women. United Nations Educational Scientific and Cultural Organization (UNESCO)[28] refers to gender as the roles and responsibilities of men and women that are created in families, societies, and our cultures. Empirical-based studies have reported that both male and female teachers experience stress (I. B. Agbigwe, Unpublished data, 2023).[24] However, from the literature reviewed, available evidence showed that teachers are experiencing stress which has continually been an obstacle in the path of goal achievement. Empirical evidence has documented poor infrastructure, over workload, inadequate teaching facilities and equipment, and unfriendly teaching and learning environment as the cause of stress to teachers especially those teaching in special schools.[16] Other researchers reported that individuals and professionals with unhealthy and dysfunctional beliefs could be vulnerable to stress.[2932] Research findings have remarked on the effectiveness of cognitive behavioral intervention (CBI) in treating psychological-related problems that could induce stress.[33] The prior studies showed that teachers teaching in inclusive schools have tried to manage their stress using different strategies like consuming alcoholics, sleeping, attending different occasions and ceremonies, watching movies and staying outside the home till late home, exercising, sharing feelings, reading, and meditation.[34,35]

In line with the high prevalence of stress and associated adverse psychological consequences, past recommendations showed that there is a need for more intervention studies on stress reduction.[33,36] In fact, to the best of our knowledge, teachers in secondary schools where there are no specific special schools, studies on such populations are lacking. Therefore, checking the role of CBI on stress among school teachers becomes imperative. Hence, understanding the meaning and assumptions of CBI is also important. Teachers’ stress, if not cushioned, can impact secondary school students’ behavior and thinking, including their decision to abuse substances such as alcohol.[37] Managing the psychological well-being of home economics teachers in secondary schools becomes paramount as shown by current research.[38] Home economics can serve as an instrument for managing conflicts within the home as well as promoting national cohesion.[39,40]

1.1. Cognitive behavioral intervention

Researchers in both developed and developing countries have recognized the effectiveness of CBI in challenging psychological-induced problems like stress. The CBI was developed by a psychologist known as Aaron Beck in the 1960s. The therapist aimed at helping individuals develop an alternative pattern of thinking to alter such dysfunctional thoughts capable of exposing them to vulnerable situations like emotional pains and psychological distress. Beck posits that all psychological disturbances are caused by dysfunctional thinking. Thus, CBI in line with other studies is an evidence-based therapy designed to assist teachers teaching in inclusive schools in dislodging their automatic pattern of thinking that negatively influences their beliefs and actions in order to achieve positivity and live a healthy life.[33,41]

Justifying why CBI was used is given the fact that stress deals with perception. CBI aims at restructuring negative perceptions. We considered personal perceptions and interpretations of work stressors by teachers as not appropriate, hence, there is a need to apply cognitive and behavioral techniques that focus on altering them for better ones. The major focus of CBI is to treat negative thoughts and unhealthy thinking that an individual is tenaciously holding regarding the situational environment, the mediating variable, and the teacher’s response to the antecedent. Thus, scholars have remarked that individual including teachers in inclusive schools passing through hell of stress could misinterpret the impact of an event and their experiences in an unhealthy manner through being inflexible, rigid, unhelpful, and self-defeating manner if neglected.[42] In order words, when teachers hold stressful situations so rigid and inflexible, such situations could be tagged as maladaptive, unhealthy situations, and dysfunctional beliefs. Beck views the situation as unacceptable and unwelcoming.[43,44] If the belief is acceptable and welcoming when it is flexible, unrigged, helpful nonextreme, and pragmatic.[33,43,44] For instance, it is unhealthy to believe and accept that 1 will die untimely due to a combination of teaching and caring for special needs children. The thought could be regarded as a nonpragmatic, rigid, and unhealthy belief. Similarly, researchers have posited that the perception and belief that individuals hold about an event or situation always inform their actions.

Relating the assumption to current situations in secondary schools, some teachers feel that they can’t continue coping with their primary assignments and bearing the burdens of children with cognitive, behavioral, and emotional characteristics in their classes. Others share the thoughts that since the government doesn’t want to look into infrastructural development in the school, they will develop waist or back pains if they continually carry disabled children to get in and out of the classroom. Other beliefs include teaching normal children and those with varied behavioral characteristics in the same classroom as the worst punishment that could lead a teacher to untimely death. Invariably, teachers with these perceptions are vulnerable to psychopathologies. Teachers who hold negative thoughts and beliefs concerning their jobs and roles will always perceive job demands in a more stressful manner compared with those who have positive mindsets and beliefs.[45,46] Therefore, investigating the psychological well-being of teachers is important[38] as it assists them to actively engage in their professional delivery.[37,39,40]

Consequently, past studies have remarked that stress and its associated effects could be effectively challenged with an active, orientated, and philosophical approach.[47,48] There are many techniques and approaches adopted in CBT to help clients cushion the cause effects of their distorted thoughts. Such approaches are not limited to social learning, stress inoculation training, problem-solving training, self-control therapy, cognitive restructuring, and mindful meditation. These approaches have been validated and acknowledged widely.[49,50] CBT, therefore, gears towards helping clients dislodge their automatic and dysfunctional thoughts that could cause psychological disturbances. Given these reasons, we hypothesized that there would be a reduction in the stress scale scores of teachers who participated in CBI compared to the control group members. We also hypothesized that the gender of the participants will influence the stress reduction. Finally, there would be an interaction effect of the group and gender on stress reduction.

2. Methods

2.1. Research design

The study adopted a pretest-posttest and follow-up control group design.

2.2. Study location

This study site was Enugu State Nigeria. Enugu State is 1 of the states in Nigeria. It is located in the southeast part of Nigeria. The state has 17 local government areas. In each local government area, there are secondary schools. The schools are managed and funded by government employees.

2.3. Participants and procedure

The ethics and research committee of the Department of Educational Foundations, University of Nigeria, Nsukka approved this study. To comply with the American Psychological Association established ethical principles and standards, the researchers sought school principals’ consent letters that authorized us to conduct the study among the teachers. Also, informed consent was voluntary for teachers who participated. This study was registered with the UMIN Clinical Registry (UMIN000053049) and it was registered retrospectively.

After securing the permission and cooperation of the principals where the study was carried out, the teachers were further screened based on the inclusion criteria. These include: must be a secondary school teacher, must be a secondary school home economics teacher, must have a license to practice by the recognized body, must have been identified by the dependent measures (baseline test). The researchers had a brief meeting with the teachers to inform them about programme and later pasted the invitation on the school notice board. Thus, out of 121 teachers, 81 teachers who met the study criteria were selected for the study and those who did not were excluded. Those who met the study criteria were randomized into the intervention arm (41 participants) and control arm (40 participants). The randomization process was implemented using the random allocation sequence mechanism (sequentially numbered containers). Please indicate any steps taken to conceal the sequence until interventions were assigned. Figure 1 further demonstrates the randomization process. Given this, the power of the sample size was determined using Gpower 3.1 software.[51] The power analysis gave a power of 0.78, the figure indicates that the sample size was adequate.

Figure 1.

Figure 1.

Participants allocation.

Thus, the intervention programme officially commenced after 2 months of recruitment. Teachers in the intervention group were exposed to cognitive behavior intervention. This lasted for 2 months and was delivered by cognitive behavior therapists. On the other hand, the participants in the nonintervention group were exposed to normal conventional counseling. At the end of the programme, the PSS and TIBS were administered to the participants for posttest (Time 2) measure to both groups. A follow-up assessment was conducted using the same instruments though, the instrument was well modified to ascertain the level of retention of the programme on the 17th day of December 2019 at exactly 11:09 am Nigerian hour at the same venue where the intervention took place. The participants and the data analysts were blinded by the researchers until the time analysis was completed. During the intervention, the core objective was to help teachers understand their cognitive error in thinking how this error affects their beliefs, emotions, and actions in relation to their fellow human beings and life endeavors, and how the cognitive errors can be modified.

During the intervention programme, the therapist adopted various techniques to actualize the objective of this study e.g. stress inoculation training, problem-solving training, self-control therapy, cognitive restructuring, and mindful meditation. The therapist gave practice exercises to the participants at the end of each session starting from session 3 which often reviewed before the commencement of the next session. Till the end of the therapeutic programme, we did not record any adverse effects. However, in 5th session, 1 of the clients’ female gender dropped given the fact that she gave birth to a twin baby reducing the number. Finally, 80 participants attended and completed all of the sessions.

We employed 2 external observers outside the research team. The job given to them was spelt out as to ensure that the objective of the treatment goals by the research team is actualized, to ensure that close monitoring is maintained, and to maintain absolute compliance with every aspect of the manual. The supervisors were given 2 different sheets to record their findings namely, the intervention supervisory report sheet and the intervention monitoring report sheet produced by the researchers. The intervention supervisory report sheet is to report the activities of the clients (teachers) during the training, while the monitoring report was designed to check the implementation procedures of the therapists.

2.4. Therapists

The professionals that implemented the intervention were 2 therapists (2 female therapists), with an average age of 43 to 57 years. The experts had PhD training in school counseling.

2.5. Intervention

The researchers adapted a CBI manual originally developed by Muñoz et al.[52] The focus of the treatment package is to help teachers in schools develop an alternative pattern of thinking; and develop the spirit of positivism in order to be proactive in belief and action. The modified version of the intervention programme manual was slated for 8 weeks of weekly sessions that lasted for 50 minutes at each meeting. Notably, the intervention was among the first to address work stress among secondary school home economics teachers. Though, some cognitive behavior coaching studies were reviewed.

The highlights of the intervention programme are as follows:

Session 1: 1 = Introductions, the establishment of the rules and regulations, confidentiality, and objective of the programme.

Session 2 = Meaning of stress and issues related to occupational stress.

Session 3 = Understanding cognitive behavior therapy, issues, and assumptions.

Session 4 = How dysfunctional and negative thought affects occupational behaviors.

Session = 5 = relating cognitive triads to stress in schools. Teaching how to dislodge automatic thought and clarification about decision would yield positivism when the school stress certain in.

Session 6 = Exposing them to CBI lesson and practice using a group interaction session.

Session 7 = Additional practical exercise on processes of dealing with negative thoughts about the school roles.

Session 8 = Revision and termination.

3. Measures

3.1. Perceived stress scale (PSS)

The current study adopted the PSS developed by Cohen et al.[53] The instrument aims to measure individuals’ response to stressful situations. The instrument has a 10-item statement rated on a 5—5-point rating scale of never (0), almost never (1), sometimes (2), fairly often (3), and very often (4). In this study, the response options were rearranged thus, never (5 points), almost never (4 points), sometimes (3 points), fairly often (2 points), and very often (1 point) in that order due to some existing circumstances. However, the reliability of the instrument has been confirmed by past researchers for example, in Nigeria; Ugwuanyi et al[31] reported 0.81 internal consistency reliability of PSS in a study conducted among the science educators. Ene et al[54] also confirmed the reliability of PSS using health workers. In the present study, the internal consistency was 0.79.

3.2. Teacher irrational belief scale (TIBS)

Bernard[55] developed the teachers’ irrational belief scale. The objective of the scale is to measure teachers ’irrational beliefs in relation to their nonpragmatic thinking, extremism, and rigidness in handling issues related to cognitive belief and their job.[56] Teachers’ irrational belief scale has a 30-item scale rated on a 5-point Likert scale of strongly disagree (5 points), disagree (4 points), not sure (3 points), agree (2 points), and strongly agree (1 points). In a sample of special education teachers in Nigeria, 0.80 internal consistency reliability was reported.[16] Ugwuoke et al[32] reported 0.9 as the overall Cronbach alpha reliability Coefficient in a sample study conducted among college technical teachers. The reliability of TIBS was tested in the context of this study and the internal consistency was 0.75.

4. Data analysis

The data collected before the treatment, immediately after the treatment, and 3-month follow-up data were analyzed using a multivariate statistical analysis.

5. Results

Among the participants, there were 14 (35.0%) males and 26 (65.0%) in the treatment group and 5 (12.5%) males and 35 (87.5%) females in the control group respectively. In terms of qualifications of the participants in the treatment group, 15 (37.5%) had Nigeria Certificate in Education (NCE), 23 (57.5%) had Bachelor Degrees in Education, and 2 (5.0%) had Masters Degree in Education. For the comparison group, 9 (22.5%) had NCE, 21 (52.5%) had Bachelor Degrees in Education, and 10 (25.0%) had Masters Degree in Education. Out of the total number of treatment group members, 7 (17.5%) were not married (single), and 25 (62.5%) were married, 8 (20.0%) had divorced. Likewise in control group, 8 (20.0%) were not married (single), 25 (62.5%) were married, 7 (17.5%) had divorced their partners. From the results of the chi-square analysis performed, there was no significant difference in the demographic characteristics of participants in terms of gender (χ2 = 5.591, P = .018), qualifications (χ2 = 6.924, P = .031), and marital status (χ2 = 0.133, P = .936) in the treatment group and control group.

Table 1 is the multivariate analysis of the effect of CBI on job stress. The baseline test result shows there was no statistically significant difference between participants in CBI and groups regarding job stress among teachers, F (1, 79) = 0.315, P = 576, η²P = .004. In the posttest test, the results indicate a significant benefit of CBT in reducing the stress level of teachers as measured by the job stress scale (PSS), F(1, 79) = 233.303, P < 01, η²P = .754. The follow-up test results also indicate that the impactful benefit of CBI on job stress reduction was significantly sustained over time, F (1, 79) = 1014.619, P < 01, η²P = .930. Regarding the influence of gender, the result shows that there was no significant influence of gender on teachers’ job stress among secondary school home economics teachers, F (1, 79) = 2.300, P = 134, η²P = .029.

Table 1.

Multivariate analysis of the effect of CBI on stress.

Source Dependent variable Type III sum of squares Df Mean square F Significance Partial Eta squared
Corrected model PSSPretest 3.097a 3 1.032 0.395 0.757 0.015
PSSPosttest 2021.117b 3 673.706 90.721 0.000 0.782
PSSFollowup 4099.430c 3 1366.477 392.908 0.000 0.939
Intercept PSSPretest 52613.819 1 52613.819 20131.346 0.000 0.996
PSSPosttest 49675.687 1 49675.687 6689.348 0.000 0.989
PSSFollowup 43866.060 1 43866.060 12612.960 0.000 0.994
Group PSSPretest 0.824 1 0.824 0.315 0.576 0.004
PSSPosttest 1732.527 1 1732.527 233.303 0.000 0.754
PSSFollowup 3528.698 1 3528.698 1014.619 0.000 0.930
Gender PSSPretest 0.092 1 0.092 0.035 0.852 0.000
PSSPosttest 17.080 1 17.080 2.300 0.134 0.029
PSSFollowup 3.188 1 3.188 0.917 0.341 0.012
Group * Gender PSSPretest 0.979 1 0.979 0.374 0.542 0.005
PSSPosttest 0.414 1 0.414 0.056 0.814 0.001
PSSFollowup 4.324 1 4.324 1.243 0.268 0.016
Error PSSPretest 198.628 76 2.614
PSSPosttest 564.383 76 7.426
PSSFollowup 264.317 76 3.478
Total PSSPretest 63207.650 80
PSSPosttest 61327.460 80
PSSFollowup 56536.860 80
Corrected Total PSSPretest 201.725 79
PSSPosttest 2585.499 79
PSSFollowup 4363.747 79
a

. R squared = 0.015 (adjusted R squared = −0.024)

b

. R squared = 0.782 (adjusted R squared = 0.773)

c

. R squared = 0.939 (adjusted R squared = 0.937)

Table 2 is the multivariate analysis of the effect of CBI on teachers’ irrational beliefs. The baseline test result shows there was no statistically significant difference between participants in CBI and waitlisted groups regarding irrational belief among teachers, F (1, 79) = 0.002, P = .962, η²P = .000. At the posttest test, the results indicate a significant benefit of CBI in reducing irrational belief of teachers as measured by teachers’ irrational belief scale (TIBS), F(1, 79) = 137.642, P < .01, η²P = .644. The follow-up test results also indicate that the impactful benefit of CBI on teachers’ irrational belief reduction was significantly sustained over time, F (1, 79) = 155.630, P < .01, η²P = .672. Regarding the influence of gender, the result shows that there was no significant influence of gender on teachers’ irrational beliefs among secondary school home economics teachers, F (1, 79) = .181, P = .672, η²P = .002.

Table 2.

Multivariate analysis of the effect of CBI on irrational beliefs.

Source Dependent variable Type III sum of squares Df Mean square F Significance Partial Eta squared
Corrected model TIBSPretest 7.208a 3 2.403 0.052 0.984 0.002
TIBSPosttest 9776.688b 3 3258.896 55.233 0.000 0.686
TIBSFollowUp 10528.771c 3 3509.590 61.125 0.000 0.707
Intercept TIBSPretest 711337.574 1 711337.574 15288.648 0.000 0.995
TIBSPosttest 588671.237 1 588671.237 9977.075 0.000 0.992
TIBSFollowUp 590179.177 1 590179.177 10278.893 0.000 0.993
Group TIBSPretest 0.109 1 0.109 0.002 0.962 0.000
TIBSPosttest 8121.188 1 8121.188 137.642 0.000 0.644
TIBSFollowUp 8935.729 1 8935.729 155.630 0.000 0.672
Gender TIBSPretest 6.265 1 6.265 0.135 0.715 0.002
TIBSPosttest 10.673 1 10.673 0.181 0.672 0.002
TIBSFollowUp 1.345 1 1.345 0.023 0.879 0.000
Group * gender TIBSPretest 1.288 1 1.288 0.028 0.868 0.000
TIBSPosttest 0.729 1 0.729 0.012 0.912 0.000
TIBSFollowUp 7.825 1 7.825 0.136 0.713 0.002
Error TIBSPretest 3536.065 76 46.527
TIBSPosttest 4484.181 76 59.002
TIBSFollowUp 4363.662 76 57.417
Total TIBSPretest 859336.884 80
TIBSPosttest 722727.226 80
TIBSFollowUp 723264.687 80
Corrected total TIBSPretest 3543.274 79
TIBSPosttest 14260.870 79
TIBSFollowUp 14892.433 79
a

R squared = 0.002 (adjusted R squared = −0.037)

b

R squared = 0.686 (adjusted R squared = 0.673)

c

R squared = 0.707 (adjusted R squared = 0.695)

6. Discussion

The objective of this research is to seek the effectiveness of CBI in managing stress among secondary school home economics teachers in Enugu state. The findings of the study showed that secondary school teachers exposed to 8-week CBI sessions showed lesser signs of stress in the posttest than in the pretest (Time 1). It was found that there was a significant benefit of CBI in reducing stress and irrational belief levels of teachers in secondary schools Regarding the influence of gender, the result shows that there was no significant influence of gender on teachers’ job stress and irrational beliefs. The mean score difference between teachers exposed to treatment and those in control groups showed relative statistical significance. The finding indicated that CBI is highly effective in dislodging such automatic and unhealthy thoughts found to be the major cause of stress among teachers in secondary schools. At the follow-up test, the finding showed a significant result indicating that the result of the treatment is maintained.

The result of this empirical-based study is consistence with past studies that CBI is effective in challenging unhealthy and irrational beliefs that could steer up stress among teachers (I. B. Agbigwe, Unpublished data, 2023).[24,25,47,48] Suggesting that CBI exposes clients to the profits of differentiating their thoughts, developing the skills to dislodge irrational and unhealthy thoughts, the skills to absorb flexibility, and pragmatically eschewing extremism and negativity in their daily lives. The stress of teachers including those in secondary schools shows a high level of improvement given the proper application of CBI strategies as documented by prior studies e.g. stress inoculation training, problem-solving training, self-control therapy, cognitive restructuring, relaxations, and mindful meditation.[5759] In line with our findings, past studies disclosed that CBI provides techniques by which people monitor their moods.[60,61] It is also, interesting that another study conducted in different cultures using individual-based CBI was effective in reducing work-related stress in a sample of workers in Denmark.[61] suggesting that CBI is a universal approach and widely used in decreasing stress levels. Significantly, the stress of English education undergraduates was reduced among those in the intervention group compared to those in the control group.[62]

More so, researchers have continued to justify the efficacy of psychological treatment. In a study conducted among electronics workshop instructors in Nigeria, the result of the finding showed a positive reduction of stress and increased workability of the participants exposed to the cognitive intervention.[63] Other studies noted a significant decrease in school stress among students due to psychological intervention.[64,65] Onuigbo et al[25] remarked that REBT proves to be effective in managing stress in the workplace. The significant positive effect of CBI among university lecturers as a past study conducted in Nigeria has revealed that lecturers’ occupational stress levels were reduced.[47] The study showed that the perception of stressors and stress symptoms was shown to have significantly decreased at the posttest and follow-up evaluations after the Y-CBT intervention.[47] It is, therefore, imperative that CBI techniques employed to resolve teachers’ stress are considered to be useful and effective and should be continually employed. Perhaps, if the problem is associated with maladaptive behavior.

Like other empirical studies, Ede et al[29] documented that CBI helps people reduce distorted thoughts irrespective of gender. I. B. Agbigwe (unpublished data, 2023)[24] noted that the mean stress scores of both male and female teachers exposed to CBI were reduced with male teachers recording higher means than females. Asghari et al[66] posited that psychotherapy was effective in reducing specific stress pregnancy in pregnant women with preeclampsia. Thus, no interaction effect of gender and stress was observed. The mean difference recorded was due to gender imbalance during recruitment.

In the modern workplace, psychosocial risk factors have increased and pose a threat to productivity. It is, therefore, necessary for workers to receive psychological intervention and understand ways to cope with stress at the workplace. As shown in this discussion section, a good number of literature within and outside Nigeria have reported the universality of CBI. Given the positive outcome of this study, it suggests that CBI practitioners are called to expose workers to CBI principles to give them early psychological support on mental health.

Despite CBI impressive contributions, this study recorded some limitations that future researchers may wish to address; the sample size was insignificant and cannot be used to compare larger sample numbers. Also, the study was limited to secondary schools in Enugu state Nigeria. Therefore, future researchers are encouraged to extend the scope across other states and regions. The current study employed quantitative research which allows for only 1 source of data collection. Therefore, future research should adopt qualitative so as to source data through other means like interviews, and observation among others. Also, none of the control group was given any intervention.

Given the number of limitations recorded, the current study was able to record success in; achieving the stated hypotheses, which validate the efficacy of CBI in treating such unhealthy and irrational thoughts capable of affecting workers’ output including secondary school home economics teachers. A remarkable effect was observed during the posttest and follow-up test. The support given to us during the time of invitation to this study by the school principals equally added to its success. That could be responsible for the good effect size of the intervention. Possibly, it could be because of the sample size, which was not large. A smaller effect size would necessitate higher sample sizes, and a large effect size would allow for the detection of such an impact in fewer samples. Large sample sizes have the potential to pick up on seemingly insignificant variations. It is also possible that the participants received positive cooperation from the therapist which endeared them to remain active and determined to change the negative thoughts about work. This is reflected in the filling of the scale at the posttest and follow-up test respectively.

7. Practice implication of this study

The psychological healthiness of teachers teaching in schools was achieved due to practical intervention of CBI strategies. The juiciest aspect of the intervention among those exposed to treatment was maintained at the follow-up test. The study prospect was achieved due to the proper application of cognitive behavioral therapeutic principles, methods, and strategies. Therefore, school counselors, CBI experts, and relevant agencies could collaborate and develop an effective intervention package that could help other populations see the need to think rationally and achieve psychological health in order to always record positive output.

School administrators should provide a good working environment for the staff as a measure to reduce stressful experiences. As the present result indicated, school administrators should ensure that CBI practitioners such as school counselors, career counselors, and others are warmly welcome to the schools. Such collaborative and administrative alliances will promote positive perceptions about work roles and schedules. Building deep connections with other teachers gives them a feeling of community and a supportive network that helps them deal with work stress. Ensuring good working relationships between teachers is 1 of your most important duties as school principal.

8. Conclusion

This study was conducted due to the researchers’ perceived adverse effect of job stress and high reported cases of teachers’ stress in Nigerian secondary schools. After administering the CBI on samples of teachers, this study concluded that CBI is an effective strategy in reducing stress among secondary school home economics teachers in Nigeria. The principles of CBI countered teachers’ feelings and thoughts about work demands as their unhealthy patterns of thinking were dislodged through the application of CBI assumptions and strategies. Thus, we suggest the need to adopt CBI in workplaces since the intervention programme has the inherent ability to challenge the clients’ unhealthy thoughts and negative beliefs into healthy and rational ones.

Author contributions

Conceptualization: Glory Mmachukwu Nwakpadolu, Moses Onyemaechi Ede, Calister Lebechukwu Nwadi, Florence Ukamaka Akudo, Amaka Bibian Ezeanwu, Edith C. Edikpa, Vera Nkiru Nwadinobi, Joy Obiageli Oneli.

Data curation: Glory Mmachukwu Nwakpadolu, Moses Onyemaechi Ede, Calister Lebechukwu Nwadi, Florence Ukamaka Akudo, Amaka Bibian Ezeanwu, Edith C. Edikpa, Vera Nkiru Nwadinobi.

Formal analysis: Glory Mmachukwu Nwakpadolu, Moses Onyemaechi Ede, Calister Lebechukwu Nwadi.

Funding acquisition: Glory Mmachukwu Nwakpadolu, Moses Onyemaechi Ede, Joy Oluchukwu Okoro, Calister Lebechukwu Nwadi, Florence Ukamaka Akudo, Grace N. Anigbogu, Amaka Bibian Ezeanwu, Edith C. Edikpa, Vera Nkiru Nwadinobi, Joy Obiageli Oneli.

Investigation: Glory Mmachukwu Nwakpadolu, Moses Onyemaechi Ede, Joy Oluchukwu Okoro, Calister Lebechukwu Nwadi, Florence Ukamaka Akudo, Grace N. Anigbogu, Amaka Bibian Ezeanwu, Edith C. Edikpa, Vera Nkiru Nwadinobi.

Methodology: Glory Mmachukwu Nwakpadolu, Moses Onyemaechi Ede, Joy Oluchukwu Okoro, Calister Lebechukwu Nwadi, Florence Ukamaka Akudo, Grace N. Anigbogu, Amaka Bibian Ezeanwu, Edith C. Edikpa.

Project administration: Glory Mmachukwu Nwakpadolu, Moses Onyemaechi Ede, Calister Lebechukwu Nwadi, Florence Ukamaka Akudo, Grace N. Anigbogu, Amaka Bibian Ezeanwu, Edith C. Edikpa.

Resources: Glory Mmachukwu Nwakpadolu, Moses Onyemaechi Ede, Joy Oluchukwu Okoro, Calister Lebechukwu Nwadi, Florence Ukamaka Akudo, Amaka Bibian Ezeanwu, Joy Obiageli Oneli.

Software: Glory Mmachukwu Nwakpadolu, Moses Onyemaechi Ede, Joy Oluchukwu Okoro, Calister Lebechukwu Nwadi, Florence Ukamaka Akudo, Amaka Bibian Ezeanwu.

Supervision: Glory Mmachukwu Nwakpadolu, Moses Onyemaechi Ede, Joy Oluchukwu Okoro, Calister Lebechukwu Nwadi, Florence Ukamaka Akudo, Grace N. Anigbogu, Amaka Bibian Ezeanwu, Edith C. Edikpa, Vera Nkiru Nwadinobi, Joy Obiageli Oneli.

Validation: Glory Mmachukwu Nwakpadolu, Moses Onyemaechi Ede, Joy Oluchukwu Okoro, Calister Lebechukwu Nwadi, Florence Ukamaka Akudo, Grace N. Anigbogu, Amaka Bibian Ezeanwu, Edith C. Edikpa, Vera Nkiru Nwadinobi, Joy Obiageli Oneli.

Visualization: Glory Mmachukwu Nwakpadolu, Moses Onyemaechi Ede, Joy Oluchukwu Okoro, Calister Lebechukwu Nwadi, Florence Ukamaka Akudo, Grace N. Anigbogu, Amaka Bibian Ezeanwu, Vera Nkiru Nwadinobi, Joy Obiageli Oneli.

Writing—original draft: Glory Mmachukwu Nwakpadolu, Moses Onyemaechi Ede, Joy Oluchukwu Okoro, Calister Lebechukwu Nwadi, Florence Ukamaka Akudo, Grace N. Anigbogu, Amaka Bibian Ezeanwu, Vera Nkiru Nwadinobi.

Writing—review & editing: Glory Mmachukwu Nwakpadolu, Moses Onyemaechi Ede, Joy Oluchukwu Okoro, Calister Lebechukwu Nwadi, Grace N. Anigbogu, Amaka Bibian Ezeanwu, Edith C. Edikpa, Vera Nkiru Nwadinobi, Joy Obiageli Oneli.

Abbreviations

CBI
cognitive behavior intervention
NCE
Nigeria Certificate in Education
PSS
perceived stress scale
TIBS
teacher irrational belief scale.

The authors have no conflicts of interest to disclose.

The datasets generated during and/or analyzed during the current study are not publicly available, but are available from the corresponding author on reasonable request.

How to cite this article: Nwakpadolu GM, Ede MO, Okoro JO, Nwadi CL, Akudo FU, Anigbogu GN, Ezeanwu AB, Edikpa EC, Nwadinobi VN, Oneli JO. Effect of psychological intervention in cushioning work-induced stress among secondary school home economics teachers: Implications for policy and administration. Medicine 2024;103:9(e37174).

Contributor Information

Glory Mmachukwu Nwakpadolu, Email: Glorywakpadolu@gmail.com.

Moses Onyemaechi Ede, Email: onyemaechi.moses@gmail.com.

Joy Oluchukwu Okoro, Email: Joykoro@gmail.com.

Florence Ukamaka Akudo, Email: Florencekamakudo@gmail.com.

Grace N. Anigbogu, Email: Gracgbogu@gmail.com.

Amaka Bibian Ezeanwu, Email: amakaanwu22@gmail.com.

Edith C. Edikpa, Email: edith.edikpa2@unn.edu.ng.

Vera Nkiru Nwadinobi, Email: Veraadinobi@yahoo.com.

Joy Obiageli Oneli, Email: Joy.oneliede@gmail.com.

References

  • [1].Anyakoha EU. Home Economics for Junior Secondary Schools. 3 rd ed. Onitsha: Africana First Publishers; 2016. [Google Scholar]
  • [2].Arogundade KK, Adebisi SO, Ogunro VO. Poverty alleviation programme in Nigeria: a call for policy harmonization. Eur J Globalization Dev Res. 2011. Available at: https://docplayer.net/41112027-European [access date March 2, 2022].
  • [3].Alabi F, Keswet L. The role of home economics in poverty alleviation for national development. Int J Contemp Appl Sci. 2015;2:72–80. [Google Scholar]
  • [4].Slyers S. Stress and Stressor. The Way Forward. Lagos. Lola Publishers; 2011. [Google Scholar]
  • [5].Iremeka FU, Okeke SA, Agu PU, et al. Intervention for stress management among skilled construction workers. Medicine (Baltimore). 2021;100:e26621. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [6].Bowen P, Edwards P, Lingard H, et al. Predictive modeling of workplace stress among construction professionals. J Constr Eng Manag. 2014;140:1–15. [Google Scholar]
  • [7].Sahoo SR. Management of stress at workplace. GJMBR-A Admin. 2016;16:1–7. [Google Scholar]
  • [8].Ezegbe BN, Ede MO, Eseadi C, et al. Effect of music therapy combined with cognitive restructuring therapy on emotional distress in a sample of Nigerian married couples. Medicine (Baltim). 2018;97:e11637. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [9].Ezegbe BN, Eseadi C, Ede MO, et al. Impacts of cognitive-behavioral intervention on anxiety and depression among social science education students: a randomized controlled trial. Medicine (Baltim). 2019;98:e14935. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [10].Kodal A, Fjermestad K, Bjelland I, et al. Long-term effectiveness of cognitive behavioral therapy for youth with anxiety disorders. J Anxiety Disord. 2018;53:58–67. [DOI] [PubMed] [Google Scholar]
  • [11].Anyanwu J, Ezenwaji IO, Enyi C. Occupational stress and management strategies of secondary school principals in cross river state, Nigeria. J Educ Pract. 2015;6. [Google Scholar]
  • [12].Adeniyi SO, Fakolade OA, Tella A. Perceived causes of job stress among special educators in selected special and integrated schools in Nigeria. New Horizons Educ. 2010;58:73–82. [Google Scholar]
  • [13].Hastings RP, Brown T. Coping strategies and the impact of challenging behaviors on special educators’ burnout. Ment Retard. 2002;40:148–56. [DOI] [PubMed] [Google Scholar]
  • [14].Antoniou AS, Polychroni F, Walters B. Sources of stress and professional burnout of teachers of special education needs in Greece. Proceedings of the International Special Education Congress. 2000. [Google Scholar]
  • [15].Goldring R, Taie S, Riddles M, Owens C. Teacher Attrition and Mobility: Results from the 2012–13 Teacher Follow-up Survey (NCES 2014-077). Washington, DC: US Department of Education, National Center ; 2014. [Google Scholar]
  • [16].Onuigbo LN, Eseadi C, Ugwoke SC, et al. Effect of rational emotive behaviortherapy on stress management and irrational beliefs of special education teachers in Nigerian elementary schools. Medicine (Baltimore). 2018;97:e12191. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [17].Kristensen TS, Borritz M, Villadsen E, et al. The Copenhagen burnout inventory: a new tool for the assessment of burnout. Work Stress. 2005;19:192–207. [Google Scholar]
  • [18].Sharma SS. Occupational stress among teachers working in secondary schools [dissertation submitted in partial fulfillment of the requirements for the award of the Degree of Masters of Public Health Degree]. Thiruvananthpuram, Kerala: Institute for Medical Sciences and Technology; . 2008. [Google Scholar]
  • [19].Maslach C, Schaufeli WB, Leiter MP. Job burnout. Annu Rev Psychol. 2001;52:397–422. [DOI] [PubMed] [Google Scholar]
  • [20].Agyapong B, Brett-MacLean P, Burback L, et al. Interventions to reduce stress and burnout among teachers: a scoping review. Int J Environ Res Public Health. 2023;20:5625. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [21].Precey M. Teacher stress levels in England ’soaring’, data shows. BBC News, File on 4. March 17, 2015. Available at: http://www.bbc.com/news/education-31921457 [access date May 20, 2017].
  • [22].Agbo I. Assessment of Stress of Teachers of Primary School Pupils in Enugu State [master’s thesis]. Awka: Nnamdi Azikiwe University; 2012. [Google Scholar]
  • [23].Ajibade BL, Olabisi OO, Fabiyi B, et al. Stress, types of stressors and coping strategies amongst selected nursing schools students in South-West, Nigeria. Eur J Biol Med Sci Res. 2016;4:1–15. [Google Scholar]
  • [24].Agbigwe IB. Effect cognitive behavioural intervention in managing stress among teachers in inclusive secondary schools in Enugu state. (unpublished M.Ed. thesis). Nsukka; University of Nigeria Nsukka. 2023. [Google Scholar]
  • [25].Onuigbo LN. Regular schools’ needs for creating an inclusive learning-friendly environment. Int J Res Arts Soc Sci. 2013;5:294. [Google Scholar]
  • [26].Haydon T, Stevens D, Leko M. Teacher stress: sources, effects, and protective factors. J Special Educ Lead. 2018;31:99–107. [Google Scholar]
  • [27].World Health Organization. Achieving universal health coverage for the world’s 1.2. 2019.
  • [28].UNESCO. Gender mainstreaming implementation framework. 2013. Available at: http://www.unesco.org/new/fileadmin/MULTIMEDIA/HQ/BSP/GENDER/PDF/ [access date December 18, 2023].
  • [29].Ede MO, Okeke CI, Oneli JO. Raising the self-esteem and reducing irrational beliefs of schoolchildren: the moderating and main effect study. Medicine (Baltimore). 2023;102:e34168. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [30].Ogbuanya TC, Eseadi C, Orji CT, et al. The effect of rational emotive behavior therapy on irrational career beliefs of students of electrical electronics and other engineering trades in technical colleges in Nigeria. J Ration Emot Cogn Behav Ther. 2018;36:201–19. [Google Scholar]
  • [31].Ugwuanyi CS, Okeke CIO, Agboeze MU, et al. Impacts of cognitive behavior therapy on occupational stress among science and social science education facilitators in open and distance learning centers and its implications for community development: a randomized trial group. Medicine (Baltimore). 2020;99:e22677. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [32].Ugwoke SC, Eseadi C, Igbokwe CC, et al. Effects of a rational-emotive health education intervention on stress management and irrational beliefs among technical college teachers in Southeast Nigeria. Medicine (Baltimore). 2017;96:e7658. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [33].Ogakwu NV, Ede MO, Agu PU, et al. School-based intervention for academic stress management and school adjustment among industrial technical education students: implications for educational administrators. Medicine (Baltimore). 2023;102:e32547. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [34].Gulwadi GB. Seeking restorative experiences: elementary school teachers’ choices for places that enable coping with stress. Environ Behav. 2006;38:503–20. [Google Scholar]
  • [35].Austin V, Shah S, Muncher S. Teacher stress and coping strategies used to reduce stress. Occup Ther Int. 2005;12:63–80. [DOI] [PubMed] [Google Scholar]
  • [36].Omeje HO, Ede MO, Okereke GKO, et al. Efficacy of rational emotive career counselling programme on occupational stress management in industrial hazard victims: safety practice implications. J Rat Emot Cogn Behav Ther. 2022;41:56–79. [Google Scholar]
  • [37].Eze NM, Njoku HA, Eseadi C, et al. Alcohol consumption and awareness of its effects on health among secondary school students in Nigeria. Medicine (Baltimore). 2017;96:e8960. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [38].Ugwuanyi CS. Evaluation of the psychological wellbeing of special science school home economics teachers. Int J Home Econ Hosp Allied Res. 2023;2:16–28. [Google Scholar]
  • [39].Loto AO, Ogboru JO, Adebayo OW. Home economics programme as a tool for marital conflict management. Int J Home Econ Hosp Allied Res. 2022;1:306–17. [Google Scholar]
  • [40].Ugwuokpe CL, Chukwuone CA. The role of home economics in curbing insecurity and inflation in Nigeria. Int J Home Econ Hosp Allied Res. 2022;1:91–104. [Google Scholar]
  • [41].Khanehkeshi A. Effectiveness of cognitive behavior therapy on academic stress among high school students. 2014;4:681–94. [Google Scholar]
  • [42].Ugwuanyi LT, Ede MO, Agbigwe IB, et al. Effect of rational emotive behaviour therapy on depressive symptoms in a sample of parents of children with intellectual disability. J Ration Emot Cognit Behav Ther. 2022;41:128–43 [Google Scholar]
  • [43].Beck AT. Depression: Clinical, Experimental and Theoretical Aspects. New York: Harper and Row; 1967. [Google Scholar]
  • [44].Ellis A, Bernard ME. What is Rational–Emotive Therapy? Clinical Applications of Rational Emotive Behaviour Therapy. New York: Plenum Press; 1985:1–30. [Google Scholar]
  • [45].Ogakwu NV, Ede MO, Manafa I, et al. Occupational health coaching for job stress management among technical college teachers: implications for educational administrators. Medicine (Baltimore). 2023;102:e32463. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [46].Eze PO. Effect of Rational Emotive Behavior Therapy on Work Stress of Special Educators in Enugu State [postgraduate diploma thesis]. Nsukka: University of Nigeria. 2016. [Google Scholar]
  • [47].Igu NCN, Ogba FN, Eze UN, et al. Effectiveness of cognitive behavioral therapy with yoga in reducing job stress among university lecturers. Front Psychol. 2023;13:950969. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [48].Eneogu ND, Ugwuanyi CK, Ugwuanyi CS. Efficacy of cognitive behavioral therapy on academic stress among rural community secondary school economics students: a randomized controlled evaluation. J Ration Emot Cognit Behav Ther. 2023. [Google Scholar]
  • [49].DiGiuseppe R, Doyle KA, Rose RD. Rational emotive behaviour therapy for depression: achieving unconditional self-acceptance. In: Reinecke MA, Davison MR. eds. Comparative Treatments of Depression. New York: Springer; 2002:220–228. [Google Scholar]
  • [50].Shaffiaa-Abadi A, Nasseri G. Theories of Counseling and Psycho- Therapy. Tehran: University Publishing Centre; 2010. [Google Scholar]
  • [51].Faul F, Erdfelder E, Lang AG, et al. G*Power 3: a flexible statistical power analysis programme for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39:175–91. [DOI] [PubMed] [Google Scholar]
  • [52].Muñoz RF, Aguilar-Gaxiola S, Guzmán J, et al. Treatment manual for cognitive behavioral therapy for depression (Therapist’s Manual). Ind Format 2007. [Google Scholar]
  • [53].Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24:385–96. [PubMed] [Google Scholar]
  • [54].Ene CU, Ugwuanyi CS, Ejimonye JC, et al. Effects of rational emotive occupational health coaching on work stress among academic staff of science and social science education in Nigerian universities: a randomised trial evaluation. Medicine (Baltimore). 2021;100:e26963. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [55].Bernard ME. Taking the stress out of teaching. Collins-Dove, Melbourne, Vic. Billion adolescents. 1990. Available at: https://www.who.int/maternalchild_adolescent/adolescence/universal-health-coverage/en/ [access date November 11, 2019].
  • [56].Bora C, Bernard ME, Decsei-Radu A. Teacher irrational belief scale—preliminary norms for Romanian population. Rom J Cogn Behav Psychother 2008;8:35–49. [Google Scholar]
  • [57].Uzodinma UE, Onyishi CN, Ngwoke AN, et al. Effectiveness of rational emotive occupational health coaching in reducing burnout symptoms among teachers of children with autism. Sci Prog. 2022;105:368504221100907. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [58].Holman D, Johnson S, O’Connor E. Stress management interventions: improving subjective psychological well-being in the workplace. In: Diener E, Oishi S, Tay L. eds. Handbook of Well-Being. DEF Publishers; 2018. [Google Scholar]
  • [59].Igwe JN, Ugwuanyi CS, Ejimonye JC, et al. Stress management among science and social science educators within open and distance learning centers using rational emotive behavior therapy: implication for curriculum and educational evaluators. J Ration Emotive Cognit Behav Ther. 2022;40:1–22. [Google Scholar]
  • [60].Agah JJ, Ede MO, Zudonu OC, et al. Testing the efficacy of the FEAR—model of cognitive behavioural therapy in treating test anxiety in chemistry students. J Ration Emotive Cognit Behav Ther. 2020;39:390–413. [Google Scholar]
  • [61].Dalgaard VL, Andersen LPS, Andersen JH, et al. Work-focused cognitive behavioral intervention for psychological complaints in patients on sick leave due to work-related stress: results from a randomized controlled trial. J Negat Results Biomed. 2017;16:13. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [62].Igbokwe UL, Onyechi KCN, Ogbonna CS, et al. Rational emotive intervention for stress management among English education undergraduates. Medicine (Baltimore). 2019;98:e17452. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [63].Ogbuanya TC, Eseadi C, Orji CT, et al. Effects of rational emotive occupational health therapy intervention on the perceptions of organizational climate and occupational risk management practices among electronics technology employees in Nigeria. Medicine (Baltimore). 2017;96:e6765. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [64].Ogakwu NV, Ede MO, Manafa IF, et al. Quality of work life and stress management in a rural sample of primary school teachers: an intervention study. J Ration Emotive Cognit Behav Ther. 2023. [Google Scholar]
  • [65].Ogbuanya TC, Eseadi C, Orji CT, et al. Effect of rational emotive behavior therapy on negative career thoughts of students in technical colleges in Nigeria. Psychol Rep. 2018;121:356–74. [DOI] [PubMed] [Google Scholar]
  • [66].Asghari E, Faramarzi M, Mohammmadi AK. The effect of cognitive behavioural therapy on anxiety, depression and stress in women with preeclampsia. J Clin Diagn Res. 2016;10:QC04–7. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Medicine are provided here courtesy of Wolters Kluwer Health

RESOURCES