{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T23:13:54Z","timestamp":1764890034754,"version":"3.46.0"},"reference-count":18,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:00:00Z","timestamp":1759968000000},"content-version":"unspecified","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,9,24]]},"published-print":{"date-parts":[[2025,10]]},"abstract":"\n Introduction<\/jats:title>\n The teaching profession plays a crucial role in society. From educating and forming future generations to fulfilling various administrative tasks and managing expectations and experiences that reach beyond the classroom\u2014teachers face immense demands on their time, energy, and emotional resources. Consequently, they are subject to high work burden. This is reflected in the high prevalence of burnout, anxiety, and depression among teachers. A scoping review of factors associated with these outcomes in teachers is required to inform the further development of preventive occupational medicine strategies. In this scoping review, we aim to (i) identify and (ii) appraise the factors (eg, workplace, environmental, lifestyle, psychological) associated with burnout, anxiety, and depression specific to secondary school teachers and to (iii) synthesise the findings from the perspective of preventive occupational medicine.<\/jats:p>\n <\/jats:sec>\n \n Methods and analysis<\/jats:title>\n The scoping review will be performed following the PRISMA extension for Scoping Reviews guidance. A systematic literature search will be conducted in the Medline, Web of Science Core Collection, PsychInfo, and Cochrane Library databases using search terms pertinent to secondary school teachers as the population of interest and depression, anxiety, and burnout as the outcomes of interest. Returned articles from the database search published pre-2017 will be excluded for the following reasons; namely, (a) that current literature will more closely reflect the current demands of the teachers, (b) the timing fits with recent systematic reviews highlighting burnout, anxiety, and depression as major problems among teachers, and (c) it facilitates feasibility of review in terms of the volume of studies. Remaining records will then be deduplicated and screened against predefined eligibility criteria that also add focus on teachers and these outcomes. Relevant data concerning factors associated with burnout, anxiety, and depression in teachers will be extracted and mapped. A narrative appraisal of included studies will be employed that will be specific to the validity of the results regarding factors (exposures, mediators, effect modifiers) that may affect the outcomes of interest (as opposed to more generic appraisal of the entirety of individual articles). Findings will be narratively synthesised from the perspective of preventive occupational medicine.<\/jats:p>\n <\/jats:sec>\n \n Ethics and dissemination<\/jats:title>\n Formal ethical approval is not required as primary data will not be collected in this study. The findings of this study will be disseminated through peer-reviewed publication, conference presentation, and condensed summaries for key stakeholders and partners in the field (including teachers, schools, and governing bodies).<\/jats:p>\n <\/jats:sec>\n \n Registration details<\/jats:title>\n \n The protocol was registered on the Open Science Framework on 26.06.2025 and can be identified using the following link:\n https:\/\/doi.org\/10.17605\/OSF.IO\/BKX56<\/jats:ext-link>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-107262","type":"journal-article","created":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T09:40:42Z","timestamp":1760002842000},"page":"e107262","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Predictors, mediators, effect modifiers and preventive actions regarding secondary school teacher burnout, anxiety and depression\u2014protocol for a systematic scoping review"],"prefix":"10.1136","volume":"15","author":[{"given":"Marius","family":"K\u00f6nig","sequence":"first","affiliation":[{"name":"Institute and Policlinic for Occupational Medicine, Environmental Medicine and Prevention Research, University Hospital of Cologne, Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonas P","family":"Wallraff","sequence":"additional","affiliation":[{"name":"Institute and Policlinic for Occupational Medicine, Environmental Medicine and Prevention Research, University Hospital of Cologne, Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florian","family":"Glenewinkel","sequence":"additional","affiliation":[{"name":"Institute and Policlinic for Occupational Medicine, Environmental Medicine and Prevention Research, University Hospital of Cologne, Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ursula","family":"Wild","sequence":"additional","affiliation":[{"name":"Institute and Policlinic for Occupational Medicine, Environmental Medicine and Prevention Research, University Hospital of Cologne, Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas C","family":"Erren","sequence":"additional","affiliation":[{"name":"Institute and Policlinic for Occupational Medicine, Environmental Medicine and Prevention Research, University Hospital of Cologne, Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5881-6032","authenticated-orcid":false,"given":"Philip","family":"Lewis","sequence":"additional","affiliation":[{"name":"Institute and Policlinic for Occupational Medicine, Environmental Medicine and Prevention Research, University Hospital of Cologne, Cologne, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,10,9]]},"reference":[{"unstructured":"Bildungsministerkonferenz . Sch\u00fcler\/-innen, klassen, lehrkr\u00e4fte und absolvierende der schulen 2014 bis 2023. Berlin: Sekretariat der St\u00e4ndigen Konferenz der Kultusminister der L\u00e4nder in der Bundesrepublik Deutschland; 2025.","key":"2025120415061949000_15.10.e107262.1"},{"unstructured":"U.S. Bureau of Labor Statistics . Civilian labor force level federal reserve bank of St. Louis2025. Available: https:\/\/fred.stlouisfed.org\/series\/CLF16OV [Accessed 6 Mar 2025].","key":"2025120415061949000_15.10.e107262.2"},{"unstructured":"National Center for Education Statistics . Department of Education, Institute of Education Sciences; Characteristics of Public School Teachers: U.S, 2023. Available: https:\/\/nces.ed.gov\/programs\/coe\/indicator\/clr\/public-school-teachers [Accessed 6 Mar 2025].","key":"2025120415061949000_15.10.e107262.3"},{"unstructured":"Statistisches Bundesamt . Eckzahlen zum arbeitsmarkt, deutschland. 2025. Available: https:\/\/www.destatis.de\/DE\/Themen\/Arbeit\/Arbeitsmarkt\/Erwerbstaetigkeit\/Tabellen\/eckwerttabelle.html [Accessed 6 Mar 2025].","key":"2025120415061949000_15.10.e107262.4"},{"unstructured":"European School Education Platform . Survey on reinforcing the attractiveness of teacher careers - results: european commission. 2024. Available: https:\/\/school-education.ec.europa.eu\/en\/discover\/viewpoints\/survey-reinforcing-attractiveness-teacher-careers [Accessed 7 Mar 2025].","key":"2025120415061949000_15.10.e107262.5"},{"doi-asserted-by":"publisher","key":"2025120415061949000_15.10.e107262.6","DOI":"10.1136\/oem.2002.006734"},{"unstructured":"World Health Organization . Burn-out an \u201coccupational phenomenon\u201d: International Classification of Diseases 2019, Available: https:\/\/www.who.int\/news\/item\/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases [Accessed 23 Sep 2025].","key":"2025120415061949000_15.10.e107262.7"},{"unstructured":"World Health Organization . Anxiety disorders 2023, Available: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/anxiety-disorders [Accessed 19 Feb 2025].","key":"2025120415061949000_15.10.e107262.8"},{"unstructured":"World Health Organization . Depressive disorder (depression) 2023. Available: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/depression [Accessed 19 Feb 2025].","key":"2025120415061949000_15.10.e107262.9"},{"key":"2025120415061949000_15.10.e107262.10","doi-asserted-by":"crossref","first-page":"2544","DOI":"10.18421\/TEM133-80","article-title":"Impacts of Workload on Teachers\u2019 Well-Being: A Systematic Literature Review","volume":"13","author":"Ab. 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