<?xml version="1.0" encoding="utf-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD Journal Publishing DTD v2.3 20070202//EN" "journalpublishing.dtd">
<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" article-type="research-article" dtd-version="2.3" xml:lang="EN">
<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Educ.</journal-id>
<journal-title>Frontiers in Education</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Educ.</abbrev-journal-title>
<issn pub-type="epub">2504-284X</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3389/feduc.2024.1489820</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Education</subject>
<subj-group>
<subject>Original Research</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Burnout of special education teachers in Saudi Arabia&#x2019;s inclusive education schools</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author" corresp="yes"><name><surname>Alahmed</surname> <given-names>Thamer</given-names></name><xref ref-type="corresp" rid="c001"><sup>&#x002A;</sup></xref>
<uri xlink:href="https://loop.frontiersin.org/people/2829148/overview"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-original-draft/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-review-editing/"/>
</contrib>
</contrib-group>
<aff><institution>Department of Special Education, Faculty of Education, Umm Al-Qura University</institution>, <addr-line>Mecca</addr-line>, <country>Saudi Arabia</country></aff>
<author-notes>
<fn fn-type="edited-by" id="fn0001">
<p>Edited by: Wing Chee So, The Chinese University of Hong Kong, China</p>
</fn>
<fn fn-type="edited-by" id="fn0002">
<p>Reviewed by: Adelinda Araujo Candeias, University of Evora, Portugal</p>
<p>Osman Aktan, Duzce University, T&#x00FC;rkiye</p>
</fn>
<corresp id="c001">&#x002A;Correspondence: Thamer Alahmed, <email>thahmed@uqu.edu.sa</email></corresp>
<fn fn-type="other" id="fn0011">
<p>Thamer Alahmed, <ext-link ext-link-type="uri" xlink:href="https://orcid.org/0009-0008-2880-2386">orcid.org/0009-0008-2880-2386</ext-link></p>
</fn>
</author-notes>
<pub-date pub-type="epub">
<day>18</day>
<month>12</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="collection">
<year>2024</year>
</pub-date>
<volume>9</volume>
<elocation-id>1489820</elocation-id>
<history>
<date date-type="received">
<day>01</day>
<month>09</month>
<year>2024</year>
</date>
<date date-type="accepted">
<day>26</day>
<month>11</month>
<year>2024</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#x00A9; 2024 Alahmed.</copyright-statement>
<copyright-year>2024</copyright-year>
<copyright-holder>Alahmed</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p>
</license>
</permissions>
<abstract>
<sec>
<title>Introduction</title>
<p>Burnout is a serious phenomenon that negatively affects teachers&#x2019; professional performance. The current study aims to determine the level of burnout among special education teachers in inclusive education schools in the Kingdom of Saudi Arabia.</p>
</sec>
<sec>
<title>Methods</title>
<p>It used a descriptive survey approach by employing an online questionnaire to collect data from 137 special education teachers in inclusive education schools.</p>
</sec>
<sec>
<title>Results and discussion</title>
<p>The study found that the level of burnout among special education teachers was average, with an arithmetic mean of 2.907 and a relative weight of 48.40%. Male teachers had higher levels of burnout than female teachers. Moreover, teachers specialising in deafness and hearing loss had higher levels of burnout than teachers in other subspecialties. The other variables, such as educational level and experience, had no significant effect on the dimensions of burnout or overall level of burnout. This study recommends the provision of intervention programmes to help reduce teachers&#x2019; burnout levels. In addition, there is a need to reduce the workload and tasks assigned to special education teachers in inclusive education schools.</p>
</sec>
</abstract>
<kwd-group>
<kwd>burnout</kwd>
<kwd>special education teachers</kwd>
<kwd>inclusive education schools</kwd>
<kwd>education</kwd>
<kwd>student</kwd>
</kwd-group>
<counts>
<fig-count count="2"/>
<table-count count="3"/>
<equation-count count="1"/>
<ref-count count="89"/>
<page-count count="12"/>
<word-count count="8397"/>
</counts>
<custom-meta-wrap>
<custom-meta>
<meta-name>section-at-acceptance</meta-name>
<meta-value>Special Educational Needs</meta-value>
</custom-meta>
</custom-meta-wrap>
</article-meta>
</front>
<body>
<sec sec-type="intro" id="sec1">
<label>1</label>
<title>Introduction</title>
<p>Global interest in inclusive education began three decades ago but has recently increased. Inclusive education for people with disabilities aims to address all the barriers that prevent learners with disabilities from participating in education (<xref ref-type="bibr" rid="ref42">Jardinez and Natividad, 2024</xref>). It helps to improve academic achievement, peer acceptance, and self-esteem as well as augment emotional, psychological, and social development (<xref ref-type="bibr" rid="ref83">UNESCO, 2023</xref>). Although special education teachers play an essential role in the effective and successful implementation of inclusive education (<xref ref-type="bibr" rid="ref48">Klochko et al., 2022</xref>), they face many professional challenges, including burnout (<xref ref-type="bibr" rid="ref45">Kabak and &#x00D6;zbak&#x0131;r, 2023</xref>). In Saudi Arabia, studies by <xref ref-type="bibr" rid="ref8">Al-Kharaan (2023)</xref> and <xref ref-type="bibr" rid="ref11">Al-Qahtani (2016)</xref> found that special education teachers suffer from high levels of burnout. This burnout affects not only the teachers but also the students and the schools they serve (<xref ref-type="bibr" rid="ref61">Nuri et al., 2017</xref>).</p>
<p>Herbert J. Freudenberger, a German physician and psychologist, was the first to describe the term <italic>burnout</italic> in his scientific paper &#x2018;Staff Burn-Out&#x2019; as &#x2018;being exhausted by making excessive demands on energy, strength or resources&#x2019; in the workplace (<xref ref-type="bibr" rid="ref31">Freudenberger, 1974</xref>, p. 159). The term was then developed by American psychologist Christina Maslach, one of the most prominent pioneers of burnout research. She developed the Maslach Burnout Inventory (MBI), which is still the most widely used inventory (<xref ref-type="bibr" rid="ref38">Heinemann and Heinemann, 2017</xref>). <xref ref-type="bibr" rid="ref54">Maslach and Leiter (2016)</xref> defined <italic>burnout</italic> as a psychological syndrome that manifests as a prolonged response to chronic personal stress at work, with three main dimensions: overwhelming exhaustion, feelings of cynicism and detachment from work, and feelings of ineffectiveness and lack of accomplishment. Despite the importance of this issue, the <xref ref-type="bibr" rid="ref86">World Health Organization (2019)</xref> has included burnout in the International Classification of Diseases (ICD-11) as an occupational phenomenon, not a disease. Burnout is a syndrome resulting from accumulated and chronic stressors in the workplace that have not been effectively and successfully managed, resulting in the depletion of an individual&#x2019;s energy, increased negative feelings about work and self, and decreased professional efficiency (<xref ref-type="bibr" rid="ref86">World Health Organization, 2019</xref>).</p>
<p>According to the above definitions, teacher burnout is a multidimensional syndrome characterised by emotional exhaustion, reduced performance, and detachment from personal relationships. Although not all teachers suffer from burnout, it is a serious professional problem that can undermine the quality of education and the well-being of teachers (<xref ref-type="bibr" rid="ref53">Mahmoodi-Shahrebabaki, 2019</xref>). According to <xref ref-type="bibr" rid="ref12">Al-Sharif (2020)</xref>, the symptoms of teacher burnout do not appear suddenly but are a process that grows gradually until the symptoms appear, and these symptoms can vary from one teacher to another. <xref ref-type="bibr" rid="ref7">Alfayez (2023)</xref> classified the symptoms of burnout as organic (physical), psychoemotional, and social. Burnout is closely related to the physical, psychological, and social health of teachers, which may negatively affect their effectiveness (<xref ref-type="bibr" rid="ref35">Hall and Goetz, 2013</xref>).</p>
<p>In recent decades, numerous scientific studies have indicated that special education teachers are more susceptible to burnout and attrition than general education teachers (<xref ref-type="bibr" rid="ref19">Brownell and Smith, 1992</xref>; <xref ref-type="bibr" rid="ref21">Brunsting et al., 2014</xref>; <xref ref-type="bibr" rid="ref16">Billingsley, 1993</xref>; <xref ref-type="bibr" rid="ref17">Boe et al., 1997</xref>; <xref ref-type="bibr" rid="ref25">DeMik, 2008</xref>; <xref ref-type="bibr" rid="ref30">Fore et al., 2002</xref>; <xref ref-type="bibr" rid="ref40">Hester et al., 2020</xref>; <xref ref-type="bibr" rid="ref9002">Jackson, 2023</xref>; <xref ref-type="bibr" rid="ref64">Plash and Piotrowski, 2005</xref>; <xref ref-type="bibr" rid="ref85">Williams and Dikes, 2015</xref>). The responsibilities and tasks of special education teachers are more than those of general education teachers in inclusive education settings (<xref ref-type="bibr" rid="ref50">Kumari et al., 2019</xref>; <xref ref-type="bibr" rid="ref67">Rogers and Johnson, 2018</xref>; <xref ref-type="bibr" rid="ref82">Tyagi, 2016</xref>; <xref ref-type="bibr" rid="ref85">Williams and Dikes, 2015</xref>). General education teachers are primarily responsible for all students, including students with disabilities, while the role of special education teachers is to provide consultation, support, and collaboration to address the needs of both general education teachers and students with disabilities within the classroom (<xref ref-type="bibr" rid="ref72">Shyman, 2015</xref>). Although special education teachers face barriers that require reconsideration of their roles and responsibilities, their duties are considered crucial in promoting inclusive education (<xref ref-type="bibr" rid="ref2">Abrol, 2023</xref>).</p>
<p>The sources and causes of burnout among special education teachers are diverse. Often, personal characteristics, such as sex, experience, educational level, and subspeciality, influence the level of burnout (<xref ref-type="bibr" rid="ref9">Al-Khatatba, 2021</xref>; <xref ref-type="bibr" rid="ref74">Stathopoulou et al., 2023</xref>; <xref ref-type="bibr" rid="ref63">Park and Shin, 2020</xref>). Some studies have found that female teachers are more likely to experience burnout than male teachers (<xref ref-type="bibr" rid="ref33">Garcia-Arroyo et al., 2019</xref>; <xref ref-type="bibr" rid="ref59">Nagar, 2012</xref>), while others have found that the opposite is true (<xref ref-type="bibr" rid="ref6">Al-dyiar and Salem, 2013</xref>; <xref ref-type="bibr" rid="ref15">Bayani et al., 2013</xref>; <xref ref-type="bibr" rid="ref34">Girgin and Baysal, 2005</xref>). Male teachers are affected by administrative and organisational issues and the school environment, while female teachers are more affected by psychological and physical reactions and workloads (<xref ref-type="bibr" rid="ref80">Tran, 2015</xref>; <xref ref-type="bibr" rid="ref81">Tsubono et al., 2024</xref>). Workload, lack of shared decision-making, and student misconduct are negatively associated with teacher burnout regardless of sex (<xref ref-type="bibr" rid="ref1">Ab&#x00F3;s et al., 2019</xref>).</p>
<p>Research on burnout among special education teachers and their experience shows mixed results. While some studies have found that more experienced teachers have higher burnout levels (<xref ref-type="bibr" rid="ref74">Stathopoulou et al., 2023</xref>; <xref ref-type="bibr" rid="ref85">Williams and Dikes, 2015</xref>), others have found that less experienced teachers have higher burnout levels (<xref ref-type="bibr" rid="ref21">Brunsting et al., 2014</xref>; <xref ref-type="bibr" rid="ref27">Duli, 2016</xref>; <xref ref-type="bibr" rid="ref29">Faskhodi and Siyyari, 2018</xref>). It can be argued that experience may not affect teacher burnout, but other factors, such as workload, school environment, emotional issues, organisational justice, and student misbehaviour (<xref ref-type="bibr" rid="ref28">El Helou et al., 2016</xref>; <xref ref-type="bibr" rid="ref57">Mota et al., 2023</xref>). Mindfulness, self-acceptance, and stress reduction training can help prevent or relieve burnout and improve the well-being of special education teachers (<xref ref-type="bibr" rid="ref76">Sun et al., 2019b</xref>).</p>
<p>Educational level is associated with burnout among special education teachers (<xref ref-type="bibr" rid="ref52">Llorent and Ruiz-Calzado, 2016</xref>; <xref ref-type="bibr" rid="ref71">Sezer, 2012</xref>). Those with higher degrees experience higher levels of burnout (<xref ref-type="bibr" rid="ref70">&#x015E;en, 2023</xref>). However, <xref ref-type="bibr" rid="ref41">Jamaludin and You (2019)</xref> argued that those with a bachelor&#x2019;s degree experience higher levels of burnout. Higher educational levels may positively influence psychological empowerment and reduce burnout among special education teachers in inclusive education schools (<xref ref-type="bibr" rid="ref22">Candeias et al., 2021</xref>; <xref ref-type="bibr" rid="ref66">Rashkovits and Livne, 2013</xref>). Regardless of educational level, lack of administrative support, role conflict, and role ambiguity positively contribute to teacher burnout (<xref ref-type="bibr" rid="ref63">Park and Shin, 2020</xref>). This leads to emotional exhaustion, depersonalisation, and reduced personal accomplishment among teachers (<xref ref-type="bibr" rid="ref46">Karanfil and Khatami, 2021</xref>). Positive support from general education teachers and school administrators can help reduce burnout among special education teachers (<xref ref-type="bibr" rid="ref51">Langher et al., 2017</xref>).</p>
<p>Teachers&#x2019; job specialisation affects their job satisfaction and burnout levels (<xref ref-type="bibr" rid="ref58">Mustafa and Ismail, 2020</xref>). Many studies have shown that special education teachers are more susceptible to burnout than general education teachers in inclusive education (<xref ref-type="bibr" rid="ref36">Hazan-Liran and Karni-Vizer, 2024</xref>; <xref ref-type="bibr" rid="ref39">Hemati and Moradi, 2021</xref>; <xref ref-type="bibr" rid="ref55">McGrew et al., 2023</xref>; <xref ref-type="bibr" rid="ref63">Park and Shin, 2020</xref>; <xref ref-type="bibr" rid="ref74">Stathopoulou et al., 2023</xref>; <xref ref-type="bibr" rid="ref77">Suvorov et al., 2021</xref>). Special education teachers in inclusive schools face significant challenges and difficulties that go beyond their teaching duties (<xref ref-type="bibr" rid="ref60">Nilsen, 2020</xref>). Moreover, burnout may vary among special education teachers themselves, depending on their subspeciality. The results from <xref ref-type="bibr" rid="ref9">Al-Khatatba (2021)</xref>, a study conducted in Saudi Arabia, showed that teachers of students with autism spectrum disorder (ASD) experienced higher levels of burnout than teachers of students with other disabilities. <xref ref-type="bibr" rid="ref79">Tahar et al. (2023)</xref> found that teachers of students with learning disabilities in integrated schools had low levels of burnout. Teachers&#x2019; negative attitudes towards disability in inclusive schools are associated with higher burnout rates (<xref ref-type="bibr" rid="ref68">Rohmer et al., 2024</xref>). Training and awareness programmes may help to change these negative attitudes and perceptions into positive ones (<xref ref-type="bibr" rid="ref78">Sze, 2009</xref>).</p>
<p>The literature on burnout levels among special education teachers in inclusive schools is lacking, especially in the Arab context. Researching and understanding this issue in depth is crucial for developing effective support mechanisms and intervention strategies that can help reduce the long-term effects of burnout, enhance teachers&#x2019; well-being, improve job performance, and create a healthier work environment. There is a gap in research that explores how factors such as sex, experience, educational level, and subspeciality intersect in the impact of burnout among special education teachers in inclusive schools. Examining these intersections may provide a more accurate understanding of the challenges faced by teachers in inclusive education settings. This research can help to address these research gaps in order to gain a more comprehensive understanding of the dynamics of burnout among special education teachers in inclusive schools and to attempt to reduce it by answering the following questions:</p>
<list list-type="order">
<list-item>
<p>What are the levels of burnout among special education teachers in inclusive education schools?</p>
</list-item>
<list-item>
<p>Are there differences in burnout levels among special education teachers in inclusive schools according to sex, experience, educational level, and subspeciality?</p>
</list-item>
</list>
</sec>
<sec sec-type="methods" id="sec2">
<label>2</label>
<title>Method</title>
<p>The current study followed the descriptive survey method because it was appropriate for the objectives and nature of the study. The descriptive survey method is considered one of the main methods used in behavioural and social research, focusing on examining reality or a phenomenon as it exists in the field and providing accurate numeric descriptions that clarify the magnitude and extent of that phenomenon (<xref ref-type="bibr" rid="ref24">Darwish, 2018</xref>). For example, surveys are among the most widely used methods in quantitative research (<xref ref-type="bibr" rid="ref43">Johnson et al., 2008</xref>).</p>
<sec id="sec3">
<label>2.1</label>
<title>Participants</title>
<p>This study was limited to special education teachers in inclusive education schools in Saudi Arabia, with 137 participating in the study. The sample was selected using simple random sampling. <xref ref-type="fig" rid="fig1">Figure 1</xref> shows the demographic data of the participants according to the study&#x2019;s variables (sex, experience, educational level, and subspeciality).</p>
<fig position="float" id="fig1">
<label>Figure 1</label>
<caption>
<p>Demographic data of participants.</p>
</caption>
<graphic xlink:href="feduc-09-1489820-g001.tif"/>
</fig>
</sec>
<sec id="sec4">
<label>2.2</label>
<title>Instrument</title>
<p>After reviewing the theoretical literature and previous studies related to burnout among special education teachers, the fourth edition of the Maslach Burnout Inventory (MBI) for educators was used. The MBI is a valid and reliable measurement tool that helps to identify teachers at risk of burnout (<xref ref-type="bibr" rid="ref9003">Trung et al., 2024</xref>). This scale consists of 22 items distributed across three main dimensions. The first dimension is emotional exhaustion and includes nine items (1, 2, 3, 6, 8, 13, 14, 16, and 20). The second dimension, depersonalization, contains five items (5, 10, 11, 15, and 22). The third dimension is personal accomplishment and includes eight items (4, 7, 9, 12, 17, 18, 19, and 21).</p>
<p>The MBI consists of a scale from 0 to 6. A score of 6 was given for the answer &#x2018;every day&#x2019;, a score of 5 for the answer &#x2018;a few times a week&#x2019;, a score of 4 for the answer &#x2018;once a week&#x2019;, a score of 3 for the answer &#x2018;a few times a month&#x2019;, a score of 2 for the answer &#x2018;once a month&#x2019;, a score of 1 for the answer &#x2018;a few times a year&#x2019;, and a score of 0 for the answer &#x2018;I do not suffer at all&#x2019;. <xref ref-type="fig" rid="fig2">Figure 2</xref> illustrates this.</p>
<fig position="float" id="fig2">
<label>Figure 2</label>
<caption>
<p>MBI scores.</p>
</caption>
<graphic xlink:href="feduc-09-1489820-g002.tif"/>
</fig>
<p>To calculate the burnout rating, the range between the highest and lowest scores was calculated and divided by the average number of categories to determine the rating range.</p>
<disp-formula id="E1">
<mml:math id="M1">
<mml:mn>2</mml:mn>
<mml:mo>=</mml:mo>
<mml:mfrac>
<mml:mrow>
<mml:mn>6</mml:mn>
<mml:mo>+</mml:mo>
<mml:mn>0</mml:mn>
</mml:mrow>
<mml:mn>3</mml:mn>
</mml:mfrac>
</mml:math>
</disp-formula>
<p>Based on this classification, the level of burnout is determined as follows: less than 2 is considered low, from 2 to less than 4 is considered moderate, and from 4 to less than 6 is considered high.</p>
</sec>
<sec id="sec5">
<label>2.3</label>
<title>Validity and reliability</title>
<p>Validity and reliability are important elements of research quality to ensure accurate and reliable results (<xref ref-type="bibr" rid="ref37">Heale and Twycross, 2015</xref>). <italic>Validity</italic> refers to the ability of the instrument to measure what it is designed to evaluate, while <italic>reliability</italic> refers to the consistency and stability of the scale (<xref ref-type="bibr" rid="ref56">Mohajan, 2017</xref>). To ensure the validity of the MBI for the participants, the instrument was reviewed by five professors from special education and psychology departments of Saudi universities. The researcher asked them to investigate the relevance and suitability of the instrument for measuring what it was designed to assess. They all confirmed its validity and suitability for use with the participants.</p>
<p>To evaluate the internal consistency of the MBI, it was administered to a pilot sample of 20 special education teachers in inclusive education schools. The internal consistency of the instrument was examined using Pearson&#x2019;s correlation coefficients. The first dimension, &#x2018;emotional exhaustion&#x2019;, ranged from 0.754 to 0.893. The second dimension, &#x2018;depersonalization&#x2019;, was between 0.631 and 0.897, and the third dimension, &#x2018;personal accomplishment&#x2019;, ranged from 0.732 and 0.807. These scores indicate that the MBI possesses acceptable internal consistency. The researcher also calculated McDonald&#x2019;s omega coefficients and Cronbach&#x2019;s alpha. All the consistency coefficients for the subdimensions and the total were very high, ranging from 0.872 to 0.891, indicating that the MBI has good internal consistency and accurately and reliably measured what it aimed to assess.</p>
</sec>
<sec id="sec6">
<label>2.4</label>
<title>Study procedure</title>
<p>After reviewing the theoretical literature and previous studies related to the current study topic, the instrument was prepared, and its validity and reliability were verified. A letter of approval was then obtained from Umm Al-Qura University to facilitate the task. The researcher shared and distributed the link to an electronic questionnaire among special education teachers in inclusive education schools via WhatsApp and email. Finally, the questionnaires were collected, audited, computerised, and statistically processed to answer the study questions and make appropriate recommendations in light of the findings of the study.</p>
</sec>
<sec id="sec7">
<label>2.5</label>
<title>Statistical methods</title>
<p>In accordance with the objectives and nature of the study, the Statistical Package for the Social Sciences (SPSS version 26) was used to analyse the study data. Descriptive statistics, such as Pearson&#x2019;s correlation coefficient, McDonald&#x2019;s omega coefficient, Cronbach&#x2019;s alpha, and multivariate analysis of variance (MANOVA), were used to extract the results of the study.</p>
</sec>
</sec>
<sec id="sec8">
<label>3</label>
<title>Findings</title>
<disp-quote>
<p>
<italic>Q-1) What are the levels of burnout among special education teachers in inclusive schools?</italic>
</p>
</disp-quote>
<p>The researcher calculated the means, standard deviations, percentages and levels of the special education teachers&#x2019; responses to the MBI&#x2019;s items. <xref ref-type="table" rid="tab1">Table 1</xref> shows this results.</p>
<table-wrap position="float" id="tab1">
<label>Table 1</label>
<caption>
<p>Results of the mean, standard deviation, percentage and level of MBI items.</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" valign="top">Dimension</th>
<th align="center" valign="top">
<italic>N</italic>
</th>
<th align="left" valign="top">Item</th>
<th align="center" valign="top">Mean</th>
<th align="center" valign="top">Std. deviation</th>
<th align="center" valign="top">Relative weight (%)</th>
<th align="left" valign="top">Level</th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="top" rowspan="10">Emotional exhaustion</td>
<td align="center" valign="middle">1</td>
<td align="left" valign="top">I feel that my job emotionally drains me due to the teaching process</td>
<td align="center" valign="middle">3.204</td>
<td align="center" valign="middle">1.960</td>
<td align="center" valign="middle">53</td>
<td align="left" valign="middle">Average</td>
</tr>
<tr>
<td align="center" valign="middle">2</td>
<td align="left" valign="middle">I feel that my energy is depleted by the end of the school day</td>
<td align="center" valign="middle">3.876</td>
<td align="center" valign="middle">1.880</td>
<td align="center" valign="middle">65</td>
<td align="left" valign="middle">Average</td>
</tr>
<tr>
<td align="center" valign="middle">3</td>
<td align="left" valign="middle">I feel exhausted when I wake up in the morning knowing I have to face a new workday</td>
<td align="center" valign="middle">3.175</td>
<td align="center" valign="middle">2.117</td>
<td align="center" valign="middle">53</td>
<td align="left" valign="middle">Average</td>
</tr>
<tr>
<td align="center" valign="middle">6</td>
<td align="left" valign="middle">Dealing with people all day long causes me stress</td>
<td align="center" valign="middle">2.949</td>
<td align="center" valign="middle">2.150</td>
<td align="center" valign="middle">49</td>
<td align="left" valign="middle">Average</td>
</tr>
<tr>
<td align="center" valign="middle">8</td>
<td align="left" valign="middle">I feel burned out from my work</td>
<td align="center" valign="middle">3.153</td>
<td align="center" valign="middle">2.152</td>
<td align="center" valign="middle">53</td>
<td align="left" valign="middle">Average</td>
</tr>
<tr>
<td align="center" valign="middle">13</td>
<td align="left" valign="middle">I feel frustrated with my teaching profession</td>
<td align="center" valign="middle">2.438</td>
<td align="center" valign="middle">2.219</td>
<td align="center" valign="middle">41</td>
<td align="left" valign="middle">Average</td>
</tr>
<tr>
<td align="center" valign="middle">14</td>
<td align="left" valign="middle">I feel that I am working in this profession with a lot of stress</td>
<td align="center" valign="middle">3.307</td>
<td align="center" valign="middle">2.205</td>
<td align="center" valign="middle">55</td>
<td align="left" valign="middle">Average</td>
</tr>
<tr>
<td align="center" valign="middle">16</td>
<td align="left" valign="middle">Directly working with people leads to severe pressure on me</td>
<td align="center" valign="middle">2.474</td>
<td align="center" valign="middle">2.163</td>
<td align="center" valign="middle">41</td>
<td align="left" valign="middle">Average</td>
</tr>
<tr>
<td align="center" valign="middle">20</td>
<td align="left" valign="middle">I feel as if I am nearing the end due to my profession</td>
<td align="center" valign="middle">2.190</td>
<td align="center" valign="middle">2.102</td>
<td align="center" valign="middle">37</td>
<td align="left" valign="middle">Average</td>
</tr>
<tr>
<td/>
<td align="left" valign="middle">Overall mean</td>
<td align="center" valign="middle">2.974</td>
<td align="center" valign="middle">1.734</td>
<td align="center" valign="middle">50</td>
<td align="left" valign="middle">Average</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="6">Depersonalization</td>
<td align="center" valign="middle">5</td>
<td align="left" valign="middle">I feel like I am dealing with some students as if they were objects, not people</td>
<td align="center" valign="middle">1.796</td>
<td align="center" valign="middle">2.160</td>
<td align="center" valign="middle">30</td>
<td align="left" valign="middle">Low</td>
</tr>
<tr>
<td align="center" valign="middle">110</td>
<td align="left" valign="middle">I have become more harsh with people due to my teaching job</td>
<td align="center" valign="middle">2.036</td>
<td align="center" valign="middle">2.201</td>
<td align="center" valign="middle">34</td>
<td align="left" valign="middle">Average</td>
</tr>
<tr>
<td align="center" valign="middle">11</td>
<td align="left" valign="middle">I feel annoyed and worried because my job increases my emotional coldness</td>
<td align="center" valign="middle">2.029</td>
<td align="center" valign="middle">2.294</td>
<td align="center" valign="middle">34</td>
<td align="left" valign="middle">Average</td>
</tr>
<tr>
<td align="center" valign="middle">15</td>
<td align="left" valign="middle">I actually do not care about the problems my students face</td>
<td align="center" valign="middle">1.642</td>
<td align="center" valign="middle">2.120</td>
<td align="center" valign="middle">27</td>
<td align="left" valign="middle">Low</td>
</tr>
<tr>
<td align="center" valign="middle">22</td>
<td align="left" valign="middle">I feel that students blame me for some of their problems</td>
<td align="center" valign="middle">1.591</td>
<td align="center" valign="middle">2.053</td>
<td align="center" valign="middle">27</td>
<td align="left" valign="middle">Low</td>
</tr>
<tr>
<td/>
<td align="left" valign="middle">Overall mean</td>
<td align="center" valign="middle">1.819</td>
<td align="center" valign="middle">1.855</td>
<td align="center" valign="middle">30</td>
<td align="left" valign="middle">Low</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="9">Personal accomplishment</td>
<td align="center" valign="middle">4</td>
<td align="left" valign="middle">It is easy to understand my students&#x2019; emotions</td>
<td align="center" valign="middle">3.876</td>
<td align="center" valign="middle">2.214</td>
<td align="center" valign="middle">65</td>
<td align="left" valign="middle">Average</td>
</tr>
<tr>
<td align="center" valign="middle">7</td>
<td align="left" valign="middle">I deal effectively with my students&#x2019; problems</td>
<td align="center" valign="middle">4.015</td>
<td align="center" valign="middle">2.139</td>
<td align="center" valign="middle">67</td>
<td align="left" valign="middle">High</td>
</tr>
<tr>
<td align="center" valign="middle">9</td>
<td align="left" valign="middle">I feel that I have a positive impact on many people through my work</td>
<td align="center" valign="middle">3.657</td>
<td align="center" valign="middle">2.052</td>
<td align="center" valign="middle">61</td>
<td align="left" valign="middle">Average</td>
</tr>
<tr>
<td align="center" valign="middle">12</td>
<td align="left" valign="middle">I feel energetic and active</td>
<td align="center" valign="middle">3.642</td>
<td align="center" valign="middle">1.988</td>
<td align="center" valign="middle">61</td>
<td align="left" valign="middle">Average</td>
</tr>
<tr>
<td align="center" valign="middle">17</td>
<td align="left" valign="middle">I can easily create a comfortable psychological environment with my students</td>
<td align="center" valign="middle">4.022</td>
<td align="center" valign="middle">2.123</td>
<td align="center" valign="middle">67</td>
<td align="left" valign="middle">High</td>
</tr>
<tr>
<td align="center" valign="middle">18</td>
<td align="left" valign="middle">I feel happy and comfortable after working with my students</td>
<td align="center" valign="middle">4.453</td>
<td align="center" valign="middle">1.886</td>
<td align="center" valign="middle">74</td>
<td align="left" valign="middle">High</td>
</tr>
<tr>
<td align="center" valign="middle">19</td>
<td align="left" valign="middle">I have achieved many valuable and significant things through my profession</td>
<td align="center" valign="middle">3.964</td>
<td align="center" valign="middle">1.983</td>
<td align="center" valign="middle">66</td>
<td align="left" valign="middle">Average</td>
</tr>
<tr>
<td align="center" valign="middle">21</td>
<td align="left" valign="middle">I handle emotional and affective problems calmly in my profession</td>
<td align="center" valign="middle">3.796</td>
<td align="center" valign="middle">1.986</td>
<td align="center" valign="middle">63</td>
<td align="left" valign="middle">Average</td>
</tr>
<tr>
<td/>
<td align="left" valign="middle">Overall mean</td>
<td align="center" valign="middle">3.928</td>
<td align="center" valign="middle">1.554</td>
<td align="center" valign="middle">66</td>
<td align="left" valign="middle">Average</td>
</tr>
<tr>
<td/>
<td/>
<td align="left" valign="middle">Overall mean of burnout</td>
<td align="center" valign="middle">2.907</td>
<td align="center" valign="middle">1.360</td>
<td align="center" valign="middle">48</td>
<td align="left" valign="middle">Average</td>
</tr>
</tbody>
</table>
</table-wrap>
<p><xref ref-type="table" rid="tab1">Table 1</xref> illustrates that the level of emotional exhaustion among special education teachers is average, with an arithmetic mean of 2.974 and a relative weight of 49.60%. In addition, the data indicate that the level of depersonalization among special education teachers is very low, with an arithmetic mean of 1.819 and a relative weight of 30.30%. Regarding personal accomplishment among special education teachers, the data indicate that it is at an average level, with an arithmetic mean of 3.928 and a relative weight of 65.50%.</p>
<p>Overall, the level of burnout among special education teachers in inclusive schools was average, with a general arithmetic mean of 2.907 and a relative weight of 48.40%. This indicates that teachers suffer from an average level of burnout because it does not reach very high levels but still requires attention and improvement. These results highlight the importance of providing continuous support and ameliorating work strategies to ensure an enhanced work experience and reduce burnout among teachers.</p>
<disp-quote>
<p>
<italic>Q-2) Are there differences in burnout levels among special education teachers in inclusive education schools according to the variables (sex, experience, educational level and subspeciality)?</italic>
</p>
</disp-quote>
<p>To evaluate the differences between the average scores of special education teachers in inclusive education schools on the MBI according to the previous variables, multivariate analysis of variance (MANOVA) was used. <xref ref-type="table" rid="tab2">Table 2</xref> demonstrates the results of the tests, indicating the significance of the differences between the groups.</p>
<table-wrap position="float" id="tab2">
<label>Table 2</label>
<caption>
<p>Statistical significance tests for multivariate analysis of variance between groups regarding burnout according to the variables of sex, experience, educational level, and subspeciality.</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" valign="top" colspan="2">Effect</th>
<th align="center" valign="top">Value</th>
<th align="center" valign="top">
<italic>F</italic>
</th>
<th align="center" valign="top">Hypothesis df</th>
<th align="center" valign="top">Error df</th>
<th align="center" valign="top">Sig.</th>
<th align="center" valign="top">Partial &#x03B7;<sup>2</sup></th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="top" rowspan="4">Intercept</td>
<td align="left" valign="top">Pillai&#x2019;s Trace</td>
<td align="center" valign="top">0.833</td>
<td align="center" valign="top">168.042</td>
<td align="center" valign="top">3.000</td>
<td align="center" valign="top">101.000</td>
<td align="center" valign="top">0.000</td>
<td align="center" valign="top">0.833</td>
</tr>
<tr>
<td align="left" valign="top">Wilks&#x2019; Lambda</td>
<td align="center" valign="top">0.167</td>
<td align="center" valign="top">168.042</td>
<td align="center" valign="top">3.000</td>
<td align="center" valign="top">101.000</td>
<td align="center" valign="top">0.000</td>
<td align="center" valign="top">0.833</td>
</tr>
<tr>
<td align="left" valign="top">Hotelling&#x2019;s Trace</td>
<td align="center" valign="top">4.991</td>
<td align="center" valign="top">168.042</td>
<td align="center" valign="top">3.000</td>
<td align="center" valign="top">101.000</td>
<td align="center" valign="top">0.000</td>
<td align="center" valign="top">0.833</td>
</tr>
<tr>
<td align="left" valign="top">Roy&#x2019;s Largest Root</td>
<td align="center" valign="top">1.649</td>
<td align="center" valign="top">168.042</td>
<td align="center" valign="top">3.000</td>
<td align="center" valign="top">101.000</td>
<td align="center" valign="top">0.000</td>
<td align="center" valign="top">0.833</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="4">Sex</td>
<td align="left" valign="top">Pillai&#x2019;s Trace</td>
<td align="center" valign="top">0.139</td>
<td align="center" valign="top">5.450</td>
<td align="center" valign="top">6.000</td>
<td align="center" valign="top">101.000</td>
<td align="center" valign="top">0.002</td>
<td align="center" valign="top">0.139</td>
</tr>
<tr>
<td align="left" valign="top">Wilks&#x2019; Lambda</td>
<td align="center" valign="top">0.861</td>
<td align="center" valign="top">5.450</td>
<td align="center" valign="top">6.000</td>
<td align="center" valign="top">101.000</td>
<td align="center" valign="top">0.002</td>
<td align="center" valign="top">0.139</td>
</tr>
<tr>
<td align="left" valign="top">Hotelling&#x2019;s Trace</td>
<td align="center" valign="top">0.162</td>
<td align="center" valign="top">5.450</td>
<td align="center" valign="top">6.000</td>
<td align="center" valign="top">101.000</td>
<td align="center" valign="top">0.002</td>
<td align="center" valign="top">0.139</td>
</tr>
<tr>
<td align="left" valign="top">Roy&#x2019;s Largest Root</td>
<td align="center" valign="top">0.162</td>
<td align="center" valign="top">5.450</td>
<td align="center" valign="top">3.000</td>
<td align="center" valign="top">101.000</td>
<td align="center" valign="top">0.002</td>
<td align="center" valign="top">0.139</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="4">Experience</td>
<td align="left" valign="top">Pillai&#x2019;s Trace</td>
<td align="center" valign="top">0.035</td>
<td align="center" valign="top">0.602</td>
<td align="center" valign="top">6.000</td>
<td align="center" valign="top">204.000</td>
<td align="center" valign="top">0.729</td>
<td align="center" valign="top">0.017</td>
</tr>
<tr>
<td align="left" valign="top">Wilks&#x2019; Lambda</td>
<td align="center" valign="top">0.965</td>
<td align="center" valign="top">0.597</td>
<td align="center" valign="top">6.000</td>
<td align="center" valign="top">202.000</td>
<td align="center" valign="top">0.733</td>
<td align="center" valign="top">0.017</td>
</tr>
<tr>
<td align="left" valign="top">Hotelling&#x2019;s Trace</td>
<td align="center" valign="top">0.036</td>
<td align="center" valign="top">0.592</td>
<td align="center" valign="top">6.000</td>
<td align="center" valign="top">200.000</td>
<td align="center" valign="top">0.736</td>
<td align="center" valign="top">0.017</td>
</tr>
<tr>
<td align="left" valign="top">Roy&#x2019;s Largest Root</td>
<td align="center" valign="top">0.026</td>
<td align="center" valign="top">0.889</td>
<td align="center" valign="top">3.000</td>
<td align="center" valign="top">102.000</td>
<td align="center" valign="top">0.449</td>
<td align="center" valign="top">0.025</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="4">Education level</td>
<td align="left" valign="top">Pillai&#x2019;s Trace</td>
<td align="center" valign="top">0.048</td>
<td align="center" valign="top">1.870</td>
<td align="center" valign="top">3.000</td>
<td align="center" valign="top">101.000</td>
<td align="center" valign="top">0.170</td>
<td align="center" valign="top">0.048</td>
</tr>
<tr>
<td align="left" valign="top">Wilks&#x2019; Lambda</td>
<td align="center" valign="top">0.952</td>
<td align="center" valign="top">1.870</td>
<td align="center" valign="top">3.000</td>
<td align="center" valign="top">101.000</td>
<td align="center" valign="top">0.170</td>
<td align="center" valign="top">0.048</td>
</tr>
<tr>
<td align="left" valign="top">Hotelling&#x2019;s Trace</td>
<td align="center" valign="top">0.051</td>
<td align="center" valign="top">1.870</td>
<td align="center" valign="top">3.000</td>
<td align="center" valign="top">101.000</td>
<td align="center" valign="top">0.170</td>
<td align="center" valign="top">0.048</td>
</tr>
<tr>
<td align="left" valign="top">Roy&#x2019;s Largest Root</td>
<td align="center" valign="top">0.051</td>
<td align="center" valign="top">1.870</td>
<td align="center" valign="top">3.000</td>
<td align="center" valign="top">101.000</td>
<td align="center" valign="top">0.170</td>
<td align="center" valign="top">0.048</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="4">Subspeciality</td>
<td align="left" valign="top">Pillai&#x2019;s Trace</td>
<td align="center" valign="top">0.475</td>
<td align="center" valign="top">3.874</td>
<td align="center" valign="top">15.000</td>
<td align="center" valign="top">309.000</td>
<td align="center" valign="top">0.000</td>
<td align="center" valign="top">0.158</td>
</tr>
<tr>
<td align="left" valign="top">Wilks&#x2019; Lambda</td>
<td align="center" valign="top">0.582</td>
<td align="center" valign="top">4.038</td>
<td align="center" valign="top">15.000</td>
<td align="center" valign="top">279.218</td>
<td align="center" valign="top">0.000</td>
<td align="center" valign="top">0.165</td>
</tr>
<tr>
<td align="left" valign="top">Hotelling&#x2019;s Trace</td>
<td align="center" valign="top">0.622</td>
<td align="center" valign="top">4.136</td>
<td align="center" valign="top">15.000</td>
<td align="center" valign="top">299.000</td>
<td align="center" valign="top">0.000</td>
<td align="center" valign="top">0.172</td>
</tr>
<tr>
<td align="left" valign="top">Roy&#x2019;s Largest Root</td>
<td align="center" valign="top">0.345</td>
<td align="center" valign="top">7.108</td>
<td align="center" valign="top">5.000</td>
<td align="center" valign="top">103.000</td>
<td align="center" valign="top">0.000</td>
<td align="center" valign="top">0.257</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="4">Sex and experience</td>
<td align="left" valign="top">Pillai&#x2019;s Trace</td>
<td align="center" valign="top">0.050</td>
<td align="center" valign="top">0.878</td>
<td align="center" valign="top">6.000</td>
<td align="center" valign="top">204.000</td>
<td align="center" valign="top">0.512</td>
<td align="center" valign="top">0.025</td>
</tr>
<tr>
<td align="left" valign="top">Wilks&#x2019; Lambda</td>
<td align="center" valign="top">0.950</td>
<td align="center" valign="top">0.878</td>
<td align="center" valign="top">6.000</td>
<td align="center" valign="top">202.000</td>
<td align="center" valign="top">0.512</td>
<td align="center" valign="top">0.025</td>
</tr>
<tr>
<td align="left" valign="top">Hotelling&#x2019;s Trace</td>
<td align="center" valign="top">0.053</td>
<td align="center" valign="top">0.879</td>
<td align="center" valign="top">6.000</td>
<td align="center" valign="top">200.000</td>
<td align="center" valign="top">0.511</td>
<td align="center" valign="top">0.026</td>
</tr>
<tr>
<td align="left" valign="top">Roy&#x2019;s Largest Root</td>
<td align="center" valign="top">0.050</td>
<td align="center" valign="top">1.702</td>
<td align="center" valign="top">3.000</td>
<td align="center" valign="top">102.000</td>
<td align="center" valign="top">0.171</td>
<td align="center" valign="top">0.048</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="4">Sex and education level</td>
<td align="left" valign="top">Pillai&#x2019;s Trace</td>
<td align="center" valign="top">0.072</td>
<td align="center" valign="top">2.623</td>
<td align="center" valign="top">3.000</td>
<td align="center" valign="top">101.000</td>
<td align="center" valign="top">0.055</td>
<td align="center" valign="top">0.072</td>
</tr>
<tr>
<td align="left" valign="top">Wilks&#x2019; Lambda</td>
<td align="center" valign="top">0.928</td>
<td align="center" valign="top">2.623</td>
<td align="center" valign="top">3.000</td>
<td align="center" valign="top">101.000</td>
<td align="center" valign="top">0.055</td>
<td align="center" valign="top">0.072</td>
</tr>
<tr>
<td align="left" valign="top">Hotelling&#x2019;s Trace</td>
<td align="center" valign="top">0.078</td>
<td align="center" valign="top">2.623</td>
<td align="center" valign="top">3.000</td>
<td align="center" valign="top">101.000</td>
<td align="center" valign="top">0.055</td>
<td align="center" valign="top">0.072</td>
</tr>
<tr>
<td align="left" valign="top">Roy&#x2019;s Largest Root</td>
<td align="center" valign="top">0.078</td>
<td align="center" valign="top">2.623</td>
<td align="center" valign="top">3.000</td>
<td align="center" valign="top">101.000</td>
<td align="center" valign="top">0.055</td>
<td align="center" valign="top">0.072</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="4">Sex and subspeciality</td>
<td align="left" valign="top">Pillai&#x2019;s Trace</td>
<td align="center" valign="top">0.205</td>
<td align="center" valign="top">1.509</td>
<td align="center" valign="top">15.000</td>
<td align="center" valign="top">309.000</td>
<td align="center" valign="top">0.100</td>
<td align="center" valign="top">0.068</td>
</tr>
<tr>
<td align="left" valign="top">Wilks&#x2019; Lambda</td>
<td align="center" valign="top">0.804</td>
<td align="center" valign="top">1.528</td>
<td align="center" valign="top">15.000</td>
<td align="center" valign="top">279.218</td>
<td align="center" valign="top">0.095</td>
<td align="center" valign="top">0.070</td>
</tr>
<tr>
<td align="left" valign="top">Hotelling&#x2019;s Trace</td>
<td align="center" valign="top">0.232</td>
<td align="center" valign="top">1.542</td>
<td align="center" valign="top">15.000</td>
<td align="center" valign="top">299.000</td>
<td align="center" valign="top">0.089</td>
<td align="center" valign="top">0.072</td>
</tr>
<tr>
<td align="left" valign="top">Roy&#x2019;s Largest Root</td>
<td align="center" valign="top">0.165</td>
<td align="center" valign="top">3.392</td>
<td align="center" valign="top">5.000</td>
<td align="center" valign="top">103.000</td>
<td align="center" valign="top">0.007</td>
<td align="center" valign="top">0.141</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="4">Experience and education level</td>
<td align="left" valign="top">Pillai&#x2019;s Trace</td>
<td align="center" valign="top">0.049</td>
<td align="center" valign="top">0.846</td>
<td align="center" valign="top">6.000</td>
<td align="center" valign="top">204.000</td>
<td align="center" valign="top">0.536</td>
<td align="center" valign="top">0.024</td>
</tr>
<tr>
<td align="left" valign="top">Wilks&#x2019; Lambda</td>
<td align="center" valign="top">0.952</td>
<td align="center" valign="top">0.838</td>
<td align="center" valign="top">6.000</td>
<td align="center" valign="top">202.000</td>
<td align="center" valign="top">0.542</td>
<td align="center" valign="top">0.024</td>
</tr>
<tr>
<td align="left" valign="top">Hotelling&#x2019;s Trace</td>
<td align="center" valign="top">0.050</td>
<td align="center" valign="top">0.830</td>
<td align="center" valign="top">6.000</td>
<td align="center" valign="top">200.000</td>
<td align="center" valign="top">0.548</td>
<td align="center" valign="top">0.024</td>
</tr>
<tr>
<td align="left" valign="top">Roy&#x2019;s Largest Root</td>
<td align="center" valign="top">0.030</td>
<td align="center" valign="top">1.011</td>
<td align="center" valign="top">3.000</td>
<td align="center" valign="top">102.000</td>
<td align="center" valign="top">0.391</td>
<td align="center" valign="top">0.029</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="4">Experience and subspeciality</td>
<td align="left" valign="top">Pillai&#x2019;s Trace</td>
<td align="center" valign="top">0.253</td>
<td align="center" valign="top">1.054</td>
<td align="center" valign="top">27.000</td>
<td align="center" valign="top">309.000</td>
<td align="center" valign="top">0.396</td>
<td align="center" valign="top">0.084</td>
</tr>
<tr>
<td align="left" valign="top">Wilks&#x2019; Lambda</td>
<td align="center" valign="top">0.763</td>
<td align="center" valign="top">1.062</td>
<td align="center" valign="top">27.000</td>
<td align="center" valign="top">295.614</td>
<td align="center" valign="top">0.385</td>
<td align="center" valign="top">0.086</td>
</tr>
<tr>
<td align="left" valign="top">Hotelling&#x2019;s Trace</td>
<td align="center" valign="top">0.290</td>
<td align="center" valign="top">1.070</td>
<td align="center" valign="top">27.000</td>
<td align="center" valign="top">299.000</td>
<td align="center" valign="top">0.375</td>
<td align="center" valign="top">0.088</td>
</tr>
<tr>
<td align="left" valign="top">Roy&#x2019;s Largest Root</td>
<td align="center" valign="top">0.197</td>
<td align="center" valign="top">2.260</td>
<td align="center" valign="top">9.000</td>
<td align="center" valign="top">103.000</td>
<td align="center" valign="top">0.024</td>
<td align="center" valign="top">0.0165</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="4">Education level and subspeciality</td>
<td align="left" valign="top">Pillai&#x2019;s Trace</td>
<td align="center" valign="top">0.218</td>
<td align="center" valign="top">1.615</td>
<td align="center" valign="top">15.000</td>
<td align="center" valign="top">309.000</td>
<td align="center" valign="top">0.068</td>
<td align="center" valign="top">0.073</td>
</tr>
<tr>
<td align="left" valign="top">Wilks&#x2019; Lambda</td>
<td align="center" valign="top">0.795</td>
<td align="center" valign="top">1.615</td>
<td align="center" valign="top">15.000</td>
<td align="center" valign="top">279.767</td>
<td align="center" valign="top">0.069</td>
<td align="center" valign="top">0.074</td>
</tr>
<tr>
<td align="left" valign="top">Hotelling&#x2019;s Trace</td>
<td align="center" valign="top">0.242</td>
<td align="center" valign="top">1.609</td>
<td align="center" valign="top">15.000</td>
<td align="center" valign="top">299.000</td>
<td align="center" valign="top">0.070</td>
<td align="center" valign="top">0.075</td>
</tr>
<tr>
<td align="left" valign="top">Roy&#x2019;s Largest Root</td>
<td align="center" valign="top">0.151</td>
<td align="center" valign="top">3.110</td>
<td align="center" valign="top">5.000</td>
<td align="center" valign="top">103.000</td>
<td align="center" valign="top">0.012</td>
<td align="center" valign="top">0.131</td>
</tr>
</tbody>
</table>
</table-wrap>
<p><xref ref-type="table" rid="tab2">Table 2</xref> indicates that the overall model had a significant impact on the studied variables, with a Pillai&#x2019;s Trace value of 0.833, <italic>F</italic>(3, 101)&#x202F;=&#x202F;168.042, <italic>p</italic>&#x202F;&#x003C;&#x202F;0.001 and &#x03B7;<sup>2</sup>&#x202F;=&#x202F;0.833. This suggests that the independent variables had a substantial influence on the dependent variables studied.</p>
<p>Moreover, sex had a notable effect, with a Pillai&#x2019;s Trace value of 0.139, <italic>F</italic>(3, 101)&#x202F;=&#x202F;5.450, <italic>p</italic>&#x202F;=&#x202F;0.002 and &#x03B7;<sup>2</sup>&#x202F;=&#x202F;0.139, indicating that sex significantly contributes to explaining differences in the dependent variables.</p>
<p>Regarding the experience variable, it did not show any significant impact, with a Pillai&#x2019;s Trace value of 0.035, <italic>F</italic>(6, 204)&#x202F;=&#x202F;0.602, <italic>p</italic>&#x202F;=&#x202F;0.729 and &#x03B7;<sup>2</sup>&#x202F;=&#x202F;0.017, indicating that experience did not significantly affect the dependent variables. Similarly, educational level did not reveal a significant effect, with a Pillai&#x2019;s Trace value of 0.048, F(3, 101)&#x202F;=&#x202F;1.708, <italic>p</italic>&#x202F;=&#x202F;0.170 and &#x03B7;<sup>2</sup>&#x202F;=&#x202F;0.048.</p>
<p>Conversely, the subspeciality had a significant effect on the studied variables, with a Pillai&#x2019;s Trace value of 0.475, <italic>F</italic>(15, 309)&#x202F;=&#x202F;3.874, p&#x202F;&#x003C;&#x202F;0.001 and &#x03B7;<sup>2</sup>&#x202F;=&#x202F;0.158, indicating that the subspeciality notably affects the differences in the dependent variables.</p>
<p>As for the interactions between the variables, such as sex and experience, sex and educational level, sex and subspeciality, experience and educational level, experience and subspeciality and educational level and subspeciality did not have a significant effect on the studied variables.</p>
<p><xref ref-type="table" rid="tab3">Table 3</xref> emphasizes the significant effect of sex on all the dependent variables measured. The results displayed a significant effect on emotional exhaustion (<italic>F</italic>&#x202F;=&#x202F;6.048, <italic>p</italic>&#x202F;=&#x202F;0.016 and &#x03B7;<sup>2</sup>&#x202F;=&#x202F;0.055), depersonalization (<italic>F</italic>&#x202F;=&#x202F;3.559, <italic>p</italic>&#x202F;=&#x202F;0.062 and &#x03B7;<sup>2</sup>&#x202F;=&#x202F;0.033), personal accomplishment (<italic>F</italic>&#x202F;=&#x202F;15.061, <italic>p</italic>&#x202F;=&#x202F;0.000 and &#x03B7;<sup>2</sup>&#x202F;=&#x202F;0.128) and overall burnout level (<italic>F</italic>&#x202F;=&#x202F;12.012, <italic>p</italic>&#x202F;=&#x202F;0.001 and &#x03B7;<sup>2</sup>&#x202F;=&#x202F;0.104). Pairwise comparisons revealed that males had markedly higher levels of emotional exhaustion, depersonalization, personal accomplishment and overall burnout compared to females, with all differences being statistically significant at the 0.05 level.</p>
<table-wrap position="float" id="tab3">
<label>Table 3</label>
<caption>
<p>Results of the four-way multivariate analysis of variance of the dimensions and the instrument.</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="left" valign="top">Dependent variable</th>
<th align="left" valign="top">Dimension</th>
<th align="center" valign="top">Type III sum of squares</th>
<th align="center" valign="top">df</th>
<th align="center" valign="top">Mean square</th>
<th align="center" valign="top">
<italic>F</italic>
</th>
<th align="center" valign="top">Sig.</th>
<th align="center" valign="top">Partial &#x03B7;<sup>2</sup></th>
</tr>
</thead>
<tbody>
<tr>
<td align="left" valign="top" rowspan="4">Corrected model</td>
<td align="left" valign="top">Emotional exhaustion</td>
<td align="center" valign="top">259.354</td>
<td align="center" valign="top">33</td>
<td align="center" valign="top">7.4859</td>
<td align="center" valign="top">5.402</td>
<td align="center" valign="top">0.000</td>
<td align="center" valign="top">0.634</td>
</tr>
<tr>
<td align="left" valign="top">Depersonalization</td>
<td align="center" valign="top">229.465</td>
<td align="center" valign="top">33</td>
<td align="center" valign="top">6.953</td>
<td align="center" valign="top">3.005</td>
<td align="center" valign="top">0.000</td>
<td align="center" valign="top">0.490</td>
</tr>
<tr>
<td align="left" valign="top">Personal accomplishment</td>
<td align="center" valign="top">222.356</td>
<td align="center" valign="top">33</td>
<td align="center" valign="top">6.738</td>
<td align="center" valign="top">6.536</td>
<td align="center" valign="top">0.000</td>
<td align="center" valign="top">0.677</td>
</tr>
<tr>
<td align="left" valign="top">Overall level of burnout</td>
<td align="center" valign="top">188.933</td>
<td align="center" valign="top">33</td>
<td align="center" valign="top">5.725</td>
<td align="center" valign="top">6.476</td>
<td align="center" valign="top">0.000</td>
<td align="center" valign="top">0.675</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="4">Intercept</td>
<td align="left" valign="top">Emotional exhaustion</td>
<td align="center" valign="top">290.449</td>
<td align="center" valign="top">1</td>
<td align="center" valign="top">290.449</td>
<td align="center" valign="top">199.640</td>
<td align="center" valign="top">0.000</td>
<td align="center" valign="top">0.660</td>
</tr>
<tr>
<td align="left" valign="top">Depersonalization</td>
<td align="center" valign="top">128.601</td>
<td align="center" valign="top">1</td>
<td align="center" valign="top">128.601</td>
<td align="center" valign="top">55.570</td>
<td align="center" valign="top">0.000</td>
<td align="center" valign="top">0.350</td>
</tr>
<tr>
<td align="left" valign="top">Personal accomplishment</td>
<td align="center" valign="top">514.628</td>
<td align="center" valign="top">1</td>
<td align="center" valign="top">514.628</td>
<td align="center" valign="top">499.226</td>
<td align="center" valign="top">0.000</td>
<td align="center" valign="top">0.829</td>
</tr>
<tr>
<td align="left" valign="top">Overall level of burnout</td>
<td align="center" valign="top">289.773</td>
<td align="center" valign="top">1</td>
<td align="center" valign="top">289.773</td>
<td align="center" valign="top">327.775</td>
<td align="center" valign="top">0.000</td>
<td align="center" valign="top">0.761</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="4">Sex</td>
<td align="left" valign="top">Emotional exhaustion</td>
<td align="center" valign="top">8.799</td>
<td align="center" valign="top">1</td>
<td align="center" valign="top">8.799</td>
<td align="center" valign="top">6.048</td>
<td align="center" valign="top">0.016</td>
<td align="center" valign="top">0.055</td>
</tr>
<tr>
<td align="left" valign="top">Depersonalization</td>
<td align="center" valign="top">8.236</td>
<td align="center" valign="top">1</td>
<td align="center" valign="top">8.236</td>
<td align="center" valign="top">3.559</td>
<td align="center" valign="top">0.062</td>
<td align="center" valign="top">0.33</td>
</tr>
<tr>
<td align="left" valign="top">Personal accomplishment</td>
<td align="center" valign="top">15.526</td>
<td align="center" valign="top">1</td>
<td align="center" valign="top">15.526</td>
<td align="center" valign="top">15.061</td>
<td align="center" valign="top">0.000</td>
<td align="center" valign="top">0.128</td>
</tr>
<tr>
<td align="left" valign="top">Overall level of burnout</td>
<td align="center" valign="top">10.620</td>
<td align="center" valign="top">1</td>
<td align="center" valign="top">10.620</td>
<td align="center" valign="top">12.012</td>
<td align="center" valign="top">0.001</td>
<td align="center" valign="top">0.104</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="4">Experience</td>
<td align="left" valign="top">Emotional exhaustion</td>
<td align="center" valign="top">1.295</td>
<td align="center" valign="top">2</td>
<td align="center" valign="top">0.647</td>
<td align="center" valign="top">0.445</td>
<td align="center" valign="top">0.642</td>
<td align="center" valign="top">0.009</td>
</tr>
<tr>
<td align="left" valign="top">Depersonalization</td>
<td align="center" valign="top">3.382</td>
<td align="center" valign="top">2</td>
<td align="center" valign="top">1.691</td>
<td align="center" valign="top">0.731</td>
<td align="center" valign="top">0.484</td>
<td align="center" valign="top">0.014</td>
</tr>
<tr>
<td align="left" valign="top">Personal accomplishment</td>
<td align="center" valign="top">2.415</td>
<td align="center" valign="top">2</td>
<td align="center" valign="top">1.207</td>
<td align="center" valign="top">1.171</td>
<td align="center" valign="top">0.314</td>
<td align="center" valign="top">0.022</td>
</tr>
<tr>
<td align="left" valign="top">Overall level of burnout</td>
<td align="center" valign="top">1.814</td>
<td align="center" valign="top">2</td>
<td align="center" valign="top">0.907</td>
<td align="center" valign="top">1.026</td>
<td align="center" valign="top">0.362</td>
<td align="center" valign="top">0.020</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="4">Educational Level</td>
<td align="left" valign="top">Emotional exhaustion</td>
<td align="center" valign="top">0.600</td>
<td align="center" valign="top">1</td>
<td align="center" valign="top">0.600</td>
<td align="center" valign="top">0.413</td>
<td align="center" valign="top">0.522</td>
<td align="center" valign="top">0.004</td>
</tr>
<tr>
<td align="left" valign="top">Depersonalization</td>
<td align="center" valign="top">6.695</td>
<td align="center" valign="top">1</td>
<td align="center" valign="top">6.695</td>
<td align="center" valign="top">2.893</td>
<td align="center" valign="top">0.092</td>
<td align="center" valign="top">0.027</td>
</tr>
<tr>
<td align="left" valign="top">Personal accomplishment</td>
<td align="center" valign="top">1.239</td>
<td align="center" valign="top">1</td>
<td align="center" valign="top">1.239</td>
<td align="center" valign="top">1.202</td>
<td align="center" valign="top">0.275</td>
<td align="center" valign="top">0.012</td>
</tr>
<tr>
<td align="left" valign="top">Overall level of burnout</td>
<td align="center" valign="top">0.054</td>
<td align="center" valign="top">1</td>
<td align="center" valign="top">0.054</td>
<td align="center" valign="top">0.061</td>
<td align="center" valign="top">0.805</td>
<td align="center" valign="top">0.001</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="4">Subspeciality</td>
<td align="left" valign="top">Emotional exhaustion</td>
<td align="center" valign="top">42.685</td>
<td align="center" valign="top">5</td>
<td align="center" valign="top">8.537</td>
<td align="center" valign="top">5.868</td>
<td align="center" valign="top">0.000</td>
<td align="center" valign="top">0.222</td>
</tr>
<tr>
<td align="left" valign="top">Depersonalization</td>
<td align="center" valign="top">58.756</td>
<td align="center" valign="top">5</td>
<td align="center" valign="top">11.751</td>
<td align="center" valign="top">5.078</td>
<td align="center" valign="top">0.000</td>
<td align="center" valign="top">0.198</td>
</tr>
<tr>
<td align="left" valign="top">Personal accomplishment</td>
<td align="center" valign="top">20.437</td>
<td align="center" valign="top">5</td>
<td align="center" valign="top">4.087</td>
<td align="center" valign="top">3.965</td>
<td align="center" valign="top">0.002</td>
<td align="center" valign="top">0.161</td>
</tr>
<tr>
<td align="left" valign="top">Overall level of burnout</td>
<td align="center" valign="top">20.444</td>
<td align="center" valign="top">5</td>
<td align="center" valign="top">4.089</td>
<td align="center" valign="top">4.625</td>
<td align="center" valign="top">0.001</td>
<td align="center" valign="top">0.183</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="4">Sex and experience</td>
<td align="left" valign="top">Emotional exhaustion</td>
<td align="center" valign="top">1.893</td>
<td align="center" valign="top">2</td>
<td align="center" valign="top">0.946</td>
<td align="center" valign="top">0.651</td>
<td align="center" valign="top">0.524</td>
<td align="center" valign="top">0.012</td>
</tr>
<tr>
<td align="left" valign="top">Depersonalization</td>
<td align="center" valign="top">5.776</td>
<td align="center" valign="top">2</td>
<td align="center" valign="top">2.888</td>
<td align="center" valign="top">1.248</td>
<td align="center" valign="top">0.291</td>
<td align="center" valign="top">0.024</td>
</tr>
<tr>
<td align="left" valign="top">Personal accomplishment</td>
<td align="center" valign="top">0.734</td>
<td align="center" valign="top">2</td>
<td align="center" valign="top">0.367</td>
<td align="center" valign="top">0.356</td>
<td align="center" valign="top">0.701</td>
<td align="center" valign="top">0.007</td>
</tr>
<tr>
<td align="left" valign="top">Overall level of burnout</td>
<td align="center" valign="top">1.181</td>
<td align="center" valign="top">2</td>
<td align="center" valign="top">0.591</td>
<td align="center" valign="top">0.668</td>
<td align="center" valign="top">0.515</td>
<td align="center" valign="top">0.013</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="4">Sex and educational level</td>
<td align="left" valign="top">Emotional exhaustion</td>
<td align="center" valign="top">9.954</td>
<td align="center" valign="top">1</td>
<td align="center" valign="top">9.954</td>
<td align="center" valign="top">6.842</td>
<td align="center" valign="top">0.010</td>
<td align="center" valign="top">0.062</td>
</tr>
<tr>
<td align="left" valign="top">Depersonalization</td>
<td align="center" valign="top">4.448</td>
<td align="center" valign="top">1</td>
<td align="center" valign="top">4.448</td>
<td align="center" valign="top">1.922</td>
<td align="center" valign="top">0.169</td>
<td align="center" valign="top">0.018</td>
</tr>
<tr>
<td align="left" valign="top">Personal accomplishment</td>
<td align="center" valign="top">0.517</td>
<td align="center" valign="top">1</td>
<td align="center" valign="top">0.517</td>
<td align="center" valign="top">0.502</td>
<td align="center" valign="top">0.480</td>
<td align="center" valign="top">0.005</td>
</tr>
<tr>
<td align="left" valign="top">Overall level of burnout</td>
<td align="center" valign="top">3.978</td>
<td align="center" valign="top">1</td>
<td align="center" valign="top">3.978</td>
<td align="center" valign="top">4.499</td>
<td align="center" valign="top">0.036</td>
<td align="center" valign="top">0.042</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="4">Sex and subspeciality</td>
<td align="left" valign="top">Emotional exhaustion</td>
<td align="center" valign="top">23.392</td>
<td align="center" valign="top">5</td>
<td align="center" valign="top">4.678</td>
<td align="center" valign="top">3.216</td>
<td align="center" valign="top">0.010</td>
<td align="center" valign="top">0.135</td>
</tr>
<tr>
<td align="left" valign="top">Depersonalization</td>
<td align="center" valign="top">12.800</td>
<td align="center" valign="top">5</td>
<td align="center" valign="top">2.560</td>
<td align="center" valign="top">1.106</td>
<td align="center" valign="top">0.362</td>
<td align="center" valign="top">0.051</td>
</tr>
<tr>
<td align="left" valign="top">Personal accomplishment</td>
<td align="center" valign="top">10.383</td>
<td align="center" valign="top">5</td>
<td align="center" valign="top">2.077</td>
<td align="center" valign="top">2.014</td>
<td align="center" valign="top">0.083</td>
<td align="center" valign="top">0.089</td>
</tr>
<tr>
<td align="left" valign="top">Overall level of burnout</td>
<td align="center" valign="top">12.771</td>
<td align="center" valign="top">5</td>
<td align="center" valign="top">2.554</td>
<td align="center" valign="top">2.889</td>
<td align="center" valign="top">0.018</td>
<td align="center" valign="top">0.123</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="4">Experience and educational level</td>
<td align="left" valign="top">Emotional exhaustion</td>
<td align="center" valign="top">3.988</td>
<td align="center" valign="top">2</td>
<td align="center" valign="top">1.994</td>
<td align="center" valign="top">1.370</td>
<td align="center" valign="top">0.259</td>
<td align="center" valign="top">0.026</td>
</tr>
<tr>
<td align="left" valign="top">Depersonalization</td>
<td align="center" valign="top">5.010</td>
<td align="center" valign="top">2</td>
<td align="center" valign="top">2.505</td>
<td align="center" valign="top">1.083</td>
<td align="center" valign="top">0.343</td>
<td align="center" valign="top">0.021</td>
</tr>
<tr>
<td align="left" valign="top">Personal accomplishment</td>
<td align="center" valign="top">0.448</td>
<td align="center" valign="top">2</td>
<td align="center" valign="top">0.224</td>
<td align="center" valign="top">0.217</td>
<td align="center" valign="top">0.805</td>
<td align="center" valign="top">0.004</td>
</tr>
<tr>
<td align="left" valign="top">Overall level of burnout</td>
<td align="center" valign="top">1.676</td>
<td align="center" valign="top">2</td>
<td align="center" valign="top">0.838</td>
<td align="center" valign="top">0.948</td>
<td align="center" valign="top">0.391</td>
<td align="center" valign="top">0.018</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="4">Experience and subspeciality</td>
<td align="left" valign="top">Emotional exhaustion</td>
<td align="center" valign="top">9.201</td>
<td align="center" valign="top">9</td>
<td align="center" valign="top">1.022</td>
<td align="center" valign="top">0.703</td>
<td align="center" valign="top">0.705</td>
<td align="center" valign="top">0.058</td>
</tr>
<tr>
<td align="left" valign="top">Depersonalization</td>
<td align="center" valign="top">18.654</td>
<td align="center" valign="top">9</td>
<td align="center" valign="top">2.073</td>
<td align="center" valign="top">0.896</td>
<td align="center" valign="top">0.532</td>
<td align="center" valign="top">0.073</td>
</tr>
<tr>
<td align="left" valign="top">Personal accomplishment</td>
<td align="center" valign="top">16.720</td>
<td align="center" valign="top">9</td>
<td align="center" valign="top">1.858</td>
<td align="center" valign="top">1.802</td>
<td align="center" valign="top">0.077</td>
<td align="center" valign="top">0.136</td>
</tr>
<tr>
<td align="left" valign="top">Overall level of burnout</td>
<td align="center" valign="top">5.4838</td>
<td align="center" valign="top">9</td>
<td align="center" valign="top">0.649</td>
<td align="center" valign="top">0.734</td>
<td align="center" valign="top">0.677</td>
<td align="center" valign="top">0.060</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="4">Educational level and specialization</td>
<td align="left" valign="top">Emotional exhaustion</td>
<td align="center" valign="top">16.947</td>
<td align="center" valign="top">5</td>
<td align="center" valign="top">3.389</td>
<td align="center" valign="top">2.330</td>
<td align="center" valign="top">0.048</td>
<td align="center" valign="top">0.102</td>
</tr>
<tr>
<td align="left" valign="top">Depersonalization</td>
<td align="center" valign="top">8.712</td>
<td align="center" valign="top">5</td>
<td align="center" valign="top">1.742</td>
<td align="center" valign="top">0.753</td>
<td align="center" valign="top">0.586</td>
<td align="center" valign="top">0.035</td>
</tr>
<tr>
<td align="left" valign="top">Personal accomplishment</td>
<td align="center" valign="top">15.302</td>
<td align="center" valign="top">5</td>
<td align="center" valign="top">3.060</td>
<td align="center" valign="top">2.969</td>
<td align="center" valign="top">0.015</td>
<td align="center" valign="top">0.126</td>
</tr>
<tr>
<td align="left" valign="top">Overall level of burnout</td>
<td align="center" valign="top">9.604</td>
<td align="center" valign="top">5</td>
<td align="center" valign="top">1.921</td>
<td align="center" valign="top">2.173</td>
<td align="center" valign="top">0.063</td>
<td align="center" valign="top">0.095</td>
</tr>
<tr>
<td align="left" valign="top" rowspan="4">Error</td>
<td align="left" valign="top">Emotional exhaustion</td>
<td align="center" valign="top">149.851</td>
<td align="center" valign="top">103</td>
<td align="center" valign="top">1.455</td>
<td/>
<td/>
<td/>
</tr>
<tr>
<td align="left" valign="top">Depersonalization</td>
<td align="center" valign="top">238.366</td>
<td align="center" valign="top">103</td>
<td align="center" valign="top">2.314</td>
<td/>
<td/>
<td/>
</tr>
<tr>
<td align="left" valign="top">Personal accomplishment</td>
<td align="center" valign="top">106.178</td>
<td align="center" valign="top">103</td>
<td align="center" valign="top">1.031</td>
<td/>
<td/>
<td/>
</tr>
<tr>
<td align="left" valign="top">Overall level of burnout</td>
<td align="center" valign="top">91.058</td>
<td align="center" valign="top">103</td>
<td align="center" valign="top">0.884</td>
<td/>
<td/>
<td/>
</tr>
<tr>
<td align="left" valign="top" rowspan="4">Total</td>
<td align="left" valign="top">Emotional exhaustion</td>
<td align="center" valign="top">1,620.818</td>
<td align="center" valign="top">137</td>
<td/>
<td/>
<td/>
<td/>
</tr>
<tr>
<td align="left" valign="top">Depersonalization</td>
<td align="center" valign="top">921.12</td>
<td align="center" valign="top">137</td>
<td/>
<td/>
<td/>
<td/>
</tr>
<tr>
<td align="left" valign="top">Personal accomplishment</td>
<td align="center" valign="top">2,444.249</td>
<td align="center" valign="top">137</td>
<td/>
<td/>
<td/>
<td/>
</tr>
<tr>
<td align="left" valign="top">Overall level of burnout</td>
<td align="center" valign="top">1,438.163</td>
<td align="center" valign="top">137</td>
<td/>
<td/>
<td/>
<td/>
</tr>
<tr>
<td align="left" valign="top" rowspan="4">Corrected total</td>
<td align="left" valign="top">Emotional exhaustion</td>
<td align="center" valign="top">409.205</td>
<td align="center" valign="top">136</td>
<td/>
<td/>
<td/>
<td/>
</tr>
<tr>
<td align="left" valign="top">Depersonalization</td>
<td align="center" valign="top">467.831</td>
<td align="center" valign="top">136</td>
<td/>
<td/>
<td/>
<td/>
</tr>
<tr>
<td align="left" valign="top">Personal accomplishment</td>
<td align="center" valign="top">328.534</td>
<td align="center" valign="top">136</td>
<td/>
<td/>
<td/>
<td/>
</tr>
<tr>
<td align="left" valign="top">Overall level of burnout</td>
<td align="center" valign="top">279.991</td>
<td align="center" valign="top">136</td>
<td/>
<td/>
<td/>
<td/>
</tr>
</tbody>
</table>
</table-wrap>
<p>In contrast, the experience variable did not show a significant effect on any dependent variables, with no statistically significant differences in emotional exhaustion (<italic>F</italic>&#x202F;=&#x202F;0.445, <italic>p</italic>&#x202F;=&#x202F;0.642 and &#x03B7;<sup>2</sup>&#x202F;=&#x202F;0.009), depersonalization (<italic>F</italic>&#x202F;=&#x202F;0.731, <italic>p</italic>&#x202F;=&#x202F;0.484 and &#x03B7;<sup>2</sup>&#x202F;=&#x202F;0.014), personal accomplishment (<italic>F</italic>&#x202F;=&#x202F;1.171, <italic>p</italic>&#x202F;=&#x202F;0.314 and &#x03B7;<sup>2</sup>&#x202F;=&#x202F;0.022) and overall burnout level (<italic>F</italic>&#x202F;=&#x202F;1.026, <italic>p</italic>&#x202F;=&#x202F;0.362 and &#x03B7;<sup>2</sup>&#x202F;=&#x202F;0.020). Similarly, the educational level variable did not show a significant effect on any dependent variables, with non-significant values for emotional exhaustion (<italic>F</italic>&#x202F;=&#x202F;0.413, <italic>p</italic>&#x202F;=&#x202F;0.522 and &#x03B7;<sup>2</sup>&#x202F;=&#x202F;0.004), depersonalization (<italic>F</italic>&#x202F;=&#x202F;2.893, <italic>p</italic>&#x202F;=&#x202F;0.092 and &#x03B7;<sup>2</sup>&#x202F;=&#x202F;0.027), personal accomplishment (<italic>F</italic>&#x202F;=&#x202F;1.202, <italic>p</italic>&#x202F;=&#x202F;0.275 and &#x03B7;<sup>2</sup>&#x202F;=&#x202F;0.012) and overall burnout level (<italic>F</italic>&#x202F;=&#x202F;0.061, <italic>p</italic>&#x202F;=&#x202F;0.805 and &#x03B7;<sup>2</sup>&#x202F;=&#x202F;0.001).</p>
<p>In contrast, the subspeciality variable had a significant effect on all dependent variables. The results were statistically significant for emotional exhaustion (<italic>F</italic>&#x202F;=&#x202F;5.868, p&#x202F;=&#x202F;0.000 and &#x03B7;<sup>2</sup>&#x202F;=&#x202F;0.222), depersonalization (<italic>F</italic>&#x202F;=&#x202F;5.078, p&#x202F;=&#x202F;0.000 and &#x03B7;<sup>2</sup>&#x202F;=&#x202F;0.198), personal accomplishment (<italic>F</italic>&#x202F;=&#x202F;3.965, <italic>p</italic>&#x202F;=&#x202F;0.002 and &#x03B7;<sup>2</sup>&#x202F;=&#x202F;0.161) and overall burnout level (<italic>F</italic>&#x202F;=&#x202F;4.625, p&#x202F;=&#x202F;0.001 and &#x03B7;<sup>2</sup>&#x202F;=&#x202F;0.183). Post-hoc comparisons revealed significant differences in favour of deafness and hearing loss specialist teachers compared to other subspecialities of disabilities. These differences highlight the importance of providing targeted support for teachers specializing in deafness and hearing loss to address elevated burnout.</p>
<p>Regarding the interactions between variables, the results showed varied effects. The interaction between sex and subspeciality had a significant effect on emotional exhaustion (<italic>F</italic>&#x202F;=&#x202F;3.216, <italic>p</italic>&#x202F;=&#x202F;0.010 and &#x03B7;<sup>2</sup>&#x202F;=&#x202F;0.135), depersonalization (<italic>F</italic>&#x202F;=&#x202F;1.106, p&#x202F;=&#x202F;0.362 and &#x03B7;<sup>2</sup>&#x202F;=&#x202F;0.051), personal accomplishment (<italic>F</italic>&#x202F;=&#x202F;2.014, <italic>p</italic>&#x202F;=&#x202F;0.083 and &#x03B7;<sup>2</sup>&#x202F;=&#x202F;0.089) and overall burnout level (<italic>F</italic>&#x202F;=&#x202F;2.889, <italic>p</italic>&#x202F;=&#x202F;0.018 and &#x03B7;<sup>2</sup>&#x202F;=&#x202F;0.123).</p>
<p>Post-hoc comparisons indicated significant differences between sex and across subspecialities in terms of emotional exhaustion, depersonalization, personal accomplishment and overall burnout level. Female teachers specializing in deafness and hearing loss showed higher rates of emotional exhaustion compared to males, while males had higher rates of depersonalization, personal accomplishment and overall burnout in deafness and hearing loss specialty. These differences underscore the importance of tailored guidance and support to meet individuals&#x2019; needs based on their sex and specialization.</p>
<p>Regarding the interactions between academic degree and subspeciality, the results showed varying effects. They had a significant effect on emotional exhaustion (<italic>F</italic>&#x202F;=&#x202F;2.330, <italic>p</italic>&#x202F;=&#x202F;0.048 and &#x03B7;<sup>2</sup>&#x202F;=&#x202F;0.102) and personal accomplishment (<italic>F</italic>&#x202F;=&#x202F;2.969, <italic>p</italic>&#x202F;=&#x202F;0.015 and &#x03B7;<sup>2</sup>&#x202F;=&#x202F;0.126). However, the interaction between academic degree and subspeciality did not have a significant effect on depersonalization (<italic>F</italic>&#x202F;=&#x202F;0.753, <italic>p</italic>&#x202F;=&#x202F;0.586 and &#x03B7;<sup>2</sup>&#x202F;=&#x202F;0.035) or overall burnout level (<italic>F</italic>&#x202F;=&#x202F;2.173, <italic>p</italic>&#x202F;=&#x202F;0.063 and &#x03B7;<sup>2</sup>&#x202F;=&#x202F;0.095). These differences suggest that the interaction between degree and subspeciality significantly affects some aspects of burnout, highlighting the importance of considering these factors when providing support and guidance. Post-hoc comparisons revealed that the interaction between academic degree and subspeciality had a significant effect on emotional exhaustion and personal accomplishment, with distinctions favoring those with a post-graduate degree compared to those with a bachelor&#x2019;s degree in most subspecialities, particularly in the field of deafness and hearing loss.</p>
<p>Other interactions between variables, such as sex and experience, sex and educational level or experience and subspeciality, did not show significant effects based on these results. It can be concluded that sex and subspeciality variables had noticeable effects on burnout levels, while experience and educational level did not have significant effects.</p>
</sec>
<sec sec-type="discussion" id="sec9">
<label>4</label>
<title>Discussion</title>
<p>The results found that special education teachers in inclusive schools suffer from moderate burnout. This result corroborates previous studies (<xref ref-type="bibr" rid="ref4">Alaraideh, 2016</xref>; <xref ref-type="bibr" rid="ref21">Brunsting et al., 2014</xref>; <xref ref-type="bibr" rid="ref73">Squillaci, 2020</xref>; <xref ref-type="bibr" rid="ref74">Stathopoulou et al., 2023</xref>). However, it differs from the results of some studies, such as <xref ref-type="bibr" rid="ref22">Candeias et al. (2021)</xref>, <xref ref-type="bibr" rid="ref62">Panagouli et al. (2019)</xref> and <xref ref-type="bibr" rid="ref79">Tahar et al. (2023)</xref>, which found that the burnout level of special education teachers was low; the results of <xref ref-type="bibr" rid="ref65">Ramdan et al. (2020)</xref> and <xref ref-type="bibr" rid="ref84">Vinogradova et al. (2020)</xref>, which found that the burnout level was moderate to high; and the results of <xref ref-type="bibr" rid="ref49">K&#x00FC;&#x00E7;&#x00FC;ks&#x00FC;leymanoglu (2011)</xref> and <xref ref-type="bibr" rid="ref85">Williams and Dikes (2015)</xref>, which found that it was high.</p>
<p>Arguably, the difference in the results of previous studies can be attributed to the timing and location of the study, as well as the inventory of burnout used. <xref ref-type="bibr" rid="ref5">Aldosiry (2022)</xref> and <xref ref-type="bibr" rid="ref22">Candeias et al. (2021)</xref> suggest that providing continuous support and improving work strategies by school administrators and general education teachers may help reduce burnout among special education teachers in inclusive schools.</p>
<p>The results indicated that male teachers had higher levels of burnout than female teachers. This result supports previous studies (<xref ref-type="bibr" rid="ref6">Al-dyiar and Salem, 2013</xref>; <xref ref-type="bibr" rid="ref34">Girgin and Baysal, 2005</xref>; <xref ref-type="bibr" rid="ref15">Bayani et al., 2013</xref>; <xref ref-type="bibr" rid="ref32">Gallegos and Barrios, 2013</xref>; <xref ref-type="bibr" rid="ref69">Sari, 2004</xref>). The findings of <xref ref-type="bibr" rid="ref47">Khajehnasiri et al. (2022)</xref> showed that higher levels of burnout among male teachers are associated with several demographic characteristics, such as lower income, number of children in their families and responsibilities. Moreover, <xref ref-type="bibr" rid="ref18">Bozku&#x015F; (2018)</xref> believes that male teachers experience greater feelings of depression, worthlessness and failure than female teachers. Consequently, the need to design intervention programs to reduce male burnout in inclusive education environments is necessary for schools, students and teachers. The results of a study conducted on Chinese special education by <xref ref-type="bibr" rid="ref75">Sun et al. (2019a)</xref> indicated that mindfulness training with social support helps reduce burnout and improve well-being for special education teachers.</p>
<p>Teachers of students with deafness and hearing loss have higher levels of burnout than their colleagues in other subspecialities. This may be due to teachers&#x2019; poor sign language qualifications (<xref ref-type="bibr" rid="ref26">Desalegn and Worku, 2016</xref>) or a lack of facilities that meet the needs of deafness and hearing loss students (<xref ref-type="bibr" rid="ref10">Almutairi and Alenezi, 2024</xref>; <xref ref-type="bibr" rid="ref14">Bamu et al., 2017</xref>). Therefore, intensifying training courses for teachers on how to communicate with deafness and hearing loss students and providing educational environments that meet their needs are essential for improving their mental health.</p>
<p>The results indicated that there was a significant interaction effect between sex and subspeciality on burnout levels. Female teachers in the deafness and hearing loss specialization reported higher rates of emotional exhaustion than male teachers, while male teachers reported higher rates of emotional numbness, a lack of a sense of accomplishment and general burnout in the deafness and hearing loss specializations and other subspecialities. The type of disability in students is associated with higher burnout among special education teachers (<xref ref-type="bibr" rid="ref44">Jovanovi&#x0107; et al., 2019</xref>). Often, work conditions may influence burnout levels among teachers (<xref ref-type="bibr" rid="ref20">Brunsting et al., 2023</xref>). Therefore, administrative support may help enhance self-efficacy and reduce burnout among special education teachers (<xref ref-type="bibr" rid="ref23">Combee, 2014</xref>).</p>
<p>The results indicated that there was a significant effect of the interaction of educational levels with subspecialities on levels of emotional stress and a lack of a sense of accomplishment, as the differences favored those with a postgraduate level compared to those with a bachelor&#x2019;s degree. Notably, burnout levels differ among teachers according to educational level. However, burnout levels are associated with different socio-demographic factors between males and females, such as age, educational level and marital status (<xref ref-type="bibr" rid="ref3">Ahola et al., 2006</xref>).</p>
<p>Conversely, the variable of educational level and experience did not show any significant effect on any dimensions of burnout or on the total score. This result corroborates some studies (<xref ref-type="bibr" rid="ref79">Tahar et al., 2023</xref>; <xref ref-type="bibr" rid="ref13">Anastasiou and Belios, 2020</xref>). However, <xref ref-type="bibr" rid="ref85">Williams and Dikes (2015)</xref> found that longer teaching experience is associated with teachers&#x2019; burnout. More experienced teachers may be less prone to burnout because they have flexibility in accommodating the students&#x2019; abilities and positive expectations for their students with disabilities (<xref ref-type="bibr" rid="ref9001">O&#x2019;Brennan et al., 2017</xref>).</p>
</sec>
<sec sec-type="conclusions" id="sec10">
<label>5</label>
<title>Conclusion</title>
<p>The current study aimed to identify the levels of burnout among special education teachers in inclusive education schools in the Kingdom of Saudi Arabia. This study found that special education teachers suffer from an average level of burnout. It recommends the provision of training programs for teachers that contribute to reducing burnout and its negative effects on them. In addition, reducing work pressures and tasks assigned to teachers of students with disabilities may help provide a supportive and healthy work environment for them. Psychosocial support services should be available within all inclusive schools.</p>
<sec id="sec11">
<label>5.1</label>
<title>Limitations and future research</title>
<p>Despite the importance of the current study in understanding the levels of burnout among special education teachers in inclusive education schools, it faced many limitations. One of these limitations is the lack of scientific studies that address this topic, especially in the Arab environment. Therefore, many studies regarding teachers in each category of disability must be conducted. Future studies should also focus on finding solutions that help overcome burnout among special education teachers. Additionally, teachers responded weakly to the questionnaire, despite the Ministry of Education sending an electronic link to all special education teachers in inclusive education schools. Therefore, focusing on qualitative designs and methods that rely on interviews in future research may save time and provide more accurate results that help achieve the main research objective.</p>
</sec>
</sec>
</body>
<back>
<sec sec-type="data-availability" id="sec12">
<title>Data availability statement</title>
<p>The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding author.</p>
</sec>
<sec sec-type="ethics-statement" id="sec13">
<title>Ethics statement</title>
<p>Ethical review and approval was not required for the study on human participants in accordance with the local legislation and institutional requirements. Written informed consent from the participants was not required to participate in this study in accordance with the national legislation and the institutional requirements.</p>
</sec>
<sec sec-type="author-contributions" id="sec14">
<title>Author contributions</title>
<p>TA: Writing &#x2013; original draft, Writing &#x2013; review &#x0026; editing.</p>
</sec>
<sec sec-type="funding-information" id="sec15">
<title>Funding</title>
<p>The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.</p>
</sec>
<sec sec-type="COI-statement" id="sec16">
<title>Conflict of interest</title>
<p>The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
<sec sec-type="disclaimer" id="sec17">
<title>Publisher&#x2019;s note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
<ref-list>
<title>References</title>
<ref id="ref1"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Ab&#x00F3;s</surname> <given-names>&#x00C1;.</given-names></name> <name><surname>Sevil-Serrano</surname> <given-names>J.</given-names></name> <name><surname>Kim</surname> <given-names>L. E.</given-names></name> <name><surname>Klassen</surname> <given-names>R. M.</given-names></name> <name><surname>Garc&#x00ED;a-Gonz&#x00E1;lez</surname> <given-names>L.</given-names></name></person-group> (<year>2019</year>). <article-title>How should stressors be examined in teachers? Answering questions about dimensionality, generalizability and predictive effects using the multicontext stressors scale</article-title>. <source>Int. J. Environ. Res. Public Health</source> <volume>16</volume>:<fpage>3388</fpage>. doi: <pub-id pub-id-type="doi">10.3390/ijerph16183388</pub-id></citation></ref>
<ref id="ref2"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Abrol</surname> <given-names>M.</given-names></name></person-group> (<year>2023</year>). <article-title>Role of teacher in promoting inclusive education</article-title>. <source>Int. J. Multidiscip. Res.</source> <volume>5</volume>, <fpage>1</fpage>&#x2013;<lpage>8</lpage>. doi: <pub-id pub-id-type="doi">10.36948/ijfmr.2023.v05i02.1626</pub-id></citation></ref>
<ref id="ref3"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Ahola</surname> <given-names>K.</given-names></name> <name><surname>Honkonen</surname> <given-names>T.</given-names></name> <name><surname>Isomets&#x00E4;</surname> <given-names>E.</given-names></name> <name><surname>Kalimo</surname> <given-names>R.</given-names></name> <name><surname>Nykyri</surname> <given-names>E.</given-names></name> <name><surname>Koskinen</surname> <given-names>S.</given-names></name> <etal/></person-group>. (<year>2006</year>). <article-title>Burnout in the general population: results from the Finnish health 2000 study</article-title>. <source>Soc. Psychiatry Psychiatr. Epidemiol.</source> <volume>41</volume>, <fpage>11</fpage>&#x2013;<lpage>17</lpage>. doi: <pub-id pub-id-type="doi">10.1007/s00127-005-0011-5</pub-id></citation></ref>
<ref id="ref4"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Alaraideh</surname> <given-names>E.</given-names></name></person-group> (<year>2016</year>). <article-title>Burnout level among special education teachers</article-title>. <source>J. Psychol. Educ. Sci.</source> <volume>2</volume>, <fpage>197</fpage>&#x2013;<lpage>227</lpage>.</citation></ref>
<ref id="ref5"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Aldosiry</surname> <given-names>N.</given-names></name></person-group> (<year>2022</year>). <article-title>The influence of support from administrators and other work conditions on special education teachers</article-title>. <source>Int. J. Disabil. Dev. Educ.</source> <volume>69</volume>, <fpage>1873</fpage>&#x2013;<lpage>1887</lpage>. doi: <pub-id pub-id-type="doi">10.1080/1034912X.2020.1837353</pub-id></citation></ref>
<ref id="ref6"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Al-dyiar</surname> <given-names>M. A.</given-names></name> <name><surname>Salem</surname> <given-names>A. A. M.</given-names></name></person-group> (<year>2013</year>). <article-title>Psychological burnout and coping strategies of special education teachers in the state of Kuwait</article-title>. <source>J. Educ. Pract.</source> <volume>4</volume>, <fpage>117</fpage>&#x2013;<lpage>127</lpage>.</citation></ref>
<ref id="ref7"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Alfayez</surname> <given-names>B.</given-names></name></person-group> (<year>2023</year>). <article-title>Burnout among special education teachers</article-title>. <source>Arab J. Disabil. Talent Sci.</source> <volume>25</volume>, <fpage>67</fpage>&#x2013;<lpage>84</lpage>. Available at: <ext-link xlink:href="https://journals.ekb.eg/article_275813_3f7f977ed4132e533c3df841d07fea42.pdf" ext-link-type="uri">https://journals.ekb.eg/article_275813_3f7f977ed4132e533c3df841d07fea42.pdf</ext-link></citation></ref>
<ref id="ref8"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Al-Kharaan</surname> <given-names>H.</given-names></name></person-group> (<year>2023</year>). <article-title>Mindfulness and its relationship to psychological burnout among special education teachers in Makkah Al-Mukarramah educational region</article-title>. <source>Educ. Psychol. Stud.</source> <volume>38</volume>, <fpage>59</fpage>&#x2013;<lpage>109</lpage>. doi: <pub-id pub-id-type="doi">10.21608/sec.2023.345957</pub-id></citation></ref>
<ref id="ref9"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Al-Khatatba</surname> <given-names>M. A. Q. A.</given-names></name></person-group> (<year>2021</year>). <article-title>The level of psychological burnout among teachers of students with autism spectrum disorder in Dammam city and its relationship to their emotional intelligence</article-title>. <source>Int. J. Educ. Psychol. Stud.</source> <volume>9</volume>, <fpage>710</fpage>&#x2013;<lpage>730</lpage>. doi: <pub-id pub-id-type="doi">10.31559/EPS2021.9.3.1</pub-id></citation></ref>
<ref id="ref10"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Almutairi</surname> <given-names>T.</given-names></name> <name><surname>Alenezi</surname> <given-names>N.</given-names></name></person-group> (<year>2024</year>). <article-title>Challenges facing inclusion programs&#x2019; hearing impairment students from the perspective of teachers in Hail City</article-title>. <source>J. Arts Psychol. Educ. Stud.</source> <volume>6</volume>, <fpage>202</fpage>&#x2013;<lpage>243</lpage>. Available at: <ext-link xlink:href="https://journal.tu.edu.ye/index.php/artsep/article/view/1826/1556" ext-link-type="uri">https://journal.tu.edu.ye/index.php/artsep/article/view/1826/1556</ext-link></citation></ref>
<ref id="ref11"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Al-Qahtani</surname> <given-names>A.</given-names></name></person-group> (<year>2016</year>). <article-title>The concept of self and psychological burnout and their relationship to the attitudes of teachers of behavioral training towards working in special education institutes and programs</article-title>. <source>Educ. Psychol. Stud.</source> <volume>93</volume>, <fpage>233</fpage>&#x2013;<lpage>282</lpage>.</citation></ref>
<ref id="ref12"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Al-Sharif</surname> <given-names>N. M. B.</given-names></name></person-group> (<year>2020</year>). <article-title>The burnout inventory level among learning disabilities teachers compared to general school teachers in Makkah</article-title>. <source>Dirasat Educ. Sci.</source> <volume>47</volume>, <fpage>177</fpage>&#x2013;<lpage>190</lpage>. Available at: <ext-link xlink:href="https://dsr.ju.edu.jo/djournals/index.php/Edu/article/view/2450" ext-link-type="uri">https://dsr.ju.edu.jo/djournals/index.php/Edu/article/view/2450</ext-link></citation></ref>
<ref id="ref13"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Anastasiou</surname> <given-names>S.</given-names></name> <name><surname>Belios</surname> <given-names>E.</given-names></name></person-group> (<year>2020</year>). <article-title>Effect of age on job satisfaction and emotional exhaustion of primary school teachers in Greece</article-title>. <source>Eur. J. Investig. Health Psychol. Educ.</source> <volume>10</volume>, <fpage>644</fpage>&#x2013;<lpage>655</lpage>. doi: <pub-id pub-id-type="doi">10.3390/ejihpe10020047</pub-id>, PMID: <pub-id pub-id-type="pmid">34542525</pub-id></citation></ref>
<ref id="ref14"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Bamu</surname> <given-names>B. N.</given-names></name> <name><surname>De Schauwer</surname> <given-names>E.</given-names></name> <name><surname>Verstraete</surname> <given-names>S.</given-names></name> <name><surname>Van Hove</surname> <given-names>G.</given-names></name></person-group> (<year>2017</year>). <article-title>Inclusive education for students with hearing impairment in the regular secondary schools in the north-west region of Cameroon: initiatives and challenges</article-title>. <source>Int. J. Disabil. Dev. Educ.</source> <volume>64</volume>, <fpage>612</fpage>&#x2013;<lpage>623</lpage>. doi: <pub-id pub-id-type="doi">10.1080/1034912X.2017.1313395</pub-id></citation></ref>
<ref id="ref15"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Bayani</surname> <given-names>A. A.</given-names></name> <name><surname>Bagheri</surname> <given-names>H.</given-names></name> <name><surname>Bayani</surname> <given-names>A.</given-names></name></person-group> (<year>2013</year>). <article-title>Influence of gender, age and years of teaching experience on burnout</article-title>. <source>Ann. Biol. Res.</source> <volume>4</volume>, <fpage>239</fpage>&#x2013;<lpage>243</lpage>.</citation></ref>
<ref id="ref16"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Billingsley</surname> <given-names>B. S.</given-names></name></person-group> (<year>1993</year>). <article-title>Teacher retention and attrition in special and general education: a critical review of the literature</article-title>. <source>J. Spec. Educ.</source> <volume>27</volume>, <fpage>137</fpage>&#x2013;<lpage>174</lpage>. doi: <pub-id pub-id-type="doi">10.1177/002246699302700202</pub-id></citation></ref>
<ref id="ref17"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Boe</surname> <given-names>E. E.</given-names></name> <name><surname>Bobbitt</surname> <given-names>S. A.</given-names></name> <name><surname>Cook</surname> <given-names>L. H.</given-names></name> <name><surname>Whitener</surname> <given-names>S. D.</given-names></name> <name><surname>Weber</surname> <given-names>A. L.</given-names></name></person-group> (<year>1997</year>). <article-title>Why didst thou go? Predictors of retention, transfer and attrition of special and general education teachers from a national perspective</article-title>. <source>J. Spec. Educ.</source> <volume>30</volume>, <fpage>390</fpage>&#x2013;<lpage>411</lpage>. doi: <pub-id pub-id-type="doi">10.1177/002246699703000403</pub-id></citation></ref>
<ref id="ref18"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Bozku&#x015F;</surname> <given-names>K.</given-names></name></person-group> (<year>2018</year>). <article-title>The level of burnout experienced by teachers</article-title>. <source>Int. J. Soc. Sci. Educ. Res.</source> <volume>4</volume>, <fpage>61</fpage>&#x2013;<lpage>67</lpage>. doi: <pub-id pub-id-type="doi">10.24289/ijsser.341790</pub-id></citation></ref>
<ref id="ref19"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Brownell</surname> <given-names>M. T.</given-names></name> <name><surname>Smith</surname> <given-names>S. W.</given-names></name></person-group> (<year>1992</year>). <article-title>Attrition/retention of special education teachers: critique of current research and recommendations for retention efforts</article-title>. <source>Teach. Educ. Spec. Educ.</source> <volume>15</volume>, <fpage>229</fpage>&#x2013;<lpage>248</lpage>. doi: <pub-id pub-id-type="doi">10.1177/088840649201500402</pub-id></citation></ref>
<ref id="ref20"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Brunsting</surname> <given-names>N. C.</given-names></name> <name><surname>Bettini</surname> <given-names>E.</given-names></name> <name><surname>Rock</surname> <given-names>M.</given-names></name> <name><surname>Common</surname> <given-names>E. A.</given-names></name> <name><surname>Royer</surname> <given-names>D. J.</given-names></name> <name><surname>Lane</surname> <given-names>K. L.</given-names></name> <etal/></person-group>. (<year>2023</year>). <article-title>Working conditions and burnout of special educators of students with EBD: longitudinal outcomes</article-title>. <source>Teach. Educ. Spec. Educ.</source> <volume>46</volume>, <fpage>44</fpage>&#x2013;<lpage>64</lpage>. doi: <pub-id pub-id-type="doi">10.1177/08884064221076159</pub-id></citation></ref>
<ref id="ref21"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Brunsting</surname> <given-names>N. C.</given-names></name> <name><surname>Sreckovic</surname> <given-names>M. A.</given-names></name> <name><surname>Lane</surname> <given-names>K. L.</given-names></name></person-group> (<year>2014</year>). <article-title>Special education teacher burnout: a synthesis of research from 1979 to 2013</article-title>. <source>Educ. Treat. Child.</source> <volume>37</volume>, <fpage>681</fpage>&#x2013;<lpage>711</lpage>. doi: <pub-id pub-id-type="doi">10.1353/etc.2014.0032</pub-id></citation></ref>
<ref id="ref22"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Candeias</surname> <given-names>A.</given-names></name> <name><surname>Galindo</surname> <given-names>E.</given-names></name> <name><surname>Calisto</surname> <given-names>I.</given-names></name> <name><surname>Borralho</surname> <given-names>L.</given-names></name> <name><surname>Reschke</surname> <given-names>K.</given-names></name></person-group> (<year>2021</year>). <article-title>Stress and burnout in teaching. Study in an inclusive school workplace</article-title>. <source>Health Psychol. Rep.</source> <volume>9</volume>, <fpage>63</fpage>&#x2013;<lpage>75</lpage>. doi: <pub-id pub-id-type="doi">10.5114/hpr.2020.100786</pub-id>, PMID: <pub-id pub-id-type="pmid">38084117</pub-id></citation></ref>
<ref id="ref23"><citation citation-type="other"><person-group person-group-type="author"><name><surname>Combee</surname> <given-names>S. W.</given-names></name></person-group> (<year>2014</year>). <italic>The relationship between administrative support and teacher efficacy in the professional life of special education teachers</italic>. Virginia Commonwealth University.</citation></ref>
<ref id="ref24"><citation citation-type="book"><person-group person-group-type="author"><name><surname>Darwish</surname> <given-names>H. A.</given-names></name></person-group> (<year>2018</year>). <source>Research methods in the humanities</source>. <publisher-loc>Cairo, Egypt</publisher-loc>: <publisher-name>The Arab Nation Foundation for Publishing and Distribution</publisher-name>.</citation></ref>
<ref id="ref25"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>DeMik</surname> <given-names>S. A.</given-names></name></person-group> (<year>2008</year>). <article-title>Experiencing attrition of special education teachers through narrative inquiry</article-title>. <source>High Sch. J.</source> <volume>92</volume>, <fpage>22</fpage>&#x2013;<lpage>32</lpage>. doi: <pub-id pub-id-type="doi">10.1353/hsj.0.0009</pub-id></citation></ref>
<ref id="ref26"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Desalegn</surname> <given-names>D.</given-names></name> <name><surname>Worku</surname> <given-names>A.</given-names></name></person-group> (<year>2016</year>). <article-title>Review of challenges of hearing-impaired students in integrated class in public schools in Ethiopia: a review article</article-title>. <source>J. Med. Physiol. Biophys.</source> <volume>22</volume>, <fpage>74</fpage>&#x2013;<lpage>78</lpage>.</citation></ref>
<ref id="ref27"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Duli</surname> <given-names>S.</given-names></name></person-group> (<year>2016</year>). <article-title>Years of work experience, an important predictor of burnout in special education</article-title>. <source>Am. Sci. Res. J. Eng. Technol. Sci.</source> <volume>17</volume>, <fpage>318</fpage>&#x2013;<lpage>322</lpage>.</citation></ref>
<ref id="ref28"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>El Helou</surname> <given-names>M.</given-names></name> <name><surname>Nabhani</surname> <given-names>M.</given-names></name> <name><surname>Bahous</surname> <given-names>R.</given-names></name></person-group> (<year>2016</year>). <article-title>Teachers&#x2019; views on causes leading to their burnout</article-title>. <source>Sch. Leadersh. Manage.</source> <volume>36</volume>, <fpage>551</fpage>&#x2013;<lpage>567</lpage>. doi: <pub-id pub-id-type="doi">10.1080/13632434.2016.1247051</pub-id></citation></ref>
<ref id="ref29"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Faskhodi</surname> <given-names>A. A.</given-names></name> <name><surname>Siyyari</surname> <given-names>M.</given-names></name></person-group> (<year>2018</year>). <article-title>Dimensions of work engagement and teacher burnout: a study of relations among Iranian EFL teachers</article-title>. <source>Aust. J. Teach. Educ. (Online)</source> <volume>43</volume>, <fpage>78</fpage>&#x2013;<lpage>93</lpage>. doi: <pub-id pub-id-type="doi">10.14221/ajte.2018v43n1.5</pub-id></citation></ref>
<ref id="ref30"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Fore</surname> <given-names>C.</given-names></name> <name><surname>Martin</surname> <given-names>C.</given-names></name> <name><surname>Bender</surname> <given-names>W. N.</given-names></name></person-group> (<year>2002</year>). <article-title>Teacher burnout in special education: the causes and the recommended solutions</article-title>. <source>High Sch. J.</source> <volume>86</volume>, <fpage>36</fpage>&#x2013;<lpage>44</lpage>. doi: <pub-id pub-id-type="doi">10.1353/hsj.2002.0017</pub-id></citation></ref>
<ref id="ref31"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Freudenberger</surname> <given-names>H. J.</given-names></name></person-group> (<year>1974</year>). <article-title>Staff burn-out</article-title>. <source>J. Soc. Issues</source> <volume>30</volume>, <fpage>159</fpage>&#x2013;<lpage>165</lpage>. doi: <pub-id pub-id-type="doi">10.1111/j.1540-4560.1974.tb00706.x</pub-id></citation></ref>
<ref id="ref32"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Gallegos</surname> <given-names>W.</given-names></name> <name><surname>Barrios</surname> <given-names>N.</given-names></name></person-group> (<year>2013</year>). <article-title>Burnout syndrome in educators of regular basic education from Arequipa</article-title>. <source>Educaci&#x00F3;n</source> <volume>22</volume>, <fpage>53</fpage>&#x2013;<lpage>76</lpage>. doi: <pub-id pub-id-type="doi">10.18800/educacion.201301.003</pub-id></citation></ref>
<ref id="ref33"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Garcia-Arroyo</surname> <given-names>J. A.</given-names></name> <name><surname>Osca Segovia</surname> <given-names>A.</given-names></name> <name><surname>Peir&#x00F3;</surname> <given-names>J. M.</given-names></name></person-group> (<year>2019</year>). <article-title>Meta-analytical review of teacher burnout across 36 societies: the role of national learning assessments and gender egalitarianism</article-title>. <source>Psychol. Health</source> <volume>34</volume>, <fpage>733</fpage>&#x2013;<lpage>753</lpage>. doi: <pub-id pub-id-type="doi">10.1080/08870446.2019.1568013</pub-id>, PMID: <pub-id pub-id-type="pmid">30688087</pub-id></citation></ref>
<ref id="ref34"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Girgin</surname> <given-names>G.</given-names></name> <name><surname>Baysal</surname> <given-names>A.</given-names></name></person-group> (<year>2005</year>). <article-title>An example for burnout: special education educator&#x2019;s burnout level and some variables</article-title>. <source>Turk. Armed Forces Prev. Med. J.</source> <volume>4</volume>, <fpage>172</fpage>&#x2013;<lpage>187</lpage>.</citation></ref>
<ref id="ref35"><citation citation-type="book"><person-group person-group-type="author"><name><surname>Hall</surname> <given-names>N. C.</given-names></name> <name><surname>Goetz</surname> <given-names>T.</given-names></name></person-group> (<year>2013</year>). <source>Emotion, motivation and self-regulation: A handbook for teachers</source>. <publisher-name>Bingley: Emerald Group Publishing</publisher-name>.</citation></ref>
<ref id="ref36"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Hazan-Liran</surname> <given-names>B.</given-names></name> <name><surname>Karni-Vizer</surname> <given-names>N.</given-names></name></person-group> (<year>2024</year>). <article-title>Psychological capital as a mediator of job satisfaction and burnout among teachers in special and standard education</article-title>. <source>Eur. J. Spec. Needs Educ.</source> <volume>39</volume>, <fpage>337</fpage>&#x2013;<lpage>351</lpage>. doi: <pub-id pub-id-type="doi">10.1080/08856257.2023.2215009</pub-id></citation></ref>
<ref id="ref37"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Heale</surname> <given-names>R.</given-names></name> <name><surname>Twycross</surname> <given-names>A.</given-names></name></person-group> (<year>2015</year>). <article-title>Validity and reliability in quantitative studies</article-title>. <source>Evid. Based Nurs.</source> <volume>18</volume>, <fpage>66</fpage>&#x2013;<lpage>67</lpage>. doi: <pub-id pub-id-type="doi">10.1136/eb-2015-102129</pub-id></citation></ref>
<ref id="ref38"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Heinemann</surname> <given-names>L. V.</given-names></name> <name><surname>Heinemann</surname> <given-names>T.</given-names></name></person-group> (<year>2017</year>). <article-title>Burnout research: emergence and scientific investigation of a contested diagnosis</article-title>. <source>SAGE Open</source> <volume>7</volume>:<fpage>2158244017697154</fpage>. doi: <pub-id pub-id-type="doi">10.1177/2158244017697154</pub-id></citation></ref>
<ref id="ref39"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Hemati</surname> <given-names>A. G.</given-names></name> <name><surname>Moradi</surname> <given-names>S.</given-names></name></person-group> (<year>2021</year>). <article-title>Job burnout in public and special school teachers</article-title>. <source>Clin. Psychol. Spec. Educ.</source> <volume>10</volume>, <fpage>63</fpage>&#x2013;<lpage>75</lpage>. doi: <pub-id pub-id-type="doi">10.17759/cpse.2021100205</pub-id></citation></ref>
<ref id="ref40"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Hester</surname> <given-names>O. R.</given-names></name> <name><surname>Bridges</surname> <given-names>S. A.</given-names></name> <name><surname>Rollins</surname> <given-names>L. H.</given-names></name></person-group> (<year>2020</year>). <article-title>&#x2018;Overworked and underappreciated&#x2019;: special education teachers describe stress and attrition</article-title>. <source>Teach. Dev.</source> <volume>24</volume>, <fpage>348</fpage>&#x2013;<lpage>365</lpage>. doi: <pub-id pub-id-type="doi">10.1080/13664530.2020.1767189</pub-id></citation></ref>
<ref id="ref9002"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Jackson</surname> <given-names>K.</given-names></name></person-group> (<year>2023</year>). <article-title>Building Resilience: Strategies to Combat Burnout and Attrition in New Special Education Teachers</article-title>. <source>Journal of Special Education Preparation</source>, <volume>3</volume>, <fpage>56</fpage>&#x2013;<lpage>70</lpage>. doi: <pub-id pub-id-type="doi">10.33043/JOSEP.3.3.56-70</pub-id></citation></ref>
<ref id="ref41"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Jamaludin</surname> <given-names>I. I.</given-names></name> <name><surname>You</surname> <given-names>H. W.</given-names></name></person-group> (<year>2019</year>). <article-title>Burnout in relation to gender, teaching experience, and educational level among educators</article-title>. <source>Educ. Res. Int.</source> <volume>2019</volume>, <fpage>1</fpage>&#x2013;<lpage>5</lpage>. doi: <pub-id pub-id-type="doi">10.1155/2019/7349135</pub-id></citation></ref>
<ref id="ref42"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Jardinez</surname> <given-names>M. J.</given-names></name> <name><surname>Natividad</surname> <given-names>L. R.</given-names></name></person-group> (<year>2024</year>). <article-title>The advantages and challenges of inclusive education: striving for equity in the classroom</article-title>. <source>Shanlax Int. J. Educ.</source> <volume>12</volume>, <fpage>57</fpage>&#x2013;<lpage>65</lpage>. doi: <pub-id pub-id-type="doi">10.34293/education.v12i2.7182</pub-id></citation></ref>
<ref id="ref43"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Johnson</surname> <given-names>M. W.</given-names></name> <name><surname>Christensen</surname> <given-names>C. M.</given-names></name> <name><surname>Kagermann</surname> <given-names>H.</given-names></name></person-group> (<year>2008</year>). <article-title>Reinventing your business model</article-title>. <source>Harv. Bus. Rev.</source> <volume>86</volume>, <fpage>50</fpage>&#x2013;<lpage>59</lpage>.</citation></ref>
<ref id="ref44"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Jovanovi&#x0107;</surname> <given-names>V. R.</given-names></name> <name><surname>Kari&#x0107;</surname> <given-names>J.</given-names></name> <name><surname>Hini&#x0107;</surname> <given-names>D.</given-names></name> <name><surname>Stojanovi&#x0107;</surname> <given-names>G.</given-names></name> <name><surname>D&#x017E;amonja-Ignjatovi&#x0107;</surname> <given-names>T.</given-names></name> <name><surname>Mihajlovi&#x0107;</surname> <given-names>G.</given-names></name></person-group> (<year>2019</year>). <article-title>Burnout syndrome in special education teachers working with children with developmental disorders</article-title>. <source>Engrami</source> <volume>41</volume>, <fpage>21</fpage>&#x2013;<lpage>33</lpage>. doi: <pub-id pub-id-type="doi">10.5937/engrami1902021J</pub-id></citation></ref>
<ref id="ref45"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Kabak</surname> <given-names>&#x015E;.</given-names></name> <name><surname>&#x00D6;zbak&#x0131;r</surname> <given-names>O.</given-names></name></person-group> (<year>2023</year>). <article-title>Assessment of psychosocial risks faced by teachers working in special education and rehabilitation centres in terms of occupational health and safety</article-title>. <source>Western Anatolia J. Educ. Sci.</source> <volume>14</volume>, <fpage>1534</fpage>&#x2013;<lpage>1552</lpage>. doi: <pub-id pub-id-type="doi">10.51460/baebd.1310940</pub-id></citation></ref>
<ref id="ref46"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Karanfil</surname> <given-names>F.</given-names></name> <name><surname>Khatami</surname> <given-names>M.</given-names></name></person-group> (<year>2021</year>). <article-title>The correlation between teachers&#x2019; burnout and workload: the case of Iranian EFL teachers</article-title>. <source>J. Asia TEFL</source> <volume>18</volume>, <fpage>1023</fpage>&#x2013;<lpage>1031</lpage>. doi: <pub-id pub-id-type="doi">10.18823/asiatefl.2021.18.3.22.1023</pub-id></citation></ref>
<ref id="ref47"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Khajehnasiri</surname> <given-names>F.</given-names></name> <name><surname>Poursadeghiyan</surname> <given-names>M.</given-names></name> <name><surname>Dabiran</surname> <given-names>S.</given-names></name></person-group> (<year>2022</year>). <article-title>Burnout level in Iranian teachers and its related factors: a health promotion approach</article-title>. <source>J. Educ. Health Promot.</source> <volume>11</volume>:<fpage>38</fpage>. doi: <pub-id pub-id-type="doi">10.4103/jehp.jehp_444_21</pub-id>, PMID: <pub-id pub-id-type="pmid">35281383</pub-id></citation></ref>
<ref id="ref48"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Klochko</surname> <given-names>O.</given-names></name> <name><surname>Pohoda</surname> <given-names>O.</given-names></name> <name><surname>Rybalko</surname> <given-names>P.</given-names></name> <name><surname>Kravchenko</surname> <given-names>A.</given-names></name> <name><surname>Tytovych</surname> <given-names>A.</given-names></name> <name><surname>Kondratenko</surname> <given-names>V.</given-names></name></person-group> (<year>2022</year>). <article-title>Features of the implementation of inclusive education: the role of the teacher</article-title>. <source>Rev. Eduweb</source> <volume>16</volume>, <fpage>131</fpage>&#x2013;<lpage>140</lpage>. doi: <pub-id pub-id-type="doi">10.46502/issn.1856-7576/2022.16.04.11</pub-id></citation></ref>
<ref id="ref49"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>K&#x00FC;&#x00E7;&#x00FC;ks&#x00FC;leymanoglu</surname> <given-names>R.</given-names></name></person-group> (<year>2011</year>). <article-title>Burnout syndrome levels of teachers in special education schools in Turkey</article-title>. <source>Int. J. Spec. Educ.</source> <volume>26</volume>, <fpage>53</fpage>&#x2013;<lpage>63</lpage>.</citation></ref>
<ref id="ref50"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Kumari</surname> <given-names>P.</given-names></name> <name><surname>Nayan</surname> <given-names>R.</given-names></name> <name><surname>Aggarwal</surname> <given-names>S. P.</given-names></name> <name><surname>Baswani</surname> <given-names>G.</given-names></name></person-group> (<year>2019</year>). <article-title>Rethinking teacher education programmes for inclusive classrooms: issues and challenges in India</article-title>. <source>Int. J. Inf. Educ. Technol.</source> <volume>9</volume>, <fpage>143</fpage>&#x2013;<lpage>148</lpage>. doi: <pub-id pub-id-type="doi">10.18178/ijiet.2019.9.2.1189</pub-id></citation></ref>
<ref id="ref51"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Langher</surname> <given-names>V.</given-names></name> <name><surname>Caputo</surname> <given-names>A.</given-names></name> <name><surname>Ricci</surname> <given-names>M. E.</given-names></name></person-group> (<year>2017</year>). <article-title>The potential role of perceived support for reduction of special education teachers&#x2019; burnout</article-title>. <source>Int. J. Educ. Psychol.</source> <volume>6</volume>, <fpage>120</fpage>&#x2013;<lpage>147</lpage>. doi: <pub-id pub-id-type="doi">10.17583/ijep.2017.2126</pub-id></citation></ref>
<ref id="ref52"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Llorent</surname> <given-names>V. J.</given-names></name> <name><surname>Ruiz-Calzado</surname> <given-names>I.</given-names></name></person-group> (<year>2016</year>). <article-title>Burnout and its relation to sociodemographic variables among education professionals working with people with disabilities in C&#x00F3;rdoba (Spain)</article-title>. <source>Cien. Saude Colet.</source> <volume>21</volume>, <fpage>3287</fpage>&#x2013;<lpage>3295</lpage>. doi: <pub-id pub-id-type="doi">10.1590/1413-812320152110.00732015</pub-id></citation></ref>
<ref id="ref53"><citation citation-type="book"><person-group person-group-type="author"><name><surname>Mahmoodi-Shahrebabaki</surname> <given-names>M.</given-names></name></person-group> (<year>2019</year>). <source>Teacher Burnout. In J. I. Liontas, T. International Association, &#x0026; M. DelliCarpini (Eds.), The TESOL Encyclopedia of English Language Teaching (pp. 1&#x2013;8). USA: John Wiley &#x0026; Sons, Inc.</source></citation></ref>
<ref id="ref54"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Maslach</surname> <given-names>C.</given-names></name> <name><surname>Leiter</surname> <given-names>M. P.</given-names></name></person-group> (<year>2016</year>). <article-title>Understanding the burnout experience: recent research and its implications for psychiatry</article-title>. <source>World Psychiatry</source> <volume>15</volume>, <fpage>103</fpage>&#x2013;<lpage>111</lpage>. doi: <pub-id pub-id-type="doi">10.1002/wps.20311</pub-id>, PMID: <pub-id pub-id-type="pmid">27265691</pub-id></citation></ref>
<ref id="ref55"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>McGrew</surname> <given-names>J.</given-names></name> <name><surname>Ruble</surname> <given-names>L.</given-names></name> <name><surname>Cormier</surname> <given-names>C. J.</given-names></name> <name><surname>Dueber</surname> <given-names>D.</given-names></name></person-group> (<year>2023</year>). <article-title>Special educators&#x2019; mental health and burnout: a comparison of general and teacher specific risk factors</article-title>. <source>Teach. Teach. Educ.</source> <volume>132</volume>:<fpage>104209</fpage>. doi: <pub-id pub-id-type="doi">10.1016/j.tate.2023.104209</pub-id></citation></ref>
<ref id="ref56"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Mohajan</surname> <given-names>H. K.</given-names></name></person-group> (<year>2017</year>). <article-title>Two criteria for good measurements in research: validity and reliability</article-title>. <source>Ann. Spiru Haret Univ. Econ. Series</source> <volume>17</volume>, <fpage>59</fpage>&#x2013;<lpage>82</lpage>. doi: <pub-id pub-id-type="doi">10.26458/1746</pub-id></citation></ref>
<ref id="ref57"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Mota</surname> <given-names>A. I.</given-names></name> <name><surname>Lopes</surname> <given-names>J.</given-names></name> <name><surname>Oliveira</surname> <given-names>C.</given-names></name></person-group> (<year>2023</year>). <article-title>The burnout experience among teachers: a profile analysis</article-title>. <source>Psychol. Sch.</source> <volume>60</volume>, <fpage>3979</fpage>&#x2013;<lpage>3994</lpage>. doi: <pub-id pub-id-type="doi">10.1002/pits.22956</pub-id></citation></ref>
<ref id="ref58"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Mustafa</surname> <given-names>K. I.</given-names></name></person-group> (<year>2020</year>). <article-title>Job satisfaction of teachers and its relationships with their burnout in Kurdistan/Iraq</article-title>. <source>Hebron Univ. Res. J. (Humanities)</source> <volume>14</volume>, <fpage>252</fpage>&#x2013;<lpage>267</lpage>.</citation></ref>
<ref id="ref59"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Nagar</surname> <given-names>K.</given-names></name></person-group> (<year>2012</year>). <article-title>Organizational commitment and job satisfaction among teachers during times of burnout</article-title>. <source>Vikalpa</source> <volume>37</volume>, <fpage>43</fpage>&#x2013;<lpage>60</lpage>. doi: <pub-id pub-id-type="doi">10.1177/0256090920120205</pub-id></citation></ref>
<ref id="ref60"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Nilsen</surname> <given-names>S.</given-names></name></person-group> (<year>2020</year>). <article-title>Inside but still on the outside? Teachers&#x2019; experiences with the inclusion of pupils with special educational needs in general education</article-title>. <source>Int. J. Incl. Educ.</source> <volume>24</volume>, <fpage>980</fpage>&#x2013;<lpage>996</lpage>. doi: <pub-id pub-id-type="doi">10.1080/13603116.2018.1503348</pub-id></citation></ref>
<ref id="ref61"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Nuri</surname> <given-names>C.</given-names></name> <name><surname>Demirok</surname> <given-names>M. S.</given-names></name> <name><surname>Direkt&#x00F6;r</surname> <given-names>C.</given-names></name></person-group> (<year>2017</year>). <article-title>Determination of self-efficacy and burnout state of teachers working in the special education field in terms of different variables</article-title>. <source>J. Educ. Train. Stud.</source> <volume>5</volume>, <fpage>160</fpage>&#x2013;<lpage>166</lpage>. doi: <pub-id pub-id-type="doi">10.11114/jets.v5i3.2237</pub-id></citation></ref>
<ref id="ref9001"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>O&#x2019;Brennan</surname> <given-names>L.</given-names></name> <name><surname>Pas</surname> <given-names>E.</given-names></name> <name><surname>Bradshaw</surname> <given-names>C.</given-names></name></person-group> (<year>2017</year>). <article-title>Multilevel examination of burnout among high school staff: Importance of staff and school factors</article-title>. <source>School Psychology Review</source>, <volume>46</volume>, <fpage>165</fpage>&#x2013;<lpage>176</lpage>. doi: <pub-id pub-id-type="doi">10.17105/SPR-2015-0019.V46-2</pub-id></citation></ref>
<ref id="ref62"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Panagouli</surname> <given-names>N.</given-names></name> <name><surname>Meimeti</surname> <given-names>E.</given-names></name> <name><surname>Galanis</surname> <given-names>P.</given-names></name> <name><surname>Tsiachri</surname> <given-names>M.</given-names></name> <name><surname>Koutsogianni</surname> <given-names>P.</given-names></name> <name><surname>Yfantis</surname> <given-names>A.</given-names></name></person-group> (<year>2019</year>). <article-title>Burnout syndrome in the professionals employed in special education schools</article-title>. <source>Hellenic J. Nurs. Sci.</source> <volume>12</volume>, <fpage>44</fpage>&#x2013;<lpage>52</lpage>. doi: <pub-id pub-id-type="doi">10.24283/hjns.2019.3.5</pub-id></citation></ref>
<ref id="ref63"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Park</surname> <given-names>E.-Y.</given-names></name> <name><surname>Shin</surname> <given-names>M.</given-names></name></person-group> (<year>2020</year>). <article-title>A meta-analysis of special education teachers&#x2019; burnout</article-title>. <source>SAGE Open</source> <volume>10</volume>, <fpage>1</fpage>&#x2013;<lpage>18</lpage>. doi: <pub-id pub-id-type="doi">10.1177/2158244020918297</pub-id></citation></ref>
<ref id="ref64"><citation citation-type="other"><person-group person-group-type="author"><name><surname>Plash</surname> <given-names>S. H.</given-names></name> <name><surname>Piotrowski</surname> <given-names>C.</given-names></name></person-group> (<year>2005</year>). <italic>Retention issues: A study of Alabama special education teachers</italic> (Doctoral dissertation, University of West Florida).</citation></ref>
<ref id="ref65"><citation citation-type="other"><person-group person-group-type="author"><name><surname>Ramdan</surname> <given-names>I. M.</given-names></name> <name><surname>Yasinta</surname> <given-names>E.</given-names></name> <name><surname>Suhatmady</surname> <given-names>B.</given-names></name></person-group> (<year>2020</year>). Burnout and related factors amongst special schoolteachers in Samarinda. In <italic>2nd educational sciences international conference (Esic 2019)</italic> (pp. 67&#x2013;71). Atlantis Press.</citation></ref>
<ref id="ref66"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Rashkovits</surname> <given-names>S.</given-names></name> <name><surname>Livne</surname> <given-names>Y.</given-names></name></person-group> (<year>2013</year>). <article-title>The effect of education level on psychological empowerment and burnout-the mediating role of workplace learning behaviors</article-title>. <source>Int. J. Psychol. Behav. Sci.</source> <volume>7</volume>, <fpage>1896</fpage>&#x2013;<lpage>1901</lpage>.</citation></ref>
<ref id="ref67"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Rogers</surname> <given-names>W.</given-names></name> <name><surname>Johnson</surname> <given-names>N.</given-names></name></person-group> (<year>2018</year>). <article-title>Strategies to include students with severe/multiple disabilities within the general education classroom</article-title>. <source>Phys. Disabil. Educ. Relat. Serv.</source> <volume>37</volume>, <fpage>1</fpage>&#x2013;<lpage>12</lpage>. doi: <pub-id pub-id-type="doi">10.14434/pders.v37i2.24881</pub-id></citation></ref>
<ref id="ref68"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Rohmer</surname> <given-names>O.</given-names></name> <name><surname>Palomares</surname> <given-names>E. A.</given-names></name> <name><surname>Popa-Roch</surname> <given-names>M.</given-names></name></person-group> (<year>2024</year>). <article-title>Attitudes towards disability and burnout among teachers in inclusive schools in France</article-title>. <source>Int. J. Disabil. Dev. Educ.</source> <volume>71</volume>, <fpage>83</fpage>&#x2013;<lpage>100</lpage>. doi: <pub-id pub-id-type="doi">10.1080/1034912X.2022.2092078</pub-id></citation></ref>
<ref id="ref69"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Sari</surname> <given-names>H.</given-names></name></person-group> (<year>2004</year>). <article-title>An analysis of burnout and job satisfaction among Turkish special school headteachers and teachers and the factors effecting their burnout and job satisfaction</article-title>. <source>Educ. Stud.</source> <volume>30</volume>, <fpage>291</fpage>&#x2013;<lpage>306</lpage>. doi: <pub-id pub-id-type="doi">10.1080/0305569042000224233</pub-id></citation></ref>
<ref id="ref70"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>&#x015E;en</surname> <given-names>C.</given-names></name></person-group> (<year>2023</year>). <article-title>Investigation of burnout levels of special education teachers</article-title>. <source>J. Educ. Gifted Young Sci.</source> <volume>11</volume>, <fpage>521</fpage>&#x2013;<lpage>528</lpage>. doi: <pub-id pub-id-type="doi">10.17478/jegys.1344410</pub-id></citation></ref>
<ref id="ref71"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Sezer</surname> <given-names>F.</given-names></name></person-group> (<year>2012</year>). <article-title>Examining of teacher burnout level in terms of some variables</article-title>. <source>Int. Online J. Educ. Sci.</source> <volume>4</volume>, <fpage>617</fpage>&#x2013;<lpage>631</lpage>.</citation></ref>
<ref id="ref72"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Shyman</surname> <given-names>E.</given-names></name></person-group> (<year>2015</year>). <article-title>Toward a globally sensitive definition of inclusive education based in social justice</article-title>. <source>Int. J. Disabil. Dev. Educ.</source> <volume>62</volume>, <fpage>351</fpage>&#x2013;<lpage>362</lpage>. doi: <pub-id pub-id-type="doi">10.1080/1034912X.2015.1025715</pub-id></citation></ref>
<ref id="ref73"><citation citation-type="other"><person-group person-group-type="author"><name><surname>Squillaci</surname> <given-names>M.</given-names></name></person-group> (<year>2020</year>). Effects of perceived workload on the health of Swiss special education teachers. <italic>INTED2020 proceedings.</italic> Available at: <ext-link xlink:href="https://library.iated.org/view/SQUILLACI2020EFF" ext-link-type="uri">https://library.iated.org/view/SQUILLACI2020EFF</ext-link></citation></ref>
<ref id="ref74"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Stathopoulou</surname> <given-names>A.</given-names></name> <name><surname>Spinou</surname> <given-names>D.</given-names></name> <name><surname>Driga</surname> <given-names>A. M.</given-names></name></person-group> (<year>2023</year>). <article-title>Burnout prevalence in special education teachers and the positive role of ICTs</article-title>. <source>Int. J. Online Biomed. Eng.</source> <volume>19</volume>, <fpage>19</fpage>&#x2013;<lpage>37</lpage>. doi: <pub-id pub-id-type="doi">10.3991/IJOE.V19I08.38509</pub-id></citation></ref>
<ref id="ref75"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Sun</surname> <given-names>J.</given-names></name> <name><surname>Wang</surname> <given-names>Y.</given-names></name> <name><surname>Wan</surname> <given-names>Q.</given-names></name> <name><surname>Huang</surname> <given-names>Z.</given-names></name></person-group> (<year>2019a</year>). <article-title>Mindfulness and special education teachers' burnout: the serial multiple mediation effects of self-acceptance and perceived stress</article-title>. <source>Soc. Behav. Personal. Int. J.</source> <volume>47</volume>, <fpage>1</fpage>&#x2013;<lpage>8</lpage>. doi: <pub-id pub-id-type="doi">10.2224/sbp.8656</pub-id></citation></ref>
<ref id="ref76"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Sun</surname> <given-names>J.</given-names></name> <name><surname>Wang</surname> <given-names>X.</given-names></name> <name><surname>Wang</surname> <given-names>Y.</given-names></name> <name><surname>Du</surname> <given-names>X.</given-names></name> <name><surname>Zhang</surname> <given-names>C.</given-names></name></person-group> (<year>2019b</year>). <article-title>The mediating effect of perceived social support on the relationship between mindfulness and burnout in special education teachers</article-title>. <source>J. Community Psychol.</source> <volume>47</volume>, <fpage>1799</fpage>&#x2013;<lpage>1809</lpage>. doi: <pub-id pub-id-type="doi">10.1002/jcop.22229</pub-id>, PMID: <pub-id pub-id-type="pmid">31374580</pub-id></citation></ref>
<ref id="ref77"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Suvorov</surname> <given-names>V. G.</given-names></name> <name><surname>Belova</surname> <given-names>T. O.</given-names></name> <name><surname>Suvorova</surname> <given-names>K. O.</given-names></name></person-group> (<year>2021</year>). <article-title>Features of mental health and emotional burnout syndrome among teachers-defectologists of specialized educational institutions of school and primary vocational education</article-title>. <source>Terapevt (General Physician)</source> <volume>7</volume>, <fpage>60</fpage>&#x2013;<lpage>69</lpage>. doi: <pub-id pub-id-type="doi">10.33920/med-12-2107-08</pub-id></citation></ref>
<ref id="ref78"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Sze</surname> <given-names>S.</given-names></name></person-group> (<year>2009</year>). <article-title>A literature review: pre-service teachers&#x2019; attitudes towards students with disabilities</article-title>. <source>Education</source> <volume>130</volume>, <fpage>53</fpage>&#x2013;<lpage>56</lpage>.</citation></ref>
<ref id="ref79"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Tahar</surname> <given-names>M. M.</given-names></name> <name><surname>Yao</surname> <given-names>L. S.</given-names></name> <name><surname>Mokhtar</surname> <given-names>U. K. M.</given-names></name> <name><surname>Erlani</surname> <given-names>L.</given-names></name> <name><surname>Pujaningsih</surname> <given-names>P.</given-names></name></person-group> (<year>2023</year>). <article-title>Burnout level of special education teachers students with learning disabilities in special integrated education programme</article-title>. <source>Int. J. Acad. Res. Progress. Educ. Dev.</source> <volume>12</volume>, <fpage>13</fpage>&#x2013;<lpage>31</lpage>. doi: <pub-id pub-id-type="doi">10.6007/IJARPED/v12-i3/18235</pub-id></citation></ref>
<ref id="ref80"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Tran</surname> <given-names>V. D.</given-names></name></person-group> (<year>2015</year>). <article-title>Effects of gender on Teachers' perceptions of school environment, teaching efficacy, stress and job satisfaction</article-title>. <source>Int. J. High. Educ.</source> <volume>4</volume>, <fpage>147</fpage>&#x2013;<lpage>157</lpage>. doi: <pub-id pub-id-type="doi">10.5430/ijhe.v4n4p147</pub-id></citation></ref>
<ref id="ref9003"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Trung</surname> <given-names>N. D.</given-names></name> <name><surname>Ngoc</surname> <given-names>H. T.</given-names></name> <name><surname>Nhan</surname> <given-names>B. D.</given-names></name></person-group> (<year>2024</year>). <article-title>Teaching Burnout in Student-Teachers and Professional Teachers: Teaching Burnout Across Teacher Groups, Genders and the Link of Teaching Burnout to Teaching Satisfaction</article-title>. <source>International Journal of Religion</source>, <volume>5</volume>, <fpage>832</fpage>&#x2013;<lpage>841</lpage>. doi: <pub-id pub-id-type="doi">10.61707/4ajwy094</pub-id></citation></ref>
<ref id="ref81"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Tsubono</surname> <given-names>K.</given-names></name> <name><surname>Oba</surname> <given-names>K.</given-names></name> <name><surname>Fudetani</surname> <given-names>Y.</given-names></name> <name><surname>Ikeda</surname> <given-names>C.</given-names></name> <name><surname>Sakamoto</surname> <given-names>J.</given-names></name></person-group> (<year>2024</year>). <article-title>Multidimensional analysis of schoolteachers&#x2019; occupational stress by the new brief job stress questionnaire: focusing on gender differences</article-title>. <source>Ind. Health</source> <volume>62</volume>, <fpage>39</fpage>&#x2013;<lpage>55</lpage>. doi: <pub-id pub-id-type="doi">10.2486/indhealth.2023-0018</pub-id>, PMID: <pub-id pub-id-type="pmid">37245982</pub-id></citation></ref>
<ref id="ref82"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Tyagi</surname> <given-names>G.</given-names></name></person-group> (<year>2016</year>). <article-title>Role of teacher in inclusive education</article-title>. <source>Int. J. Educ. Appl. Res.</source> <volume>6</volume>, <fpage>115</fpage>&#x2013;<lpage>116</lpage>.</citation></ref>
<ref id="ref83"><citation citation-type="other"><person-group person-group-type="author"><collab id="coll2">UNESCO</collab></person-group>. (<year>2023</year>). <italic>Global Education Monitoring Report Summary, 2020: Inclusion and education: All means all</italic>. Available at: <ext-link xlink:href="https://www.unesco.org/en/articles/global-education-monitoring-report-summary-2020-inclusion-and-education-all-means-all" ext-link-type="uri">https://www.unesco.org/en/articles/global-education-monitoring-report-summary-2020-inclusion-and-education-all-means-all</ext-link></citation></ref>
<ref id="ref84"><citation citation-type="other"><person-group person-group-type="author"><name><surname>Vinogradova</surname> <given-names>N.</given-names></name> <name><surname>Syomina</surname> <given-names>M.</given-names></name> <name><surname>Kokhan</surname> <given-names>S.</given-names></name></person-group> (<year>2020</year>). Occupational burnout of educators implementing inclusive education programs in general educational institutions. In <italic>International scientific and practical conference on education, health and human wellbeing (ICEDER 2019)</italic> (pp. 155&#x2013;157). Atlantis Press.</citation></ref>
<ref id="ref85"><citation citation-type="journal"><person-group person-group-type="author"><name><surname>Williams</surname> <given-names>J.</given-names></name> <name><surname>Dikes</surname> <given-names>C.</given-names></name></person-group> (<year>2015</year>). <article-title>The implications of demographic variables as related to burnout among a sample of special education teachers</article-title>. <source>Education</source> <volume>135</volume>, <fpage>337</fpage>&#x2013;<lpage>345</lpage>.</citation></ref>
<ref id="ref86"><citation citation-type="other"><person-group person-group-type="author"><collab id="coll3">World Health Organization</collab></person-group>. (<year>2019</year>). Burn-out an &#x2018;occupational phenomenon&#x2019;, <italic>International Classification of Diseases.</italic> Available at: <ext-link xlink:href="https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases" ext-link-type="uri">https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases</ext-link></citation></ref>
</ref-list>
</back>
</article>