Abstract

Introduction

Physical violence is defined as the use of force or power with the objective of injuring, causing pain or incapacity, and even potentially leading to death ¹1. Minayo MCS. Violência e saúde. Rio de Janeiro: Editora Fiocruz; 2006.. Although it is not the most common form of violence, physical violence is the most frequently identified kind due to the lesions it causes and their consequences ²2. Martins CBG, Mello-Jorge MHP. Violência física contra menores de 15 anos: estudo epidemiológico em cidade do sul do Brasil. Rev Bras Epidemiol 2009; 12:325-37.. In Brazil, a total of 59,681 deaths from physical violence were reported in 2014, of which 42,755 involved the use of firearms and 12,102 involved cold steel weapons ³3. Lima RS, Bueno S, Martins C, Marques D, Pröglhöf PN, Astolfi R, et al. 10º anuário brasileiro de segurança pública. Ano 10, 2016. http://www.forumseguranca.org.br/storage/10_anuario_site_18-11-2016-retificado.pdf (acessado em 01/Mar/2017).
http://www.forumseguranca.org.br/storage... .

Violence in school is a major social problem, specifically when perpetrated against teachers. This type of violence is not detected by traditional information systems, which makes it difficult to monitor its occurrence. Thus, studies are needed to identify the prevalence, characteristics, and factors involved in violence in schools. An American survey, the APA Task Force on Violence Directed Against Teachers, investigated the experience of violence against 2,000 teachers working at various levels of teaching. The results showed that 80% of the teachers reported having experienced at least one episode of violence in the previous year, 94% of which perpetrated by students. Nearly half of the teachers (44%) reported having suffered physical aggression ⁴4. Espelage D, Anderman EM, Brown VE, Jones A, Lane KL, McMahon SD, et al. Understanding and preventing violence directed against teachers: recommendations for a national research, practice, and policy agenda. Am Psychol 2013; 68:75-87..

In studies with teachers, sociodemographic characteristics such as gender, conjugal status, and educational level were factors associated with the occurrence of physical violence ⁵5. Wilson CM, Douglas KS, Lyon DR. Violence against teachers: prevalence and consequences. J Interpers Violence 2011; 26:2353-71.^,66. Ervasti J, Kivimaki M, Pentti J, Salmi V, Suominen S, Vahtera J, et al. Work-related violence, lifestyle, and health among special education teachers working in Finnish basic education. J Sch Health 2012; 82:336-43.^,77. Wei C, Gerberich SG, Alexander BH, Ryan AD, Nachreiner NM, Mongin SJ. Work-related violence against educators in Minnesota: rates and risks based on hours exposed. J Safety Res 2013; 44:73-85.. Still, characteristics related to work condition and the school itself are more closely related to the occurrence of violence, like the number of students per classroom, teaching level, type of school ⁷7. Wei C, Gerberich SG, Alexander BH, Ryan AD, Nachreiner NM, Mongin SJ. Work-related violence against educators in Minnesota: rates and risks based on hours exposed. J Safety Res 2013; 44:73-85., size of the school, and perception of the school environment ⁸8. Khoury-Kassabri M, Astor RA, Benbenishty R. Middle Eastern adolescents' perpetration of school violence against peers and teachers: a cross-cultural and ecological analysis. J Interpers Violence 2009; 24:159-82.. A study in Minnesota, USA, further showed that teachers who had witnessed physical violence between one and three times in the 30 days prior to the survey showed threefold higher odds of suffering the same form of violence themselves ⁽⁹9. Gerberich SG, Nachreiner NM, Ryan AD, Church TR, McGovern PM, Geisser MS, et al. Case-control study of student-perpetrated physical violence against educators. Ann Epidemiol 2014; 24:325-32..

Despite this troubling situation, quantitative studies on school violence in Brazil are still scarce, and most focus on violence between students or against students ¹⁰10. Marriel LC, Assis SG, Avanci JQ, Oliveira RVC. Violência escolar e auto-estima de adolescentes. Cad Pesqui 2006; 36:35-50.^,1111. Moura DR, Cruz ACN, Quevedo LA. Prevalência e características de escolares vítimas de bullying. J Pediatr (Rio J.) 2011; 87:19-23.^,1212. Oliveira JC, Barbosa AJG. Bullying entre estudantes com e sem características de dotação e talento. Psicol Reflex Crit 2012; 25:747-55.^,1313. Tortorelli MFP, Carreiro LRR, Araújo MV. Correlações entre a percepção da violência familiar e o relato de violência na escola entre alunos da cidade de São Paulo. Psicol Teor Prát 2010; 12:32-42.. A recently published systematic review identified only four articles with quantitative data that investigated violence against teachers in Brazilian schools ¹⁴14. Nesello F, Sant'Anna FL, Santos HG, Andrade SM, Mesas AE, González AD. Características da violência escolar no Brasil: revisão sistemática de estudos quantitativos. Rev Bras Saúde Matern Infant (Online) 2014; 14:119-36.. The main forms of violence against teachers in these studies were: aggression ¹⁵15. Ferreira LP, Latorre MRDO, Giannini SPP. A violência na escola e os distúrbios de voz de professores. Distúrb Comun 2011; 23:165-72.^,1616. Gasparini SM, Barreto SM, Assunção AA. Prevalência de transtornos mentais comuns em professores da rede municipal de Belo Horizonte, Minas Gerais, Brasil. Cad Saúde Pública 2006; 22:2679-91.^,1717. Medeiros AM, Assunção AA, Barreto SM. Absenteeism due to voice disorders in female teachers: a public health problem. Int Arch Occup Environ Health 2012; 85:853-64., threats, insults ¹⁵15. Ferreira LP, Latorre MRDO, Giannini SPP. A violência na escola e os distúrbios de voz de professores. Distúrb Comun 2011; 23:165-72.^,1818. Levandoski G, Ogg F, Cardoso FL. Violência contra professores de educação física no ensino público do Estado do Paraná. Motriz Rev Educ Fís (Impr) 2011; 17:374-83., racist attacks ¹⁵15. Ferreira LP, Latorre MRDO, Giannini SPP. A violência na escola e os distúrbios de voz de professores. Distúrb Comun 2011; 23:165-72., and feelings of insecurity in the school environment ¹⁸18. Levandoski G, Ogg F, Cardoso FL. Violência contra professores de educação física no ensino público do Estado do Paraná. Motriz Rev Educ Fís (Impr) 2011; 17:374-83., showing the limited range of the literature on physical violence against teachers.

Studies on physical violence against teachers generally analyze for direct relations between independent variables and the outcome, such as linear regression ⁵5. Wilson CM, Douglas KS, Lyon DR. Violence against teachers: prevalence and consequences. J Interpers Violence 2011; 26:2353-71., logistic regression ⁶6. Ervasti J, Kivimaki M, Pentti J, Salmi V, Suominen S, Vahtera J, et al. Work-related violence, lifestyle, and health among special education teachers working in Finnish basic education. J Sch Health 2012; 82:336-43., and Poisson regression ⁷7. Wei C, Gerberich SG, Alexander BH, Ryan AD, Nachreiner NM, Mongin SJ. Work-related violence against educators in Minnesota: rates and risks based on hours exposed. J Safety Res 2013; 44:73-85.. However, considering violence as a complex phenomenon, analyses are needed that also examine indirect effects or mediation, such as with structural equation models ¹⁹19. Gunzler D, Chen T, Wu P, Zhang H. Introduction to mediation analysis with structural equation modeling. Shanghai Arch Psychiatry 2013; 25:390-4..

Considering the theme’s relevance and using structural equation modeling, the current study aimed to identify associations between sociodemographic, workplace, and school environmental factors and physical violence against teachers.

Methods

This was a cross-sectional epidemiological study in Londrina, Paraná State, Brazil, from August 2012 to June 2013, as part of a larger study: Pro-Teacher: Health, Lifestyle, and Work of Teachers in the State School System in Londrina. The invitation to participate was addressed to all teachers from the 20 schools with the most teachers in Londrina’s city limits (out of 63) in the state elementary and middle school system. The schools were selected by convenience, due to accessibility, distributed across all areas of the city, and including approximately 70% of the elementary teachers. The current study only considered teachers that had taught for at least a year.

Data were collected by previously trained interviewers at the teacher’s school, scheduled when they were not involved in classroom activities. The data collection instrument was tested in a pilot study with 82 teachers from three state schools in a smaller city in Greater Metropolitan Londrina. After adjustments, the definitive instruments consisted of a form for annotation of the answers to the interviews (taking approximately 40 minutes) and a questionnaire completed by the teachers themselves after the interview (taking approximately 15 minutes), with questions that were essentially self-reported, for example race/color, and scales validated only for self-completion, not used in the current study. The data were double-keyed in a databank created in Epi Info (Centers for Disease Control and Prevention, Atlanta, USA), version 3.5.4 for Windows, and after checking and correcting for discrepancies, the consolidated databank was analyzed.

Losses were defined as teachers that were on leave at the time of the data collection (21 days in each school) and did not return to work within 30 days after the end of the data collection, those whom it was not possible to contact after five attempts, and those who refused to participate in the study.

Physical violence in school (in the 12 months prior to the study and in the school’s space) was the study outcome, defined as an affirmative answer to one of the three following questions: “Have you suffered physical aggression or attempts at physical aggression?”; “Have you suffered physical aggression or attempts at physical aggression with cold steel weapons (knives, pocket knives, scissors, etc.)?”; and “Have you suffered physical aggression or attempts at physical aggression with firearms?”.

The independent variables refer to sociodemographic characteristics (gender, age, and self-reported race/color), work (type of employment contract and number of workplaces), and school environment (quality of teacher-student relationship, having been threatened, or having witnessed physical violence in the school in the 12 months prior to the study). Gender and self-reported race/color were recorded by the teacher on the questionnaire. The other variables were obtained during the interview.

The race/color variable was collected with the following options (according to the official Brazilian census categories): yellow, white, indigenous, brown, or black, and was then grouped as white or non-white. Information on age was collected as continuous and then categorized as 40 years or less and 41 years or more. The variable “number of workplaces” (number of different schools where the teachers were teaching) was categorized as one, two, and three or more, and “type of contract” as stable versus temporary employment contract. Information on the teacher-student relationship was collected with the following question: “How do you rate your relationship with students?”. The options were excellent, good, fair, or bad. This variable was then dichotomized as excellent/good and fair/bad. Having witnessed physical violence against other teachers or students and having received threats in the school were categorized as yes or no.

Structural equation models were used to investigate associations between physical violence and teacher-student relationship, sociodemographic characteristics, work conditions, threats, and witnessing physical violence in the school. These models allow analyzing the theoretical complexity of the study variables through the definition of a linear equations system that represents hypothetical effects, established by the researcher, of the independent variables over the course of the target outcome’s causal chain ²⁰20. Greenland S. Causal analysis in the health sciences. J Am Stat Assoc 2000; 95:286-9.. Two equations are used: the measurement equation, referring to the definition of the latent variables, and the structural equation, used to identify the effect of the latent and/or observed variables on the target outcome. In this context, two types of variables can be used: observable, i.e. directly measured, and latent, represented by measurement equations and only partially measured by linear combinations of the observed variables. For specification of the structural equation, the latent variables are further classified as exogenous (independent) or endogenous (dependent). Exogenous latent variables are independent variables whose causes are not added to the model. Meanwhile, the endogenous variable is the model’s dependent variable, determined theoretically by relations specified by the researcher ²¹21. Bollen KA. Structural equations with latent variables. Chichester: John Wiley & Sons; 1989.^,2222. DiLalla LF. A structural equation modeling overview for medical researchers. J Dev Behav Pediatr 2008; 29:51-4..

A path diagram was thus developed, based on previous studies on the theme, in which sociodemographic characteristics ⁵5. Wilson CM, Douglas KS, Lyon DR. Violence against teachers: prevalence and consequences. J Interpers Violence 2011; 26:2353-71.^,66. Ervasti J, Kivimaki M, Pentti J, Salmi V, Suominen S, Vahtera J, et al. Work-related violence, lifestyle, and health among special education teachers working in Finnish basic education. J Sch Health 2012; 82:336-43.^,77. Wei C, Gerberich SG, Alexander BH, Ryan AD, Nachreiner NM, Mongin SJ. Work-related violence against educators in Minnesota: rates and risks based on hours exposed. J Safety Res 2013; 44:73-85. and work conditions ⁷7. Wei C, Gerberich SG, Alexander BH, Ryan AD, Nachreiner NM, Mongin SJ. Work-related violence against educators in Minnesota: rates and risks based on hours exposed. J Safety Res 2013; 44:73-85.^,88. Khoury-Kassabri M, Astor RA, Benbenishty R. Middle Eastern adolescents' perpetration of school violence against peers and teachers: a cross-cultural and ecological analysis. J Interpers Violence 2009; 24:159-82. showed a significant association with physical violence against schoolteachers, establishing possible relations between the observed and latent variables and this outcome.

The latent variable “physical violence” (PV) was constructed from three observed variables: violence or attempts at physical aggression (PA), aggression with cold steel weapons (CS), and aggression with firearms (FA). Work conditions (WC) resulted from two observed variables: number of workplaces (NW) and type of work contract (TC). Having witnessed physical violence against other teachers or students (WV) and having suffered threats (TH) were combined to form the latent variable “other situations of violence in the school” (OV).

The structural model considered the relations between exogenous latent variables (WC and OV) and the endogenous variable (PV), adjusted for teacher’s gender, age, and race/color and perceived teacher-student relationship (RelStudent) (Figure 1). Modification indices were analyzed to identify relations not considered in the model’s specification that might improve its fit.

Missing data and outliers were verified. Only the variable “having witnessed physical violence in school” showed missing data. To adjust the structural equation model, we used weighted least squares mean and variance adjusted estimation (WLSMV), appropriate for modeling categorical observed variables. The model’s goodness of fit was verified by the Tucker-Lewis index (TLI) (reference for good fit: TLI > 0.90), confirmatory fit index (CFI) (reference for good fit: > 0.90), root mean square error of approximation (RMSEA) (reference for good fit: < 0.05), and standardized root mean square residual (SRMR) (reference for good fit: < 0.08).

All the analyses were performed with the public domain R package, version 2.4.1 (The R Foundation for Statistical Computing, Vienna, Austria, http://www.r-project.org). The structural equation model was adjusted with the Lavaan statistical package.

The research project was approved by the Institutional Review Board of Universidade Estadual de Londrina (case review n. 01817412.9.0000.5231), and the interview was only conducted after explanation of the study’s objectives and consent by the participant, who signed a free and informed consent form.

Results

Of the 937 teachers eligible for the study in the 20 selected schools, 65 (6.9%) were on leave and did not return within 30 days after the end of the data collection at their schools, 20 (2.1%) had not been found after five attempts, and 63 (6.7%) refused to participate, totaling 148 losses (15.8%). The final study sample thus consisted of 789 teachers (response rate = 84.2%).

Teachers’ mean age was 40.7 years (standard deviation = 9.9 years; range 23-68). Nearly two-thirds were women (66.4%), and nearly three-fourths were white (74%). The majority had stable work contracts (64.1%) and nearly one-third worked in three or more schools (31.8%). A small proportion of the teachers rated their relations with students as fair or bad (10.3%). As for “other situations of violence in the school environment”, 601 teachers (76.3%) reported having witnessed some episode of physical violence, while 169 (21.4%) reported having suffered threats (Table 1).

Sixty-two (7.9%) of the teachers reported having suffered aggression or attempts at physical aggression, of which six (0.8%) with cold steel weapons and four (0.5%) with firearms (Table 1). The frequency of reports of physical violence in the school, was 8.4%, since some teachers had suffered more than one type of violence.

As for measurement of the exogenous variables, except for the observed variable “number of workplaces” (λ = 0.456), the factor loads showed low values (less than 0.40), albeit statistically significant (p < 0.05). For the endogenous variable PV, the factor loads were also low, and not significant (p = 0.198) in the case of the observed variable “aggression with firearms”.

Different regression equations were tested for the structural model, with analysis of modification indices. Goodness of fit was unsatisfactory for race/color and gender in the model, so these variables, which did not show statistical significance, were removed from the subsequent analyses. In addition, the covariances between teacher’s age, type of contract, and number of workplaces were added to the model. The final model thus included the observed variables age and teacher-student relationship (RelStudent) and the latent variables work conditions and other situations of violence in the school.

There was a statistically significant association between “work conditions” and physical violence (p = 0.032), and although “other violence in the school” did not show a p-value < 0.05, it was the variable with the strongest effect on physical violence (Table 2). There were also positive correlations between the observed variables “age” and “number of workplaces”, “age” and “type of contract”, and between the latent variables “work conditions” and “other violence in the school”. The model’s goodness of fit indices, RMSEA, CFI, and SRMR, showed satisfactory values (Table 2).

Work conditions had a significant direct effect on the physical violence construct. Age showed an indirect association with physical violence, correlating (age ≤ 40 years) with worse work conditions (Figure 2).

Discussion

This study found that one out of twelve teachers reported having suffered physical violence in the school in the 12 months prior to the interview. Work conditions, such as temporary work contracts and number of different schools in which they taught were significantly associated with physical violence. Having witnessed or suffered other types of violence in school were also associated with physical violence, without reaching statistical significance due to the level set in the study (p < 0.05), but close to it (p = 0.059).

Some methodological issues should be addressed. The study is unique in Brazil in that it discusses physical violence against teachers, specifically using structural equation modeling. The analysis provided a better understanding of how the factors relate to each other and their direct and indirect influences on physical violence against teachers. Although it was a cross-sectional study and did not allow determining the temporal relationship between any two variables, we proposed a causal diagram considering that sociodemographic factors and work conditions precede physical violence in schools, according to the literature ⁵5. Wilson CM, Douglas KS, Lyon DR. Violence against teachers: prevalence and consequences. J Interpers Violence 2011; 26:2353-71.^,66. Ervasti J, Kivimaki M, Pentti J, Salmi V, Suominen S, Vahtera J, et al. Work-related violence, lifestyle, and health among special education teachers working in Finnish basic education. J Sch Health 2012; 82:336-43.^,77. Wei C, Gerberich SG, Alexander BH, Ryan AD, Nachreiner NM, Mongin SJ. Work-related violence against educators in Minnesota: rates and risks based on hours exposed. J Safety Res 2013; 44:73-85.^,88. Khoury-Kassabri M, Astor RA, Benbenishty R. Middle Eastern adolescents&apos; perpetration of school violence against peers and teachers: a cross-cultural and ecological analysis. J Interpers Violence 2009; 24:159-82.. The observed variables showed low loads in the construction of the latent variables, probably due to the small numbers in reports of physical violence, threats, and worse work conditions, but the theoretical model showed high goodness of fit indices.

The way information was obtained on violence against teachers, based on self-report, is subject to distortions resulting from recall bias, the interviewees’ urge to report the experience of violence, and even their perception of violence. Despite the possibility of information bias, physical violence is considered a traumatic event, potentially unforgettable for the victims. Healthy worker bias may also have occurred due to loss of some teachers (15.8%), especially those on sick leave. These losses may have led to underestimation of the study’s results, since adverse work conditions ⁽²³23. Cruz RM, Welter M, Guisso L. Saúde docente, condições e carga de trabalho. Revista Electrónica de Investigación y Docencia 2010; 4:147-60. and having experienced situations of violence ²⁴24. Ortega A, Christensen KB, Hogh A, Rugulies R, Borg V. One-year prospective study on the effect of workplace bullying on long term sickness absence. J Nurs Manag 2011; 9:752-59. are important factors for teachers’ sick leave. Another limitation involves the study’s external validity, i.e., the impossibility of extrapolating the findings to other samples of teachers and other contexts, even though the profile of the teachers in Londrina is similar to that of other cities in Brazil ²⁵25. Reis EJFB, Carvalho FM, Araújo TM, Porto LA, Silvany Neto AM. Trabalho e distúrbios psíquicos em professores da rede municipal de Vitória da Conquista, Bahia, Brasil. Cad Saúde Pública 2005; 21:1480-90.^,2626. Vedovato TG, Monteiro MI. Perfil sociodemográfico e condições de saúde e trabalho dos professores de nove escolas estaduais paulistas. Rev Esc Enferm USP 2008; 42:291-97.. Neither is school violence exclusive to that city ¹⁵15. Ferreira LP, Latorre MRDO, Giannini SPP. A violência na escola e os distúrbios de voz de professores. Distúrb Comun 2011; 23:165-72.^,1616. Gasparini SM, Barreto SM, Assunção AA. Prevalência de transtornos mentais comuns em professores da rede municipal de Belo Horizonte, Minas Gerais, Brasil. Cad Saúde Pública 2006; 22:2679-91.^,1717. Medeiros AM, Assunção AA, Barreto SM. Absenteeism due to voice disorders in female teachers: a public health problem. Int Arch Occup Environ Health 2012; 85:853-64.. We should also highlight the study’s positive features, like the high response rate and the fact that the participating teachers represent approximately 70% of the elementary and middle school teacher population in Londrina.

Reports of physical aggression and use of weapons against teachers reveal the seriousness of this type of violence in school. The low frequency of the variables comprising the latent variable “physical violence”, especially aggression involving cold steel weapons and firearms, may have affected the model, with insufficient power to demonstrate effects with statistical significance. However, even with lower frequencies than psychological violence ⁵5. Wilson CM, Douglas KS, Lyon DR. Violence against teachers: prevalence and consequences. J Interpers Violence 2011; 26:2353-71., the use of weapons in schools is an extremely serious event that poses grave risks to people’s physical and mental health. According to Malta et al. ²⁷27. Malta DC, Porto DL, Crespo C, Andreazzi MAR, Silva CS, Silva MMA, et al. Vivência de violência entre escolares brasileiros: resultados da Pesquisa Nacional de Saúde do Escolar (PeNSE). Ciênc Saúde Coletiva 2010; 15 Suppl 2:3053-63., the feeling of insecurity and fights with cold steel weapon and firearms reflect the violence pervading the school environment, expressed by the inequalities and iniquities in the distribution of resources and equipment in the country.

The same context includes reports of other types of violence in school. This finding is consistent with observations in a North American study that identified higher odds of suffering physical violence in teachers that had witnessed more episodes of violence, especially physical aggression ⁹9. Gerberich SG, Nachreiner NM, Ryan AD, Church TR, McGovern PM, Geisser MS, et al. Case-control study of student-perpetrated physical violence against educators. Ann Epidemiol 2014; 24:325-32.. Thus, the association between having witnessed physical violence or having received threats and having actually suffered violence is a recurrent problem that appears simultaneously in different ways in schools, such that teachers feel unsafe and constantly vulnerable to violence. Violence in the workplace has major adverse consequences for physical ²⁸28. Miranda H, Punnett L, Gore RJ; ProCare Research Team. Musculoskeletal pain and reported workplace assault: a prospective study of clinical staff in nursing homes. Hum Factors 2014; 56:215-27.^,2929. Kivimaki M, Virtanen M, Vartia M, Elovainio M, Vahtera J, Keltikangas-Jarvinen L. Workplace bullying and the risk of cardiovascular disease and depression. Occup Environ Med 2003; 60:779-83. and psychological health ³⁰30. Verkuil B, Atasayi S, Molendijk ML. Workplace bullying and mental health: a meta-analysis on cross-sectional and longitudinal data. PLoS One 2015; 10:e0135225., besides jeopardizing the school’s ultimate objectives of educating, teaching, and learning ⁽³¹31. Abramovay M. Victimización en las escuelas: ambiente escolar, robos y agresiones físicas. Revista Mexicana de Investigación Educativa 2005; 10:833-64..

Teachers’ work conditions were directly associated with physical violence. Teachers on temporary contracts are often overworked, with a high classroom load, teaching in more schools and having less decision-making power on the schools where they are allocated to teach, when compared to teachers with job stability ³²32. Ferreira DCK, Abreu CBM. Professores temporários: flexibilização das contratações e condições de trabalho docente. Trabalho & Educação 2014; 23:129-39.. Such conditions, indicative of precarization of work, significantly expose teachers to physical violence. Thus, teachers on temporary contracts tend to be sent to schools located in more violence-prone neighborhoods.

Age had an indirect impact on physical violence, since it correlates with work conditions. This result is explained by the fact that temporary contracts are more common among younger teachers. According to a study from 2002 to 2013, Brazil’s elementary school system underwent a major change in teachers’ age profile. There was a large drop in the contingent of teachers 25 years and younger who started their teaching careers on stable contracts ³³33. Plano Nacional de Educação. Transformações recentes no perfil do docente das escolas estaduais e municipais de educação básica. (Nota Técnica, 141). http://www.dieese.org.br/notatecnica/2014/notaTec141DocentesPnadvf.pdf (acessado em 10/Mar/2017).
http://www.dieese.org.br/notatecnica/201... . In other words, younger teachers are probably working proportionally more as temps and under less adequate work conditions. However, it is not possible to rule out that older and more experienced teachers also have greater capacity to deal with conflicts ⁽³⁴34. Kourmousi N, Alexopoulos EC. Stress sources and manifestations in a nationwide sample of pre-primary, primary, and secondary educators in Greece. Front Public Health 2016; 4:73. and thus reduce the risk of physical violence.

Gender and race/color were not associated statistically with physical violence in this study. However, they are factors of human diversity that are frequently related to violent events that generate suffering and negatively influence victims’ health ³⁵35. Rios FC, Chong WK, Grau D. The need for detailed gender-specific occupational safety analysis. J Safety Res 2017; 62:53-62.^,3636. Berger M, Sarnyai Z. "More than skin deep": stress neurobiology and mental health consequences of racial discrimination. Stress 2015; 18:1-10. and work ³⁷37. Triana MDC, Jayasinghe M, Pieper JR. Perceived workplace racial discrimination and its correlates: a meta-analysis. J Organ Behav 2015; 36:491-513.. Other factors that may expose teachers to higher risk of violence, such as sexual orientation, religion, or beliefs, were not examined in this study.

Violence is a complex phenomenon resulting largely from relations in society, communication, and conflicts of power, with its conceptual thrust determined by each individual’s sociocultural conception and life experience ⁽¹1. Minayo MCS. Violência e saúde. Rio de Janeiro: Editora Fiocruz; 2006.^,3838. Assis SG, Marriel NSM. Reflexões sobre violência e suas manifestações na escola. In: Assis SG, Constantino P, Avanci JQ, organizadores. Impactos da violência na escola: um diálogo com professores. Rio de Janeiro: Editora Fiocruz; 2010. p. 41-64.. The current article thus did not aim to exhaust the topic, but to understand that violence in schools should be viewed in light of the violence in society as a whole and around schools ³⁹39. Becker, KL, Kassouf AL. Violência nas escolas públicas brasileiras: uma análise da relação entre o comportamento agressivo dos alunos e o ambiente escolar. Nova Economia 2016; 26:653-77., resulting mainly from social exclusion and intrinsically related to other aspects not addressed here, such as cultural impositions, social inequalities, the drug traffic, and lack of future prospects, opportunities, and work ⁴⁰40. Oliveira ECS, Martins STF. Violência, sociedade e escola: da recusa do diálogo à falência da palavra. Psicol Soc (Online) 2007; 19:90-8.^,4141. Priotto EP, Boneti LW. Violência escolar: na escola, da escola e contra a escola. Revista Diálogo Educacional 2009; 9:161-79.. In addition, the perpetration of violence and its victimization involve situations of tension, revolt, emotions, and feelings that should be addressed in greater depth in other types of studies, including those with qualitative approaches, for example.

In summary, the current study found that work conditions and other forms of violence in the school are factors that contribute to physical violence against teachers. The findings thus highlight the importance of improving teachers’ work conditions and implementing measures to prevent violence both in schools and in society as a whole. In school, it is important to encourage measures to promote democratic relations, respect for diversity, and peaceful coexistence ⁴²42. Silva FR, Assis SG. Prevenção da violência escolar: uma revisão da literatura. Educação e Pesquisa 2018; 44:e157305.. Such measures should be holistic, interdisciplinary, and permanent ⁴²42. Silva FR, Assis SG. Prevenção da violência escolar: uma revisão da literatura. Educação e Pesquisa 2018; 44:e157305.. Public policies to reduce violence in the schools’ surroundings and in society in general can have a direct effect on reducing such violence inside schools ²⁷27. Malta DC, Porto DL, Crespo C, Andreazzi MAR, Silva CS, Silva MMA, et al. Vivência de violência entre escolares brasileiros: resultados da Pesquisa Nacional de Saúde do Escolar (PeNSE). Ciênc Saúde Coletiva 2010; 15 Suppl 2:3053-63.^,3939. Becker, KL, Kassouf AL. Violência nas escolas públicas brasileiras: uma análise da relação entre o comportamento agressivo dos alunos e o ambiente escolar. Nova Economia 2016; 26:653-77..

Acknowledgments

The authors wish to thank Brazilian Graduate Studies Coordinating Board (Capes) for the Master’s and PhD scholarships and the Brazilian National Research Council (CNPq) for the research productivity grants.

References

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