121 Summary and general discussion distal secondary outcomes, factors more distantly or indirect related, large effects were found for teacher self-efficacy at both post-treatment and follow-up. Moderate effect sizes were noted for teacher-perceived classroom climate quality at post-treatment and 3-month follow-up. Between-group post-hoc tests showed significant results for most distal outcomes over the course of the follow-up period. Classroom climate quality fell just short of significance. There was no significant interaction effect for teacher-perceived pupil-teacher relationship. No significant moderation effects were found for any of the baseline variables past or present psychological problems, school weight, teachers’ years of experience and age on the primary outcome at post-measurement. In conclusion, the study provided compelling evidence that standard MBSR training may affect mental health through reducing perceived stress and improving well-being in elementary school teachers. Teacher self-efficacy and classroom climate quality also significantly improved, as well as mindfulness skills, emotion regulation and self-compassion. Chapter 5 describes the effects of the MBSR training on four potential mediators (mindfulness skills, self-compassion, emotion regulation and teacher self-efficacy) and explored whether changes in these processes are related to the program effectiveness. The multiple mediation model showed that changes in self-compassion and emotion regulation during the training mediated the effects of the MBSR training on perceived stress at 3-month follow-up. Additionally, changes in self-compassion during the training mediated the effect on well-being at 3-month follow-up and changes in teacher self-efficacy the effect on improvement of classroom climate quality. These findings indicate that including intervention components targeting self-compassion, emotional regulation and selfefficacy might increase the effectiveness of MBSR in reducing teachers’ perceived stress, increasing teachers’ well-being and improving the classroom climate quality. Chapter 6 details an explorative qualitative study (N = 46). Teachers who participated in the RCT between September 2020 until April 2021 were invited to the qualitative study. Twenty teachers from the intervention groups took part in semi-structured focus groups 16 weeks after completing MBSR, while 26 teachers from the control group, who participated in MBSR after the follow-up assessment in March 2021, were asked to evaluate the training during the last session of MBSR. Three key themes arose: a) changes affecting the teacher personally, (b) changes affecting the teacher professionally and (c) changes affecting the pupils as observed by the teacher. These themes were further subdivided into subthemes. A significant part of the participants reported increased awareness and insight in unhelpful patterns on a personal level but also during teaching. They experienced a positive effect on their emotion regulation by shifting from an automatic stress reaction to a conscious stress response. Furthermore, the acquired personal skills were found to positively impact professional skills, enabling teachers to better adapt their teaching to the needs of their pupils. Additionally, it is concluded that a mutual connection exists between teachers’ personal and professional skills. In addition, teachers also experienced that changing their attitude, behavior and lesson content (e.g. interweaving short mindfulness exercises during the day) directly impacted the classroom climate quality in a positive manner. 7
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