Intervention Program to Reduce Academic Burnout in University Mexican Students

Abstract

Academic burnout is the stress that students experience for a long time as a result of academic tasks. The objective of the present study was to examine whether the use of refresh activation, which is an active meditation that uses movement, conscious breathing, focus on attention and music, as a coping technique contributes positively to academic burnout. The refresh activation intervention program lasted 8 weeks. To measure the impact of the program, a pre-/posttest of the Maslach Burnout Inventory-Student Survey (MBI-SS) was used, as well as another questionnaire for stress perception in different areas of life and another for satisfaction in daily practice de la activation refresh. The participants were university Mexican students. The experimental group was composed of 36 students, also four students volunteered to share in a qualitative manner their experience in the practice of refresh activation, this to reinforce how the program helped them in reducing burnout.

1. Introduction

In recent years, the study of academic burnout has acquired vital importance, especially due to the negative repercussions experienced by university students in the digital era, where stress has become more relevant [1]. Furthermore, according to the World Health Organization (WHO), burnout syndrome is considered a disease [2]. In the educational work environment, stress becomes a constant danger, given the direct contact with students. This phenomenon manifests itself when there is an increased demand for individual capabilities to cope with the tasks at hand [3].

With the advent of the pandemic, people around the world have experienced higher levels of stress, less rest, and less enjoyment in their daily lives. Before the pandemic, in 2020, seven out of 10 people worldwide felt rested (69%), enjoyed themselves a lot (70%), and smiled or laughed often (72%). However, in 2021, half of the world’s population (50%) experienced a three percentage point decrease in feeling well-rested, and the percentage of those who enjoyed it a lot decreased by two points. Furthermore, in 2021, stress in the world affected four of 10 adults, who experienced a lot of worry (42%) or stress (41%), and 31% suffered a great deal of physical pain [4].

More than 20% of adolescents worldwide suffer from mental disorders, with suicide being the second leading cause of death in young people aged 15–19 years. In low and middle-income countries, 25% of adolescents have considered to commit suicide [5]. The lack of sleep to which young people are exposed can lead to obesity and depression, also affecting their safety and academic performance [6].

According to a study published in the Journal of Adolescent Health, young people suffer from chronic sleep deprivation, with more than 59% of them classified as severely sleep deprived. That is, they sleep on average 6 hours or less during the week [7]. There is evidence supporting a significant relationship between perceived stress and sleep quality, where it is observed that the higher the perceived stress, the worse the quality of sleep, and vice versa, the worse the quality of sleep, the higher the perceived stress [8]. These findings, together with other studies conducted with students, demonstrate the influence of academic stress on their student lives and its impact on their health [9].

The mental health of young people has been systematically ignored in national and international health plans, and very few have access to programs that teach them how to manage their emotions [5]. Some young people manage to acquire the necessary skills to continue with their academic development, while others face difficulties in obtaining them. In this context, the stressors that affect the student population most are exams, academic overload, short deadlines and the personality or character of teachers [10]. A tendency has even been observed in students to experience a decrease in their academic self-concept during the period close to exams [9].

Stress precedes burnout, as when stress accumulates over a prolonged period, it can give rise to burnout [11]. Burnout refers to a condition in which a person feels “burned out, worn out, exhausted, and has lost enthusiasm for work” [12]. Although the concept of burnout is attributed to the psychiatrist Freudenberger, Dr. Maslach is the main researcher who has given worldwide recognition to this syndrome [13].

In the academic environment, the chronic stress to which students are exposed is known as academic burnout, and it is important to have coping strategies to reduce stress and prevent negative consequences, such as anxiety and depression [14]. During the semester, many students face stressful situations and have difficulty managing their emotions, so it is essential to pay attention to the emotional aspect in the educational environment, without limiting the focus of educational quality improvement only to academics [15].

Unfortunately, a high percentage of young people do not receive treatment for mental health disorders, despite meeting diagnostic criteria, highlighting the need to provide them with adequate support and care [16]. Coping refers to the cognitive resources used to deal with stressful situations and there are different strategies, such as seeking social support in the close environment, which helps to solve problems and improve emotional well-being [17], and religion, as a way of coping with stress [18]. Avoiding or escaping stressful situations may contribute to the development of burnout, whereas strategies focused on solving the problem may prevent its occurrence. Burnout can be considered a self-defense mechanism when stress has been prolonged over a long period [19].

Coping strategies can be classified into action-focused, which seeks to solve the problem, and emotion-focused, which refers to in-the-moment emotional responses [20]. Emotion-focused strategies are closely related to stress and emotions [17]. The choice of a coping strategy depends on personal and situational factors and is linked to the degree of perceived stress, which implies an inseparable relationship between stress, coping and emotion [21].

In this context, this study aims to evaluate whether refresh activation, as a coping strategy, has a positive impact on the reduction of academic burnout.

2. Academic burnout

Stress occurs when a person is unable to cope with the demands of his or her environment, while anxiety refers to an emotional reaction to a cognitive, physiological, motor and emotional threat, and distress is related to the threat to the individual’s moral values and physical and psychological integrity [22]. Stress precedes burnout, as the latter develops when stress is experienced over a long period of time [23].

Burnout has been described as a phenomenon that especially affects professionals who work with people and is characterized by three dimensions: emotional exhaustion, depersonalization and lack of personal fulfillment at work [24]. In the academic setting, the Maslach Burnout Inventory-General Survey (MBI-GS) has been adapted to the Maslach Burnout Inventory Students Survey (MBI-SS), which assesses burnout, low academic efficacy and cynicism [25].

Although burnout has been widely studied in work settings, it is not limited exclusively to human services professionals but can manifest itself in various work contexts and academia [26]. Academic burnout has been investigated in various areas, such as medicine, physiotherapy, nursing, business, veterinary medicine, engineering, and psychology, among others [27, 28, 29, 30, 31, 32].

In the development of the Maslach Burnout Inventory, three subscales were identified: emotional exhaustion, depersonalization and self-efficacy. Although there is no hierarchy among the subscales, emotional exhaustion is considered the key aspect in the manifestation of burnout, as it occurs when a person’s emotional resources of a person are depleted due to the chronic stress to which he or she is exposed.

2.1 A key to burnout development

In the academic environment, multiple factors influence the development or prevention of burnout, both obstacles and facilitators. These factors can be classified into academic, environmental and intrapersonal variables. Intrapersonal variables include personality traits, motivation, satisfaction, expectations, time planning, and social and cognitive competencies [33].

Intrapersonal is the form of emotional perception that refers to the focus of attention on one’s feelings and understanding of oneself. Along with interpersonal skills, intrapersonal skills are considered to make up emotional intelligence. Interpersonal refers to the perception of emotions that occur in social interaction or other words, to the understanding of others [34].

Emotional intelligence has been revealed as a protective factor against depression, anxiety, stress and academic burnout [35]. It is defined as the ability to perceive, recognize and understand emotions, as well as to regulate them appropriately for emotional and intellectual growth [36]. Studies have shown that emotional intelligence is positively related to academic efficacy, dedication and absorption, and negatively related to perceived stress and the burnout and cynicism dimensions of academic burnout [37]. In addition, a significant relationship has been found between emotional intelligence and academic performance [38].

Academic performance is inversely related to stress. The relationship between academic variables such as performance and expectations of success is positive, while the relationship with academic efficacy tends to be negative and is associated with dropping out of school. Besides, the dimensions of burnout and cynicism have a negative correspondence with performance and expectations of success. These findings demonstrate the importance of considering academic variables about academic burnout [39].

Findings from a study with Mexican students showed that negative intrapersonal perception is associated with low educational achievement due to poor emotional management, lack of personal confidence and lack of motivation. Similarly, negative interpersonal perception is related to low school achievement. The findings also show that positive intrapersonal and interpersonal perceptions are positively associated with higher educational achievement [40]. Increased emotional intelligence leads to the development of intrapersonal and interpersonal skills that in turn lead to greater adaptability and stress management [41].

The intrapersonal state of students also plays a relevant role in burnout due to its influence on interpersonal communication. The intrapersonal state of students, both with teachers and with peers, friends and family, affects their studies, expectations of recognition, trust and interpersonal support. One study highlighted the importance of self-discipline and planning, showing that students with better grades had lower levels of burnout and cynicism, as well as higher professional efficacy. In addition, a lack of support and trust among students was associated with academic burnout [42]. Communication skills and openness to communication are personal coping resources for stress [43].

Time management is also linked to academic performance. One study revealed that students who applied time management strategies performed better academically in laboratory courses compared to those who did not pay as much attention to this area. Time management was negatively associated with test anxiety, suggesting better academic performance [44]. Another study found that students with higher time management skills showed lower levels of burnout [45].

Due to the influence of variables such as emotional intelligence, interpersonal communication, academic performance and time management on academic stress and burnout, it is recommended to implement stress-coping strategies, activities that promote well-being and healthy interactions, as well as time management techniques [46].

3. Coping techniques

Stress coping techniques can be classified into two categories: problem-focused and emotion-focused, according to Lazarus [47]. In the problem-focused strategy, the person seeks concrete solutions to solve the stressful situation, whereas in the emotion-focused strategy, one seeks to regulate the emotions generated by the stress through different approaches, such as positive reinterpretation or denial [17].

In a study conducted by Benavete, Quispe and Callata [48], various coping strategies used by individuals were identified. Problem-oriented strategies, such as planning and active coping, were the most frequent. On the other hand, emotion-oriented strategies included positive reinterpretation, personal growth, and denial. Perception-oriented strategies, such as mental disengagement and focusing and releasing emotions, were also observed.

In addition to these strategies, there are other coping techniques used to cope with stressful events in daily life. For example, the mindfulness meditation program has been shown to have a significant impact on the development of coping strategies, such as positive reappraisal and planning [49].

Meditation is a simple stress-reducing practice that can be easily learned. It focuses on focusing attention and pushing away stressful thoughts. This practice includes elements such as focused attention on a certain object or image, diaphragmatic breathing to expand the lungs, creating a calm environment free of distractions, and adopting a comfortable posture, whether sitting, lying down, or moving. In addition, an open attitude that allows thoughts to flow without judgment is encouraged [50].

The elements of meditation also include focused attention or creative relaxation, which allows access to memories stored in the mind and recreating pleasant images or situations [51]. Creative relaxation involves physical relaxation, and each individual can use his or her imagination to create strategies, resources and visualizations that provide well-being [52]. This technique has been shown to improve self-concept and imagination in children.

Breathing is another fundamental element in meditation, as it connects us with the present. Various techniques such as mindfulness meditation, Tai Chi, Yoga variants, Qigong and Vipassana, emphasize the importance of breathing [53, 54, 55, 56, 57, 58].

Movement also plays an important role in meditative techniques. Practices such as Qigong and Tai Chi have proven results in improving health [58]. Osho’s active meditation has also been shown to reduce psycho-emotional levels that cause stress. In addition, several studies claim that a higher intensity of vigorous physical activity is associated with a decrease in stress. In particular, aerobic training contributes to decreased perceived stress, and emotional fatigue and increases general well-being and sleep quality in people with burnout syndrome [59].

Although not all techniques involve the use of music, some of them use it as a resource to redirect stressful thoughts and other environmental stimuli [60]. Thus, the combination of breathing, movement, visualization and music gives rise to a new coping technique called refresh activation, which is the main focus of this research.

3.1 Refresh activation technique

Refresh activation is a new coping technique based on active meditation [61]. This technique involves engaging in activities such as dancing, where movements are performed without aiming for specific coordination. In addition, music is used to help raise energy and breathing is incorporated to help connect with the present moment and achieve focus and relaxation. During the refresh activation, the person is guided through a physical movement visualization, accompanied by uplifting music. At the same time, breathing is used as an element to help focus on the present and relax. Thus, refresh activation combines four main elements: breathing, movement, music and creative visualization. This technique seeks to achieve well-being and emotional balance by promoting connection with the present moment and raising energy through movement and music.

3.1.1 Breathing

Human energy manifests in different ways, including sound and breath. The way energy (known as prana or lung) manifests itself through the breath, and the voice through the sound that is generated by breathing. Often, however, the energetic level of the voice is imbalanced, because the energy remains stagnant, diminished or altered [62].

In the refresh activation technique, deep inhalation using the diaphragm muscle is used to expand the lungs. The goal of this is to connect with the present moment, helping the person to control their thoughts with conscious breathing [50]. This practice seeks to facilitate relaxation and well-being.

3.1.2 Movement

Energy in the human being is manifested by movement. This energetic movement is what constitutes its emotional aspect [62]. Active meditation requires a certain degree of physical activity, shouting and even dancing while involving uncoordinated movements, to reach a passive state [61].

Cortisol is an indicator of stress. In a study on dynamic meditation by Osho, cortisol levels dropped in participants after 21 days of meditation [61]. Other studies where they use movement, as happens in Yoga and Tai Chi, contributed to reducing emotional disturbances and stress levels [53].

In refresh activation, body movement is free. Through body flow, the practitioner becomes aware of every part of his body, making slow movements and increasing the intensity of the movement, helping to release the flow of thoughts.

3.1.3 Music

Music is a pleasant perception of sounds that generate well-being. With it, chemicals are activated that act on “the central nervous system [which] stimulates the production of neurotransmitters (dopamine, oxytocin, endorphins) and with it, joy and optimism”[63].

Music has been shown to have a positive effect on decreasing stress during exam times when students experience its highest levels. This, in turn, favors academic performance [64, 65]. Music also helps improving concentration in the completion of tasks and projects [65, 66].

It should be noted that music, not only benefits students; it also has a positive effect on clinical staff [67]. In the refresh activation technique, cheerful music is used to enhance the moos of individuals. This music is part of the practice in order to promote a sense of well-being and relaxation.

3.1.4 Visualization

Visualization refers to the creation or recreation of an experience in the mind, using images and all the senses. This technique, also known as mental rehearsal, requires a proper understanding of what is to be achieved in order to have an effective impact [68].

The importance of visualization lies in allowing the release of negative thoughts and emotions that can generate blockages. By using all senses vividly, one seeks to integrate thoughts as real as possible. This helps by focusing on the proposed achievement and promoting a positive mental state [13, 68].

Visualization is effective in rehabilitation programs for injured athletes. It has been observed that this technique contributes in improving self-efficacy, motivation and reduction of anxiety in these athletes [69].

In the refresh activation technique, the visualization stage consists of three key steps: release, integrate and focus. First, the individual releases the flow of negative thoughts, allowing their release and detachment. Next, he begins to imagine in great detail how he would like to be or what he would like to achieve, using as many senses as possible to make it as vivid and realistic as possible. Finally, he focuses on action, visualizing specifically how he will carry out his goals and objectives [50].

Based on this, the following hypothesis is proposed:

The refresh activation technique reduces the effects of burnout syndrome in university students, which are manifested through exhaustion, decreased academic efficacy and cynical attitudes.

4. Materials and methods

The present research was designed with a qualitative and descriptive approach, using the contemporary case method to evaluate the impact of the refresh activation coping technique on the dimensions of academic burnout in undergraduate university students. The study was quasiexperimental in nature, as a pre- and post-intervention measurement was conducted, but participants could not be randomly assigned to treatment and control groups. Also, a longitudinal approach was adopted by taking measurements using the MBI-SS scale at two different points in time. Four cases of students with elevated stress perception are analyzed in detail in the research.

4.1 Participants

In the quantitative part of the research, undergraduate students from a university in Bajío, Mexico, who perceived a high level of stress, participated on a voluntary basis. The sample consisted of 43 students, with an average age of 22 years, from a university population of more than 5000 students (5504). The inclusion criteria were practicing the refresh activation technique for a daily average of 20 minutes and to attend at least 85% of the virtual sessions. A total of 36 students met these criteria and were part of the sample.

For the case selection process, students were invited to participate and four of the 36 students voluntarily accepted to share their experience after completing the refresh activation program.

4.2 Instruments

For the measurement of the dimensions of academic burnout, the MBI-SS instrument was applied, which is composed of 15 items distributed as follows: 5 items for Emotional Exhaustion, four items for Cynicism and six items for Academic Efficacy. The MBI-SS is the most prolific instrument among the scientific community for the measurement of burnout in academic contexts; it has structural validity and reliability [70].

In addition, a satisfaction questionnaire was applied to evaluate the students’ perception of control over the variables influencing burnout and to know the effectiveness of the refresh activation technique as a coping strategy against burnout. This self-report questionnaire includes the assessment of emotional intelligence, communication, time management and academic performance. The use of self-report questionnaires is a common practice in the evaluation of psychological variables since it allows information to be obtained on people’s feelings, perceptions and behaviors [71].

Once the eight weeks of training in the refresh activation technique were completed, an interview was conducted with the four students, after signing the informed consent form.

4.3 Procedure

To avoid bias in the results, the students were given an introduction to the refresh activation technique on the first day of their participation in the program, without providing themwith detailed theoretical information about the technique. This was done to prevent any bias that might influence the results of the program. The main objective of the program was to evaluate the effectiveness of the refresh activation as a burnout coping technique, therefore, participants needed to practice the technique on a daily basis.

To ensure and motivate daily practice, a WhatsApp group chat was created to remind students about the importance of performing the refresh activation and encourage them to post when completed. This also fostered motivation among group members. In addition, they were required to attend a weekly one-hour virtual session in which the refresh activation was performed as a group. During these sessions, the three key elements of meditation were reinforced: breathing, movement, music and visualization. A minimum attendance threshold of 80% was established for these sessions.

The individual interviews lasted an estimated time 18 minutes and sought to create a calm and trusting environment that allowed the students to share their experience with the refresh activation technique and how it had helped them in their daily lives and academic performance. During the in-depth interviews, students were asked about how they felt before and after the 8 weeks of using the refresh activation.

To ensure the quality and objectivity of the research, three validity tests were applied: “construct validity, external validity and reliability” [72]. For the first, a review of the preliminary report of the interviews conducted with the students was carried out, thus ensuring the congruence and consistency of the data collected.

4.4 Data analysis

To estimate the dimensions of burnout, the mean of each group of items of the MBI-SS was calculated. These items were scored on a scale between 0 (zero) and 6 (six), and the NTP-732 of the “Instituto Nacional de Seguridad e Higiene en el Trabajo” (INSHT) of Spain [73] was implemented, considering that the NTP-732 has a vast implementation history as a reference to interpret the MBI in different contexts [30, 74]. To compare the pairs of data obtained from the MBI-SS, the Wilcoxon test for dependent samples was used.

The satisfaction questionnaire was applied at two points in time, to perform a paired sample analysis and estimate the significant evolution according to self-report. The items of the questionnaire were elaborated on a Likert-type scale from 1 to 10, and the result was the percentage obtained from the sum of the 10 items. The nonparametric Wilcoxon signed-rank test was applied to compare and evaluate the scores at the end of the intervention with those initially obtained.

The interview data were recorded and transcribed. The opinions of the students, who freely expressed their experiences, were taken into account. Emphasis was placed on preserving the maximum fidelity of the data and the interviews were transcribed as they were spoken. Subsequently, a description of the cases was made.

5. Results

The sample consisted of 36 students who completed the refresh activation program, with 47.2% female and 52.8% male. The average age of the students was 22.08 years (SD = 1.66), and they dedicated an average of 19.27 hours (SD = 19.79) to academic activities.

According to the results of the MBI-SS, a favorable evolution was observed in the students. Emotional Exhaustion decreased from a mean of 3.92 to 3.26, showing a p-value of 0.0033 (p < 0.05). The Cynicism score experienced a minimal change, going from a mean of 2.06 to 2.02 at the end of the intervention, without showing statistical significance, given that the p-value of 0.4658 is above the accepted alpha (0.05). On the other hand, Academic Efficacy increased significantly, going from a mean of 4.12 to 4.42, with a p-value of 0.0037 (p < 0.05). The internal consistency of the MBI-SS questionnaire was good in the Emotional Exhaustion (0.86), Cynicism (0.85) and Academic Efficacy (0.71) dimensions, according to Cronbach’s alpha coefficient [75].

For the satisfaction test, students obtained a mean of 47.42 in the first application and 71 in the second. The favorable change in self-report was significant according to the Wilcoxon test, with a p-value below 0.01 (p = 2.944E−05). The reliability of the questionnaire was good, with a Cronbach’s alpha coefficient score of 0.87 (Table 1).

Dimensions		Emotional exhaustion	Cynicism	Academic efficacy	Satisfaction test
Pretest	M	3.92	2.06	4.12	47.42
	SD	1.27	1.41	0.81	15.5
Postest	M	3.26	2.02	4.42	71
	SD	1.38	1.39	0.77	23.59
Z Wilcoxon		2.71	0.08	2.67	4.01
p value		0.0033	0.4658	0.0037	2.944E−05

Table 1.

Statistical test results.

Table 2 shows the academic impact experienced by the students, who reported feeling more relaxed as they learned to manage their time more effectively. In addition, they emphasized how important it is to allow themselves to experience emotions such as nervousness and the feeling of release when realizing that the nervousness disappeared.

Cases	Impact on the academic environment
Case 1	We all suffer stress from homework and internships and all that.; As for establishing my time, it was something I did not do, before it was like I have to study or I have to do this work and I was lazy.; I feel that in terms of my time-taking, my schedules and all that, yes, it helped me. But I feel that it helped me to organize the times of when to do my homework.
Case 2
Case 3	The more I said “I feel nervous” and repressed myself, I felt like it was accumulating and I said: “Come on! I feel nervous, so feel it, feel that nervousness in your body”. And the moment I exposed myself, it went very well… like all that nervousness went away, and I was like “ahh”. I was very pleased.
Case 4

Table 2.

Areas for improvement in the academic environment with refresh activation.

Table 3 shows the positive impact of the refresh activation program in the environment of the cases. In case 3, although no significant improvement is observed in comparison with the others, the conscious recognition that this is an area in which he needs to work and learn to express himself better stands out. In case 4, it is also perceived that the technique began to have an effect, given that the participant experienced more closeness with his family members.

Cases	Impact on the student’s environment
Case 1
Case 2
Case 3	And… it is very easy when we do exercises like this in the sessions, it is very easy to criticize you or tell you the negative things rather than the positive ones. So I think that, in that aspect, it helps me a lot. So I have gone through many emotions and many moments in which it has helped me a lot, but I feel that yes: I have to keep working… To know how to express myself with others and not to keep everything to myself.
Case 4	I had anxiety attacks… very serious problems. Believe me, I wanted to give up everything when I had the attacks… and that is when I fell flat. And then, now that I’m back with my family, problems came back. But now I am closer to them, I feel that I have changed and that I am changing.; And that’s when I realized, “Okay, you are changing, you are growing, that’s a good thing.” And that’s when I started to realize that all this is working.

Table 3.

Areas of improvement with their environment with refresh activation.

Table 4 details the improvements observed in the intrapersonal area of the four cases. It is highlighted that the refresh activation program helped them to increase their self-confidence, improve their self-esteem and allow their feelings to flow freely. These results indicate a positive impact on their self-perception and emotional well-being.

Cases	Intrapersonal impact
Case 1	Refresh is a lot of fun because it tells you to move, to let go… and it relaxes you. I feel that way, it really relaxes your soul. On a personal level, yes, it helped me to believe a little more in myself. And that was what was failing me the most. I did not believe in myself, or I almost always made myself less me.
Case 2	At the beginning of the technique, I let my feelings flow… I learned not to repress things so much.
Case 3	At the beginning it was very difficult for me. It gave me a lot of anxiety. It was so helpful to be told and to let our emotions and feelings be felt… That was very helpful to me.
Case 4	If I had stopped the method, because of all the disorder that came to me I did not feel like anything and that’s when I said “this is helping me in some way, so I’m going to take it up again.” It did not become a habit as such, but little by little. It’s not just that. I’m getting into the habit of studying. I’m taking better care of myself. Starting with the fact that I’m loving myself more, because I did not love myself at all…

Table 4.

Areas of intrapersonal improvement with refresh activation.

6. Discussion and conclusions

The findings resulting from the quantitative assessment methods show a significant improvement in the students after participating in the refresh activation intervention. In the scores, a significant decrease in Emotional Exhaustion and an increase in Academic Efficacy were observed. However, the Cynicism dimension did not show a significant decrease. These results are supported by the students’ reports in the self-report questionnaire, where they manifested an improved self-perception of their emotional intelligence, academic performance, communication and time management. The consistency between the results of both questionnaires suggests that better management of emotions is related to a decrease in emotional exhaustion, and higher academic performance is linked to greater academic efficacy.

In addition, in the interviews conducted, there was an evident coincidence in the impact of the intervention on the intrapersonal aspect. Students considered it important to learn to recognize and cope with emotion, which is in line with what was found by Berra Ruiz et al. [17], where emotion-based coping strategies were identified.

It is clarified that, in previous research with university students [30], variables such as school year and tobacco use have been linked to higher scores in the Cynicism dimension. However, these variables were not addressed in this research, so additional studies exploring vocational attitudes, dropout, motivation and satisfaction, among others, are suggested to better understand the particularities of this dimension.

Finally, considering that academic overload is one of the main stressors that affects the balance between time dedicated to academic activities and other areas of life (family and social), the implementation of coping strategies that promote the integral development of the student and encourage a healthy lifestyle is recommended [76].

Acknowledgments

For funding the project, to the Burnout Institute and its director and creator of Refresh Activation Rosy D’Amico. To the student volunteers and the institute’s team for the realization of the project. To Monica Peña and Edgar Moreno for their support in the translation of this work.