Validation of a single‐item measure of burnout against the Maslach Burnout Inventory among physicians

The measurement of burnout among physicians is important because physician well‐being has the potential to affect workforce stability and quality of care. In this study, a single‐item measure of burnout was validated against the sub‐scales of the Maslach Burnout Inventory (emotional exhaustion, depersonalization, and personal accomplishment). Survey items included the 22‐item Maslach Burnout Inventory, a single‐item measure of burnout, and other questions regarding demographics, practice characteristics, and occupational satisfaction. The surveys were mailed to Texas Tech University School of Medicine Alumni classes of 1980–1989. The response rate was 43 per cent (n = 307). Pearson correlation coefficients and ANOVA were used to determine the association between the Maslach Burnout Inventory scores and the single‐item burnout question. The single‐item was correlated at r = 0.64 (p < 0.0001) with emotional exhaustion and the ANOVA yielded an R² of 0.5 (p < 0.0001). Hence, in surveys of physicians where emotional exhaustion is the primary sub‐scale of interest, a single‐item measure of burnout may be used as an alternative to the Maslach Burnout Inventory in order to abbreviate survey material and potentially increase response rates among physicians. Copyright © 2004 John Wiley & Sons, Ltd.     

Burnout and depressive symptoms in teachers: Factor structure and construct validity of the Maslach Burnout inventory‐educators survey among elementary and secondary school teachers in Hungary

This study validated the Hungarian version of the Maslach Burnout Inventory–Educators Survey on a sample of n = 211 elementary and secondary teachers. To test factorial validity, we ran a series of confirmatory analysis with eight models. The best fitting model was the bifactor model with general burnout and three specific factors: emotional exhaustion, depersonalization, and personal accomplishment. Analyzing the covariates revealed that gender and age were not associated with burnout, but depressive symptoms and overcommitment had a significant relationship with general burnout, and overcommitment was related to emotional exhaustion as well.     

The level of burnout in a group of dental research assistants

Working as doctor or dentist may entail higher levels of burnout than experienced by the general population. Maslach Burnout Inventory, evaluates emotional exhaustion, depersonalization and reduced personal accomplishment. This article presents data conserning levels and sources of burnout in dental research assistants taking postgraduate education in two dental schools in Turkey. One, a new school and the other, an established school. In this study we aimed to investigate if there was an association between the level of burnout and sociodemographic factors and to measure the level of burnout in dental research assistants. Seventy‐eight dental research assistants working in two different dental schools participated in the study. Sociodemographic data were obtained. Sociodemographic characteristics were not significantly different between the two dental schools. In addition, there were statistically significant differences between the two schools in personal accomplishment, depersonalization and work related strain, but no significant difference in emotional exhaustion. Copyright © 2004 John Wiley & Sons, Ltd.     

A Longitudinal Analysis of Burnout in Middle and High School Korean Teachers

This study examines longitudinal relationships among three burnout dimensions in middle and high school teachers. For this study, 419 middle and high school teachers participated in a panel survey, which was conducted in three waves. Using Amos 7.0, we performed autoregressive cross‐lagged modeling to obtain a complete picture of the longitudinal relationships among the three factors of the Maslach Burnout Inventory‐Educator Survey. Results indicated that the paths from emotional exhaustion at Time1 and Time2 to depersonalization at Time2 and Time3 were statistically significant. In addition, the paths from personal accomplishment at Time1 and Time2 to depersonalization at Time2 and Time3 were also statistically significant. Empirically identifying the process by which burnout occurs could help practitioners and policy makers to design burnout prevention strategies. Copyright © 2012 John Wiley & Sons, Ltd.     

Burnout in mental health nurses: much ado about nothing?

The syndrome of burnout has been the focus of much research in the caring professions. Maslach and Jackson operationally defined the syndrome as comprising high levels of emotional exhaustion, high depersonalization and a reduced sense of personal accomplishment. They argued that the syndrome could be reliably measured using the 22‐item Maslach Burnout Inventory. The present authors gave this scale to 648 ward‐based mental health nurses along with a range of other standardized scales. The total sample was then divided into a high burnout group (high scores on all three subscales, N=37 or 5.7 percent) and a low burnout group (low scores on all subscales, N=66 or 10.2 percent). The findings show that burnout is a much less significant problem for mental health nurses than other researchers have indicated. There was, however, clear evidence for the construct validity of the burnout concept. Future directions for burnout research with mental health nurses are outlined. Copyright © 1999 John Wiley & Sons, Ltd.     

How Do Areas of Work Life Drive Burnout in Orthopaedic Attending Surgeons,Fellows, and Residents?

BackgroundConcerning levels of burnout have been reported among orthopaedic surgeons and residents. Defined as emotional exhaustion and depersonalization, physician burnout is associated with decreased productivity, increased medical errors, and increased risk of suicidal ideation. At the center of burnout research, person-centered approaches focusing on individual characteristics and coping strategies have largely been ineffective in solving this critical issue. They have failed to capture and address important institutional and organizational factors contributing to physician burnout. Similarly, little is known about the relationship between burnout and the working environments in which orthopaedic physicians practice, and on how orthopaedic surgeons at different career stages experience and perceive factors relevant to burnout.Questions/purposes(1) How does burnout differ among orthopaedic attending surgeons, fellows, and residents? (2) What specific areas of work life are problematic at each of these career stages? (3) What specific areas of work life correlate most strongly with burnout at each of these career stages?MethodsTwo hundred orthopaedic surgeons (residents, fellows, and attending physicians) at a single institution were invited to complete an electronic survey. Seventy-four percent (148 of 200) of them responded; specifically, 43 of 46 residents evenly distributed among training years, 18 of 36 fellows, and 87 of 118 attending physicians. Eighty-three percent (123 of 148) were men and 17% (25 of 148) were women. Two validated questionnaires were used. The Maslach Burnout Inventory was used to assess burnout, measuring emotional exhaustion and depersonalization. The Areas of Worklife Survey was used to measure congruency between participants and their work environment in six domains: workload, control, reward, community, fairness, and values. Participants were invited to openly share their experiences and suggest ways to improve burnout and specific work life domains. The main outcome measures were Maslach Burnout Inventory subdomains of emotional exhaustion and depersonalization, and Areas of Worklife Survey subdomains of workload, control, reward, community, fairness and values. We compared outcome measures of burnout and work life between groups. Simple linear regression models were used to report correlations between subscales. Stratified analyses were used to identify which group demonstrated higher correlations. All open comments were analyzed and coded to fully understand which areas of work life were problematic and how they were perceived in our population.ResultsNine percent (7 of 80) of attending surgeons, 6% (1 of 16) of fellows, and 34% (14 of 41) of residents reported high levels of depersonalization on the Maslach Burnout Inventory (p < 0.001). Mean depersonalization scores were higher (worse) in residents followed by attending surgeons, then fellows (10 ± 6, 5 ± 5, 4 ± 4 respectively; p < 0.001). Sixteen percent (13 of 80) of attending surgeons, 31% (5 of 16) of fellows, and 34% (14 of 41) of residents reported high levels of emotional exhaustion (p = 0.07). Mean emotional exhaustion scores were highest (worse) in residents followed by attending surgeons then fellows (21 ± 12, 17 ± 10, 16 ± 14 respectively; p = 0.11). Workload was the most problematic work life area across all stages of orthopaedic career. Scores in the Areas of Worklife Survey were the lowest (worse) in the workload domain for all subgroups: residents (2.6 ± 0.4), fellows (3.0 ± 0.6), and attending surgeons (2.8 ± 0.7); p = 0.08. Five problematic work life categories were found through open comment analysis: workload, resources, interactions, environment, and self-care. Workload was similarly the most concerning to participants. Specific workload issues identified included administrative load (limited job control, excessive tasks and expectations), technology (electronic medical platform, email overload), workflow (operating room time, patient load distribution), and conflicts between personal, clinical, and academic roles. Overall, worsening emotional exhaustion and depersonalization were most strongly associated with increasing workload (r = - 0.50; p < 0.001; and r = - 0.32; p < 0.001, respectively) and decreasing job control (r = - 0.50; p < 0.001, and r = - 0.41; p < 0.001, respectively). Specifically, in residents, worsening emotional exhaustion and depersonalization most strongly correlated with increasing workload (r = - 0.65; p < 0.001; and r = - 0.53; p < 0.001, respectively) and decreasing job control (r = - 0.49; p = 0.001; and r = - 0.51; p = 0.001, respectively). In attending surgeons, worsening emotional exhaustion was most strongly correlated with increasing workload (r = - 0.50; p < 0.001), and decreasing job control (r = - 0.44; p < 0.001). Among attending surgeons, worsening depersonalization was only correlated with increasing workload (r = - 0.23; p = 0.04). Among orthopaedic fellows, worsening emotional exhaustion and depersonalization were most strongly correlated with decreasing sense of fairness (r = - 0.76; p = 0.001; and r = - 0.87; p < 0.001, respectively), and poorer sense of community (r = - 0.72; p = 0.002; and r = - 0.65; p = 0.01, respectively).ConclusionsWe found higher levels of burnout among orthopaedic residents compared to attending surgeons and fellows. We detected strong distinct correlations between emotional exhaustion, depersonalization, and areas of work life across stages of orthopaedic career. Burnout was most strongly associated with workload and job control in orthopaedic residents and attending surgeons and with fairness and community in orthopaedic fellows.Clinical RelevanceInstitutions wishing to better understand burnout may use this approach to identify specific work life drivers of burnout, and determine possible interventions targeted to orthopaedic surgeons at each stage of career. Based on our institutional experience, leadership should investigate strategies to decrease workload by increasing administrative support and improving workflow; improve sense of autonomy by consulting physicians in decision-making; and seek to improve the sense of control in residents and sense of community in fellows.     

A test of carver and scheier's self-control model of stress in exploring burnout among mental health nurses

A sample of Australian psychiatric nurses completed a questionnaire which included operational measures of elements of Carver and Scheier's self-control model of stress including the frequency dimension of the subscales of the Maslach Burnout Inventory — emotional exhaustion, depersonalization, and diminished accomplishment. Other scales completed by participants included independent subscales contained in the Positive and Negative Affectivity Scale and the private and public self-focus and social anxiety subscales of the Self-Consciousness Scale (Revised). Two interpretable canonical variates labelled emotional exhaustion–depersonalization and diminished accomplishment were derived from analysis of the date. Each element of the self-control model showed an expected contribution to an emotional exhaustion–depersonalization canonical variate, whereas reported levels of only positive affectivity and private self-focus made a notable contribution to explanation of variance on the diminished accomplishment canonical variate.     

Effect of the 80-hour workweek on resident burnout

HYPOTHESIS: With the introduction of the newly mandated restrictions on resident work hours, we expected improvement in subjective feelings of personal accomplishment and lessened emotional exhaustion and depersonalization. DESIGN: Residents and faculty members completed an anonymous online Maslach Burnout Inventory Human Services Survey (3rd ed; Consulting Psychologist Press Inc, Palo Alto, Calif) and work-hour registry before and after implementation of new restrictions. SETTING: Urban, university-based department of surgery. PARTICIPANTS: All house staff (n = 37) and faculty (n = 27). INTERVENTION: Introduction of new Institutional Standards for Resident Duty Hours 2003.Main Outcome Measure Resident work hours and levels of emotional exhaustion, perceived degree of depersonalization, and personal accomplishment. RESULTS: Resident work hours per week decreased from 100.7 to 82.6 (P < .05) with introduction of the new schedule. Home call and formal educational activity time within working hours (eg, clinical conferences) significantly (P < .05) decreased from 11.5 and 4.8 hours to 4.6 and 2.5 hours per week, respectively. Operating room hours, clinic time, and duration of rounds did not show a significant change. Changes in parameters of resident and faculty emotional exhaustion, depersonalization, and personal accomplishment did not show statistical significance (P > .05). CONCLUSIONS: Despite successful reductions in resident work hours, measures of burnout were not significantly affected. However, important clinical activities such as time spent in the operating room, clinic, and making rounds were maintained. Formal in-hospital education time was reduced.     

Factor structure and psychometric properties of the Maslach Burnout Inventory‐Educators Survey among elementary and secondary school teachers in Cyprus

Burnout is described as a syndrome of emotional exhaustion, depersonalization and reduced personal accomplishment that can occur among individuals who work with other people in some capacity. The present research examines the psychometric properties and factor structure of Maslach, Jackson and Leiter's (1996) educators' burnout measure, the Maslach Burnout Inventory‐Educators Survey (MBI‐ES), in a sample of 771 Greek Cypriot teachers. Results, using exploratory and confirmatory factor analytic techniques, support the three factor structure of the construct which was tested against alternative models. Other psychometric qualities are also very satisfactory. Findings are compared to the published normative data for the MBI. Female teachers appear more emotionally exhausted than their male counterparts. Primary school teachers scored higher on emotional exhaustion, but depersonalization was higher among secondary school teachers. Overall, the results suggest that the Greek MBI represents a valid and reliable adaptation of the instrument, which can be confidently used to measure burnout. Copyright © 2006 John Wiley & Sons, Ltd.     

The Bifactor Model of the Maslach Burnout Inventory–Human Services Survey (MBI‐HSS)—An Alternative Measurement Model of Burnout

The purpose of the present study was to examine the construct validity of the Hungarian language version of the Maslach Burnout Inventory–Human Services Survey (MBI‐HSS). A sample of 653 healthcare professionals (420 physicians and 233 nurses and nursing assistants) completed the MBI‐HSS. A series of confirmatory factor analyses showed that a hierarchical bifactor model including a global burnout factor and three specific factors of emotional exhaustion, depersonalization and reduced personal accomplishment had the closest fit to the data, compared with an alternative second‐order three‐factor hierarchical model as well as to non‐hierarchical one‐factor, two‐factor, three‐factor, four‐factor and five‐factor models. However, only the global burnout factor and the specific personal accomplishment factor explained a considerable unique proportion of variance in observed scores. Our study confirms the validity of the MBI‐HSS and suggests an alternative structural model, which may contribute to further understanding of the burnout construct. Copyright © 2013 John Wiley & Sons, Ltd.     

Exploring the relationship between burnout and grit during general surgery residency: A longitudinal,single-institution analysis

BackgroundHow burnout changes during general surgery residency remains unknown.MethodsFrom 2015 to 2018, general surgery residents completed the Maslach Burnout Inventory and Grit Scale. Statistical analyses were adjusted for repeated measures and compared to the incoming intern level.ResultsFifty-five residents participated in this study. Burnout rates varied by program level, with an increased risk occuring in the third clinical year (OR = 11.7, p = 0.03). Emotional exhaustion (EE) peaked during the first and third clinical years, depersonalization (DP) peaked during the first and second clinical years, and personal achievement (PA) reached a nadir during the third clinical year (all p < 0.05). Residents with burnout had lower grit scores compared to those without burnout (3.71 vs 4.02, p < 0.01). Increasing grit was linearly associated with decreasing EE, decreasing DP, and increasing PA (all p < 0.05).ConclusionsBurnout varies throughout surgical residency, and grit is inversely related to burnout.     

护士感知的医院事务参与度及其与工作疲溃的关系研究

目的了解护士感知的医院事务参与度,并分析其对护士工作疲溃的影响。方法采用护士工作指数量表修订版的医院事务参与度分量表对1 133名护士感知的医院事务参与情况进行测评,同时采用Maslach的疲溃量表对护士疲溃进行测量。结果27.80%的护士认为医院事物参与度较低,44.40%的护士存在情绪耗竭。回归分析显示,护士感知医院事物参与度好能降低护士情绪耗竭、个人成就感和工作冷漠感的比数比(OR),OR值分别为0.281、0.504和0.328。结论护士感知的医院事务参与度尚可,有大量的病区护士存在工作相关的疲溃;改善护士在医院事务的参与度,可以降低护士的工作相关疲溃。     

Burnout levels of hemodialysis nurses

Background: Previous studies have found significant stressors experienced by nurses working in hemodialysis units. The purpose of this study was to determine the burnout levels of hemodialysis nurses working in hemodialysis units and their relation with some sociodemographic variables. Methods: The study was conducted between July 2012 and Sept 2012 in hemodialysis units of four hospitals, including one university, one public and two private hospitals, in the province of Erzurum. The population of the study consisted of 32 nurses rendering service in hemodialysis units of the related hospitals. Information forms, which were prepared by researchers in accordance with the literature, and aimed at determining the personal characteristics of nurses and Maslach Burnout Inventory were used for the data collection. Results: Examining mean scores obtained by nurses from the Maslach Burnout Inventory, it is observed that they scored 17.07?±?8.29 from subscale of emotional exhaustion, 5.89?±?4.13 from subscale of depersonalization and 20.64?±?4.10 from subscale of personal accomplishment. Conclusion: The results of the study revealed that nurses working in hemodialysis units experience a medium-level burnout in terms of subscales of emotional exhaustion, depersonalization, and a high-level burnout in terms of the subscale of personal accomplishment.     

The reliability and validity of three‐item screening measures for burnout: Evidence from group‐employed health care practitioners in upstate New York

We investigate the psychometric validity and reliability of three‐item screening measures for emotional exhaustion, depersonalization, and personal achievement comprising an abbreviated version of the Maslach Burnout Inventory®. Despite its utilization in multiple studies, the shortened instrument has not been sufficiently validated in diverse settings, populations, and organizational contexts. We examine its ability to assess burnout accruing from patient care practice in a rural, underserved area. Utilizing data from a cross‐sectional survey of 308 rural‐based medical professionals, we investigate how the three short‐form subscales of the nine‐item abbreviated inventory compare with their gold‐standard parent subscales from the original 22‐item human services scale in measuring corresponding dimensions of burnout. The findings provide significant evidence that the three‐item measures are valid and reliable proxies for the long‐form subscales. The short‐form measures are highly correlated with the original subscales and display high convergent and discriminant validity. Each of the abbreviated subscales manifests the kind of high sensitivity with adequate specificity that one would expect to see in a good screening instrument. We conclude that the short‐form measures can be utilized to rapidly screen human service professionals such as rural health care practitioners for symptoms of each of the three dimensions of burnout.     

Prevalence of burnout among anesthesiologists at Hospital Universitario Virgen Macarena de Sevilla

Burnout, characterized by emotional exhaustion, depersonalization, and lowered sense of professional accomplishment, is a consequence of chronic stress. Few studies have been published on burnout in anesthesiology even though this specialty is considered particularly stressful. We surveyed members of the department of anesthesiology and postoperative care in our hospital, using an anonymous questionnaire including items on social and personal characteristics and the Spanish language version of the Maslach Burnout Inventory. Forty-valid questionnaires were returned, for a response rate of 69.4%. Mean (SD) scores were 19.5 (9.5) points for emotional exhaustion, 7.4 (5.5) for depersonalization, and 32.5 (9.1) for professional accomplishment. We detected high levels of emotional exhaustion in 19.5% of the anesthesiologists and of depersonalization in 31.7%. Scores reflecting low levels of sense of personal accomplishment were recorded for 41.4%. Scores for concern on at least 1 subscale were noted for 58.3% of the anesthesiologists, on 2 subscales for 21.8%, and on 3 subscales for 12.1%. No significant differences were detected in relation to gender, age, stage in professional life, or employment status. Burnout levels in our department are similar to those reported for anesthesiologists in other countries and detectably lower than those of other specialties in Spain.     

Burnout in health care providers of dialysis service in Northern Italy--a multicentre study.

BACKGROUND: Few data are available regarding the prevalence of burnout among dialysis health care workers. Aims of the present study were to assess and compare burnout levels in a sample of nurses and physicians working in dialysis units, and to investigate their relationships with quality of life, in a cross-sectional observational study. METHODS: A total of 344 workers from 10 dialysis centres in Northern Italy completed a battery of questionnaires including the Maslach Burnout Inventory, the MOS-36 Item Short Form Health Survey [SF36: physical (PCS) and mental (MCS) component scores] and the 30-item General Health Questionnaire (GHQ30). Data on social and demographic characteristics and working conditions were also collected. General Estimating Equations models were used for the analysis. RESULTS: Overall, burnout scores were lower than the Italian normative sample, with no significant differences between physicians and nurses. However, 30% of nurses had high emotional exhaustion vs 18% of physicians (adjusted OR 2.38, P = 0.003). Emotional exhaustion was also predicted by number of worked hours and months worked in dialysis in the previous 2 years. Depersonalisation was predicted by male gender and bad relationship with coworkers. Having no children and having a permanent hospital position predicted low personal accomplishment. PCS was lower in nurses (50.0 vs 53.3, P < 0.001), while no significant difference was found for MCS and GHQ30. Lower PCS was associated with emotional exhaustion (P = 0.007) and GHQ30 > 5 with depersonalization (P = 0.032). CONCLUSIONS: Although burnout is not a general problem in dialysis health care providers, a subgroup of them may be identified, who would benefit from supportive measures to prevent this condition. Nurses appeared more burned-out in the emotional exhaustion scale than physicians.     

Burnout Among Chinese Adult Reconstructive Surgeons: Incidence,Risk Factors,and Relationship With Intraoperative Irritability

Background

Burnout is a major concern in human service occupations, mainly characterizing in emotional exhaustion and depersonalization. There is very limited research dealing with burnout in orthopedic surgeons. Exploring burnout prevalence, risk factors, and intraoperative irritability-related incidences is necessary to improve the quality of life for surgeons.

Burnout and Resilience Among Transplant Nurses in 22 Hospitals in China

Background

In this study we assessed burnout and resilience levels among transplant nurses to analyze the relationship between these 2 variables, and to address whether demographic factors were associated with burnout.

Burnout as an important factor in the psychophysiological responses to a work day in Teachers

Burnout syndrome is an important psychosocial risk in the job context, especially in professions with a strong social interaction, as in the case of teaching. This study analyses the role of burnout in the psychophysiological responses to a work day in teachers. High burnout was related to worse mood, and higher perceived stress throughout the work day. Moreover, burnout is positively related to systolic blood pressure and negatively related to salivary cortisol levels at the beginning of the work day. Higher scores of burnout in teachers are also related to lower heart rate in the middle of the work day. The psychophysiological responses to a work day are specifically associated with the different burnout subscales (emotional exhaustion, depersonalization and personal accomplishment). Men presented higher diastolic blood pressure than women at the beginning and the middle of the work day. Burnout could induce an alteration in mood together with a dysregulation of the cardiovascular activity and the hypothalamo‐pituitary‐adrenocortical axis functioning in response to a work day in teachers. Moreover, our results offer different burnout‐dependent patterns of relationships between psychological, cardiovascular and cortisol responses, and they suggest that gender plays a moderator role in the cardiovascular response to a work day. Copyright © 2010 John Wiley & Sons, Ltd.