Examining factor structure of Maslach burnout inventory among nurses in Taiwan

lee h.-f., chien t.-w. & yen m. (2013) Journal of Nursing Management  21 , 648–656 Examining factor structure of Maslach burnout inventory among nurses in Taiwan Aim  To investigate the factorial structure of a Chinese version of the MBI-HSS for nurses in Taiwan. Background  Previous studies have presented different factorial structures using the Maslach burnout inventory-human services survey (MBI-HSS). Methods  Secondary data analysis was implemented to explore the factor structure of MBI-HSS using exploratory factor analysis. Confirmatory factor analysis was then performed to verify the modified structure for nurses in Taiwan. Results  The EFA found that three factors explaining 57% of the variance were extracted, and 20 of the 22 items were retained. The goodness-of-fit test was performed using the CFA approach, and it was verified that the modified version of MBI-HSS is a suitable instrument for measuring burnout for nurses in Taiwan. Conclusions  A nationwide sample confirmed the factorial structure of MBI-HSS for nurses in Taiwan with a three-dimension, 20-item assessment, and the variance was not diminished in this sample. Implications for nursing management  These findings demonstrate that the modified version of MBI-HSS provides a suitable instrument for measuring burnout for nurses in Taiwan. Therefore, the modified version of MBI-HSS can be used to compare burnout of nurses across cultures, providing valuable information for policies or preventions in the future.     

The relations between personality characteristics, work environment, and the professional well-being of music therapists

The purpose of this correlational study was to investigate the relations between professional well-being (as characterized by positive attitudes toward work and longevity as a practicing music therapist) and the following factors: age, level of education, income, attitudes regarding the workplace (e.g., perceived control, feeling valued, as well as the amount of perceived comfort and input into administrative policies), attitudes toward work as measured by the Maslach Burnout Inventory (Maslach & Jackson, 1986a), and measures of stress and stress management as measured by the Stress Profile (Nowack, 1999a). Participants included 49 music therapists who had between one to 36 years of work experience. Correlations indicated that those respondents with greatest professional longevity tended to have higher ratings on items regarding cognitive coping strategies (e.g., positive appraisal and threat minimization) and greater perception of personal achievement. These correlational results are related to psychological theories regarding occupational burnout and cognitive hardiness.     

Personality traits among burnt out and non‐burnt out health‐care personnel at the same workplaces: A pilot study

ABSTRACT: Stress‐related illnesses, such as burnout, have increased over the last decade, but not everyone at the same workplace develops burnout, suggesting that individual factors may contribute to this phenomenon. The aim of this study was to describe patterns of personality traits among two groups of health‐care personnel from the same workplaces, one group on sick leave due to medically‐assessed burnout, and one group with no indication of burnout, respectively. Fourteen psychiatric‐ (n = 7) and elderly (n = 7)‐care units, located in one specific area in a municipality in northern Sweden, participated in this questionnaire‐based study. The participants (n = 40), on sick leave due to medically‐assessed burnout (n = 20), and those with no indication of burnout (n = 20), respectively, completed Cattell's 16 Personality Factors Questionnaire between February and December 2004. Conventional statistical methods and partial least square regression were used to analyze data. The results showed that the burnout group had lower scores regarding emotional stability and higher scores regarding anxiety than the non‐burnout group, but the results also showed a wide variation of personality traits within groups. The most important indicators for belonging to the burnout group were ‘openness to changes’ and ‘anxiety’, and for belonging to the non‐burnout group, ‘emotional stability’, ‘liveliness’, ‘privateness’ (i.e. forthright or discreet), and ‘tension’. The result indicates complex interactions between personality traits and the context in which the individual lives. It seems to be important to increase our awareness of when personality traits may constitute opportunities versus risks in dealing with one's existing circumstances.     

Factor structure of the Maslach Burnout Inventory among Finnish nursing staff

The purpose of the study was to investigate the factor structure of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) among Finnish nursing staff. Although the factorial validity of the MBI-HSS has been studied across different countries, the factor structure has never been investigated among Finnish nursing staff. The data were gathered by postal questionnaires from nursing staff working in health-care organizations around Finland. The sample consisted of 627 nurses and nurse managers. The factor structure was studied by using exploratory and confirmatory factor analysis. The fit of the hypothesized three-factor model to the data was superior to the alternative one-factor and two-factor models. The three-factor structure (emotional exhaustion, depersonalization, reduced personal accomplishment) showed the best fit, while the internal consistencies of the subscales were satisfactory. The MBI-HSS is a highly suitable instrument for measuring burnout among nursing staff and it is very applicable to Finnish health-care research.     

Personality Traits Associated with Occupational ‘Burnout’ in ABA Therapists

Background

Applied behaviour analysis (ABA) therapists typically work one‐to‐one with children with autism for extended periods of time, which often leads to high levels of job‐related stress, lower levels of job satisfaction, increased frequency of occupational ‘burnout’ and higher than average job turnover (Journal of Autism Development, 39 , 2009 and 42). This is particularly unfortunate, in that these vulnerable clients need stability and consistency in care, both of which are empirically related to clinical outcomes (Journal of Autism Development, 39 , 2009 and 42). It is reasonable to assume that some individuals, by virtue of their personal characteristics, are better suited to this type of work than are others.

Method

The purpose of the this study was to investigate associations between personality traits, using the five‐factor model of personality, and key job‐related variables, including burnout and job satisfaction, in a sample of therapists (n = 113) who work one‐to‐one with individuals diagnosed with autism.

Results

Significant correlations were found between Neuroticism and all three subscales of burnout (Exhaustion, Cynicism and Professional Efficacy). Extraversion and Conscientiousness were significantly negatively correlated with Cynicism and positively correlated with Professional Efficacy. Agreeableness was positively associated with Professional Efficacy. Job satisfaction was correlated positively with Extraversion and negatively with Neuroticism. Level of perceived personal and professional support partially mediated the effect of personality traits on job satisfaction.

Conclusions

These results may help to identify job applicants who are dispositionally less suited to this type of work, as well as currently employed therapists who are in need of support or intervention.     

Factor structure of the Maslach burnout inventory: An analysis of data from large scale cross-sectional surveys of nurses from eight countries

Background

Job burnout is an important predictor of nurse retention. Reliable and valid measures are required to monitor this phenomenon internationally.

Objective

To evaluate the applicability of the Maslach burnout inventory (MBI) in international nursing research.

Design

Secondary analysis of cross-sectional hospital nurse survey data from eight countries.

Settings

Hospitals in the U.S., Canada, the U.K., Germany, New Zealand, Japan, Russia and Armenia.

Participants

54,738 direct care professional nurses from 646 hospitals in eight countries.

Methods

Confirmatory and exploratory factor analysis were undertaken to identify the factor structure of the MBI. The internal consistencies of the subscales were investigated.

Results

Exploratory factor analysis revealed three factors being extracted from the 22-item Maslach burnout inventory. In nearly all countries the two items (6 and 16) related to the “stress” and “strain” involved in working with people loaded on the depersonalization subscale rather than the emotional exhaustion subscale to which they were initially assigned. The three subscales exhibited high reliability with Cronbach alphas exceeding the critical value of 0.70. The correlation coefficients for the emotional exhaustion and depersonalization subscales were strong and positive.

Conclusions

The 22-item Maslach burnout inventory has a similar factor structure and, with minor modifications, performed similarly across countries. The predictive validity of the emotional exhaustion and depersonalization subscales might be improved by moving the two items related to stress and strain from the emotional exhaustion to the depersonalization subscale. Nevertheless, the MBI can be used with confidence as a burnout measure among nurses internationally to determine the effectiveness of burnout reduction measures generated by institutional and national policies.     

Proactive personality,professional self-efficacy and academic burnout in undergraduate nursing students in China

BackgroundAcademic burnout can affect nursing students' academic performance and psychological well-being. Little is known about the associations between proactive personality, professional self-efficacy and academic burnout.PurposeTo assess the prevalence of academic burnout in undergraduate nursing students and to explore the associations between proactive personality, professional self-efficacy and academic burnout among nursing students in China.MethodsThis study used a cross-sectional design. Undergraduate nursing students were recruited from five medical schools in China to participate in an online survey from April to May 2020. The Proactive Personality Scale, Professional Self-Efficacy Scale for Nursing Students and Academic Burnout Scale were used to measure students' proactive personality, professional self-efficacy and academic burnout.ResultsA total of 1219 nursing students completed the questionnaire. The prevalence of academic burnout was 31.5% in nursing students, and improper behaviour showed the highest subscale score. Proactive personality, professional self-efficacy and academic year were negatively associated with nursing students' academic burnout.ConclusionsAcademic burnout is prevalent in undergraduate nursing students in China. This study contributes to the understanding of the associations between proactive personality, professional self-efficacy and academic burnout in nursing students. Nursing educators should develop strategies to enhance students' proactivity and professional self-efficacy to decrease their academic burnout.     

Relationships of work and practice environment to professional burnout: testing a causal model

BACKGROUND: Research has established clear links between nurses' experience of professional burnout and many qualities of work environments but more work is needed to clarify interrelationships among aspects of complex organizational settings. OBJECTIVE: To test a nursing worklife model that defined structured relationships among professional practice environment qualities and burnout. METHODS: Hospital-based nurses in Canada (N = 8,597) completed an assessment of worklife (Nursing Work Index, NWI) and burnout (Maslach Burnout Inventory-Human Service Scale, MBI-HSS). RESULTS: A causal model was used to confirm the factor structure of the Professional Environment Scale (NWI-PES) on a subset of NWI items and the factor structure of the MBI-HSS. The analysis provided support for a structural model (nursing worklife model) linking the five worklife factors used to define a fundamental role for nursing leadership in determining the quality of worklife regarding policy involvement, staffing levels, support for a nursing model of care, and physician-nurse relationships. The analysis supported a direct path (negatively weighted) from staffing to emotional exhaustion and a direct path (positively weighted) from nursing model of care to personal accomplishment. DISCUSSION: Implications for refining a model of worklife are discussed. Implications for enhancing the quality of worklife and supporting engagement with work are considered.     

Association between Type-D Personality and Affective (Anxiety,Depression, Post-traumatic Stress) Symptoms and Maladaptive Coping in Breast Cancer Patients: A Longitudinal Study

Background:Type-D (distressed) personality has not been prospectively explored for its association with psychosocial distress symptoms in breast cancer patients.Objective:The objective of the study was to test the hypothesis that Type-D personality can be associated with psychosocial distress variables in cancer over a 2-point period (6 month-follow-up).Aims:The aim of the study was to analyze the role of Type-D personality in relation to anxiety, depression, post-traumatic stress symptoms, general distress, and maladaptive coping among cancer patients.Methods:145 breast cancer patients were assessed within 6 months from diagnosis (T0) and again 6 months later (T1). The Type-D personality Scale, the Hospital Anxiety and Depression Scale, Depression subscale (HAD-D), the Brief Symptom Inventory (BSI-18) Anxiety subscale, the Distress Thermometer (DT), the Post-traumatic Symptoms (PTS) Impact of Event Scale (IES), and the Mini Mental Adjustment to Cancer (Mini-MAC) Anxious Preoccupation and Hopelessness scales were individually administered at T0 and T1.Results:One-quarter of cancer patients met the criteria for Type-D personality, which was stable over the follow-up time. The two main constructs of Type-D personality, namely social inhibition (SI) and negative affectivity (NA), were related to anxiety, depression, PTS, BSI-general distress and maladaptive coping (Mini-MAC anxious preoccupation and hopelessness). In regression analysis, Type-D SI was the most significant factor associated with the above-mentioned psychosocial variables, both at T0 and T1.Conclusion:Likewise other medical disorders (especially cardiology), Type-D personality has been confirmed to be a construct significantly related to psychosocial distress conditions and maladaptive coping that are usually part of assessment and intervention in cancer care. More attention to personality issues is important in oncology.     

Burnout symptoms in forensic mental health nurses: Results from a longitudinal study

Burnout in nursing staff is a major cause for turnover and absenteeism. Identifying risk and protective factors may be helpful in decreasing burnout symptoms. Moreover, research indicates that ambulatory assessments of the autonomic nervous system might be helpful in detecting long‐term stress and burnout symptoms. One hundred and ten forensic nursing staff members completed questionnaires measuring experiences with aggressive behaviour, emotional intelligence, personality, and job stress during four waves of data collection across a 2‐year period. Multilevel analyses were used to test the predicted associations and moderation effects with (the development of) burnout symptoms. Burnout was predicted by a combination of emotional intelligence, job stress, aggression, personality factors, and skin conductance, but no moderation effects over time were found. Over a period of 2 years, the model approximately predicts a change in one burnout category on the Maslach Burnout Inventory . The amount of burnout symptoms in nurses might be used as an indicator to predict turnover and absenteeism considering the increase in symptoms over time . Nursing staff who experience severe aggression and who have relatively low levels of emotional intelligence and altruism and high levels of neuroticism and job stress should be monitored and supported to decrease the risk of burnout. Staff members can be trained to increase their emotional intelligence and relieve stress to decrease their burnout symptoms and turnover and absenteeism on the long term. Ambulatory assessment might be helpful as a nonintrusive way to detect increasing levels of burnout.     

护士群体应对方式和人格特征对职业倦怠的影响

目的：探讨应对策略、人格特征对护士职业倦怠的影响。方法采取整群抽样法,选择本院内科、外科及精神科的临床护士140名为研究对象,采用护士职业倦怠量表、简易应对方式问卷以及五大人格简式量表对这140名临床护士进行调查。结果护士职业倦怠在不同年龄、文化程度、工作岗位、劳动关系以及职称5个方面具有显著性差异（P＜0．05）;职业倦怠高分组在神经质人格特征方面得分显著高于低分组（P＜0．01）,积极应对方式、外倾性、宜人性以及谨慎性则是低分组显著高于高分组（P＜0．01）;情绪疲惫、人格解体、个人成就感降低以及职业倦怠总分与积极应对方式、宜人性及谨慎性人格特征呈显著负相关,而与神经质人格特征呈显著正相关（P＜0．01）;劳动关系、职称、神经质、宜人性和谨慎性人格特征可以对职业倦怠进行预测,可解释回归模型40．6％的变异量。结论年龄在26～30岁、学历高、职称低、从事内外科护理的非在编人员职业倦怠水平高;高职业倦怠水平护士不善于采用积极应对方式,人格特征方面表现为焦虑、压抑等神经质倾向,而宜人性及谨慎性等积极人格特征相对缺少;积极应对方式和人格特质对职业倦怠起到保护作用,而消极应对方式和人格特质是职业倦怠的危险因素。     

心理咨询培训对学员人格特质的影响

目的：探讨心理咨询培训对学员人格特质的影响.方法：用卡特尔十六种个性因素问卷（16PF）对研究组、对照组进行前后两次测试.结果：第一次测试时研究组与对照组16PF各因子分差异无显著性,第二次测试时研究组兴奋性、幻想性因子分高于对照组,而怀疑性、忧虑性、紧张性因子分低于对照组,次级因素中适应与焦虑性因子分低于对照组,心理健康因素因子分高于对照组.对照组16PF各因子分前后两次测试差异无显著性,而研究组培训后兴奋性、独立性、心理健康因素因子分升高,敏感性、忧虑性、紧张性、适应与焦虑性因子分降低.结论：心理咨询理论、技能培训有助于学员人格完善、成熟.     

临床护理人员工作倦怠与家庭功能的相关性研究

目的调查临床护理人员工作倦怠的现状,分析家庭功能与工作倦怠之间的关系。方法采用整群抽样的方法,应用工作倦怠感量表、家庭功能评定量表对165名临床一线护理人员进行调查。结果护理人员的去人性化、个人成就感呈高度倦怠,情绪耗竭呈中度倦怠,家庭总的功能处于健康水平。情绪耗竭与家庭角色呈正相关（P〈0．05）,去人性化与角色、行为控制、总的功能呈正相关（P〈0．01）。结论家庭功能对护士工作倦怠有显著的影响,护理管理者应重视对护理人员家庭的支持,从而预防和降低护理人员的工作倦怠,维护其身心健康。     

Using a 0-10 scale for assessment of anxiety in patients with acute myocardial infarction.

Patients with acute myocardial infarction (AMI) often experience anxiety, an emotion that predicts adverse physiologic outcomes. The purpose of this study was to determine whether a single-item anxiety assessment instrument, the Anxiety Level Index (ALI), is a valid alternative to the State Anxiety Index (SAI) or the anxiety subscale of the Brief Symptom Inventory (BSI) for assessing state anxiety for patients with AMI. In this prospective multicenter study, 243 inpatients with AMI rated their anxiety using the SAI, the anxiety subscale of the BSI, and the ALI. Anxiety Level Index scores were compared to SAI and BSI anxiety subscale scores. There were moderate, positive correlations between the SAI and the ALI (rs = 0.52, P < .001), and between the ALI and the anxiety subscale of the BSI (rs = 0.45, P < .001). Although ALI scores were moderately and significantly correlated with scores on the SAI and the BSI anxiety subscales, the results of the Bland-Altman method indicate a lack of construct validity of the single-item measure. The quest continues to construct a simple self-report measure of anxiety that is appropriate for critically ill patients with AMI.     

¿Es replicable la estructura factorial del Maslach Burnout Inventory Human Service Survey (MBI-HSS) en la profesión de enfermera del Perú?: un estudio nacional

ObjectiveThe Maslach Burnout Inventory (MBI) is an instrument commonly used for the evaluation of burnout syndrome. The version of the MBI-Human Service Survey (MBI-HSS) was applied to Peruvian nurses to explore the prevalence of this syndrome without previously considering possible evidence of validity to accredit its use. The purpose of this research is to evaluate the internal structure and reliability of the MBI-HSS in Peruvian nurses.MethodsThe study was prepared through secondary data analysis based on the information collected from 2809 nurses in Peru obtained from the National Survey of Satisfaction of Health Users (ENSUSALUD) applied in 2014. An exploratory and confirmatory factor analysis was prepared; reliability was estimated with Cronbach alpha and omega.ResultsThe analyses indicated the presence of three factors, but with a reduction of 7 items; reliability was acceptable with the omega coefficient.ConclusionThe results question the validity of the original version of the MBI-HSS for its application in Peruvian nurses, therefore, its diagnostic utility should be viewed with caution. As an alternative, it is advisable to prioritise the 15-item version and to continue with validation studies.     

The Psychometric Properties of Taiwanese Version of the Memorial Anxiety Scale for Prostate Cancer

ContextThe Memorial Anxiety Scale for Prostate Cancer (MAX-PC) has been used in different countries to assess the specific anxiety of patients with prostate cancer.ObjectivesThis research aims to test the reliability and validity of the Taiwanese version of the MAX-PC (MAX-PC-T).MethodsPatients with prostate cancer in the urology clinics of three hospitals are recruited via a convenience sampling. Patients completed the MAX-PC-T, Positive and Negative Affect Schedule (PANAS), and the Short Form (SF)-12 Health Survey. The internal consistency is tested to determine the reliability of the MAX-PC-T. The correlation among the MAX-PC-T, PANAS, and SF-12 is used to test concurrent and discriminant validity. Confirmatory factor analysis is performed to determine the convergent and discriminant validity of the scale.ResultsThe MAX-PC-T conforms to the three structures of the original MAX-PC, which includes the prostate cancer anxiety subscale, prostate-specific antigen anxiety subscale, and fear of recurrence subscale. The factor loading of the items in each subscale is >0.50. The MAX-PC-T was significantly negatively correlated with the positive affect subscale of the PANAS and the mental component summary of the SF-12 and significantly positively correlated with the negative affect subscale of the PANAS. Cronbach's α value of internal consistency is 0.94 in the MAX-PC-T.ConclusionThe MAX-PC-T demonstrates appropriate reliability and validity. It can be used with patients with prostate cancer to assess their specific anxiety.     

The effect of music therapy on relaxation, anxiety, pain perception, and nausea in adult solid organ transplant patients

Organ transplant recipients characteristically experience low levels of relaxation and high levels of anxiety, pain, and nausea. Although music therapy has demonstrated effectiveness in ameliorating these types of conditions with patients in other areas of medical hospitals, no studies have evaluated the effects of music therapy on solid organ transplant patients. The purpose of this study was to assess the impact of music therapy on anxiety, relaxation, pain, and nausea levels in recovering patients on the adult transplant unit of the hospital utilizing a pre-posttest design. Participants (N = 58) received an individual 15-35 minute music therapy session consisting of live patient-preferred music and therapeutic social interaction. To remain consistent with the hospital's evaluative instruments during this pilot study, participants' self-reported levels of anxiety, relaxation, pain, and nausea, were based on separate 10-point Likert-type scales. The principal investigator observed affect and verbalizations at pre and posttest. Results indicated there were significant improvements in self-reported levels of relaxation, anxiety (both p < .001), pain (p < .01), and nausea (p < .05). Although there was no reliability measure, there were significant increases in positive verbalizations and positive affect (p < .001). All participants reported that they would desire music therapy again during a future long-term hospital stay. From the results of this exploratory study, it seems that music therapy can be a viable psychosocial intervention for hospitalized postoperative solid transplant patients. Implications for clinical practice and suggestions for future research are provided.