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.     

Chronic Work Stress and Depressive Symptoms: Assessing the Mediating Role of Teacher Burnout

A conceptual model of the relationship between stress, the mediating role of burnout, and depressive symptoms was examined. Results indicated that teachers (n = 267) experiencing greater stress were more burned out. The subscale emotional exhaustion was moderately related to depressive symptoms, whereas depersonalization and reduced personal accomplishment had small positive relationships. After controlling for burnout and demographics, the relationship between stress and depressive symptoms was small but significant. Emotional exhaustion mediated the association between stress and depressive symptoms. The total effect of stress on depressive symptoms, taking together the direct and indirect effects via burnout, accounted for 43% of the total variance. Copyright © 2011 John Wiley & Sons, Ltd.     

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.     

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.     

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.     

Job stress and employee well‐being: a cross‐cultural empirical study

This study examined the relationship between job stress and employee well‐being among teachers in Canada and Pakistan. Job stress was operationalized in terms of perceived experiences at the job which were chronic in nature. Employee well‐being was operationalized in terms of burnout and its three dimensions (emotional exhaustion, lack of accomplishment and depersonalization), intrinsic motivation, job involvement and turnover intention. Data were collected by means of a structured questionnaire from teachers in metropolitan cities in Canada (N=420) and Pakistan (N=335). Pearson correlation and moderated multiple regression were used to analyze the data. In both countries, job stress was significantly related to a number of well‐being variables. Moderated multiple regression did not support the role of gender as a moderator of the stress–well‐being relationship. Copyright © 1999 John Wiley & Sons, Ltd.     

Children and work‐related stress among physicians

The aim of this study was to analyse the influence of gender and children on physicians' stress and burnout and to obtain information on the compromises physicians make between family and work. The study was based on a nationwide survey of 3313 Finnish physicians. The results showed that work was the commonest reason for stress for both male and female physicians. If physicians had children, combining work and family was the commonest reason for stress among the women, but work still remained the commonest reason for stress among the men. The female physicians had made compromises between family and work more often than the male physicians (limited the number of children, delayed having children, given up postgraduate or continuing medical education, worked part‐time because of family, and given up a job because of a spouse's need to move). The female physicians—with or without children—were more likely than the male physicians to experience severe or moderate exhaustion and less likely than the male physicians to experience cynicism as components of burnout. Among both genders of physicians, having children was associated with less cynicism and reduced personal accomplishment, but the children did not affect exhaustion. In conclusion, having children is associated with a lower level of some burnout symptoms. Additional studies are needed to explain the health effects of work–family balance for physicians. Copyright © 2004 John Wiley & Sons, Ltd.     

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.     

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.     

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.     

Work–family interference as a mediator between job demands and job burnout among doctors

There is an increasing realization that the connections between work and family life are of critical importance in contemporary society. The present study examined the relationship between job demands and burnout, and the mediational role of work–family interference (WFI) in a sample of Greek doctors (N = 162). The main findings are: (1) emotional job demands were found to be a strong independent predictor of both emotional exhaustion and depersonalization; (2) quantitative job demands were found to predict emotional exhaustion; (3) WFI was found to partially mediate the relationship between both quantitative/emotional job demands and emotional exhaustion; (4) additionally, WFI partially mediated the relationship between emotional job demands and depersonalization. The results and limitations are discussed with reference to the medical profession. Copyright © 2006 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 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.     

Burnout in intensive care unit

AIM: The aim of this paper was to study in intensive care unit (ICU) the impact of variable 'professional role' and 'gender' on the defence mechanisms, on the troubles of mood and on the markers of the burnout syndrome, and to study the correlation between specific defence mechanisms or specific troubles of mood and the onset of burnout syndrome. METHODS: An observational study by administration of psychometric tests was carried out. Twenty-five nurses and 25 doctors working in two differents ICU of the Azienda Ospedaliera-Universitaria Pisana were enrolled. Three psychometric tests concerning the defence mechanisms (Defense Mechanism Inventory), the troubles of mood (Profile of Moods States) and the burnout syndrome (Maslach Burnout Inventory) were administered and the three tests were analysed to study the features of each person enrolled. RESULTS: The study shows the presence within doctors of two dimensions of burnout syndrome (emotional exhaustion in women and depersonalization in men) much greater than nurses. The doctors show the presence of defence mechanism as overturning, aggressiveness and rationalization, and troubles of mood as depression-despondency and aggressiveness-anger. Compared to men, women show turning to one self as defence mechanisms, whereas the men show aggressiveness-anger as trouble of mood. The women doctors show depression-disheartement as trouble of mood, the men doctors show tension-anxiety. We showed a correlation between tiredness-indolence, depression-disheartement and onset of emotional exhaustion, as a correlation between aggressiveness, aggressiveness-anger in man and oncet of depersonalization. Finally we correlated the absence of tension-anxiety as trouble of mood and overturning as defence mechanism with a good personal accomplishment at work. CONCLUSION: The burnout syndrome is present in health-care workers in ICU and it is significantly affected by operating role and gender. We must be aware of this phenomenon in order to study it and to reduce it.     

Burnout and self‐employment: a cross‐cultural empirical study

This study examined the differences between full‐time self‐employed and organizationally employed individuals in Canada (n = 248) and Pakistan (n = 306) in terms of overall burnout and its three dimensions (emotional exhaustion, depersonalization and lack of accomplishment), turnover intentions and non‐work satisfaction. Data were collected by means of a structured questionnaire from Canadian employees in Montreal and Pakistani employees in Lahore. One‐way analysis of variance and multivariate analysis of variance were used to analyse the data. The self‐employed reported significantly higher overall burnout, emotional exhaustion, lack of accomplishment, non‐work satisfaction and turnover intention than the organizationally employed in both countries. No significant differences were found between self‐employed and organizationally employed in terms of depersonalization in both countries. Results are discussed in light of previous empirical evidence on self‐employment and the quality of work and non‐work life from cross‐cultural perspectives. Copyright © 2007 John Wiley & Sons, Ltd.     

Stress and burnout among Portuguese anaesthesiologists

BACKGROUND AND OBJECTIVE: Anaesthesiology is considered a stressful occupation. Our purpose was to assess stress and burnout among Portuguese anaesthesiologists. METHODS: A cross-sectional survey based on an anonymous questionnaire was sent to all Portuguese anaesthesiologists registered by the Portuguese Medical Association. Data on patient characteristics and professional variables, perceived stress (Perceived Stress Scale), the subscale of work satisfaction of the Pressure Management Indicator scale, burnout (Maslach Burnout Inventory) and main stress factors were collected. The proportion of participation was 31.8%. RESULTS: The average value of perceived stress scale was 24.0 (range: 0-56). Among the 263 anaesthesiologists, 57.9% experienced emotional exhaustion, 44.8% lack of personal accomplishment and 90.9% depersonalisation. Lack of personal accomplishment increased with number of children among women but not among men; depersonalisation was more frequent among anaesthesiologists working in community hospitals and anaesthesiologists with leadership functions experienced less professional stress. CONCLUSION: There are stress conditions and burnout amongst Portuguese anaesthesiologists. The prevalence of depersonalisation was extremely high in the studied sample. Emotional exhaustion is partially explained by high perceived-stress and low satisfaction with organisation in the job according to Pressure Management Indicator scale.     

Psychological well‐being and psychosocial work environment characteristics among emergency medical and nursing staff

The aim of this study was to determine if the effect of psychosocial work environment on psychological well‐being was different for doctors and nurses who work in emergency departments in Spain. A cross‐sectional survey was carried out among 945 emergency doctors and nurses staff from Spain. The outcome variable was the psychological well‐being measured by two dimensions of SF‐36 Health Survey (SF‐36) (mental health, vitality) and one dimension of Maslach's Burnout Inventory (emotional exhaustion). The explanatory variable was the psychosocial work environment evaluated according to Karasek and Johnson's demand‐control model that includes the dimensions of psychological demands, job control, supervisor social support and co‐workers' social support. The adjusted odds ratios and their 95 per cent confidence intervals were calculated by logistic regression. The prevalence of low vitality, bad mental health and high emotional exhaustion was higher among doctors than nurses. Exposure to high psychological demands increased the probability of low vitality, bad mental health and high emotional exhaustion among doctors and nurses. Low job control and low co‐workers' social support at work were associated with poor psychological well‐being only among doctors. Low job supervisors' social support increased the risk of bad mental health among doctors and of high emotional exhaustion among nurses. There is a different effect of psychosocial work environment on psychological well‐being between doctors and nurses. Copyright © 2007 John Wiley & Sons, Ltd.     

Burnout among Plastic Surgery Residents in India: An Observational Study

Introduction  Burnout syndrome can be defined as emotional exhaustion, depersonalization, and perceived lack of personal accomplishment, all of which lead to decreased effectiveness at work. The Medscape burnout and depression report of 2018 suggests that the burnout range across various specialties ranges from 23 to 48%. There are no studies to assess the burnout among plastic surgery residents in India. This study is an attempt to assess the same. Materials and Methods  An online survey was conducted in March and April 2019 for plastic surgery residents across India. Various parameters including those related to gender, year of the curriculum, hobbies, exercise, and marital status were assessed. There were multiple sections in the survey, which included the demographic details, stress-related variables, and the abbreviated Maslach Burnout Inventory. The abbreviated Maslach Burnout Inventory is a validated scale that has been used to assess the burnout among plastic surgery residents in India. The three subscales, emotional exhaustion, depersonalization, and personal accomplishment were measured on a Likert scale. Univariable and multivariable analysis of factors associated with burnout was performed. Results  Of the 185 respondents, 48.4% experienced moderate-to-high burnout. Of these, 25% ( n = 46) were above the 75th centile of the overall burnout score, indicating severe burnout. Insufficient faculty involvement, insufficient time allotted for formalized teaching, conflict with colleagues, and lack of adequate support staff correlated with resident burnout on multivariate analysis. Residents who pursued their hobbies or performed physical activities for exercise had significantly lesser burnout. Conclusion  The incidence of burnout in plastic surgery residents surveyed in our study was 48.4%. The faculty of the departments and the residents themselves, as well as the governing bodies, all have a role to play to address the issue of burnout among residents. Dedicated and persistent efforts toward improving physical and psychological well-being of plastic surgery residents will positively impact not only the well-being of the residents but also the quality of patient care.     

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.     

Job satisfaction,stress and burnout in Australian specialist anaesthetists

A postal survey was sent to specialist anaesthetists in Australia looking at aspects of job satisfaction, dissatisfaction and stress. Burnout was measured using the Maslach Burnout Inventory. The response rate was 60% (422/700) with the majority of respondents being male (83%). Stressful aspects of anaesthesia included time constraints and interference with home life. Experienced assistants and improved work organisation helped to reduce stress. The high standard of practice and practical aspects of the job were deemed satisfying, whereas poor recognition and long hours were the major dissatisfying aspects of the job. With respect to burnout, high emotional exhaustion, high levels of depersonalisation and low levels of personal achievement were seen in 20, 20 and 36% of respondents, respectively. Female anaesthetists reported higher stress levels than males (p = 0.006), but tended to prioritise home/work commitments better than males (p = 0.05). Private practitioners rated time issues of high importance compared with public hospital doctors, whereas public hospital doctors rated communication problems as being more significant than with private specialists. Although burnout levels are high in anaesthetists, they compare favourably with other medical groups. There are, however, aspects of the anaesthetist's job that warrant further attention to improve job satisfaction and stress.