Measures Of Burnout Research Articles

The effect of remote scribes on primary care physicians’ wellness, EHR satisfaction, and EHR use

BackgroundPhysician burnout is a major problem in the United States. Small studies suggest scribes can improve clinician satisfaction, but scribe programs have not been evaluated using separate control groups or structured measures of electronic health record (EHR) use. MethodsWe conducted a pre-post, non-randomized controlled evaluation of a remote scribe pilot program introduced in September 2019 in an academic primary care practice. Scribes were paired with physicians via an audio-only cellphone connection to hear and document in real-time. Physician wellness was measured with the 10-item Mini-Z and 16-item Professional Fulfillment Index. EHR use was measured using vendor-derived platforms that provide routine EHR-related data. Results37 of 38 scribe users (97.4%) and 68 of 160 potential control physicians (42.5%) completed both pre and post intervention questionnaires. Compared with controls, scribe users had improvements in Mini-Z wellness metrics including Joyful Workplace (mean improvement 2.83, 95%CI 0.60, 5.06) and a single-item dichotomized burnout measure (OR 0.15, 95%CI 0.03, 0.71). There were significant reductions among scribe users compared to controls in total EHR time per 8 scheduled hours (−1.14 h, 95%CI -1.55, −0.72), and an increase in the percentage of orders with team contribution (10.4%, 95%CI 5.2, 15.6). These findings remained significant in adjusted analyses. Conclusions/implicationsA remote scribe program was associated with improvements in physician wellness and reduced EHR use. Healthcare organizations can consider scribe programs to help improve wellness among their physician workforce.

Server connection versus marital disconnection: An investigation of the effect of internet addiction on couple burnout in Iran

The internet has become ubiquitous in many people's lives to an extent that necessitates the investigation of its impact on marital relationships. There has been a lack of such studies in the Iranian context and the present study investigated the relationship between internet addiction and couple burnout. A total of 377 married individuals participated in an online survey comprising demographic information, the Internet Addiction Test (IAT), and the Couple Burnout Measure (CBM). Partial least squares –structure equation modeling (PLS-SEM) was used to assess the relationships in the proposed research model. Structural equation modelling showed a significant effect of sub-components of internet addiction (lack of control; social withdrawal and emotional conflict; time management problems; and concealing problematic behavior) on emotional burnout. In addition, lack of control and time management problems showed significant and positive effect on somatic burnout. However, the relationships between internet addiction components and psychological burnout were not demonstrated as hypothesized. Given the explained relationships between factors comprising internet addiction and couple burnout, couple therapists need to be made more aware of the risks of internet overuse upon marital relationships and to encourage couples to optimize the internet use to prevent negative outcomes (in particular emotional burnout) among couples.

Measurement of burnout during the prolonged pandemic in the Chinese zero-COVID context: COVID-19 burnout views scale.

Burnout is an important public health issue at times of the COVID-19 pandemic. Current measures which focus on work-based burnout have limitations in length and/or relevance. When stepping into the post-pandemic as a new Norm Era, the burnout scale for the general population is urgently needed to fill the gap. This study aimed to develop a COVID-19 Burnout Views Scale (COVID-19 BVS) to measure burnout views of the general public in a Chinese context and examine its psychometric properties. A multiphase approach including literature review, expert consultation, and pilot testing was adopted in developing the scale. The scale was administered to a sample of 1,078 of the general public in Hong Kong with an average age of 34.45 years (SD = 12.47). Exploratory and Confirmatory Factor Analyses suggested a 5-item unidimensional model of COVID-19 BVS. The CFA results indicated that the COVID-19 BVS had a good model fit, as χ2 (10.054)/5 = 2.01, SRMR = 0.010, CFI = 0.998, RMSEA = 0.031. Five items were maintained in EFA with high internal consistency in terms of Cronbach's α of 0.845 and McDonald's ω coefficient of 0.87, and the corrected item-to-total correlations of 0.512 to 0.789 are way above the acceptable range. The KMO values of 0.841 and Bartlett's Test of Sphericity (p < 0.01) verified the normal distribution of the EFA and the adequacy of the EFA sampling. The analyses suggest that the COVID-19 BVS is a promising tool for assessing burnout views on the impacts of the epidemic on the Chinese general populations.

Burnout Integrative Measure: A preliminary validation among French college students.

The aim of this research was to create and validate an integrative measure of college students' burnout. A burnout measure was proposed and extended the three-dimensional conceptualization of burnout (weariness, detachment toward social objects, inadequacy). Based on prior research, our conceptualization and measure distinguished between types of weariness (cognitive, physical, and emotional weariness) and between different targets of detachment toward social objects (studies, other students, teachers). We also relied on negatively worded items to assess inadequacy, as suggested in the literature. The criterion-related validity of our Burnout Integrative Measure (BIM) was examined by exploring associations with two closely related constructs, namely stress and depression. The participants are 905 students in several disciplinary (psychology, nursing care, medicine, science and techniques in sports and physical activities). Results from structural equation modelling provided support for a third-order model encompassing the different targets of detachment, the distinct types of weariness, and inadequacy. The third-order model had a better fit than a first-order model (with a global burnout) and a second-order model (with no distinction between the targets of detachment and the types of weariness). Correlations with related constructs (depression and stress) mostly confirmed our hypotheses. Results and practical implications are discussed.

PLS-SEM Validation for Burnout Measures in Latino College Students: A Socially Sustainable Educational Return

Health care is an essential factor in the social sustainability of the university; therefore, it is a challenge and a responsibility to monitor a safe return to school that ensures the support of the physical and emotional well-being of students. In this sense, the Maslach Burnout Inventory-Student Survey (MBI-SS) is a validated resource with robust techniques in several regions of the world to diagnose school burnout. However, few efforts appear in the literature to validate it from a predictive approach in the Latin region. This study aims to validate, from a predictive approach, measures of school burnout in Latino university students from Mexico and Colombia. A total of 235 surveys were administered (Mx. n = 127, Co. n = 108), and a Partial Least Squares (PLS) measurement model was validated using the statistical program SmartPLS 3.3.7. As a result, 22 valid items were obtained in four reliable subconstructs: burnout, family cynicism, inefficacy, and somatization. The value of this research is its contribution to filling two gaps related to the MBI-SS scale (1) to contribute to the validation of the MBI-SS in a Latin context and (2) the use of the nonparametric statistical technique PLS focused on prediction.

Prevalence and determinants of Italian physicians’ burnout in the “post-COVID-19” era

PurposeSeveral studies investigated prevalence and determinants of physicians’ burnout during the peak of the COVID-19 pandemic, but only a few during the chronic phase of the pandemic. This study thus aimed to examine this topic referring to the “post-COVID-19 era”, defined as a chronic and likely-to-be endemic status quo.MethodsA cross-sectional, online survey (November 2021–January 2022) was addressed to physicians in Lombardia (Northern Italy). Besides socio-demographic and COVID-19-related data, measures of personal, work- and patient-related burnout (Copenhagen Burnout Inventory; CBI), depression (Patient Health Questionnaire-8), anxiety (General Anxiety Disorder-7), and self-efficacy (General Self-Efficacy Scale) were collected. Linear/generalized linear models were run to test associations/predictions of interest.ResultsAmong the 958 respondents, burnout symptoms were clinically significant in 18.5% of them. Predictive models showed that female sex (OR = 0.73, 95% CI 0.42–1.27), younger age (OR = 0.94, 95% CI 0.59–1.48), shorter job tenure (OR = 1.01, 95% CI 0.62–1.65), trainee status (OR = 1.41, 95% CI 1.16–7.10), higher PHQ-8 (OR = 1.260, 95% CI 1.16–1.37), and GAD-7 scores (OR = 1.19, 95% CI 1.10–1.30) increased the risk to suffer from clinical burnout. COVID-19-related variables were mostly not related/associated to burnout levels.ConclusionIn Italy, physicians’ burnout is moderately prevalent also in the chronic phase of the pandemic, with its determinants being more intrinsic than environmental. The development of effective interventions is needed to help physicians cope with the new challenges of their job.

A constructivist grounded theory exploration of Mindfulness for Healthcare Professional students

Background and purposeTo better understand the effects of an intervention, Mindfulness for Healthcare Professional (MIHP), and how it may improve healthcare professional student (HCP) functioning, a constructivist grounded theory exploration was conducted. Materials and methodsTen participants with the lowest or highest changes on quantitative measures of burnout and perceived stress at the end of MIHP were interviewed at a long-term follow-up. A theoretical framework was developed from the resultant themes to describe the mechanisms by which MIHP had effects on work-relevant functioning. ResultsThree overarching themes emerged as mechanisms of change both from their presence in those participants reporting an improvement in stress and their missingness from those participants who reported no change: developing a mindfulness practice, integrating practice into daily life, and enhanced awareness. These mechanisms led to optimized work-relevant functioning: 1) emotional competencies, including nonjudgement, emotion regulation, and burnout prevention; and 2) patient-centered care, including improved listening, patience, and efficiency at work. ConclusionThe resultant framework is discussed in the context of previous literature on MIHP and mindfulness theory more broadly. Implications for future disseminations of MIHP encourage the use of group interventions with emphasis on developing at-home practice and informal mindfulness integrated into daily work.

App-Based Three Good Things and Gratitude Journaling Incentive Program for Burnout in Pediatric Residents: A Nonrandomized Controlled Pilot.

Despite extensive literature measuring the prevalence and the consequences of burnout among resident physicians, effective interventional controlled trials are lacking.1,2 Mindfulness, therapy, and schedule changes have shown small benefits, but require learning a new skill, significant institutional resources, or organizational change.2 Additionally, ability to safely participate in many group or self-care activities has been limited by the recent COVID-19 pandemic. Gratitude3 and 3 good things3 (G/3GT) journaling are low-cost, individual-level interventions that have been shown to significantly improve measures of burnout, happiness, depression, gratitude, and stress; studies so far have not focused on resident burnout.

Identification of Surgeon Burnout via a Single-Item Measure.

Burnout is endemic in surgeons in the UK and linked with poor patient safety and quality of care, mental health problems, and workforce sustainability. Mechanisms are required to facilitate the efficient identification of burnout in this population. Multi-item measures of burnout may be unsuitable for this purpose owing to assessment burden, expertise required for analysis, and cost. To determine whether surgeons in the UK reporting burnout on the 22-item Maslach Burnout Inventory (MBI) can be reliably identified by a single-item measure of burnout. Consultant (n = 333) and trainee (n = 217) surgeons completed the MBI and a single-item measure of burnout. We applied tests of discriminatory power to assess whether a report of high burnout on the single-item measure correctly classified MBI cases and non-cases. The single-item measure demonstrated high discriminatory power on the emotional exhaustion burnout domain: the area under the curve was excellent for consultants and trainees (0.86 and 0.80), indicating high sensitivity and specificity. On the depersonalisation domain, discrimination was acceptable for consultants (0.76) and poor for trainees (0.69). In contrast, discrimination was acceptable for trainees (0.71) and poor for consultants (0.62) on the personal accomplishment domain. A single-item measure of burnout is suitable for the efficient assessment of emotional exhaustion in consultant and trainee surgeons in the UK. Administered regularly, such a measure would facilitate the early identification of at-risk surgeons and swift intervention, as well as the monitoring of group-level temporal trends to inform resource allocation to coincide with peak periods.

Travma Yaşamış Bireylerde Aidiyet Duygusu ve Psikolojik Sağlamlık İlişkisinde Tükenmişlik Duygusunun Aracı Rolü

Individuals encounter at least one negative experience or traumatic event in their lifetime and react differently to these experiences. While some develop vulnerability in the face of such events, others grow stronger. Psychological resilience is the individual’s ability to display healthy development despite negative experiences or to positively adapt to challenging situations. Risk factors and protective factors play an important role in the development of resilience. Therefore, the current study aimed to investigate the effect of burnout as a risk factor and the sense of belonging as a protective factor in explaining psychological resilience. Particularly, this study mainly investigated the mediating role of burnout in the relationship between the sense of belongingness and psychological resilience among university students who had experienced at least one traumatic event. The age of the participants varied between 17 and 35 (M = 24.17, SD = 3.90). General Belongingness Scale, the Resilience Scale for Adults (RSA), and the Burnout Measure, Short Version were used as data collection tools. In data analysis, Pearson Product Moment Correlation and Structural Equation Modeling were performed. It was found that the fit indices established in the research provided good fits and the obtained coefficients were statistically significant. The theoretical model confirmed that burnout plays an intermediary role and significantly affects the relationship between the general sense of belongingness and psychological resilience.

Validation of the Burden Transfer Inventory-abbreviated and examination across veterinary medicine positions and settings in the United States.

Burden transfer, when veterinary client caregiver burden underlies stressful encounters with providers, elevates risk for occupational distress in veterinary medicine. To date, burden transfer has been primarily examined in veterinarians working in general practice, using methods that are time consuming. The current work validates an abbreviated Burden Transfer Inventory (BTI-A) and explores burden transfer across positions of employment and veterinary settings. Participants completed online measures of burden transfer, stress and burnout. A BTI-A with items representing each BTI domain was created with an initial validation sample (n = 1151 veterinarians). Confirmatory psychometric analyses were conducted in a cross-validation sample (n = 440 veterinarians and support staff), followed by exploration of the BTI and BTI-A across veterinary settings and position of employment. The BTI-A correlated with the full-length BTI (r = 0.89-0.96) shows good internal consistency (α = 0.72-0.88) and 1-month test-retest reliability (r = 0.69-0.74). The BTI-A correlated significantly (p < 0.001) with stress and burnout. Exploratory comparisons suggested group differences including greater reactivity in general compared to specialty referral/emergency practice (p = 0.02). The BTI-A can be used in place of the original measure when brevity is important. Use of the BTI-A may help guide allied mental health professionals in providing support for wellbeing in veterinary healthcare team members.

Experiences of attending a reflective practice group in a neuro-rehabilitation setting: A mixed methods service evaluation

This service evaluation aimed to explore ward staff’s experiences of attending a reflective practice (RP) group within an inpatient neuro-rehabilitation setting. Thirteen staff members completed a bespoke questionnaire and three staff members engaged in semi-structured interviews. Findings suggested that the group was a good use of participant’s time, felt a safe space, and was a good space to discuss team dynamics. There were mixed findings regarding whether the group improved staff’s confidence or their understanding of patient’s behaviour. Thematic analysis revealed four core themes, including ‘organisational pressures’ which impacted the RP group; ‘group practicalities’; ‘benefits and improvements’; and the ‘safe space’ of the group. Future evaluations would benefit from using a validated questionnaire and measures of burnout to explore the wider impact of RP.

Ohio Physicians’ Retrospective Pre-Post COVID-19 Pandemic Reports of Burnout and Well-Being

ABSTRACT This cross-sectional, retrospective, pre-post repeated measures study aimed to describe Ohio physicians’ burnout and mental health experiences as perceived prior to and during the COVID-19 pandemic. A one-time online survey was completed by 1,613 physicians registered with the State Medical Board of Ohio (SMBO). Wilcoxon signed-rank tests were used to assess differences between physicians’ self-reports of burnout and mental health prior to and during the pandemic. Mann-Whitney U tests examined response differences between physicians and residents. Data revealed statistically significant differences between physicians’ pre-pandemic and pandemic experiences for all measures of burnout and mental health (p &amp;lt; 0.001) with moderate effect sizes for feeling emotionally drained from work (Z = −16.71, r = 0.43); feeling down, depressed, or hopeless (Z = −18.09, r = 0.46); feeling less accomplished (Z = −11.03, r = 0.29); and caring less about what happens to patients (Z = −12.04, r = 0.31). Small effect sizes were found for thoughts of suicide and concerns about one’s substance use. Additionally, resident physicians were more likely than physicians to report many burnout and mental health concerns prior to and during the pandemic, although these effect sizes were small. These findings can inform stakeholders’ efforts toward the prevention and reduction of physician burnout and improvement of well-being.

Emotional labour strategies and job burnout: A meta‐analysis of Chinese employees

Emotional labour strategies have a significant impact on job burnout. However, current research results are controversial and unclear. A meta‐analysis was conducted to explore the relationship between emotional labour strategies (surface acting and deep acting) and job burnout. A total of 84 empirical studies that included 28,242 participants were selected. The meta‐analysis of the relationships between job burnout and surface acting and deep acting included 84 and 75 independent samples respectively. The results show that surface acting had a positive association (r = 0.25) with job burnout, whereas deep acting (r = −0.27) had a negative association with job burnout. Occupational types and measures of emotional labour strategies moderated the relationship between emotional labour strategies and job burnout, but this relationship was not moderated by measures of job burnout.

140 Factors Influencing Emergency Medical Services Burnout

140 Factors Influencing Emergency Medical Services Burnout

Point prevalence of burnout in Switzerland: a systematic review and meta-analysis.

To estimate the prevalence of occupational burnout among the Swiss working population. We interrogated three international databases (Medline (PubMed), EMBASE, and PsycINFO) and the databases of 15 Swiss universities to identify studies reporting the prevalence of occupational burnout in Swiss workers over the last 10 years, before the COVID-19 pandemic. Data were summarised descriptively and quantitatively using random-effects meta-analysis. We investigated between-study heterogeneity by stratifying results according to the type of burnout measurement tool, by occupation and by cut-off values. Three outcomes were considered: clinical/severe burnout, overall burnout and emotional exhaustion. We identified 23 studies about workers in Switzerland and estimated the prevalence of clinical or severe burnout at 4% (95% confidence interval [CI] 2-6%). The average prevalence estimates for overall burnout and emotional exhaustion were similar at 18% (95% CI 12-25%) and 18% (95% CI 15-22%), respectively. When stratified by occupation, the clinical or severe burnout rates were higher among the healthcare workers than the general working population. These estimates of prepandemic (baseline) prevalence of occupational burnout are comparable with those available in the other countries where it is recognised and treated as a disease. They may prove useful in planning and assessing the effectiveness of interventions for prevention of occupational burnout and in minimising its negative consequences on individuals and on societies during and after the pandemic.

A Measure of Burnout in Current NCAA Student-Athletes.

IntroductionThe prevalence of athletes who specialize in sports has increased in recent years. Substantial literature on youth sports has linked early sport specialization to negative consequences, such as burnout and injury. However, empirical evidence comparing rates of burnout and specialization in NCAA athletes is limited. The purpose of this study was to survey current NCAA Division I student-athletes to compare levels of burnout to sex, year of NCAA eligibility, and age at the beginning of sport specialization.MethodsA self-reported survey was distributed to student-athletes at two NCAA Division I institutions, which included demographics, sport specialization history, injury history, and the Athlete Burnout Questionnaire. Results from the three measures of the Athlete Burnout Questionnaire (reduced sense of accomplishment, exhaustion, sport devaluation) were compared to sex, year of NCAA eligibility, age of beginning sport specialization, and injury history.ResultsA total of 267 athletes (95 males and 172 females) completed the survey. Of those, 156 (58.4%) were in their first or second year of NCAA eligibility, and 111 (41.6%) were in their third, fourth, or fifth year. Of the total, 121 (46.4%) reported specializing before the age of 15, and 140 (53.6%) specialized at age 16 or older. Females reported significantly higher levels of exhaustion than males (Difference of means (M) = 0.43, 95% confidence interval (CI) = [0.20, 0.66], p < 0.01). Athletes in their third, fourth, or fifth year of eligibility reported significantly higher levels of sport devaluation (M = 0.27, 95% CI = [0.05, 0.48], p < 0.05) than athletes in their first or second year. Athletes who specialized before age 15 did not report significantly higher levels of burnout than athletes who specialized at age 16 or later. In total, 203 athletes (77.2%) reported experiencing any injury. Athletes who reported a history of experiencing any injury demonstrated significantly higher feelings of reduced sense of accomplishment than athletes with no injury history (Difference of means (M) = 0.24, 95% confidence interval (CI) = [0.03, 0.45], p < 0.05).ConclusionsAthletes were more likely to experience elevated levels of burnout if they reported female sex, older NCAA eligibility, or a past injury history. However, athletes were not more likely to experience increased burnout based on age of beginning specialization. The results demonstrated a need to address burnout in athletes following injury and to be aware that females and older athletes are more prone to burnout.

Development and Validation of a Novel Instrument to Measure the Community Well-Being of Residency Programs.

To develop and validate the Residency Community Well-Being (RCWB) instrument, a novel instrument to measure the subjective community well-being of an individual residency program, and to explore differences in RCWB scores between demographic groups. An initial questionnaire to measure a residency program's community well-being was developed after literature review. Items were pilot tested, and the questionnaire was reviewed by experts in the fields of residency education, survey design, and sociology. The questionnaire was administered electronically between March and July 2021 to U.S. residents in 18 specialties recruited through convenience and snowball sampling using social media, a listserv, and personal emails to residency program leaders. Three previously validated instruments were administered as well to examine criterion validity: the Professional Fulfillment Index, the Brief Inventory of Thriving, and a single-item burnout measure. Data were analyzed with descriptive statistics, and exploratory factor analysis was performed using principal axis factoring with direct oblimin rotation to reduce the items and identify subscales. Of the 366 participants who opened and started the survey, 219 completed it (completion rate: 59.8%). Most respondents were women (133, 60.7%), 26-30 years old (132, 60.3%), and White (149, 68.0%). Three subscales emerged with 18 items: program leadership, structures, and practices (PLSP); resident interpersonal relationships (RIR); and resident mistreatment (RM). The Cronbach's alphas were 0.96 for PLSP, 0.92 for RIR, 0.82 for RM, and 0.95 for the overall RCWB. RCWB score positively correlated with professional fulfillment ( r = .52, P < .001) and thriving ( r = .45, P < .001) and inversely correlated with burnout ( r = -.39, P < .001). The RCWB instrument demonstrates strong internal consistency and content and criterion validity that shows that a residency program's subjective community well-being is primarily composed of program leadership quality, supportive interpersonal relationships, and the absence of mistreatment.

Reciprocal effects of mathematics performance, school engagement and burnout during adolescence.

Transitioning into adolescence while simultaneously facing greater academic demands as the level of education increases often entails both academic challenges and general declines in students' school-related well-being. Still, however, relatively little is known about the causal relationship between students' academic well-being (i.e., school engagement and burnout) and their performance during the adolescent years. This study examined longitudinal relations between adolescents' mathematics performance, school engagement and burnout (exhaustion, cynicism and inadequacy) across lower secondary education. Data came from a longitudinal research project, following Finnish lower secondary school (grades 7-9) students (N=1131) over 4 years (2016-2019). Students completed standardized mathematics tests and self-report measures of school engagement and burnout at four time points, twice within both 7th and 9th grade. A random intercept cross-lagged panel model (RI-CLPM) was used to examine pathways between engagement, burnout and mathematics performance over time. Higher mathematics performance increased students' engagement and lowered their exhaustion and cynicism over time, whereas both engagement and exhaustion predicted higher performance. Negative relations were also found from inadequacy and cynicism on students' mathematics performance. Furthermore, school burnout predicted engagement both positively (from exhaustion) and negatively (from cynicism and inadequacy) within and between the school years, whereas engagement only predicted cynicism and inadequacy negatively within 7th grade. Findings suggest that the overall relation between students' mathematics performance, engagement and burnout is rather reciprocal, but also, that the relations become more prominent over time, demonstrating the importance of supporting both learning and well-being in school.

Modelling self-diagnosed burnout as a categorical syndrome.

There is currently little consensus as to how burnout is best defined and measured, and whether the syndrome should be afforded clinical status. The latter issue would be advanced by determining whether burnout is a singular dimensional construct varying only by severity (and with some level of severity perhaps indicating clinical status), or whether a categorical model is superior, presumably reflecting differing 'sub-clinical' versus 'clinical' or 'burning out' vs 'burnt out' sub-groups. This study sought to determine whether self-diagnosed burnout was best modelled dimensionally or categorically. We recently developed a new measure of burnout which includes symptoms of exhaustion, cognitive impairment, social withdrawal, insularity, and other psychological symptoms. Mixture modelling was utilised to determine if scores from 622 participants on the measure were best modelled dimensionally or categorically. A categorical model was supported, with the suggestion of a sub-syndromal class and, after excluding such putative members of that class, two other classes. Analyses indicated that the latter bimodal pattern was not likely related to current working status or differences in depression symptomatology between participants, but reflected subsets of participants with and without a previous diagnosis of a mental health condition. Findings indicated that sub-categories of self-identified burnout experienced by the lay population may exist. A previous diagnosis of a mental illness from a mental health professional, and therefore potentially a psychological vulnerability factor, was the most likely determinant of the bimodal data, a finding which has theoretical implications relating to how best to model burnout.