A Rasch analysis of the Burnout Assessment Tool (BAT)

Exploratory rasch analysis of a static-99R clinical cohort assessment

Modern test theory supplements the more prevalent classic methods for assessing test properties. However, such an assessment of the commonly used sexual recidivism risk assessment instrument, Static-99R, has yet to be attempted. This study evaluated the psychometric properties of said instrument using Rasch analysis. The clinical cohort assessed consisted of individuals with mental disorders convicted of a sexual offense (N = 146). Results showed that the original ten-item Static‑99R did not meet the Rasch model requirements, and revisions of the instrument with seven and nine items each only marginally improved performance. More reliable results could likely have been obtained with a larger, non-clinical sample and a more randomized distribution of missing data. Despite the consistently poor performance of item 3 ("Index non-sexual violence") in all three analyses, reliability was slightly improved by dichotomizing the only two polytomous items in the Static-99R; items 1 ("Age at release from index offense") and 5 ("Prior sexual offenses"). These results may be of interest considering the significant change of splitting the formerly dichotomous item 1 into four different response categories in the revision of Static-99 to Static-99R.

Line Managers' Perspectives and Responses when Employees Burn Out

PURPOSE

Little is known about whether burnout can be stopped at an emerging stage. To develop this knowledge, we focus on line managers' perspectives and responses when an employee who seems to be heading for burnout is still at work.

METHODS

We interviewed 17 line managers working in the educational and health care sectors, who had been confronted with the sickness absence of at least one employee due to burnout in the past. Interviews were transcribed, coded, and analyzed thematically.

RESULTS

During the period that the employee seemed to be developing burnout while still at work, line managers experienced three different, successive phases: picking up signals, role-taking, and re-evaluation. Line managers' personal frame of reference (e.g., having experience with burnout) seemed to influence whether and how they picked up signals of burnout. Line managers not picking up signals, did not take any action. When picking up the signals, the managers however generally took an active role: they started a conversation, changed work tasks, and - at a later stage - adapted the employee's job description, sometimes without consulting the employee. The managers felt powerless yet learned from the experience when subsequently re-evaluating the period during which employees developed symptoms of burnout. These re-evaluations resulted in an adapted personal frame of reference.

CONCLUSION

This study shows that improving line managers' frame of reference, e.g., by organizing meetings and/or training, may help them to detect early signals of burnout and take action. This is a first step to prevent the further development of early burnout symptoms.

The burnout-depression conundrum: investigating construct-relevant multidimensionality across four countries and four patient samples

This research seeks to contribute to the ongoing discussion about the distinctive nature of burnout and depression. In a first study, we relied on employee samples from four European countries (N = 5199; 51.27% women; Mage = 43.14). In a second study, we relied on a large sample of patients (N = 5791; 53.70% women; Mage = 39.54) who received a diagnosis of burnout, depressive episode, job strain, or adaptation disorder. Across all samples and subsamples, we relied on the bifactor exploratory structural equation modelling to achieve an optimal disaggregation of the variance shared across our measures of burnout and depression from the variance uniquely associated with each specific subscale included in these measures. Our results supported the value of this representation of participants' responses, as well as their invariance across samples. More precisely, our results revealed a strong underlying global factor representing participants' levels of psychological distress, as well as the presence of equally strong specific factors supporting the distinctive nature of burnout and depression. This means that, although both conditions share common ground (i.e. psychological distress), they are not redundant. Interestingly, our results also unexpectedly suggested that suicidal ideation might represent a distinctive core component of depression.

The ultra-short version of the Burnout Assessment Tool (BAT4)-development, validation, and measurement invariance across countries, age and gender

Given that burnout is a major problem in many societies and that employers are legally obliged to act in preventing job stress, there is a need of validated and reliable short self-report instruments. The Burnout Assessment Tool (BAT) is developed to measure burnout as a syndrome with four core components (exhaustion, mental distance, cognitive and emotional impairment). So far, the BAT was tested in over 40 studies with encouraging results. Although a short, 12-item version of the BAT exists, there is need for an ultra-short version with even less items. The overall aim is to develop an ultra-short 4-item version of the BAT (BAT4) and to evaluate its construct validity using Rasch analysis in samples from various countries along with its measurement invariance regarding country, age and gender. The BAT4 was developed using mixed methods, i.e. combining the results from a Rasch analysis, a subject matter analysis and expert judgements. Construct validity was tested on data from national representative samples from eight countries (the Netherlands, Belgium (Flanders), Austria, Czech Republic, Finland, Germany, Ireland, and Japan) and in a pooled sample combing the data from all eight countries. Differential item functioning regarding age, gender and country was investigated. The BAT4 fulfilled all the criteria required by the Rasch measurement model to constitute a valid measure in the pooled and country specific samples, except Austria and Japan. In the pooled sample, measurement invariance between the eight countries as well as between gender and age was found. Analyses within different countries showed occasional gender and age DIF for some items. The results were promising regarding BAT4's construct validity and measurement invariance. Although the BAT4 includes only four items, its content coverage is acceptable. The BAT4 can be used as a short screening instrument for burnout complaints at the group or organisational level.

Psychometric validity of the Shirom-Melamed Burnout Measure and the Burnout Assessment Tool: a systematic review

In the absence of internationally recognised standardised criteria, several patient-reported outcome measures (PROMs) have been developed to measure occupational burnout. The aim of this study was to extend our 2021 review of the psychometric validity of five PROMs to the Shirom-Melamed Burnout Measure (SMBM) and the Burnout Assessment Tool (BAT). To do that we ran a systematic literature search in the MEDLINE, PsycINFO, and Embase databases following our previous methodological framework and the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN). We assessed the level of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) guideline. We identified 694 publications on SMBM and 421 on BAT, but the final review includes eight papers on SMBM and three on BAT. Of the seven psychometric properties assessed for SMBM, content, structural, and criterion validity were rated as insufficient, whereas the quality of evidence for construct and internal consistency was high and moderate, respectively. Of the nine psychometric properties assessed for BAT, content, structural, criterion, and construct validity was moderate and internal consistency was high. One limitation of this study is that we did not assess cross-cultural validity, because the number of studies reviewed is too small and content validity can only be assessed based on the original PROM version rather than translation. To conclude, BAT is superior to SMBM in terms of psychometric validity, but the quality of evidence for some properties is low or very low, suggesting a need for additional validation studies.

Burnout and depression: Points of convergence and divergence

BACKGROUND

Debate is ongoing as to whether burnout can be differentiated from depression. This study evaluated whether burnout and depression could be distinguished using a new burnout measure and other variables.

METHODS

Scores on the Sydney Burnout Measure (SBM) were compared between participants with self-diagnosed burnout (BO-all group; n = 622) and clinically-diagnosed depression (DEP-all group; n = 90). The latter group was split into melancholic (DEP-mel; n = 56) and non-melancholic (DEP-nonmel; n = 34) depression subgroups for subsequent analyses. Differences in reporting of depressive symptoms and causal attributions were also evaluated.

RESULTS

While total SBM scores showed poor differentiation, the BO-all group had lower social withdrawal and higher empathy loss subscale scores than the depression groups. Odds ratios were significant for several of the depressive symptoms and causal attribution items when comparing the BO-all group to the DEP-all and DEP-mel groups, while only a few items were significant when comparing the BO-all and DEP-nonmel groups.

LIMITATIONS

Participants in the depression group were assigned by clinician-based depression diagnoses, rather than by a standardised diagnostic interview, and the group had a relatively small sample size. Participants in the burnout group were self-diagnosed and not assessed for comorbid psychiatric diagnoses.

CONCLUSIONS

There were some nuanced symptoms differences between burnout and depression, but many of the SBM symptoms were not specific to burnout. Results also suggested that burnout overlaps more with non-melancholic than melancholic depression, and that differentiation of burnout and depression may rely more on weighting causal factors over symptoms.

Healthcare in distress: A survey of mental health problems and the role of gender among nurses and physicians in Sweden

INTRODUCTION

The present article aimed to investigate 1) if mental health problems (depression and burnout including the dimensions; emotional exhaustion, mental distance and cognitive and emotional impairment) differed between nurses and physicians in Sweden, 2) if any differences were explained by differences in sex compositions, and 3) if any sex differences were larger within either of the two professions.

METHOD

Data were derived from a representative sample of nurses (n = 2903) and physicians (n = 2712) in 2022. Two scales were used to assess burnout (KEDS and BAT) and one to assess depression (SCL-6). The BAT scale has four sub-dimensions. Descriptive statistics and logistic regression were used to analyse each scale and dimension separately.

RESULTS

Results showed that 16-28 % of nurses and physicians reported moderate to severe symptoms of burnout. The prevalence differed between occupations across the scales and dimensions used. Nurses reported higher scores on KEDS while physicians reported higher scores on BAT including the four dimensions. Also, 7 % of nurses' and 6 % of physicians' scores were above the cut-off for major depression. The inclusion of sex in the models changed the odds ratios of differences between doctors and nurses in all mental health dimensions except mental distance and cognitive impairment.

LIMITATIONS

This study was based on cross-sectional survey data which has some limitations.

CONCLUSION

Our study suggests that the prevalence of mental health problems is prominent among nurses and physicians in Sweden. Sex plays an important role in the difference in the prevalence of mental health problems between the two professions.

Mindful Self-Compassion as an Antidote to Burnout for Mental Health Practitioners

The objective of this correlational study was to explore the relationship between levels of self-compassion and burnout for currently practicing mental health practitioners (MHPs) in the United States. All professionals are vulnerable to burnout based on various types of organizational stressors, but burnout is of particular concern for health care service providers who may need to adopt a stance of detachment, or emotional distance, as relief from intense workloads, with clients. The data were collected through an online survey. Regression analysis found that scores from Neff's Self-Compassion Scale were a significant negative predictor of levels of MHP burnout, as assessed by Schaufeli et al.'s Burnout Assessment Tool, p < 0.001. The implication of this finding is that cultivating self-compassion appears to be a pragmatic self-care strategy for MHPs to mitigate the negative effects of burnout. More educational and occupational training in self-compassion practices as self-care should be provided to help protect the physical and emotional well-being of MHPs. The deleterious systemic effects of burnout make MHP self-care an ethical issue, along with the need to identify protective factors, prevention, and treatment of burnout.

What is the prevalence of burnout amongst first contact physiotherapists working within primary care?

BACKGROUND

It has long been known general practitioners suffer with burnout. First contact physiotherapists (FCP's) are a new role to primary care. However, concerns have been raised around the longevity and sustainability of the role and the risk of clinician burnout.

AIMS

To assess the prevalence of burnout amongst the FCP workforce.

METHOD

A self-reporting online questionnaire was developed and captured key demographical data and burnout scores amongst FCP's between February 2022 and March 2022. The burnout assessment tool (BAT12) was used to assess clinician burnout.

RESULTS

A total of 332 responses were collected. Overall, 13% of clinicians were burnt out, and 16% at risk. The BAT12 also found 43% of the clinicians are exhausted and a further 35% are at risk of exhaustion. Non-clinical hours were significantly associated with burnout score. Clinicians who had more non-clinical time per month were the least burnt out. Increased non-clinical hours was significant in reducing burnout score.

CONCLUSIONS

This study found 13% of clinicians are suffering from burnout with a further 16% at risk. Worryingly 78% of clinicians are either exhausted or at risk of exhaustion. Non-clinical hours have a direct impact on burnout and every effort is needed by employers to increase non-clinical time. This study supports the release by the Chartered Society of Physiotherapy whereby they recommend sufficient time be allocated within job plans for appropriate supervision, training and continued professional development. Further research is needed to explore the association of non-clinical time and clinician burnout.

Exploring the validity of the Sydney Burnout Measure

This study aimed to examine the convergent validity of a new measure of burnout, the Sydney Burnout Measure (SBM) by comparison against the field standard measure - the Maslach Burnout Inventory (MBI). A second aim was to consider burnout's association with psychological distress. 1483 dental professionals completed the two burnout measures as well as two measures of psychological distress. The overall correlation between total scores on the two measures (and on shared constructs) was high, and thus the convergent validity of the SBM was supported. Further, the SBM and MBI total scores correlated highly with total scores on the two measures of distress. Exploratory structural equation modelling (ESEM) also identified substantial overlap between the measures, especially in relation to the exhaustion subscales of the burnout measures and their overlap with psychological distress items. While future research is required to determine which burnout measure and its associated burnout definition is most valid, our findings argue for further consideration of how burnout may best be conceptualized, as well as whether the syndrome is worthy of elevation to mental disorder status.

The Greek Burnout Assessment Tool: Examining Its Adaptation and Validity

Burnout is a significant challenge in the workplace. Its extent is global and its unfavourable consequences are diverse, affecting the individual, the organization, and society. The aim of the present study was to examine the adaptation and assess the validity of the Greek version of the Burnout Assessment Tool (BAT). The adaptation process included the translation and back-translation of the BAT. Data were collected from 356 Greek employees from diverse sectors. Confirmatory factor analysis and item response theory were utilized to assess the validity of the Greek version of the BAT. According to the findings of the present research, the core symptoms scale and the secondary symptoms scale of BAT-23 and BAT-12 models demonstrated adequate structures for the analysis and measurement of burnout in the Greek context. Finally, the psychometric performance of the BAT-GR-12 compared to the BAT-GR-23 establishes it as a more optimum instrument for the assessment of burnout across Greek working adults.

Psychometric properties of the Burnout Assessment Tool across four countries

BACKGROUND

The Burnout Assessment Tool (BAT) is a new burnout measure developed to replace the Maslach Burnout Inventory (MBI). Studies have supported the psychometric properties and cross-cultural measurement invariance of the BAT. However, some unresolved questions remain. These questions are the appropriate level of score interpretation, convergent validity with the MBI, and measurement invariance using sample groups from countries outside of Europe.

METHODS

We used a cross-sectional survey approach to obtain 794 participants from Australia (n = 200), the Netherlands (n = 199), South Africa (n = 197), and the United States (n = 198). In brief, we used bifactor modelling to investigate the appropriate score interpretation and convergent validity with the MBI. Hereafter, we used the Rasch model and ordinal logistic regression to investigate differential item functioning.

RESULTS

The bifactor model showed a large general factor and four small group factors, which suggests calculating and interpreting a general burnout score. This model further shows that the BAT and MBI measure the same burnout construct but that the BAT is a more comprehensive burnout measure. Most items fit the Rasch model, and few showed non-negligible differential item functioning.

CONCLUSIONS

Our results support the psychometric properties and cross-cultural measurement invariance of the BAT in Australia, the Netherlands, South Africa, and the United States. Furthermore, we provide some clarity on the three previously mentioned unresolved questions.

The student version of the Burnout assessement tool (BAT): psychometric properties and evidence regarding measurement validity on a romanian sample

The objective of the present research was to investigate the psychometric properties and the validity of the student version of the Burnout Assessment Tool (BAT) in a Romanian undergraduate student sample. A sample of undergraduate students (N = 399, 60,70% female) from a Romanian university completed the BAT and other measures used for assessing measurement validity. Confirmatory factor analyses supported the original factor structure of the BAT, and all scales showed good internal consistency. The validity of the BAT scales was supported by their strong associations with measures of depression, anxiety, stress, psychosomatic symptoms, prospective appraisal of future tasks, and coping strategies.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-023-04232-w.

School staff wellbeing: A network-based assessment of burnout

Burnout is commonly associated with professions that entail a high rate of close relationships with other individuals or groups. This paper explores the association between burnout and interpersonal relationships using a relational, social network framework. We collected data on advice-seeking relationships among 102 teachers and administrative staff from a secondary school in Melbourne, Australia. Burnout was measured using the Burnout Assessment Tool and we focused on four core subscales: (1) exhaustion; (2) mental distance; (3) emotional impairment; and (4) cognitive impairment. We applied a particular class of statistical model for social networks called Exponential Random Graph Models (ERGMs) to shed new light on how level of burnout relates to formation of advice relations among school staff. Results indicated that high levels of overall burnout were linked to a higher number of advice-seeking ties among school staff. Additionally, teachers who scored high in cognitive impairment (i.e., difficulties in thinking clearly and learn new things at work) tended to seek and to provide advice to a greater number of others. Finally, school staff who scored high in exhaustion (i.e., a severe loss of energy that results in feelings of both physical and mental exhaustion) tended to be sought out less as advisors to others, while those high in mental distance (i.e., psychologically distancing oneself from others) were generally less likely to seek advice from other school staff. We discuss these findings drawing on Conservation of Resource theory. Notably, our results show that burnout is not only an individual-level problem, but that burnout is associated with reduced social connectivity in specific ways that may impact on how other school staff collaborate, culminating in a staff-wide overall impact that affects how schools function.

Burnout among midwives—the factorial structure of the burnout assessment tool and an assessment of burnout levels in a Swedish national sample

Background

Many workplaces, within the healthcare sector, experience high rates of mental health problems such as burnout, anxiety, and depression, due to poor psychosocial working conditions and midwives are not an exception. To develop preventive interventions, epidemiologic surveillance of burnout levels, and their relation to professional specific working conditions is needed. Aims of this study is to assess the construct validity of the Burnout Assessment Tool (BAT) in the context of Swedish midwives, to evaluate whether the item responses can be combined into a single score and differential item functioning regarding age. Another aim was to assess the burnout levels of Swedish midwives.

Methods

Data come from a national cohort of Swedish midwives (n = 1664). The construct validity was evaluated using Rasch analysis. Burnout levels were presented by median and first (Q1) and third (Q3) quartiles for the BAT total score and the four subscales (exhaustion, mental distance, cognitive and emotional impairment).

Results

In the analysis including all 23 items the fit to the Rasch model was not obtained. Items within each subscale clustered together in a residual correlation matrix in a pattern consistent with the underlying conceptualization of the BAT, indicating multidimensionality. The Rasch analysis was re-run using the four testlets as input variables which resulted in a good fit. The median burnout level was 2.0 (Q1 = 1.6, Q3 = 2.4). The four subscales differentiated the picture (elevated levels on exhaustion and low levels on the other three subscales).

Conclusions

The construct validity of the BAT for use in the context of Swedish midwives was confirmed. The results indicated a strong general factor, meaning that the responses can be combined into a single burnout score. The scale works invariantly for different age groups. The results of this study secure access to a validated instrument to be used for accurate assessment of the burnout levels among midwives in Sweden.

The psychometric properties and measurement invariance of the Burnout Assessment Tool (BAT-23) in South Africa

BACKGROUND

Burnout is an increasing public health concern that afflicts employees globally. The measurement of burnout is not without criticism, specifically in the context of its operational definition as a syndrome, also recently designated as such by the World Health Organisation. The Burnout Assessment Tool (BAT-23) is a new measure for burnout that addresses many of the criticisms surrounding burnout scales. The aim of this study is to determine the validity, reliability, and measurement invariance of the BAT-23 in South Africa.

METHOD

A quantitative, cross-sectional survey, approach was taken (n = 1048). Latent variable modelling was implemented to investigate the construct-relevant multidimensionality that is present in the BAT. For measurement invariance, the configural, metric, scalar, and strict models were tested.

RESULTS

The analyses showed that the hierarchical operationalisation of BAT-assessed burnout was the most appropriate model for the data. Specifically, a bifactor ESEM solution. Composite reliability estimates were all well above the cut-off criteria for both the global burnout factor and the specific factors. The measurement invariance tests showed that gender achieved not only strong invariance, but also strict invariance. However, ethnicity initially only showed strong invariance, but a test of partial strict invariance did show that the mean scores could be fairly compared between the groups when releasing certain constraints.

CONCLUSIONS

The BAT-23 is a valid and reliable measure to investigate burnout within the Southern African context.

A workplace organisational intervention to improve hospital nurses' and physicians' mental health: study protocol for the Magnet4Europe wait list cluster randomised controlled trial

INTRODUCTION

The increasing burden of mental distress reported by healthcare professionals is a matter of serious concern and there is a growing recognition of the role of the workplace in creating this problem. Magnet hospitals, a model shown to attract and retain staff in US research, creates positive work environments that aim to support the well-being of healthcare professionals.

METHODS AND ANALYSIS

Magnet4Europe is a cluster randomised controlled trial, with wait list controls, designed to evaluate the effects of organisational redesign, based on the Magnet model, on nurses' and physicians' well-being in general acute care hospitals, using a multicomponent implementation strategy. The study will be conducted in more than 60 general acute care hospitals in Belgium, England, Germany, Ireland, Norway and Sweden. The primary outcome is burnout among nurses and physicians, assessed in longitudinal surveys of nurses and physicians at participating hospitals. Additional data will be collected from them on perceived work environments, patient safety and patient quality of care and will be triangulated with data from medical records, including case mix-adjusted in-hospital mortality. The process of implementation will be evaluated using qualitative data from focus group and key informant interviews.

ETHICS AND DISSEMINATION

This study was approved by the Ethics Committee Research UZ/KU Leuven, Belgium; additionally, ethics approval is obtained in all other participating countries either through a central or decentral authority. Findings will be disseminated at conferences, through peer-reviewed manuscripts and via social media.

TRIAL REGISTRATION NUMBER

ISRCTN10196901.

The Diagnosis of Burnout: Some Challenges

ABSTRACT

Burnout is a topic of high public and research interest, but debate remains as to how the syndrome should best be defined, measured, and diagnosed. In this article, we overview how issues relating to burnout's definition and measurement as well as the debate surrounding its overlap with depression have led to ambiguity surrounding its diagnostic status. We argue for a broader conceptualization of burnout and detail why we position it as distinct from depression, before providing recommendations for clinicians when considering a burnout diagnosis. We highlight that all measures of burnout risk "false-positive" diagnoses and that they should more be viewed as screening strategies with a definitive diagnosis (of "burning out" or "being burnt out") requiring close clinical assessment and exclusion of alternate psychological and physical conditions.

A post-lockdown study of burnout risk amongst New Zealand essential workers

BACKGROUND AND RATIONALE

Job burnout is an essential topic for researchers and a pressing issue for employers and employees. However, the most popular tool has become widely critiqued, and a new measure of burnout - the Burnout Assessment Tool (BAT) - is used here. The BAT is helpful because it provides a cut-off threshold score representing high burnout risk. This study provides one of the first BAT studies post Covid-19 pandemic and focuses on comparing high burnout risk rates between essential and non-essential workers after the first lockdown in New Zealand (May 2020).

METHODS AND RESULTS

Using representative data from 955 employees across a wide range of occupations, sectors, and industries, we calculate an overall burnout risk of 11.1%, with essential workers higher (14%) than non-essential workers (9%). The odds ratios of burnout risk and having high levels of mental health complaints were 10-20 times higher for burnout risk workers. For essential workers, they were significantly higher for high job depression risk (35 times). Building on these results, to develop a deeper understanding of the factors contributing to burnout risk, we report on a qualitative analysis of comments (n = 213) provided by essential workers on their lockdown work experiences.

CONCLUSIONS

Findings provide evidence that while a range of (1) health-related concerns (i.e., increased risk of getting and spreading covid) and (2) employee- and employer-specific pressures related to challenging lockdown work practices contribute to essential worker burnout risk, an unwavering sense of pride and purpose in the value of their essential work serves to reduce this risk. We discuss the implications, highlighting the unique issues facing essential workers.

Shortening of the Burnout Assessment Tool (BAT)-from 23 to 12 items using content and Rasch analysis

BACKGROUND

Burnout is related to huge costs, for both individuals and organizations and is recognized as an occupational disease or work-related disorder in many European countries. Given that burnout is a major problem it is important to measure the levels of burnout in a valid and reliable way. The Burnout Assessment Tool (BAT) is a newly developed self-report questionnaire to measure burnout. So far, studies concerning the psychometric properties of the original version of the Burnout Assessment Tool (BAT) including 23 items show promising results and suggest that the instrument can be used in many different settings. For various reasons there is a need of a shorter instrument. For example, burnout questionnaires are typically included in employee surveys to evaluate psychosocial risk-factors, which according to the European Occupational Safety and Health Framework Directive, should be carried out in organizations on a regular basis. The aims of this paper are to develop a shorter version of the BAT, including only 12 items (BAT12) and to evaluate its construct validity and differential item functioning regarding age, gender and country.

METHODS

Using data from representative samples of working populations in the Netherlands and Belgium (Flanders) a shorter version of the BAT was developed by combining quantitative (Rasch analysis) and qualitative approaches (item content analysis and expert judgements). Construct validity of the new BAT12 was evaluated by means of Rasch analysis.

RESULTS

In an iterative procedure, deleting one item from each subscale at each step, a short version of the BAT - BAT12 was developed. The BAT12 fulfils the measurement criteria according to the Rasch model after accounting for local dependency between items within each subscale. The four subscales can be combined into a single burnout score.

CONCLUSION

The new BAT12 developed in the present study maintains the breath of item content of the original version of the BAT. The new BAT12 has sound psychometric properties. The scale works invariantly for older and younger, women and men and across two countries. A shorter version of the BAT is timesaving compared to the BAT23 and can be used in e.g. employee surveys.

Burnout Assessment Tool (BAT): Validity Evidence from Brazil and Portugal

The Burnout Assessment Tool (BAT) has been gaining increased attention as a sound and innovative instrument in its conceptualization of burnout. BAT has been adapted for several countries, revealing promising validity evidence. This paper aims to present the psychometric properties of the Brazilian and Portuguese versions of the BAT in both the 23-item and 12-item versions. BAT’s validity evidence based on the internal structure (dimensionality, reliability, and measurement invariance) and validity evidence based on the relations to other variables are the focus of research. A cross-sectional study was conducted with two non-probabilistic convenience samples from two countries (N = 3103) one from Brazil (n_Brazil = 2217) and one from Portugal (n_Portugal = 886). BAT’s original structure was confirmed, and it achieved measurement invariance across countries. Using both classic test theory and item response theory as frameworks, the BAT presented good validity evidence based on the internal structure. Furthermore, the BAT showed good convergent evidence (i.e., work engagement, co-worker support, role clarity, work overload, and negative change). In conclusion, the psychometric properties of the BAT make this freely available instrument a promising way to measure and compare burnout levels of Portuguese and Brazilian workers.

Determining levels of nurse burnout during the COVID-19 pandemic and Lebanon's political and financial collapse

Background

The COVID-19 pandemic compounded political and financial pressures on the nursing workforce in Lebanon. The government resigned in October 2019 in response to the popular uprising that called for an end to corruption and economic mismanagement 5 months before the first COVID-19 case appeared in the country. The continuing crises and the added stress of COVID-19 has increased the risk of occupational burnout and turnover in the nursing workforce. Therefore, valid and reliable measurement is imperative to determine burnout levels, prioritize intervention, and inform evidence-based workforce policy and practice. The primary aim of the study was to delineate burnout levels and cut-points in a national sample of nurses to inform workforce policies and prioritize interventions.

Methods

Multidimensional and unidimensional Rasch analyses of burnout data collected from a national convenience sample of 457 hospital nurses 9–12 months after Lebanon’s political and economic collapse began. The data were collected in July–October 2020.

Results

Multidimensional Rasch analysis confirmed that the Copenhagen Burnout Inventory has three highly correlated unidimensional scales that measure personal burnout, work-related burnout, and client-related burnout. Except for a ceiling effect of ~ 2%, the three scales have excellent measurement properties. For each scale, Rasch rating scale analysis confirmed five statistically different nurse burnout levels. The mean personal burnout scores and work-related burnout scores (50.24, 51.11 respectively) were not higher than those reported in the international literature. However, the mean client-related burnout score of 50.3 was higher than reported for other countries. Compared with a baseline study conducted at the beginning of Lebanon’s political and economic crises, only client-related burnout scores were higher p. <.01.

Conclusions

The CBI scales are reliable and valid measures for monitoring nurse burnout in crises torn countries. Stakeholders can use the CBI scales to monitor nurse burnout and prioritize burnout interventions. Urgent action is needed to reduce levels of client-related burnout in Lebanon’s nursing workforce.

The Swedish HealthPhys Study: Study Description and Prevalence of Clinical Burnout and Major Depression among Physicians

Objectives

The study purpose was to describe the Swedish HealthPhys cohort. Using data from the HealthPhys study, we aimed to describe the prevalence of clinical burnout and major depression in a representative sample of Swedish physicians across gender, age, worksite, hierarchical position, and speciality in spring of 2021, during the third wave of the Covid-19 pandemic.

Method

The HealthPhys questionnaire was sent to a representative sample of practising physicians (n = 6699) in Sweden in February to May of 2021 with a 41.3% response rate. The questionnaire included validated instruments measuring psychosocial work environment and health including measurements for major depression and clinical burnout.

Results

Data from the HealthPhys study showed that among practising physicians in Sweden the prevalence of major depression was 4.8% and clinical burnout was 4.7%. However, the variations across sub-groups of physicians regarding major depression ranged from 0% to 10.1%. For clinical burnout estimates ranged from 1.3% to 14.5%. Emergency physicians had the highest levels of clinical burnout while they had 0% prevalence of major depression. Prevalence of exhaustion was high across all groups of physicians with physicians working in emergency departments, at the highest (28.6%) and anaesthesiologist at the lowest (5.6%). Junior physicians had high levels across all measurements.

Conclusions

In conclusion, the first data collection from the HealthPhys study showed that the prevalence of major depression and clinical burnout varies across genders, age, hierarchical position, worksite, and specialty. Moreover, many practising physicians in Sweden experienced exhaustion and were at high risk of burnout.

Examination of validity, reliability, and interpretability of a self-reported questionnaire on Occupational Balance in Informal Caregivers (OBI-Care) - A Rasch analysis

Objectives

Informal caregivers often experience a restriction in occupational balance. The self-reported questionnaire on Occupational Balance in Informal Caregivers (OBI-Care) is a measurement instrument to assess occupational balance in informal caregivers. Measurement properties of the German version of the OBI-Care had previously been assessed in parents of preterm infants exclusively. Thus, the aim of this study was to examine the measurement properties of the questionnaire in a mixed population of informal caregivers.

Methods

A psychometric study was conducted, applying a multicenter cross-sectional design. Measurement properties (construct validity, internal consistency, and interpretability) of each subscale of the German version of the OBI-Care were examined. Construct validity was explored by assessing dimensionality, item fit and overall fit to the Rasch model, and threshold ordering. Internal consistency was examined with inter-item correlations, item-total correlations, Cronbach’s alpha, and person separation index. Interpretability was assessed by inspecting floor and ceiling effects.

Results

A total of 196 informal caregivers, 171 (87.2%) female and 25 (12.8%) male participated in this study. Mean age of participants was 52.27 (±12.6) years. Subscale 1 was multidimensional, subscale 2 and subscale 3 were unidimensional. All items demonstrated item fit and overall fit to the Rasch model and displayed ordered thresholds. Cronbach’s Alpha and person separation index values were excellent for each subscale. There was no evidence of ceiling or floor effects.

Conclusions

We identified satisfying construct validity, internal consistency, and interpretability. Thus, the findings of this study support the application of the German version of the OBI-Care to assess occupational balance in informal caregivers.

Burnout: modeling, measuring, and managing

OBJECTIVE

As burnout has been neglected in medical and psychiatric education, we seek to provide a summary overview.

METHODS

We extract salient findings from the published literature and offer some challenges.

RESULTS

We critique the current principal model of burnout, argue for broadening the symptom constructs and for a diathesis-stress model where a perfectionistic personality style is a key predisposing factor, and observe that burnout is not limited by those in formal work. We argue that burnout is not synonymous with depression, overview biological underpinnings, and summarise a three-fold management model.

CONCLUSION

As many burnout patients are referred to psychiatrists, awareness of its symptom pattern and management nuances is of key importance.

Psychometric Properties of the Italian Version of the Burnout Assessment Tool (BAT)

The most popular instrument to measure burnout is the Maslach Burnout Inventory (MBI). Recently, to overcome some of the limitations of the MBI, a new instrument has been proposed, namely the Burnout Assessment Tool. The purpose of this study is to examine the psychometric properties of the Italian version of the BAT. This tool is comprised of a set of four core dimensions (BAT-C; i.e., exhaustion, mental distance, cognitive and emotional impairment) and two secondary symptom dimensions (BAT-S; i.e., psychological and psychosomatic complaints). Data were collected on a sample of 738 participants from heterogeneous sectors and professional roles. In the sample women were slightly overrepresented (52.9%), the participants had a mean age of 41.57 years (SD = 10.51) and a mean organizational tenure of 9.65 years (SD = 8.50). The reliability and factorial structure of the BAT-C and BAT-S, together with the convergent and discriminant validity of BAT-C and MBI were explored, as well as the incremental validity to the BAT-C, over and beyond the MBI. Our results confirmed the factorial validity of a two-factor second-order factor model (BAT-C and BAT-S) represented by 4 first-order factors in the case of BAT-C and 2 first-order factors for BAT-S. Results also attested that BAT-C explains additional variance of the BAT-S, above and beyond what is explained by the MBI-GS. All in all, this study provided evidence that the Italian version of BAT represents a reliable and valid tool for measuring burnout in the work context.

The Burnout Assessment Tool (BAT): A Contribution to Italian Validation with Teachers’

This study aims to validate the Burnout Assessment Tool (BAT) adapted to the Italian education sector. Teacher burnout is physical and emotional pain, due to prolonged exposure to school-related stress factors. Previous research has abundantly proven that preventive assessment of teachers’ risk level for burnout may reduce adverse outcomes. In this regard, new assessment tools, able to bring together evidence from fifty years of research on this topic, were mainly used to monitor burnout-risk levels in the school context. For the present work, 846 Italian teachers (Female, 91.1%; M age = 47.52; SD = 9.94) were involved in the study. Confirmatory factor analysis supported a four-factor structure for the core dimensions (BAT-C; exhaustion, mental distance, emotional impairment, cognitive impairment), and a two-factor structure for the secondary dimensions (BAT-S; psychological distress, psychosomatic complaints). The Italian version of the BAT-C and BAT-S has shown good internal consistency (respectively, α = 0.900 and ω = 0.913; α = 0.845 and ω = 0.857) and validity (all correlations between variables showed a p value < 0.01). Our findings support the Italian adaptation of the original version of the BAT as a valid instrument for measuring teachers’ burnout through principal and secondary symptoms.

Be Aware of Burnout! The Role of Changes in Academic Burnout in Problematic Facebook Usage among University Students

Most previous research has examined the relationship between FB addiction and burnout level by conducting cross-sectional studies. Little is known about the impact of changes in burnout on FB addiction in an educational context. Through a two-way longitudinal survey of a student population sample (N = 115), this study examined the influence of changes in academic burnout over time and FB motives and importance (measured at the beginning and the end of the semester) on FB intrusion measured at the end of the academic semester. The findings show that: (1) increases in cynicism and in FB motives and importance significantly predicted time2 FB intrusion; (2) FB importance enhanced the prediction power of changes in the academic burnout total score, exhaustion and personal inefficacy, and reduced the regression coefficient of changes in cynicism; (3) the interaction effects between FB social motive use and changes in academic burnout, as well as between FB importance and personal inefficacy and exhaustion, accounted for a significant change in the explained variance of time2 FB intrusion. About 20–30% of the variance in time2 FB intrusion was explained by all the examined variables and by the interactions between them. The results suggest that changes in academic burnout and FB motives and importance are suppressive variables, as including these variables in the regression model all together changed the significance of the relationship between independent variables and FB intrusion.

Burnout, Organizational Self-Efficacy and Self-Esteem among Brazilian Teachers during the COVID-19 Pandemic

The purpose of this study was to assess the prevalence of, and the association between burnout, organizational self-efficacy and self-esteem, and to assess the predictive influence of burnout and organizational self-efficacy on self-esteem among Brazilian teachers during the COVID-19 pandemic. Brazilian teachers (n = 302) between 24 and 70 years old (M_age = 46.75, SD = 11.02) participated in this study. Measurement instruments included a sociodemographic questionnaire, the Burnout Assessment Tool, the Organizational Self-Efficacy Scale and the Rosenberg Self-Esteem Scale. The prevalence of burnout symptoms was 3.2%, the prevalence of low occupational self-efficacy was 21.5%, and the prevalence of low self-esteem was 2.7%. Significant correlations were found between all variables under study. Hierarchical linear regression analysis showed that overall levels of burnout explained 40% of the variance of self-esteem, while together with organizational self-efficacy, it explained 55%. This study presents evidence of the impact of overall levels of burnout and self-efficacy on teachers’ self-esteem and also contributes to the body of knowledge under construction about the scenario perceived by teachers in Brazil during the COVID-19 pandemic.

The Ecuadorian Version of the Burnout Assessment Tool (BAT): Adaptation and Validation

This study aimed to adapt and show evidence of validity for the Ecuadorian version of the Burnout Assessment Tool (BAT) considering only its "core" dimensions. The adaptation process included its translation and back translation. For content validation, expert reviews and focus groups were carried out. A confirmatory factor analysis was used to identify the psychometric properties and dimensionality of the scale. The reliability of the scale was assessed through the alpha, omega and composite reliability indices. To carry out the study, the questionnaire was applied to a sample of workers with a high level of education in Ecuador. In total, 2237 respondents were considered in the analysis. The results showed that the hierarchical model for BAT-23 and its short version, the BAT-12 scale, is the most adequate structure for analysis of the construct in the Ecuadorian context. The reliability of the general factor of burnout and its dimensions, evaluated by composite reliability, omega and Cronbach's alpha, showed satisfactory indices. The findings obtained provide support for the reliability and validity of the Burnout Assessment Tool for the Ecuadorian context.

Is There Utility in Specifying Professional Efficacy as an Outcome of Burnout in the Employee Health Impairment Process

The aim of this study was to investigate the utility of specifying professional efficacy as an outcome of burnout in the employee health impairment process of the job demands–resources model. The sample comprised a general, but purposive, sample of employees (n = 660). Specifically, participants needed to be at least 18 years of age and be employed in the formal sector. Structural equation modeling methods were applied to analyze the data with a mean- and variance-adjusted weighted least squares estimation. The results showed that the research model was a good fit to the data. Furthermore, the results showed that burnout had a statistically significant negative structural path to professional efficacy, but that professional efficacy in turn did not statistically significantly explain variance in either psychological distress or turnover intention beyond burnout. There were also no meaningful indirect effects, from emotional load to either psychological distress or turnover intention, of professional efficacy. All in all, the results showed that there was no practical utility in specifying professional efficacy as an outcome of burnout in the employee health impairment process of the job demands–resources model, except if professional efficacy is being investigated as an outcome for its own sake.

Burnout Assessment Tool (BAT)-Development, Validity, and Reliability

This paper introduces a new definition for burnout and investigates the psychometric properties of the Burnout Assessment Tool (BAT). In a prior qualitative study, 49 practitioners were interviewed about their conceptualization of burnout (part 1). Using a dialectical approach, four core dimensions—exhaustion, mental distance, and impaired emotional and cognitive impairment—and three secondary dimensions—depressed mood, psychological distress, and psychosomatic complaints—emerged, which constitute the basis of the BAT. In the second study, the psychometric characteristics of the BAT were investigated in a representative sample of 1500 Flemish employees, focusing on factorial validity, reliability, and construct validity, respectively. Results demonstrate the assumed four-factor structure for the core dimensions, which is best represented by one general burnout factor. Contrary to expectations, instead of a three-factor structure, a two-factor structure was found for the secondary dimensions. Furthermore, the BAT and its subscales show adequate reliability. Convergent validity and discriminant validity with other burnout measures—including the MBI and OLBI—was demonstrated, as well as discriminant validity with other well-being constructs, such as work engagement and workaholism.