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

A Persian validation of the burnout assessment tool

BACKGROUND

Burnout is an increasing public health concern. Its prevalence has extended across diverse professions globally, posing significant challenges to individuals, organizations, and society. This phenomenon has undermined employee well-being, productivity, and organizational effectiveness, making it a critical concern in contemporary work environments. The present study aimed to examine the adaptation and assess the validity of the Persian version of the Burnout Assessment Tool (BAT).

METHODS

The adaptation process included the translation and back-translation of the BAT. Data were collected on a sample of 580 teachers using the convenience sampling. The BAT-Persian and Utrecht Work Engagement Scale were administered to collect the data. The reliability, factorial structure of the BAT-C and BAT-S, and the convergent and discriminant validity of BAT-C and work engagement were explored.

RESULTS

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). In the second-order model, the item loadings on the four factors of BAT-C ranged from 0.35 to 0.85, and on two factors of BAT-S ranged from 0.63 to 0.89. The Persian versions of the BAT-C and BAT-S showed good internal consistency (respectively, α = 0.95 and 0.90). Additional evidence supports the convergent and discriminant validity of the BAT-GR. the BAT-C and its scales were negatively correlated with work engagement and dimensions (i.e., vigor, dedication, and absorption). Moreover, the BAT-S and its scales negatively correlated with work engagement and dimensions.

CONCLUSIONS

This study provided evidence that the Iranian version of BAT represents a reliable and valid tool for measuring burnout in the work context. A reliable and valid tool for assessing burnout in the Iranian workplace enables early detection of employee distress, allowing for timely intervention and support. This means that identifying the signs and symptoms of burnout in the early stages can prevent more severe consequences such as absenteeism, reduced productivity, or turnover.

Development and validation of burnout factors questionnaire in the operating room nurses

Nurses may experience burnout more than other professions. Occupational burnout is a serious concern considering the importance of nurses' jobs in patient care. This study was carried out with the aim of designing and validating the questionnaire of burnout factors in the operating room nurses. Mixed method study was done in two qualitative and quantitative phases in 2022 on Iranian operating room nurses. In the first stage, the concept of operating room nurses' burnout was explained using interviews and literature review, and items were generated. In the second stage, the face validity, content and construct validity of the questionnaire was examined with 342 operating room nurses, and also the reliability of the questionnaire was tested using internal consistency (Cronbach's alpha) and stability (test-retest). After conducting the interview and literature review, 65 questions were extracted. Based on face validity, 4 items were modified. After content validity, 40 items remained. In construct validity, after exploratory factor analysis, 34 items with 5 dimensions were extracted. These dimensions included Organizational, Individual, Interpersonal, Occupational Nature and Managerial factors. Cronbach's alpha and intra-class correlation coefficient were equal to 0.937 and 0.946, respectively. The designed tool based on understanding the concept of burnout in operating room nurses has appropriate and acceptable validity and reliability. Therefore, it can be used to measure burnout in operating room nurses.

Techno-Stress Creators, Burnout and Psychological Health among Remote Workers during the Pandemic: The Moderating Role of E-Work Self-Efficacy

During the COVID-19 pandemic, remote working was pervasively implemented, causing an increase in technology-related job demands. Concurrently, there was an increase in psychological problems in the occupational population. This study on remote workers tested a moderated mediation model positing burnout, conceptualized according to the Burnout Assessment Tool, as the mediator between techno-stressors and psychological health outcomes and e-work self-efficacy as a protective personal resource. A sample of 225 remote workers filled out anonymous questionnaires measuring techno-stressors, e-work self-efficacy, burnout, and psychological health symptoms (i.e., depressive mood and anxiety symptoms). The data were analyzed using structural equation mediation and moderated mediation models, adopting a parceling technique. The results showed that burnout totally mediated the relationship between techno-stressors and depressive mood, while partially mediating the association between techno-stressors and anxiety symptoms. Moreover, e-work self-efficacy buffered the positive effects of techno-stressors on depressive mood and anxiety symptoms through burnout. The present research attested to the relevance of techno-stressors for the psychological health of remote workers and supported burnout as a mediator of this process, although anxiety symptoms were also directly related to techno-stressors. Moreover, the protective role of domain-specific self-efficacy was confirmed in the realm of remote working. Limitations and practical implications are discussed.

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.

Students' Burnout at University: The Role of Gender and Worker Status

Students' burnout has been widely investigated in recent decades, mainly showing a higher risk for female students across academic levels. To our knowledge, few studies have investigated whether employed students experience higher academic burnout risks. In this regard, previous findings have shown mixed results. The current study investigated the differences in burnout experience based on students' gender and worker status. We expected to find differences among study groups in their burnout levels. The participants were 494 Italian university students (49.6% female students; 49.4% working students) who completed the short version of the Burnout Assessment Tool Core dimensions (BAT-C). Firstly, we investigated the BAT-C measurement invariance across gender and worker status subgroups. Secondly, a multivariate analysis of variance (MANOVA) showed significant gender differences in burnout levels. Specifically, female students showed higher levels of exhaustion, cognitive impairment, and emotional impairment than male students. Nevertheless, no interactive effects between gender and worker status were observed in the current sample. To sum up, gender is a key factor for understanding several BAT symptoms, and it should be considered by academic staff interested in preventing burnout at university and its dropout consequences.

Analysis on Burnout, Job Conditions, Alexithymia, and Other Psychological Symptoms in a Sample of Italian Anesthesiologists and Intensivists, Assessed Just before the COVID-19 Pandemic: An AAROI-EMAC Study

Background. It was previously reported that health care professionals working in the fields of anesthesiology and emergency are at higher risk of burnout. However, the correlations between burnout, alexithymia, and other psychological symptoms are poorly investigated. Furthermore, there is a lack of evidence on which risk factors, specific to the work of anesthetists and intensivists, can increase the risk of burnout, and which are useful for developing remedial health policies. Methods. This cross-sectional study was conducted in 2020 on a sample of 300 professionals recruited from AAROI-EMAC subscribers in Italy. Data collection instruments were a questionnaire on demographic, education, job characteristics and well-being, the Maslach Burnout Inventory Tool, the Toronto Alexithymia Scale, the Symptom Checklist-90-R, and the Rosenberg Self-Esteem Scale administered during refresher courses in anesthesiology. Correlations between burnout and physical and psychological symptoms were searched. Results. With respect to burnout, 29% of individuals scored at high risk on emotional exhaustion, followed by 36% at moderate–high risk. Depersonalization high and moderate–high risk were scored by 18.7% and 34.3% of individuals, respectively. Burnout personal accomplishment was scored by 34.7% of respondents. The highest mean scores of burnout dimensions were related to dissatisfaction with one’s career, conflicting relationships with surgeons, and, finally, difficulty in explaining one’s work to patients. Conclusions. Burnout rates in Italian anesthesiologists and intensivists have been worrying since before the COVID-19 pandemic. Anesthesiologists with higher levels of alexithymia are more at risk for burnout. It is therefore necessary to take urgent health policy measures.

Italian Validation of the 12-Item Version of the Burnout Assessment Tool (BAT-12)

The Burnout Assessment Tool (BAT) has shown satisfactory validity evidence in several countries, with the 23-item version of the instrument reporting adequate psychometric properties also in the Italian context. This paper is aimed to present results from the Italian validation of the 12-item version of the BAT. Based on a sample of 2277 workers, our results supported the factorial validity of a higher-order model represented by 4 first-order factors corresponding to the core dimensions of burnout, namely exhaustion, mental distance, and emotional and cognitive impairment. The measure invariance of the BAT-12 between data collected before and during the COVID-19 pandemic was supported. However, ANCOVA results suggest a higher score on the second-order burnout factor on data collected during the COVID-19 pandemic in comparison with earlier data. In line with the JD-R model, the BAT-12 total score reported a positive association with job demands (i.e., workload, time pressure, and role conflict) and a negative association with job resources (i.e., job autonomy, coworkers’ support) and personal resources (i.e., optimism, social self-efficacy, and task self-efficacy). Additionally, the BAT-12 showed a negative association with work engagement components (i.e., vigor, dedication, and absorption) and positive job attitudes (i.e., job satisfaction, affective commitment). All in all, our results identify the Italian version of the BAT-12 as a brief and reliable tool for measuring burnout among workers.

A new tool to evaluate burnout: the Italian version of the BAT for Italian healthcare workers

BACKGROUND

Healthcare workers (HCWs) represents one of the highest-risk population to develop burnout symptoms. Recently, a new tool has been designed to measure several dimensions that capture an exhaustive expression of burnout symptoms by six dimensions (i.e., exhaustion; mental distance; cognitive impairment; emotional impairment; psychological distress; psychosomatic complaints).

METHODS

The current study aims to adapt the Burnout Assessment Tool (BAT) to an Italian Healthcare workers' sample confirming the original second-order factorial structure. Furthermore, we expected to find good indexes of reliability and validity tests. Participants were 697 Italian Health Care Workers (Female = 68.44%; mean age = 36.47; SD = 11.20). Data were collected by self-report questionnaires submitted by the snowball method.

RESULTS

Findings show a good fit of the BAT's structure, confirming the hypothesized second-order factorial model. Furthermore, good reliability has been established with the study's measures.

CONCLUSIONS

The BAT for HCWs is eligible as a new tool to evaluate burnout in the at-risk HCWs as a multi-facet constellation of symptoms.

An Italian Adaptation of the Burnout Assessment Tool-Core Symptoms (BAT-C) for Students

Burnout is psychological, physical, and emotional suffering that may affect students with low or inadequate resources to face stressful events at school. Although the existing instruments are used worldwide to assess school burnout risk, they show several flaws and mainly focus on the emotional facets of the syndrome. No previous studies have developed a multi-component tool to reveal students’ burnout by simultaneously analyzing cognitive, behavioral, and emotional problems. The central core of the current study is to adapt the Burnout Assessment Tool-Core symptoms (BAT-C; Schaufeli et al., 2020), comprising four subscales, exhaustion, mental distance, cognitive impairment, and emotional impairment, for a sample of Italian students. The factor structure, the reliability, and the validity of the scale are investigated. The participants are 745 middle school students (male, 52.2%; aged 9–13, M = 11.84, and SD = 1.21). Confirmatory factor analyses confirmed the best fit of the second-order model (four first-order factors and one second-order factor). Specifically, four factors were loaded onto a main high-order factor, which constitutes the BAT-C. Our findings support the Italian adaptation of the BAT-C for students’ samples as a valid instrument for measuring the core symptoms of school burnout.

Interest of a Joint Use of Two Diagnostic Tools of Burnout: Comparison between the Oldenburg Burnout Inventory and the Early Detection Tool of Burnout Completed by Physicians

Most research on burnout is based on self-reported questionnaires. Nevertheless, as far as the clinical judgement is concerned, a lack of consensus about burnout diagnosis constitutes a risk of misdiagnosis. Hence, this study aims to assess the added value of a joint use of two tools and compare their diagnostic accuracy: (1) the early detection tool of burnout, a structured interview guide, and (2) the Oldenburg burnout inventory, a self-reported questionnaire. The interview guide was tested in 2019 by general practitioners and occupational physicians among 123 Belgian patients, who also completed the self-reported questionnaire. A receiver operating characteristic curve analysis allowed the identification of a cut-off score for the self-reported questionnaire. Diagnostic accuracy was then contrasted by a McNemar chi-squared test. The interview guide has a significantly higher sensitivity (0.76) than the self-reported questionnaire (0.70), even by comparing the self-reported questionnaires with the interviews of general practitioners and occupational physicians separately. However, both tools have a similar specificity (respectively, 0.60-0.67), except for the occupational physicians' interviews, where the specificity (0.68) was significantly lower than the self-reported questionnaire (0.70). In conclusion, the early detection tool of burnout is more sensitive than the Oldenburg burnout inventory, but seems less specific. However, by crossing diagnoses reported by patients and by physicians, they both seem useful to support burnout diagnosis.