![]() ![]() The phase model hypothesized that cynicism is the early minimum phase of burnout, followed by the additions of inefficacy, and finally by exhaustion. A third approach was the phase model, in which the three burnout dimensions were split into high and low categories, yielding eight different patterns, or phases, of burnout. A process model, which emerged from the earlier qualitative work, proposed a first stage of emotional exhaustion, in response to work demands that taxed people’s emotional resources a second stage of depersonalization, as people tried to cope by withdrawal and negative, cynical reactions and a third stage of reduced personal accomplishment, when people began to experience inefficacy and failure. For example, the transactional model of burnout proposed a first stage of an imbalance between work demands and individual resources (job stressors), a second stage of an emotional response of exhaustion and anxiety (individual strain), and a third stage of changes in attitudes and behavior, such as greater cynicism (defensive coping). The potential of having three interrelated dimensions of burnout was first discussed in terms of a sequence of stages over time. The measure that emerged from that psychometric research was the Maslach Burnout Inventory (MBI), which assessed these three dimensions and has been used in many research studies over the years. That research identified three basic dimensions: exhaustion (also described as wearing out, loss of energy, depletion, debilitation, and fatigue) feelings of cynicism and detachment from the job (also described as depersonalization, negative or inappropriate attitudes, detached concern, irritability, loss of idealism, and withdrawal) and a sense of professional inefficacy and lack of accomplishment (also described as reduced productivity or capability, low morale, and an inability to cope). Based on this exploratory work, psychometric research was carried out to establish a method for assessing the burnout experience. The first phase of research on the phenomenon of burnout involved a lot of exploratory, qualitative field studies, which amassed many descriptions of the burnout phenomenon based on observations, interviews, case studies, and personal experience. Latent burnout profiles: A new approach to understanding the burnout experience. However, the self-defined burnout and MBI measures are not interchangeable.īurnout health services research measurement.The following answer is from Leiter, M. The self-defined burnout measure has a low response burden, is free to administer, and yields similar associations across two burnout predictors from prior studies. ![]() Compared to the MBI, the self-defined burnout measure misses half of high-burnout clinicians and more than 40% of high-burnout staff. Point estimates of burnout notably differ between the self-defined and MBI measures. Team culture and atmosphere were significantly associated with both self-defined burnout and the MBI, confirming concurrent validity. Area under the receiver operator curve was 0.82 for clinicians and 0.81 for staff. The self-defined measure's sensitivity to correctly identify MBI-assessed burnout was 50.4% for clinicians and 58.6% for staff specificity was 94.7% for clinicians and 92.3% for staff. In contrast, 29% of clinicians (95% CI: 25-33%) and 31% of staff (95% CI: 28-35%) reported "definitely burning out" or more severe symptoms on the self-defined burnout measure. Similar to other nationally representative burnout estimates, 52% of clinicians (95% CI: 47-57%) and 46% of staff (95% CI: 42-50%) reported high MBI emotional exhaustion or high MBI cynicism. (J Am Board Fam Med 27(2):229-38, 2014) and a standard question about workplace atmosphere as reported by Rassolian et al. Concurrent validity was assessed using a validated, 7-item team culture scale as reported by Willard-Grace et al. The MBI measure, calculated from a high score on either the emotional exhaustion or cynicism subscale, and a single-item measure of self-defined burnout. To identify the sensitivity, specificity, and concurrent validity of the self-defined burnout measure compared to the more established MBI measure.Ĭross-sectional survey (November 2016-January 2017).įour hundred forty-four primary care clinicians and 606 staff from three San Francisco Aarea healthcare systems. Relatively little is known about how the measures compare. Two common burnout assessments are the Maslach Burnout Inventory (MBI) and a single-item, self-defined burnout measure. Clinicians and healthcare staff report high levels of burnout. ![]()
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