Measuring Burnout Among University Students: Factorial Validity, Invariance, and Latent Profiles of the Italian Version of the Maslach Burnout Inventory Student Survey (MBI-SS)

How does the double-track human resource management model contribute to job burnout and mental health among Chinese government departments? A Chinese police study

Objectives

This study aims to investigate the contribution of the double-track human resource management model to the job performance and mental health of frontline police within China's public security organs.

Methodology

An individual-centered approach, latent profile analysis (LPA), was utilized in this study, which used cluster sampling to survey all police of all 118 frontline police stations in an economically underdeveloped area of China and 839 personnel were selected for the analysis. This method allowed for a detailed examination of the contribution of the double-track system to job performance and mental health.

Findings and conclusion

The study identified three subtypes of job burnout among Chinese police: low job burnout, medium job burnout, and emotional exhaustion type. The double-track human resource management model in China's public security organs has contributed to significant disparities between civilian and auxiliary police, such as more severe job burnout among civilian police, lower job performance, and mental health among auxiliary police.

Implications

To mitigate the potential risks associated with the double-track human resource management model, adjustments are necessary for both the management system and the treatment distribution system, which would also help address the disparities and improve the overall wellbeing and performance of all police officers.

Is the fire even bigger? Burnout in 800 medical and nursing students in a low middle income country

BACKGROUND

Burnout, characterized by emotional exhaustion (EX), depersonalization (DP), and a reduced sense of personal efficacy (PF) among medical and nursing students can lead to suicidal ideation, lack of empathy, and dropouts. Previous studies have used over-simplified definitions of burnout that fail to capture its complexity. We describe the prevalence of burnout profiles and its risk factors among medical and nursing students.

METHODS

A cross sectional study was conducted at a tertiary care University Hospital in Pakistan. The Maslach Burnout Inventory (MBI) survey was disseminated via SurveyMonkey over a period of 4 months (November 2019 to February 2020) to 482 Medical and 441 nursing students. The MBI tool measures the dimensions of EX, DP, and PF to describe seven burnout profiles. Multivariable regression was used to identify predictors of burnout.

RESULTS

The response rate was 92% in nursing and 87.3% in medical students. The prevalence of burnout in medical and nursing students was 16.9% and 6.7% respectively (p<0.001), with 55.7% (n = 427) suffering from at least one burnout profile. Only 32.5% (n = 250) students felt engaged, (42.3% medical, 22.7% nursing students, p<0.001). The most common profile was ineffective (32.5%, n = 250), characterized by a reduced sense of personal efficacy (35.6% medical, 29.4% nursing students; p = 0.065). Medical students were at higher risk of burnout compared to nursing students (OR = 2.49 [1.42, 4.38]; p<0.001) with highest risk observed in year 4 (OR = 2.47 [1.02, 5.99]; p = 0.046). Other risk factors for burnout included occasional drug use (OR = 1.83 [1.21, 8.49]; p = 0.017) and living in a hostel (OR = 1.64 [1.01,2.67]; p = 0.233).

CONCLUSION AND RELEVANCE

Two-thirds of our participants experienced at least one dimension of burnout with the highest prevalence of a reduced sense of PF. Drivers of burnout unique to a lower-middle-income country need to be understood for effective interventions. Faculty training on principles of student evaluation and feedback may be beneficial.

Group psychological counseling to contrast academic burnout: a research protocol for a randomized controlled trial

Academic burnout is a condition characterized by exhaustion, cynicism, a distant attitude toward studying, and diminished self-efficacy in academic activities. Preliminary scientific findings indicate that interventions designed to alleviate work burnout also hold promise for mitigating academic burnout, however clear evidence based on randomized controlled trials is still missing. This research protocol describes a randomized controlled trial aimed at evaluating the efficacy of an online group psychological intervention to contrast academic burnout. Participants with high levels of burnout will be assigned to a psychological counseling group or a waiting list control group. The research comprises several phases: (T0) Screening, Recruitment, and Randomization; (T1) Baseline assessment (pre-intervention); (T2) Outcome Assessment (post-intervention); and (T3) Follow-up Assessment (3 months post-intervention). The primary outcomes include burnout symptoms, general wellbeing, and academic achievement. Additionally, secondary variables such as effort-reward imbalances, satisfaction/frustration of basic psychological needs, intrapersonal and interpersonal emotion regulation, coping strategies, and social support will be examined. The psychological intervention strategies will encompass psychoeducation, self-awareness enhancement, cognitive restructuring, and promotion of social support. This research protocol is an initial step toward evidence-based psychological interventions to treat academic burnout.

Validation of the Maslach Burnout Inventory-General Survey 9-item short version: psychometric properties and measurement invariance across age, gender, and continent

Background

The Maslach Burnout Inventory-General Survey (MBI-GS) stands as the preeminent tool for assessing burnout across various professions. Although the MBI-GS9 emerged as a derivative of the MBI-GS and has seen extensive use over several years, a comprehensive examination of its psychometric properties has yet to be undertaken.

Methods

This study followed the Standards for Educational and Psychological Testing guidelines to validate the MBI-GS9. Employing a combined approach of classical test theory and item response theory, particularly Rasch analysis, within an integrated framework, the study analyzed data from 16,132 participants gathered between 2005 and 2015 by the Centre for Organizational Research at Acadia University.

Results

The findings revealed that the MBI-GS9 exhibited satisfactory reliability and validity akin to its predecessor, the MBI-GS. Across its three dimensions, Cronbach's α and omega coefficients ranged from 0.84 to 0.91. Notably, the MBI-GS9 displayed no floor/ceiling effects and demonstrated good item fit, ordered threshold, acceptable person and item separation and reliability, clear item difficulty hierarchy, and a well-distributed item threshold. However, the results suggested a recommended minimum sample size of 350 to mitigate potential information loss when employing the MBI-GS9. Beyond this threshold, the observed mean difference between the MBI-GS and MBI-GS9 held minimal practical significance. Furthermore, measurement equivalence tests indicated that the MBI-GS9 maintained an equivalent three-factor structure and factor loadings across various gender, age, and continent groups, albeit with inequivalent latent values across continents.

Conclusion

In sum, the MBI-GS9 emerges as a reliable and valid alternative to the MBI-GS, particularly when utilized within large, diverse samples across different age and gender demographics. However, to address potential information loss, a substantial sample size is recommended when employing the MBI-GS9. In addition, for cross-cultural comparisons, it is imperative to initially assess equivalence across different language versions at both the item and scale levels.

A Multilevel Person-Centered Perspective on the Role of Job Demands and Resources for Employees' Job Engagement and Burnout Profiles

The present study examined the configurations, or profiles, taken by distinct global and specific facets of job engagement and burnout (by relying on a bifactor operationalization of these constructs) among a nationally representative sample of Canadian Defence employees (n = 13,088; nested within 65 work units). The present study also adopted a multilevel perspective to investigate the role of job demands (work overload and role ambiguity), as well as individual (psychological empowerment), workgroup (interpersonal justice), supervisor (transformational leadership), and organizational (organizational support) resources in the prediction of profile membership. Latent profile analyses revealed five profiles of employees: Burned-Out/Disengaged (7.13%), Burned-Out/Involved (12.13%), Engaged (18.14%), Engaged/Exhausted (15.50%), and Normative (47.10%). The highest turnover intentions were observed in the Burned-Out/Disengaged profile, and the lowest in the Engaged profile. Employees' perceptions of job demands and resources were also associated with profile membership across both levels, although the effects of psychological empowerment were more pronounced than the effects of job demands and resources related to the workgroup, supervisor, and organization. Individual-level effects were also more pronounced than effects occurring at the work unit level, where shared perceptions of work overload and organizational support proved to be the key shared drivers of profile membership.

Promotion of Healthy Habits in University Students: Literature Review

The increase in responsibilities, together with the multiple challenges that students face in the university period, has a direct impact on their healthy lifestyles. This literature review describes the benefits of promoting healthy habits in college, highlighting the fundamental role of prevention and promotion. A systematic review was carried out following the PRISMA recommendations, searching for information in the WOS and Scopus databases. On the other hand, a search was carried out within the existing and available grey literature. The review focused on finding information about physical activity, nutrition, and stress (with an emphasis on resilience and academic burnout) in university students. This bibliographic review includes 32 articles and six web pages, containing information on the benefits of physical activity, healthy habits, and health prevention. The information collected in this study shows that university students are exposed to multiple changes during this period, increasing as the academic years progress. At that time, their habits worsen, with low adherence to the Mediterranean diet, low physical activity, and high levels of stress, specifically increasing cases of academic burnout. The establishment of healthy habits during the university period is necessary, observing an improvement in all the variables studied. Prevention has played a fundamental role.

Burnout and depression in college students

Research on burnout has garnered considerable attention since its inception. However, the ongoing debate persists regarding the conceptual model of burnout and its relationship with depression. Thus, we conducted a network analysis to determine the dimensional structure of burnout and the burnout-depression overlap. The Maslach Burnout Inventory-Student Survey and Patient Health Questionnaire-9 were used to measure burnout and depression among 1096 college students. We constructed networks for burnout, depression, and a burnout-depression co-occurrence network. The results showed that cynicism symptom was the most central to the burnout network. In the co-occurrence network, depressive symptoms ("anhedonia", "fatigue") and burnout symptom ("doubting the significance of studies") were the most significant in causing burnout-depression comorbidity. Community detection revealed three communities within burnout symptoms, aligning closely with their three dimensions identified through factor analysis. Additionally, there was no overlap between burnout and depression. In conclusion, our findings support a multidimensional structure of burnout, affirming it as a distinct concept separate from depression. Cynicism, rather than exhaustion, plays the most important role in burnout and the burnout-depression comorbidity.

The effects of mindfulness training for emergency department and intermediate care unit nurses

AIM

The aim of this study was to determine the effects of mindfulness and self-compassion skills on the experienced stress and work satisfaction of emergency department (ED) and intermediate care unit employees.

METHODS

All ED and intermediate care unit employees in the study hospital were invited to participate in an introductory lecture about mindfulness, compassion, and the intervention in January 2020. After the lecture, it was possible to enroll in training. This training was postponed due to Covid-19 and started in October 2020.

RESULTS

The most important findings of this study are that instructor-led mindfulness training, and the regular use of a smartphone mindfulness application can significantly reduce stress and burnout and promote mindfulness and well-being of ED and intermediate care unit personnel.

CONCLUSIONS

This study shows that compact mindfulness training via innovative digital technology has a positive effect in reducing ED and intermediate care unit employees stress and burnout, while improving mindfulness and well-being, and this is consistent with the wider literature.

KEY FINDINGS

The regular practice of smartphone-guided mindfulness can reduce stress and burnout, as well as promote mindfulness and well-being among ED and intermediate care unit employees.

Development of the social burnout scale for college students

Although fruitful achievements have been explored about job burnout, little is known about burnout in the field of social interaction among college students. To address this limitation, this study defined the concept of Social Burnout and developed a measurement tool for it. The study adopted the method of combining qualitative research with quantitative research. After the qualitative study, we gathered examples of social burnout and finished item writing. Using convenient sampling and theoretical sampling methods, six different samples were recruited for reliability and validity testing. Confirmatory factor analysis (CFA) revealed the scale's two-factor structure: emotional exhaustion and depersonalization. Cronbach's alpha measured the internal consistency of the social burnout scale (SBS), which was excellent (Cronbach's alpha of emotional exhaustion = 0.94; depersonalization = 0.82; the overall = 0.92). Susequently, the method of calculating AVE and CR evaluated the scale's convergent and discriminant validity, which were relatively good (AVE of emotional exhaustion = 0.60, depersonalization = 0.59; CR of emotional exhaustion = 0.93, depersonalization = 0.81). Then, regression analysis verified the nomological network and criterion-related validity (r = -0.30, p < 0.01; r = -0.39, p < 0.01; β = -0.25, p < 0.01). The SBS was shown to be a reliable and appropriate measure for assessing students' social burnout. Furthermore, the SBS is recommended for use in academic research and by healthcare professionals to measure students' social distress. Further validation studies of this scale are needed in other cultural contexts.

Analyzing Latent Burnout Profiles in a Sample of Spanish Nursing and Psychology Undergraduates

There is abundant literature suggesting that university students in helping professions experience high levels of stress, leading to an increased risk of developing burnout. The objective of this study was to identify burnout profiles in a sample of 1162 Spanish nursing and psychology undergraduates using latent profile analysis, a person-oriented statistical method that can identify hidden homogenous subgroups within a heterogeneous population. We expected to replicate in university students the five-profile structure (burnout, overextended, disengaged, ineffective, and engagement) proposed by Leiter and Maslach using the burnout dimensions (emotional exhaustion, cynicism, and inefficacy) as indicators. The results showed that burnout, overextended, and engagement profiles were adequately replicated. Given that levels of inefficacy and cynicism were medium to low, the ineffective and disengaged profiles somewhat deviated from those identified by Leiter and Maslach. We found differences between the five latent profiles in several psychological variables, such as depression and anxiety. These results suggest that psychosocial factors (e.g., workload) are significant among students and may adversely impact their health, leading to psychosomatic and emotional disorders. Hence, designing effective interventions to prevent health problems associated with burnout seems advisable, considering the specific burnout profile that a student exhibits.

Construction and validation of the Areas of Academic Life Scale to measure organizational risk factors for student burnout

OBJECTIVES

Academic burnout poses a challenge to the educational process. Higher education institutions have responsibilities similar to the ones of management in business settings. These institutions are responsible for creating conditions conducive to development and, as such, may be interested in verifying the presence of student burnout and pinpointing its causes. The purpose of this study was to answer these needs and develop a scale to measure the effect of organizational factors that may predict student burnout.

MATERIAL AND METHODS

This paper reports the results of a study conducted on a sample of Polish students (N = 659) to construct and validate a multidimensional measure of organizational factors impacting academic burnout, focusing on students. For background purposes and as a starting point, the authors used the concept of the areas of worklife by Ch. Maslach and M. Leiter, who identified 6 areas of the work environment that affect the relationships people develop with their work, i.e., workload, control, reward, community, fairness, and values.

RESULTS

The authors assessed the factor structure, reliability, and construct validity and performed confirmatory factor analysis of the new scale to measure 6 areas of academic life. Given the results of this study, the scale can be recommended as an adequate tool to measure organizational (academic) factors of burnout in students.

CONCLUSIONS

The authors have validated the final scale, which can be used to advance the understanding of the academic burnout phenomenon. Int J Occup Med Environ Health. 2023;36(6):798-811.

Alexithymia, Burnout, and Hopelessness in a Large Sample of Healthcare Workers during the Third Wave of COVID-19 in Italy

In the present study, we aimed to assess the frequency of and the relationships between alexithymia, burnout, and hopelessness in a large sample of healthcare workers (HCWs) during the third wave of COVID-19 in Italy. Alexithymia was evaluated by the Italian version of the 20-item Toronto Alexithymia Scale (TAS-20) and its subscales Difficulty in Identifying Feelings (DIF), Difficulty in Describing Feelings (DDF), and Externally Oriented Thinking (EOT), burnout was measured with the scales emotional exhaustion (EE), depersonalisation (DP), and personal accomplishment (PA) of the Maslach Burnout Test (MBI), hopelessness was measured using the Beck Hopelessness Scale (BHS), and irritability (IRR), depression (DEP), and anxiety (ANX) were evaluated with the Italian version of the Irritability' Depression' Anxiety Scale (IDA). This cross-sectional study recruited a sample of 1445 HCWs from a large urban healthcare facility in Italy from 1 May to 31 June 2021. The comparison between individuals that were positive (n = 214, 14.8%) or not for alexithymia (n = 1231, 85.2%), controlling for age, gender, and working seniority, revealed that positive subjects showed higher scores on BHS, EE, DP IRR, DEP, ANX, DIF, DDF, and EOT and lower on PA than the not positive ones (p < 0.001). In the linear regression model, higher working seniority as well as higher EE, IRR, DEP, ANX, and DDF scores and lower PA were associated with higher hopelessness. In conclusion, increased hopelessness was associated with higher burnout and alexithymia. Comprehensive strategies should be implemented to support HCWs' mental health and mitigate the negative consequences of alexithymia, burnout, and hopelessness.

Quality of Life Predictors in a Group of Informal Caregivers during the COVID-19 Pandemic

Background and Objectives: The informal caregiver's contribution to the wellbeing of dementia patients is critical since these individuals become dependent on others for all daily activities. Our goal was to investigate the dynamics of anxiety, depression, burnout, sleep, and their influence on quality of life over a 6-month period in the context of pandemic distress in a sample of informal caregivers of Alzheimer's patients. Materials and Methods: For this prospective, longitudinal study, we conducted a 6-month telephonic survey between 2021 and 2022, administering a series of questionnaires at three timepoints (baseline, 3 months and 6 months) to a group of informal caregivers of patients suffering from dementia due to Alzheimer's disease. Results: A total of 110 caregivers were included at baseline, out of which 96 continued to the second stage and 78 followed through to the last stage. The majority of the participants were female (most likely the patients' daughters), around 55 years old, living in urban areas, married, with children, having a high school degree or a higher education degree, and working in jobs that required physical presence; in the best-case scenario, they were sharing their responsibilities with another two-three caregivers. More than half of the 110 participants (50.9%) reported mild to moderate anxiety at baseline, and 27.3% reported significant anxiety, with no changes between the three timepoints, F(2, 154) = 0.551, p = 0.57; 25% reported moderate-severe depression at the start, with no changes between the three timepoints, F(2, 154) = 2.738, p = 0.068; and many reported a decrease in quality of life, poor quality of sleep, and decreased fear of COVID infection. Cynicism, professional effectiveness, anxiety, depression, and sleep quality explained up to 87.8% of the variance in quality of life. Conclusions: Caregivers' decreased quality of life during the pandemic was explained by their levels of burnout, anxiety, and depression throughout the 6-month period.

Gender and country differences in academic motivation, coping strategies, and academic burnout in a sample of Italian and Russian first-year university students

Background

The first year of university represents a challenging period that requires students to make significant investments in adaptive resources to face the new academic environment. The present study intends to contribute to the controversial discussion of gender differences in academic motivation, coping strategies, and academic burnout. This cross-sectional study examined above-mentioned constructs among first-year university students in a cross-cultural context.

Methods

The sample consisted of 637 Italian and 496 Russian first-year university students (n = 1133), 40.3% of whom were females. The participants' ages ranged from 17 to 23 years, with a mean age of 18.75 years (SD = 1.07). To assess academic motivation, coping strategies, and academic burnout, participants responded to the Academic Motivation Scale (AMS), the Coping Inventory for Stressful Situations (CISS), and the Maslach Burnout Inventory-Student Survey (MBI-SS) application.

Results

The findings reveal gender and country differences in academic motivation, emotion and avoidance oriented coping strategies, and emotional exhaustion and expands previous studies in this educational area.

Conclusion

Given the technical nature of the research topic, the target audience for our study is academic career guidance practitioners, who can apply the findings to the design of effective programmes aimed at improving positive academic goals and reducing the tendency to switch academic courses or abandon the university among first-year students.

Experiences of burnout, anxiety, and empathy among health profession students in Qatar University during the COVID-19 pandemic: a cross-sectional study

BACKGROUND

The prevalence of burnout and anxiety is constantly increasing among health profession students worldwide. This study evaluates the prevalence of burnout and its relationship to anxiety and empathy during the COVID-19 pandemic among health profession students in the main governmental institution in Doha, Qatar using validated instruments.

METHODS

A cross-sectional survey of health profession students using validated instruments was employed. The Maslach Burnout Inventory-General Students Survey (MBI-GS(S)) to measure burnout; The Generalized Anxiety Disorder (GAD-7) to measure anxiety; and Interpersonal Reactivity Index (IRI) to measure empathy were utilized. Descriptive statistics and multivariable linear regression were used.

RESULTS

Of the 1268 eligible students, 272 (21.5%) completed the online survey. Burnout was found to be prevalent amongst the students. The mean scores for the MBI-GS(S) subscales of emotional exhaustion, cynicism, and professional efficacy were 4.07, 2.63, and 3.97, respectively. Anxiety was found to be a strong predictor for burnout and burnout was positively associated with empathy.

CONCLUSIONS

Findings from this study demonstrated relationships between health profession students' burnout, anxiety, and empathy. These findings might have an impact on the development of curriculum interventions to enhance student well-being. More burnout awareness and management programs that cater to the specific needs of health profession students are needed. Furthermore, findings of this study may have implications for future educational interventions during times of crisis or how this can be used to improve student experiences in normal times.

Academic Burnout of Polish Students: A Latent Profile Analysis

According to Maslach and Leiter, burnout syndrome consists of three elements: exhaustion, cynicism, and a sense of ineffectiveness experienced by individuals in the work environment. However, burnout does not only apply to professional activity but can also be experienced by students pursuing higher education. This is important because the consequences of student burnout can be related to students' mental and physical health. Until recently, the dominant diagnostic trend in the studies of burnout syndrome was based on a variable-focused approach. This approach focuses primarily on identifying subgroups in the population and presents different configurations of the various dimensions of burnout. However, there is emerging research using a person-centered approach and including the analysis of latent profiles to study professional and student burnout. This approach allows us to isolate subgroups of individuals in the study sample who have a similar burnout pattern. It focuses on the differences between individuals, which helps us to look at the phenomenon of professional burnout from a different perspective and shows the individuality of its experience. Our research aimed at identifying latent profiles, was conducted on a sample of 1519 Polish students, and partly confirms reports from other countries. We identified four profiles: low burnout, moderate below-average burnout, moderate above-average burnout, and very high burnout groups.

Reliability and validity study of the Thai adaptation of the Maslach Burnout Inventory-Student Survey among preclinical medical students at a medical school in Thailand

Burnout syndrome is characterized by emotional exhaustion, cynicism, and lack of professional efficacy. A considerable proportion of medical students experience burnout syndrome during their educational training. Therefore, this issue has become a major concern in the medical education community. The Maslach Burnout Inventory-Student Survey (MBI-SS) is the most widely used assessment of burnout syndrome among college students, including preclinical medical students. Therefore, our objective was to culturally modify and validate the MBI-SS in a Thai context for use with preclinical medical students. The MBI-SS comprises 16 items, including five items for emotional exhaustion, five items for cynicism, and six items for academic efficacy. Four hundred and twenty-six preclinical medical students participated in this study. We randomly divided the samples into two equivalent subsamples of 213 participants. The first subsample was used to calculate McDonald's omega coefficients to assess internal consistency and to perform exploratory factor analysis. McDonald's omega coefficients for exhaustion, cynicism, and academic efficacy were 0.877, 0.844, and 0.846, respectively. The scree plot from the unweighted least squares estimation and a direct oblimin rotation, supplemented with Horn's parallel analysis and the Hull method, revealed three major factors of the Thai MBI-SS. Due to the violation of the multivariate normality assumption in the second subsample, we performed a confirmatory factor analysis with the unweighted least squares with a mean and variance adjusted estimation approach. The results of the confirmatory factor analysis showed favorable goodness-of-fit indices. Data from 187 out of 426 participants (43.9%), who completed a second questionnaire, were utilized to evaluate test-retest reliability. The correlation coefficients for test-retest reliability with a three-week period between tests were 0.724, 0.760, and 0.769 for the exhaustion, cynicism, and academic efficacy domains, respectively (all p < 0.05). This indicates that the Thai MBI-SS is a valid and reliable instrument to assess burnout syndrome in our Thai preclinical medical student population.

Latent burnout profiles of veterinarians in Canada: Findings from a cross-sectional study

BACKGROUND

Although burnout is often discussed as 'present' or 'not-present', the conceptual framework of an engagement-burnout continuum is more accurate and useful. Recognition of individuals' transitional states of burnout also allows for earlier detection of issues and tailored interventions to address the full burnout spectrum.

METHODS

Previously reported Maslach Burnout Inventory-Human Services Scale (MBI-HSS) data from a 2017 national survey of 1272 veterinarians across Canada were re-analysed using a latent profile analysis to classify individuals along the engagement-burnout continuum.

RESULTS

Four clusters were identified: engaged (10.8%), ineffective (18.9%), overextended (29.6%) and burnout (40.7%). These results indicate that most participants (89.2%) had one, or a combination, of high exhaustion, high depersonalisation and low professional efficacy.

LIMITATIONS

This cross-sectional study represents data from one point in time and may be subject to response bias.

CONCLUSION

We discuss strategies-particularly long-term, organisational-level interventions-to promote engagement and help address workplace issues contributing to inefficacy, overextension and burnout in the veterinary profession. We also recommend MBI data be analysed via latent profiles to provide a more nuanced view of burnout, allow for earlier recognition of workplace issues and facilitate more meaningful interventions and comparisons across populations.

STUDY OF NEUROTICISM AND EXTRAVERSION AS PREDICTORS OF THE SYNDROME OF EMOTIONAL BURNOUT (EBS) IN STUDENTS

OBJECTIVE

The aim: To investigate internal factors - neuroticism and extroversion, which can be predictors of emotional burnout syndrome and their prevalence among student youth.

PATIENTS AND METHODS

Materials and methods: Used a complex of methods: theoretical - theoretical analysis, synthesis, systematization; sociological method of questioning; empirical: observation, testing-Eysenck's methods for assessing the impact of neuroticism and externality; statistical. The object of the research is the process of influence of personal characteristics (individual factors) on the development and spread of EBS among students. Subject - personal characteristics (individual factors) of students - extraversion and neuroticism. The number of respondents was 610 students.

RESULTS

Results: A study of the personal characteristics of neuroticism and extraversion, which can be predictors in the genesis of EBS, was conducted. It has been established that several negative internal factors influence students. The significant prevalence of internal risk factors of EBS indicates the need for a comprehensive approach to its prevention and the need for the development and application of modern adequate methods, forms, and methods of prevention.

CONCLUSION

Conclusions: The presence and influence of internal factors on the development of EBS have been theoretically proven. It has been established that there is a significant propagation of personal characteristics that may have signs of negative internal factors. The need for preventive measures for the development of EBS among students has been revealed.

University students' profiles of burnout symptoms amid the COVID-19 pandemic in Germany and their relation to concurrent study behavior and experiences

Burnout symptoms are prevalent among university students. This study examined students' understudied profiles of burnout symptoms and their relation to procrastination, dropout intentions, and study- and life satisfaction. We used cross-sectional data from two online-studies conducted in Germany in April 2020 amid the COVID-19 pandemic (N _study1 = 597, N _study2 = 857). Latent profile analyses indicated three profiles in both studies: (1) well-functioning, (2) moderately exhausted-inefficacious, and (3) burned-out. Most students belonged to Profiles 1 and 2 with low to moderate burnout symptoms. Students in Profile 3 reported the highest symptoms, most procrastination, strongest dropout intentions, and lowest study- and life satisfaction. The distinct profiles broaden knowledge about intra-individual differences in students' burnout experiences and underpin the need for tailored interventions.

NICU Staff's Perceptions and Attitudes Toward the Family Integrated Care (FICare) Model: A Chinese Cross-sectional Study

BACKGROUND

Family Integrated Care (FICare) is an innovative model that encourages parents to assume the role of primary caregivers during the neonatal period.

PURPOSE

To conduct a survey of neonatal intensive care unit (NICU) nurses and physicians on a national scale to determine their perceptions and attitudes toward FICare.

METHODS

Data on 3 domains were collected: demographic characteristics, FICare perceptions, and attitudes. The survey included 299 NICU nurses and physicians from 31 tertiary-level NICUs across China (response rate = 96.5%).

RESULTS

The respondents showed a positive attitude toward implementing FICare and recognized its positive impact on infants. However, some respondents raised concerns regarding its feasibility and limitations of the NICU setting. The respondents' perceptions and attitudes of FICare varied based on their personal characteristics, such as marital status and day/night work shifts.

IMPLICATIONS FOR PRACTICE AND RESEARCH

Most NICU nurses and physicians reported that FICare can benefit infants. Despite some constraints related to the NICU environmental conditions, most NICU leaders felt positive about implementing FICare in China. Therefore, establishing key strategies for performing FICare, selecting appropriate personnel, and educating the staff regarding FICare are useful approaches to promote FICare implementation. FICare requires the team's collaborative effort with the support of NICU leaders to overcome system and setting barriers. Nurses should serve as navigators to guide its implementation. More studies on healthcare setting policies, parents' perceptions, and approaches for healthcare professionals to perform FICare in China are required.

Analysis of burnout and its influencing factors among prison police

Background

Burnout among prison police is an occupational health issue in the field of public health. Although burnout has been a hot issue for decades, there has not been a focus on the specific group of prison police. This study explores the burnout status and its influencing factors among prison police.

Methods

The Maslach Burnout Questionnaire-General Survey (MBI-GS) was used to conduct a questionnaire survey among 1,024 prison police.

Results

It indicates that emotional exhaustion, negative detachment, and self-efficacy were the most significant dimensions of the burnout among prison police officers. The results of multiple linear regression analysis showed that gender (-0.201, P = 8.8958E-11 <0.05), workload (-0.441, P = 1.6287E-9 <0.05), whether they have direct contact with supervisory subjects (-0.394, P = 2.1449E-39 <0.05), and a sense of organizational support (-0.298, P = 3.7182E-7 <0.05) were risk factors for burnout in prison police.

Conclusions

Burnout among prison officers can be reduced through preferential treatment of prison police, sound organizational mechanisms, and self-improvement of prison police.

Burnout Profiles Among Young Researchers: A Latent Profile Analysis

Introduction

Burnout is a growing problem among young researchers, affecting individuals, organizations and society. Our study aims to identify burnout profiles and highlight the corresponding job demands and resources, resulting in recommendations to reduce burnout risk in the academic context.

Methods

This cross-sectional study collected data from young researchers (n = 1,123) at five Flemish universities through an online survey measuring burnout risk, work engagement, sleeping behavior, and the most prominent job demands (e.g., publication pressure) and resources (e.g., social support). We conducted Latent Profile Analysis (LPA) to identify burnout profiles in young researchers and subsequently compared these groups on job demands and resources patterns.

Results

Five burnout profiles were identified: (1) High Burnout Risk (9.3%), (2) Cynical (30.1%), (3) Overextended (2.3%), (4) Low Burnout Risk (34.8%), and (5) No Burnout Risk (23.6%). Each burnout profile was associated with a different pattern of job demands and resources. For instance, high levels of meaningfulness (OR = −1.96) decreased the odds to being classified in the Cynical profile.

Conclusion

Our findings show that the Cynical profile corresponds to a relatively high number of young researchers, which may imply that they are particularly vulnerable to the cynicism dimension of burnout. Additionally, work-life interference and perceived publication pressure seemed the most significant predictors of burnout risk, while meaningfulness, social support from supervisor and learning opportunities played an important protective role.

Burnout Among University Students During Distance Learning Period due to the COVID-19 Pandemic: A Cross Sectional Study at the University of Jordan

OBJECTIVE

The COVID-19 pandemic led to a deviation from classical face-to-face learning to distance learning. Few studies examined burnout among university students during the distance learning period due to the COVID-19 pandemic. This study that aims to investigate the prevalence of burnout among university students during distance learning and the factors associated with it.

METHOD

A cross-sectional study was conducted among undergraduate students at the University of Jordan. The modified version of the Maslach Burnout Inventory for students (MBI-SS) was used to assess burnout.

RESULTS

The total number of participants was 587 and the mean total of MBI-SS score was 63.34 ± 8.85. Based on the MBI-SS definition, 6.6% of the study participants were found to have symptoms of burnout. Practicing hobbies, level of satisfaction with distance learning, and thoughts about quitting courses were significant predictors of burnout.

CONCLUSION

This study showed a relatively low prevalence of burnout among students during the distance learning period with several factors associated with it. As a result, identifying these factors will help both students and educational institutions to implement strategies that are needed for the primary and secondary prevention of burnout.

Predicting Student Engagement: The Role of Academic Belonging, Social Integration, and Resilience During COVID-19 Emergency Remote Teaching

Background

The COVID-19 pandemic has forced higher education (HE) to shift to emergency remote teaching (ERT), subsequently influencing academic belonging and social integration, as well as challenging students' engagement with their studies.

Aims

This study investigated influences on student engagement during ERT, based on student resilience. Serial mediation analyses were used to test the predictive effects between resilience, academic belonging, social integration, and engagement.

Methods

The Student Well-being Monitor (SWM 2021) was completed by 1332 HE students studying at Inholland University of Applied Sciences in the Netherlands. Predictive models were compared among students with low, normal, or high resilience using SPSS extension Macro PROCESS.

Results

A significant serial mediation model was found among all HE students, including positive mediating effects of academic belonging and social integration. More so, independent partial predictive effects of academic belonging and social integration on engagement were also present. Assessment of student resilience profiles revealed substantial differences between predictive models. For low resilience students, serial mediation was present and included the largest partial predictive effect from social integration compared to other groups. For highly resilient students, mediation via academic belonging was found, including the strongest partial and indirect effects compared to other groups.

Conclusions

Overall, academic belonging and social integration positively mediate the effect of resilience on engagement in addition to demonstrating independent positive predictive effects. Inspection of resilience profiles reveals substantial model fit differences, suggesting use of different engagement strategies between student groups. Findings contribute to understanding of HE student engagement during ERT in the Netherlands and provide novel insight on the mechanisms between resilience and engagement. While ERT continues to be required, engagement may be enhanced by stimulating academic belonging for all students generally, but low resilience students could be best served by additionally targeting social integration and resilience.

Should Burnout Be Conceptualized as a Mental Disorder?

Burnout is generally acknowledged by researchers, clinicians, and the public as a pervasive occupational difficulty. Despite this widespread recognition, longstanding debates remain within the scientific community regarding its definition and the appropriateness of classifying burnout as its own pathological entity. The current review seeks to address whether burnout should (or could) be characterized as a distinctive mental disorder to shed light on this debate. After briefly reviewing the history, theoretical underpinnings, and measurement of burnout, we more systematically consider the current evidence for and against its classification as a mental disorder within existing diagnostic systems. Stemming from a lack of conceptual clarity, the current state of burnout research remains, unfortunately, largely circular and riddled with measurement issues. As a result, information regarding the unique biopsychosocial etiology, diagnostic features, differential diagnostic criteria, and prevalence rates of burnout are still lacking. Therefore, we conclude that it would be inappropriate, if not premature, to introduce burnout as a distinct mental disorder within any existing diagnostic classification system. We argue, however, that it would be equally premature to discard burnout as a psychologically relevant phenomenon and that current evidence does support its relevance as an important occupational syndrome. We finally offer several avenues for future research, calling for cross-national collaboration to clarify conceptual and measurement issues while avoiding the reification of outdated definitions. In doing so, we hope that it one day becomes possible to more systematically re-assess the relevance of burnout as a distinctive diagnostic category.

The Nexus between Study Burnout Profiles and Social Support -The Differences between Domestic (Finnish) and International Master's Degree Students

The present study investigated the variation in higher education students' study burnout experiences and how they are related to academic success and social support needs. Similarities and differences between the international and domestic students were also explored. In this mixed-methods study, the data were collected through a self-reported questionnaire, and a total of 902 (response rate 42%) first year master's students from the fields of arts, business and technology responded. Using Latent Profile Analysis (LPA), we detected three distinct study burnout risk profiles (No exhaustion or cynicism; Exhausted; Exhausted and cynical). The following distinct forms of social support needs were found using theory-based qualitative content analysis: informational, instrumental, emotional, and co-constructional support. We found out that the students with highest risk of burnout had the lowest grade point averages (GPAs). Further investigation showed that international students pass their courses despite the experiences of study burnout, even though the GPAs might deteriorate. When the domestic students experience study burnout symptoms, they both gain fewer study credits and earn lower GPAs. Finally, a relationship between the form of support needed and the burnout profile was identified.

The Development of Teacher Burnout and the Effects of Resource Factors: A Latent Transition Perspective

To better understand burnout and its development, researchers have shown an increasing interest in recent years in identifying different profiles of burnout and its development process. However, there have been few longitudinal studies on the profile and development of teacher burnout. This study used a person-centred approach to explore the profiles of teacher burnout, transition probabilities and the associations between these aspects and resource factors. Data were collected from 3743 primary school teachers in a two-wave longitudinal test over three years. The results showed that teacher burnout exhibited six relatively stable profiles across the whole study population and that the transition of individual profiles over time followed a certain probability. Psychological capital and professional identity were important resource factors in reducing the occurrence of teacher burnout and increasing transition probability toward burnout symptom alleviation over time, while positive coping played an important role in reducing the occurrence of teacher ineffectiveness. Therefore, the results indicated that the overall teacher burnout profile was stable, a discovery which has important implications for conducting group interventions to benefit more teachers, while the individual burnout profile exhibited a latent transition probability over time. Interventions employing different resource factors can be adopted to alleviate the symptoms of different burnout profiles.

Burnt Out and Dropping Out: A Comparison of the Experiences of Autistic and Non-autistic Students During the COVID-19 Pandemic

Autistic students are more likely to drop out of university, while facing both challenges and opportunities within university environments. This study compared the experiences of autistic and non-autistic current United Kingdom students, in terms of thoughts about dropping out, burnout, mental health and coping, during the COVID-19 pandemic. Burnout was of particular interest as this is a relatively unexamined phenomenon for autistic students. Seventy autistic and 315 non-autistic students, completed a mixed methods questionnaire with standardized measures of burnout (personal and academic), mental health (depression, stress, and anxiety), and coping styles (adaptive and maladaptive). We also included qualitative questions about dropping out and COVID-19 experiences. We found autistic participants experienced higher rates of burnout and mental health symptoms and were more likely to have thought about dropping out. Reasons given for thinking about dropping out, for both groups, focused on poor mental well-being, doubts about university, and academic challenges. For autistic participants, further analyses did not identify specific predictors of thinking about dropping out, but for non-autistic participants, this was predicted by maladaptive coping styles and academic burnout. Academic and personal burnout predicted one another for autistic students, and age, maladaptive coping, autistic characteristics, stress, and anxiety additionally predicted burnout for non-autistic students. Similarities in experiences during the pandemic were noted, with both groups experiencing negative social implications, difficulties adjusting to emergency online learning, and poorer psychological well-being. Moving forward from COVID-19, universities must find ways to enhance both academic and social support, to enable equal opportunity within Higher Education for autistic students.

Psychometric properties and validation of the Arabic maslach burnout inventory-student survey in Saudi dental students

Background:

Few studies have studied burnout among dental students worldwide, and no such study is available from Saudi Arabia. In addition, an Arabic version of the Maslach Burnout Inventory-Student Survey (MBI-SS) has not yet been validated for use among students.

Objectives:

This study aimed to translate and validate an Arabic version of the MBI-SS questionnaire and to examine the psychometric properties of burnout among dental college students at a university in Saudi Arabia.

Materials and Methods:

This cross-sectional questionnaire study included all dental students at King Khalid University, Saudi Arabia, and was conducted between December 2019 and January 2020. After the MBI-SS questionnaire was translated, its face validity was determined and the test–retest reliability was assessed. Confirmatory factor analysis and reliability analysis were performed following the full-scale study to validate the Arabic MBI-SS.

Results:

A total of 433 dental students responded in the full-scale study (mean age: 21.9 ± 1.6 years). Emotional exhaustion was present in 32.3% (95% confidence interval: 28%–36.9%), cynicism in 33.7% (29.3%–38.4%), and poor academic efficacy in 34.2% (29.8%–38.9%) of the dental students. Emotional exhaustion and cynicism were significantly associated with academic level, a history of medication due to academic stress, and thoughts of quitting the course (for all, P < 0.05). The reliability of MBI-SS was found to be adequate for all three subscales: Emotional exhaustion, Cronbach's α = 0.827; cynicism, α = 0.855; academic efficacy, α = 0.704.

Conclusions:

All three subscales of burnout were highly prevalent in the study cohort. The Arabic version of the MBI-SS inventory was shown to be a valid and reliable tool for assessing the psychometric properties of burnout among dental students, and its use may aid in identifying burnout in the early stages.

Would you Bribe your Lecturer? A Quasi-experimental Study on Burnout and Bribery in Higher Education

Bribery is a complex and critical issue in higher education (HE), causing severe economic and societal harm. Traditionally, most scholarship on HE corruption has focused on institutional factors in developing countries and insights into the psychological and motivational factors that drive HE bribery on the micro-level mechanisms are virtually non-existent. To close this research gap, this study investigates the connection between study-related burnout and university students' willingness to offer bribes to their lecturers to pass important exams. Conducting a vignette-based quasi-experimental replication study with 624 university students in Germany, Belgium, and the Netherlands we find that university students in three countries differentiate sharply between different shades of bribery and that a majority accept using emotional influence tactics to pass (failed) exams. In contrast, offering a helping hand or money (i.e., darker shades of bribery) to their lecturer was less acceptable. Study-related burnout is associated with a higher likelihood of engaging in these darker shades of bribery and students' commitment to the public interest is but a weak factor in preventing unethical behavior. In summary, this study provides solid empirical evidence that university students are likely to use emotional influence tactics violating both the ethical codes of conduct and the formalized bureaucratic procedures of HE examination, particularly if they suffer from study-related burnout. However, the accelerating effect of burnout on bribery is conditional in that it only holds for darker shades of bribery. HE institutions may benefit from implementing the four-eye principle and from launching awareness campaigns that enable lecturers to better recognize these tactics and engage students in creating a transparent environment for testing, grading, and collaboration that is resistant to bribery.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s11162-021-09669-1.

Impact of COVID-19 on the mental health in a cohort of Italian rehabilitation healthcare workers

The COVID-19 pandemic has had a strong impact on healthcare workers (HCWs), affecting their physical and mental health. In Italy, HCWs have been among the first exposed to unprecedented pressure, dealing with large numbers of infections during the first pandemic wave. However, the severe psychological consequences on HCWs find little evidence in the literature, especially in terms of comparison to the status quo ante pandemic. The aim of this study was to provide an assessment of the mental health burden in a cohort of Italian HCWs during the COVID-19 pandemic, comparing their condition with that before the emergency, to direct the promotion of mental well-being among HCWs worldwide. In this retrospective study, we included physicians, physical therapists, and nurses working in the Respiratory Intensive Care Unit, Neurology Unit, and Rehabilitation Unit from a Southern Italy University Hospital. All study participants underwent a battery of psychological tests, aimed at verifying their state of mental health during the COVID-19 emergency and before it. Depressive, anxiety, and burnout symptoms were assessed using the following questionnaires: Maslach Burnout Inventory, Patient Health Questionnaire-9 (PHQ-9), and General Anxiety Disorder-7. Depressive, anxiety, and burnout clinical relevance symptoms were present in HCWs during the COVID-19 pandemic more than those before the emergency. Fifty percent of the HCWs obtained a score clinically significant during the emergency. Moreover, a depersonalization factor showed a statistically significant increase in average scores (p < 0.0001). The PHQ-9 scale showed that 47.1% of the operators reported depressive state presence. The number of operators scoring above the cut-off for the anxiety scale tripled during the emergency (p < 0.0001). The female gender conferred greater risks for depression. Taken together, the findings of this study showed that our sample of Italian HCWs showed a greater risk for depression, anxiety, and stress during the COVID-19 pandemic. These data might be a starting point to plan mental health monitoring and prevention programs for HCWs, thus ensuring patients receive the best possible care performances even during healthcare crises such as the current pandemic.

Complementary variable- and person-centered approaches to the dimensionality of burnout among fire station workers

This research relies on variable- and person-centered approaches to illustrate how each of these approaches may help to improve our understanding of the dimensionality of the burnout construct. Both studies (Study 1: N = 247 administrative and technical employees; Study 2: N = 654 firefighters), showed that employees' burnout ratings simultaneously reflected a global overarching construct co-existing with two specific dimensions (cynicism and emotional exhaustion), with a distinct factor reflecting reduced professional efficacy. In Study 1, perceived supervisor recognition and job satisfaction were associated with lower levels of global burnout levels. In Study 2, we examined the configurations, or profiles, taken by burnout dimensions (global burnout, specific cynicism, specific emotional exhaustion, and reduced professional efficacy), and documented associations between these profiles and four covariates (organizational, supervisor, and colleagues recognition as well as job satisfaction). Five profiles were identified using latent profile analyses: Very Low Burnout Risk, Mentally Distanced, Low Burnout Risk, High Burnout Risk, and Moderately High Burnout Risk. Employees' perceptions of supervisor and colleagues recognition were related to their likelihood of profile membership. Employees' job satisfaction levels also differed as a function of their profile.

Burnout profiles among French workers in health units for inmates: results of the EHCAU study

BACKGROUND

Health care personnel who work in penitentiary environments are at risk of burnout due to a variety of factors. Latest research have brought forward a classification system consisting of five burnout profiles on a continuum between engagement and burnout. The objective of this study was to measure the prevalence of these profiles among professionals working in French health units providing health services for inmates according to the three levels of care and to investigate their characteristics to propose appropriate management and prevention approaches.

METHODS

This study involved a cross-sectional analysis of data from the Evaluation of Health CAre in Units for inmates (EHCAU) study, a multicentric cohort study of professionals practising in health units for inmates in eastern France. Burnout was assessed by the Maslach Burnout Inventory (MBI) at the levels of emotional exhaustion, depersonalization and personal accomplishment. Job conditions and characteristics were measured using the Karasek Job Content Questionnaire and the Effort-Reward Imbalance Questionnaire. Data on sociodemographic characteristics and self-reported health status were also collected. Differences between MBI profiles were identified using Fisher's exact test and the Wilcoxon test.

RESULTS

Of the 350 professionals surveyed, 150 responded (42.9%). The most frequent profiles were ineffective (36.9%) and engagement (34.8%). The burnout (7.8%), overextended (15.6%) and disengaged (5.0%) profiles made up the remaining quarter. Significant differences in the burnout profiles were observed in regard to professional occupation (p = 0.01), irregular eating hours (p = 0.04), history of complaint procedures (p = 0.05), anxiety (p < 0.0001), depression (p < 0.0001) and the mental component of self-reported quality of life (p < 0.0001).

CONCLUSIONS

These results confirm that special attention should be given to professionals working in these challenging settings. The results have important implications for theory and research and for more customized approach interventions.

TRIAL REGISTRATION

ID RCB: 2018-A03029-46.

Psychometric Properties of the German Short Version of the Maslach Burnout Inventory – Student Survey

Abstract. Background: Higher education is a challenging context in which students – particularly those endowed with a small array of resources – are susceptible to suffer from burnout. To screen, identify, and support students that are at risk of burnout, psychometrically robust instruments are essential. To this end, we extended the validation of the German short version of the Maslach Burnout Inventory – Student Survey (MBI-SS-KV) that allows measuring burnout among German-speaking university students. Method: We conducted a longitudinal study and analyzed the factorial validity, reliability, measurement invariance, and convergent as well as discriminant validity of the MBI-SS-KV in a sample of German university students ( N = 1,435). Results: Our results replicated the original three-factor structure of the MBI-SS-KV. Yet, a bi-factor structure of the MBI-SS-KV – composed of a general factor (i.e., student burnout) and three domain-specific factors (i.e., emotional exhaustion, cynicism, and reduced professional efficacy) – revealed a comparable fit and was used for further analyses due to theoretical and methodological advantages. Based on the bi-factor structure of the MBI-SS-KV, nested models with increasing invariance constraints provided support for measurement invariance of this instrument across female and male university students and across time. Besides, the average variance extracted estimates and the comparisons of these estimates with shared variances demonstrated convergent and discriminant validity of the factors emotional exhaustion and cynicism, but not for the factor reduced professional efficacy. Conclusion: To sum up, we found that the MBI-SS-KV is a reliable and for the most part valid instrument for the assessment of student burnout in German higher education.

Work Fatigue Profiles: Nature, Implications, and Associations With Psychological Empowerment

The present study examined the distinct configurations, or profiles, taken by work fatigue dimensions among samples of military (n = 1,436) and civilian (n = 2,477) employees. We also tested profile similarity across these two samples of employees. In addition, this research documented the relations between the identified work fatigue profiles, one predictor variable (psychological empowerment), and a series of attitudinal outcomes (job satisfaction, career satisfaction, and turnover intentions) among military employees. Six profiles of employees characterized by different levels of global and specific (emotional, physical, and mental) work fatigue were identified using latent profile analyses: Low Fatigue, Physically and Emotionally Depleted, Emotionally Depleted, Globally and Mentally Depleted, Globally and Emotionally Depleted, and Balanced. In both samples, employees corresponding to the Balanced profile displayed average levels of global and specific work fatigue. However, this profile slightly differed across sample, as indicated by the observation of work fatigue levels that were slightly higher among the military than among civilians. Militaries’ perceptions of psychological empowerment were significantly related to their likelihood of belonging to all profiles. In turn, militaries’ career satisfaction, job satisfaction, and turnover intentions were also found to differ as a function of profile membership.

The COVID-19 era: How therapists can diminish burnout symptoms through self-care

COVID-19 is a frightening, stress-inducing, and unchartered territory for all. It is suggested that stress, loneliness, and the emotional toll of the pandemic will result in increased numbers of those who will seek psychological intervention, need support, and guidance on how to cope with a time period that none of us were prepared for. Psychologists, in general, are trained in and know how to help others. They are less effective in taking care of themselves, so that they can be their best in helping others. The article, which aims to heighten clinicians' awareness of the need for self-care, especially now in the post-pandemic era, describes the demanding nature of psychotherapy and the initial resistance by therapists to engage in self-care, and outlines the consequences of neglecting to care for themselves. We covered the demanding nature of psychotherapy and its grinding trajectory, the loneliness and isolation felt by clinicians in private practice, the professional hazards faced by those caring for others, and the creative and insightful ways that mental health practitioners can care for themselves for the good of their clients, their families, and obviously, themselves.

Assessment of burnout in medical students using the Maslach Burnout Inventory-Student Survey: a cross-sectional data analysis

BACKGROUND

Medical student burnout can cause emotional and physical exhaustion and detachment. The objectives of this study were to evaluate burnout using the Maslach Burnout Inventory-Student Survey (MBI-SS), identify factors that may predict burnout, and assess wellness initiatives effectiveness at reducing burnout.

METHODS

The MBI-SS was administered to all medical students (Classes 2019 to 2022) at the University of Illinois College of Medicine (UICOM) from February to May 2019. Factor analysis and internal consistency of the MBI-SS were assessed. Mean MSBI-SS subscale scores for burnout were calculated for cynicism (CY), emotional exhaustion (EE), and academic efficacy (AE). Multiple regression analysis was used to identify student factors that may predict burnout.

RESULTS

A total of 273 (21.6%) UICOM students completed the survey and 110 (40.3%) respondents reported self-perceived burnout. MBI-SS subscale scores were significantly higher for CY and EE, and significantly lower for AE in students who reported suffering from burnout versus students who did not report burnout. Mean ± SD subscale scores for CY, EE, and AE in burnout students were 14.44 ± 5.59, 23.23 ± 4.74, and 24.81 ± 5.35, respectively. In comparison, mean ± SD subscale scores for CY, EE, and AE in non-burnout students were 7.59 ± 5.16, 14.96 ± 5.71, and 28.74 ± 3.21, respectively. Regression analysis denoted significant associations between burnout and being out-of-phase in the curriculum, the effectiveness of wellness initiatives, and strength of motivation for medical school (SMMS) in both the two- and three-dimensional MBI-SS models. Gender was significantly associated with burnout in only the two-dimensional model.

CONCLUSIONS

Self-reported burnout in medical students at UICOM was validated using the MBI-SS. Being out-of-phase in the curriculum, being female, rating wellness initiatives as less effective, and demonstrating lower motivation for continued medical school education may be used as predictors of medical student burnout. This investigation may act as a guide for measuring burnout in medical student populations and how the implementation of wellness initiatives may ameliorate burnout.

Stress among medical students: factor structure of the University Stress Scale among Italian students

OBJECTIVES

The main purpose of the current study was to investigate the psychometric properties of the Italian version of the University Stress Scale (USS) among Italian medical students.

DESIGN, SETTING AND PARTICIPANTS

A cross-sectional observational study based on data from an online cross-sectional survey from 11 to 23 December 2018. A total of 1858 Italian medical students participated in the study.

OUTCOME MEASURES

We measured perceived stress among medical students using the USS, the Effort-Reward Imbalance Student Questionnaire (ERI-SQ) and the Kessler-10 (K10).

RESULTS

Results showed that a bifactor-Exploratory Structural Equation Modeling solution provided excellent levels of fit to the data. Our results suggest that the modified version of 19 items of the Italian version of the USS does not have a simple unidimensional structure. Overall, an inspection of ancillary indices (omega indices, ECV and percentage of uncontaminated correlations) revealed that these were too low to suggest the use of the USS as a composite measure of university stress. We tested an alternative unidimensional short form (eight items; USS-S) that assessed all the five sources of stress. This version provided a good fit to the data. Evidence of convergent validity of the USS-S was observed by analysing the correlations between the USS and ERI-SQ (ranging from -0.34 to 0.37, all p<0.01). Finally, based on the clinical cut-off recommended on the K10, results from receiver operating characteristic showed that considering the clinical cut-off of the USS is 7.5 and that 59.70% of medical students reported stress levels in the clinical range.

CONCLUSION

Finally, our results showed a lack of support for using the USS to measure a general university stress factor, as the general USS factor accounted for little variance in our sample. In this sense, stress scores among Italian students can be better assessed by the use of the USS-S.

Farmer Burnout in Canada

While farmers in several countries worldwide are reported to be at higher risk for poor mental health outcomes like chronic stress, depression, and anxiety, there is a paucity of research on burnout in farmers. This cross-sectional study used an online survey administered between September 2015 and February 2016 to investigate burnout (as measured by the Maslach Burnout Inventory-General Survey (MBI-GS)) amongst farmers in Canada. The specific objectives were to measure the three components of burnout (exhaustion, cynicism, and professional efficacy), and to explore potential associated risk factors, as well as to determine the prevalence of the different burnout profiles (engaged, ineffective, overextended, disengaged, and burnout). MBI-GS results were obtained from 1075 farmers. Approximately 70% of the study sample identified as male and 30% as female, and participants were from a variety of farming commodities. Scores for exhaustion, cynicism, and professional efficacy were all higher than international norms. While 43% of participants were classified as engaged, 44% were classified in the ineffective, overextended, or disengaged profiles (i.e., intermediate profiles on the engagement - burnout continuum), and 12% were classified in the burnout profile. Risk factor results highlighted the positive effects of farmer support from spouse/romantic partner, friends, and industry. Overall, the results from this study demonstrate cause for concern with respect to farmer burnout, suggest potential avenues for intervention, and serve as a call to action to better support farmers in Canada.

Exploring burnout and depression of Thai medical students: the psychometric properties of the Maslach Burnout Inventory

OBJECTIVES

To examine the psychometric properties of the Maslach Burnout Inventory-Student Survey (MBI-SS) Thai version and to determine the frequency of burnout and correlation between burnout and associated factors.

METHODS

A cross-sectional study was conducted among undergraduate medical students using convenience sampling (n=545, 76.1% response rate, female 52.1%). Data were collected by a self-report survey. The MBI-SS was translated in Thai and tested for internal consistency using Cronbach's coefficient alpha. A confirmatory factor analysis was performed using as fit indices of the chi-square and degree of freedom ratio (χ²/df), Comparative Fit Index (CFI), the Goodness of Fit Index (GFI), the Non-normed Fit Index (NNFI), Akaike information criterion (AIC) and the Root Mean Square Error of Approximation (RMSEA). Spearman and Kendall's tau-b were used to identify correlations between burnout, depression and other factors.

RESULTS

Interrater reliability was acceptable with Kappa of 0.83. Confirmatory factor analysis demonstrated good fit indices (χ²/df=197.62/83, CFI=0.97, GFI=0.95, NNFI=0.96, AIC=271.62 and RMSEA=0.06). Burnout had a weak, positive association with the PHQ-9 (r=0.294, df=2, p< 0.001). The screening depression score had a significant, modest positive association with emotional exhaustion (r=0.469, df=4, p<0.001) and cynicism (r=0.411, df=4, p< 0.001), and a weak inverse association with professional efficacy (r=-0.273, df=4, p< 0.001).

CONCLUSIONS

The Thai version of the MBI-SS had adequate psychometric properties among Thai medical students and can be used to assess burnout among undergraduate medical students in Thailand. Burnout was associated with risk for depression. Further studies on other associated factors contributing to depression are suggested.

Stress among university students: factorial structure and measurement invariance of the Italian version of the Effort-Reward Imbalance student questionnaire

Background

In the last decade academic stress and its mental health implications amongst university students has become a global topic. The use of valid and theoretically-grounded measures of academic stress in university settings is crucial. The aim of this study was to examine the factorial structure, reliability and measurement invariance of the short student version of the effort-reward imbalance questionnaire (ERI-SQ).

Methods

A total of 6448 Italian university students participated in an online cross-sectional survey. The factorial structure was investigated using exploratory factor analysis and confirmatory factor analysis. Finally, the measurement invariance of the ERI-SQ was investigated.

Results

Results from explorative and confirmatory factor analyses showed acceptable fits for the Italian version of the ERI-SQ. A modified version of 12 items showed the best fit to the data confirming the 3-factor model. Moreover, multigroup analyses showed metric invariance across gender and university course (health vs other courses).

Conclusions

In sum, our results suggest that the ERI-SQ is a valid, reliable and robust instrument for the measurement of stress among Italian university students.