Transcultural Adaptation of the Oldenburg Burnout Inventory (OLBI) for Brazil and Portugal

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.

The association between use of ambient voice technology documentation during primary care patient encounters, documentation burden, and provider burnout

BACKGROUND

The burden of documentation in the electronic medical record has been cited as a major factor in provider burnout. The aim of this study was to evaluate the association between ambient voice technology, coupled with natural language processing and artificial intelligence (DAX™), on primary care provider documentation burden and burnout.

METHODS

An observational study of 110 primary care providers within a community teaching health system. The primary objectives were to determine the association between DAX™ usage and provider burnout scores on the Oldenburg Burnout Inventory (OLBI) as well as the effect on documentation time per patient encounter (minutes).

RESULTS

The completion rate for the survey was 75% (83/110) and high DAX™ use (>60% of encounters) was seen in 28% of providers (23/83). High DAX™ use was associated with significantly less burnout on the OLBI disengagement sub-score (MD [Mean Difference] -2.1; 95% confidence interval [CI] -3.8 to -0.4) but not the OLBI disengagement sub-score (-1.0; 95% CI -2.9 to 1.0) or total score (MD -3.0; 95% CI -6.4 to 0.3). Nineteen providers with high implementation of DAX™ had pre and postimplementation data on documentation time per encounter. After DAX™ implementation average documentation time in notes per encounter was significantly reduced by 28.8% (1.8 min; 95% CI 1.4-2.2).

CONCLUSIONS

The use of ambient voice technology during patient encounters was associated with significantly reduced documentation burden and primary care provider disengagement but not total provider burnout scores.

Forensic Professionals' Stress Inventory (FPSI): Development and psychometric properties

Professionals in the justice system are particularly susceptible to occupational stress and burnout due to factors intrinsic to their profession. The Forensic Professional's Stress Inventory (FPSI) was designed to assess stress and psychological distress specifically in justice system professionals. A preliminary 41-item scale was administered to a sample of 690 forensic professionals (i.e., judges, lawyers, and attorneys). Exploratory factor analysis, exploratory structural equation modeling, and confirmatory factor analysis were conducted to find the most interpretable and parsimonious factor solution for FPSI. The 25-item bifactor model (with four first-order factors) demonstrated the most adequate fit to the data. Overall, FPSI revealed adequate psychometric properties and would be a useful instrument for assessing psychological strain and stress in forensic professionals.

Resilience and burnout of healthcare workers during the early COVID-19 pandemic

INTRODUCTION

The COVID-19 pandemic has led to significantly more healthcare workers (HCWs) experiencing burnout than previously. This burnout is strongly associated with low resilience. Addressing organisational stresses and the introduction of resilience training will help to reduce the proportion of HCWs experiencing this phenomenon.

AIMS

The aim of this study was to assess the impact of the biopsychosocial changes and challenges associated with the COVID-19 pandemic on the healthcare workforce, exploring, specifically, the impact on and relationship between HCWs' resilience and burnout.

METHODS

An electronic opt-in survey was distributed to HCWs through hospital and professional association communications emails and websites, as well as social media. The survey consisted of demographic questions, the Oldenburg Burnout Inventory to assess burnout, Brief Resilience Scale to assess general resilience, and 10-item Connor-Davidson Resilience Scale to assess resilience during the pandemic. Univariate and multivariate analysis was undertaken to examine the relationship between these factors.

RESULTS

A total of 1370 HCWs completed the questionnaire, with 802 (58.5%) having burnout, 348 (25.4%) having low general resilience and 390 (28.5%) having low COVID resilience. Burnout was significantly associated with being public sector workers, low general resilience and low COVID resilience. Resilience training was found to be protective for burnout.

CONCLUSION

The introduction of resilience training in the workplace is a fundamental tool that will significantly benefit HCWs when working under challenging conditions.

The relationships between nurses' resilience, burnout, perceived organisational support and social support during the second wave of the COVID-19 pandemic: A quantitative cross-sectional survey

AIMS

To examine the level of resilience and burnout among British nurses during the second wave of the COVID-19 pandemic and the influence of personal, social and organisational factors on nurses' resilience and burnout.

BACKGROUND

Nurses experienced excessive workload and emotional demands over a prolonged period during the COVID-19 pandemic which may have led to exhaustion. Little research has examined the correlation between the pandemic variables, nurses' resilience and burnout during the second wave of the COVID-19 pandemic.

DESIGN

This study utilised a descriptive, cross-sectional research design.

METHODS

A cross-sectional and self-report survey involved 111 staff nurses, who completed a self-administrated questionnaire between January and April 2021. A STORBE checklist was used to report the study results.

FINDINGS

The study found that nurses experienced a high level of burnout and low to moderate levels of resilience. The study revealed significant negative relationships between the level of burnout and perceived organisational support and nurses' resilience. The impact of the COVID-19 pandemic on nurses' social roles and their worries about patient safety were positively correlated with burnout. The perceived organisational support, the impact of the COVID-19 pandemic on nurses' social roles and the level of resilience were significant factors for burnout.

CONCLUSIONS

Nurses experienced a high level of burnout during the second wave of the COVID-19 pandemic, which may be influenced by how they felt their organisations supported them. Nurses' feelings that the pandemic affected their social roles were associated with increasing their burnout.

RELEVANCE TO CLINICAL PRACTICE

Strategies should be developed to address staff burnout and resilience. Nurse managers and educators should play leadership roles in creating professional training to include competencies and psychological preparedness for disasters and to implement strategies to increase the organisational commitments to staff safety and well-being.

Safety attitudes, burnout and well-being among healthcare workers during the COVID-19 pandemic: an Indo-Pacific regional cross-sectional study

Introduction

The coronavirus disease 2019 (COVID-19) pandemic has had an unprecedented impact in Asia and has placed significant burden on already stretched healthcare systems. We examined the impact of COVID-19 on the safety attitudes among healthcare workers (HCWs), as well as their associated demographic and occupational factors, and measures of burnout, depression and anxiety.

Methods

A cross-sectional survey study utilising snowball sampling was performed involving doctors, nurses and allied health professions from 23 hospitals in Singapore, Malaysia, India and Indonesia between 29 May 2020 and 13 July 2020. This survey collated demographic data and workplace conditions and included three validated questionnaires: the Safety Attitudes Questionnaire (SAQ), Oldenburg Burnout Inventory and Hospital Anxiety and Depression Scale. We performed multivariate mixed-model regression to assess independent associations with the SAQ total percentage agree rate (PAR).

Results

We obtained 3,163 responses. The SAQ total PARs were found to be 35.7%, 15.0%, 51.0% and 3.3% among the respondents from Singapore, Malaysia, India and Indonesia, respectively. Burnout scores were highest among respondents from Indonesia and lowest among respondents from India (70.9%-85.4% vs. 56.3%-63.6%, respectively). Multivariate analyses revealed that meeting burnout and depression thresholds and shifts lasting ≥12 h were significantly associated with lower SAQ total PAR.

Conclusion

Addressing the factors contributing to high burnout and depression and placing strict limits on work hours per shift may contribute significantly towards improving safety culture among HCWs and should remain priorities during the pandemic.

Working time arrangements and exhaustion: The role of recovery experiences and satisfaction with the schedule

Working time arrangements may be a source of strain and entail negative consequences for workers, one of which can be exhaustion. Based on the job demands-resources and the conservation of resources theories, this study explores recovery experiences from work and satisfaction with the work schedule as possible resources that may prevent or minimize such negative consequences. With a sample of 386 workers (n = 287 women; 99 men) and using a cluster analysis, we identified five working time arrangements: fixed standardized, part-time, irregular standardized, flexible standardized, and nonstandard work schedule (NWS). A one-way ANOVA found that workers in the irregular standardized schedule report higher exhaustion compared to the fixed standardized and the part-time. Exhaustion of workers in NWS is higher compared to the part-time workers. A multiple linear regression analysis found that the link between recovery experiences and exhaustion varies according to the working time arrangement. Lastly, an interaction analysis confirmed the moderator effect of satisfaction with the work schedule in the relationship between recovery experiences and exhaustion for the whole sample. When this analysis was performed separately for each cluster, this effect was only significant for NWS and by disentangling this finding by recovery dimensions, only relaxation had a significant interaction effect. This study clarifies the links between different recovery experiences and exhaustion, and points to the importance of satisfaction with the work schedule in facilitating recovery under demanding working time arrangements. Results are discussed considering the complex nature of the work-family interface.

Protecting Police Officers Against Burnout: Overcoming a Fragmented Research Field

This study aims to identify the determinants of burnout in police officers. We considered a wide range of psychosocial risk factors, individual variables that have been previously found to be associated with burnout in police officers (affective and cognitive empathy, self-care), and variables whose unique impact on burnout of police officers needs further clarification (organizational justice and organizational identification). The study was conducted in Portugal, and the sample was constituted by 573 members of the National Republican Guard (GNR-Guarda Nacional Republicana). The participants were invited to answer an online anonymous survey, which included previously validated measures of the following variables: burnout (exhaustion and disengagement), psychosocial risk factors, self-care, empathy (cognitive and affective), organizational justice, and organizational identification. Furthermore, we controlled for the potential impact of demographic variables (age, gender, years of professional experience, religiosity, political orientation, and income). Multiple regression analysis showed that when taken together, only a few of the variables associated with burnout had a unique impact on both exhaustion and disengagement: quantitative demands and affective empathy were burnout risk factors; meaningful work, organizational justice (distributive justice, procedural justice, and interactional justice), and organizational identification were burnout protective factors. Our results highlight the importance of developing theoretical models and planning interventions to prevent burnout in police officers, focusing mainly on the above-mentioned variables.

Adaptation, confirmatory factor analysis, and psychometric properties of the Brazilian version of the Repetitive Eating Questionnaire

OBJECTIVE

The Repetitive Eating Questionnaire (Rep(eat)-Q) is a brief self-report measure developed to assess grazing behavior-an understudied problematic eating behavior associated with eating disorder psychopathology and poor weight management. This study aimed to adapt and test the psychometric properties and factor structure of the Rep(eat)-Q in a Brazilian community sample.

METHOD

We used the International Test Commission guidelines for the adaptation of psychological measures between cultures. Participants were recruited from the community and on a university campus and completed a set of questionnaires including the Rep(eat)-Q, psychological measures, and sociodemographic data.

RESULTS

A total of 718 (86.4% female) completed the Rep(eat)-Q and were eligible for the confirmatory factor analysis (CFA). Only 542 completed the entire survey (Rep(eat)-Q and other psychological measures) and were eligible for the analysis of the validity evidence based on the relations to other variables. CFA revealed support for a two first-order model as originally proposed, however, a hierarchical (i.e., second-order) model is proposed. We found support for second-order scalar invariance across sex. Both first- and second-order internal consistency estimates presented very good evidence. Analysis (n = 542) revealed moderate to strong correlations (≥.58 to .77) between grazing (total score and subscales) and binge eating and other psychological measures, presenting good convergent evidence.

DISCUSSION

This study reports good psychometric properties of the Rep(eat)-Q for the Brazilian community sample.

PUBLIC SIGNIFICANCE

Grazing is a problematic eating behavior and the Rep(eat)-Q is one of the measures to assess grazing. The article aimed to adapt and test the psychometric properties of the Rep(eat)-Q in a Brazilian community sample. The results support a two-factor structure and suggest that the Rep(eat)-Q possesses good psychometric properties to be used with the Brazilian populations.

Burnout and Suicidal Behaviours in Health Professionals in Portugal: The Moderating Effect of Self-Esteem

The main objective of this study was to investigate the effect of burnout on suicidal behaviours and the mediating effect of self-esteem in this relationship. A total of 1172 healthcare professionals working in Portugal's private and public sector organisations participated in this study. The results indicate a high level of burnout among these professionals and that exhaustion (β = 0.16; p < 0.001) and disengagement (β = 0.24; p < 0.001) positively and significantly affect suicidal behaviours. In turn, self-esteem has a significant and negative effect (β = -0.51; p < 0.001) on suicidal behaviours. Self-esteem moderates the relationship between disengagement and suicidal behaviours (B = -0.12; p < 0.001) and the relationship between exhaustion and suicidal behaviours (B = -0.11; p < 0.001), representing an essential variable for future lines of research, namely on the role of self-esteem in preventing burnout and suicidal behaviours in professionals from other professional areas.

Burnout and quality of life in nursing staff during the COVID-19 pandemic

OBJECTIVE

To investigate the association between burnout and quality of life among nursing staff at intensive care units during the new coronavirus pandemic and identify the influence of sociodemographic variables.

METHODS

A cross-sectional study was conducted with 109 nursing staff members at intensive care units of a public hospital in Brazil. Data collection involved the administration of a sociodemographic questionnaire as well as the WHOQOL-Bref and Oldenburg Burnout Inventory.

RESULTS

The participants presented a high state of burnout and a low score in the physical domain of the quality-of-life instrument. Men (p = 0.037), income (p = 0.011) and burnout (p < 0.001) independently influenced quality-of-life (p < 0.01). Age, being a nursing technician and working at two hospitals exerted an influence on burnout status (p < 0.05). A negative association was found between quality of life and burnout (p < 0.01).

CONCLUSION

Our findings showed that burnout due to occupational circumstances affected negatively the quality of life perceptions of nursing staff working at intensive care units during the COVID-19 pandemic.

Randomized controlled trial of emotion-focused training for helping professionals

Introduction

The aim of this study was to examine the short- and long-term effectiveness of the novel Emotion-focused Training for Helping Professions on levels of compassion fatigue (secondary traumatic stress & burnout), self-criticism, self-compassion, and compassion for others.

Methods

A randomized controlled trial study was conducted. A total of 253 participants were recruited and randomly assigned to either the experimental group or the control group. The experimental group attended a 14-day online training. The control group did not perform any tasks.

Results

Results showed that after completing the intervention the experimental group participants reported significantly lower scores for secondary traumatic stress, burnout and self-criticism, and higher scores for self-compassion and that these lasted for two months after completion. Compared to the control group, the experimental group participants had significantly lower scores of secondary traumatic stress, burnout, self-criticism, and higher scores of self-compassion after the intervention. No significant changes were found for the control group, except a significant increase in time in the reported score for one dimension of burnout - exhaustion.

Discussion

The novel EFT-HP training was shown to be effective in reducing levels of compassion fatigue (secondary traumatic stress and burnout) and self-criticism and increasing self-compassion.

High prevalence of burnout syndrome among medical and nonmedical residents during the COVID-19 pandemic

BACKGROUND

Since the beginning of the COVID-19 pandemic, health professionals have been working under extreme conditions, increasing the risk of physical and mental illness. We evaluated the prevalence of burnout and its associated factors among postgraduate student residents in health professions during the global health crisis.

METHODS

Healthcare residents were recruited from all across Brazil between July and September 2020 through digital forms containing instruments for assessing burnout (Oldenburg Burnout Inventory (OLBI)), resilience (brief resilient coping scale (BRCS)) and anxiety, stress and depression (depression, anxiety and stress scale (DASS-21) and Patient Health Questionnaire (PHQ-9)). Additionally, the relationships between burnout and chronic diseases, autonomy and educational adequacy in the residency programme, personal protective equipment (PPE), workload and care for patients with COVID-19 were evaluated. The chi-square test, Student's t test, Pearson's correlation test and logistic regression were performed.

RESULTS

A total of 1,313 participants were included: mean (standard deviation) age, 27.8 (4.4) years; female gender, 78.1%; white race, 59.3%; and physicians, 51.3%. The overall prevalence of burnout was 33.4%. The odds (odds ratio [95% confidence interval]) of burnout were higher in the presence of pre-existing diseases (1.76 [1.26-2.47]) and weekly work > 60 h (1.36 [1.03-1.79]) and were lower in the presence of high resilience (0.84 [0.81-0.88]), autonomy (0.87 [0.81-0.93]), and educational structure (0.77 [0.73-0.82]), adequate availability of PPE (0.72 [0.63-0.83]) and non-white race (0.63 [0.47-0.83]). Burnout was correlated with anxiety (r = 0.47; p < 0.05), stress (r: 0.58; p < 0.05) and depression (r: 0.65; p < 0.05).

CONCLUSIONS

We observed a high prevalence of burnout among residents during the COVID-19 pandemic. Individual characteristics and conditions related to the work environment were associated with a higher or lower occurrence of the syndrome.

Protective and Vulnerability Factors of Municipal Workers' Mental Health: A Cross-Sectional Study

Work is fundamental to an individual's mental health; however, an unfavourable work environment can lead to mental health problems. Despite existing studies addressing workers' mental health, it is essential to understand the reality of specific contexts to design effective tailored interventions. Thus, this study aimed to examine the influence of potential protective and vulnerability factors on municipal workers' depressive symptoms, anxiety and stress levels, and burnout. A cross-sectional study was conducted with data collection performed between July and December 2021 using online self-report measures. The sample comprised 115 municipal workers. The findings revealed that psychological vulnerability is a significant vulnerability factor for the presence of mental health symptoms. In addition, job satisfaction was found to be a significant protective factor for depressive symptoms, anxiety, and burnout of the municipal workers. The results of this study enhance the understanding of factors that influence worker mental health, which may facilitate the proper planning of specific interventions to promote mental health in the workplace.

Burnout: personal and work factors in volunteer and career firefighters

Purpose

Firefighters are daily confronted with adverse, unpredictable and demanding situations. It is a dangerous profession that puts firefighters at risk of developing burnout. Although the literature has already identified personal and work-related factors of burnout, the examination of specific factors explaining burnout among volunteer and career firefighters is still needed. The purpose of this study is to investigate the explaining role of personal and work-related factors on volunteer and career firefighters’ burnout.

Design/methodology/approach

A nonrandom convenience sample of 250 firefighters (67% volunteer; Mage = 31.88) completed a sociodemographic questionnaire, the Oldenburg Burnout Inventory, the Proactive Coping Scale and a standard of living subscale item. Hierarchical multiple linear regression models were tested. Fisher’s criterion was considered, with p-values lower than 0.05 interpreted as statistically significant.

Findings

Personal and work-related factors accounted for 18% of volunteer and 31% of career firefighters’ variations in burnout. Personal factors offered a greater contribution explaining volunteer and career firefighters’ burnout. Still, variations in the role played by age, family responsibilities, proactive coping and satisfaction with standard of living on burnout were found among volunteer and career firefighters. Taking the work-related factors into account, working in rotative shifts constituted a risk factor for career firefighters’ burnout.

Research limitations/implications

This study advances the understanding about the role of personal and work-related factors in volunteer and career firefighters’ burnout.

Originality/value

This study adds information about specific factors explaining burnout among voluntary and career firefighters. It deepens existing knowledge on variations in the role played by age, family responsibilities, work conditions, proactive coping and satisfaction with standard of living on the burnout of volunteer and career firefighters.

Mediating effect of sleep disturbance and rumination on work-related burnout of nurses treating patients with coronavirus disease

Background

COVID-19 has created significant and unprecedented psychological distress on nurses working with COVID-19 patients. Nurses dealing with such psychological distress are prone to burnout. This study examined the mediating role of sleep disturbance and rumination in the association between psychological distress and work-related burnout of nurses treating COVID-19 patients.

Methods

A cross-sectional study was conducted from 26th February to 16th March 2021, on a sample of 250 nurses who were actively working during the COVID-19 pandemic in five referral hospitals in Tehran, Iran. The Oldenburg Burnout Inventory, Kessler Psychological Distress Scale (K10), Pittsburgh Sleep Quality Index, and Ruminative Responses Scale were used to collect data. Data analysis was based on pearson’ correlation analysis and path analysis.

Results

Psychological distress has a significant effect on job burnout. When sleep disturbances were modeled as a mediator, path coefficients of psychological distress showed a significant effect on job burnout. Also, according to the findings, rumination poses a significant mediating effect on the association between psychological distress and job burnout.

Conclusion

This study demonstrated the importance of designing psychological interventions intended to reduce sleep disturbances and rumination when experiencing stressful events to avoid job burnout among nurses.

Marginalized identities, mistreatment, discrimination, and burnout among US medical students: cross sectional survey and retrospective cohort study

OBJECTIVE

To describe the association between mistreatment, burnout, and having multiple marginalized identities during undergraduate medical education.

DESIGN

Cross sectional survey and retrospective cohort study.

SETTING

140 US medical schools accredited by the Association of American Medical Colleges.

PARTICIPANTS

30 651 graduating medical students in 2016 and 2017.

MAIN OUTCOME MEASURES

Self-reported sex, race or ethnicity, and sexual orientation groups were considered, based on the unique combinations of historically marginalized identities held by students. Multivariable linear regression was used to determine the association between unique identity groups and burnout along two dimensions (exhaustion and disengagement) as measured by the Oldenburg Burnout Inventory for Medical Students while accounting for mistreatment and discrimination.

RESULTS

Students with three marginalized identities (female; non-white; lesbian, gay, or bisexual (LGB)) had the largest proportion reporting recurrent experiences of multiple types of mistreatment (88/299, P<0.001) and discrimination (92/299, P<0.001). Students with a higher number of marginalized identities also had higher average scores for exhaustion. Female, non-white, and LGB students had the largest difference in average exhaustion score compared with male, white, and heterosexual students (adjusted mean difference 1.96, 95% confidence interval 1.47 to 2.44). Mistreatment and discrimination mediated exhaustion scores for all identity groups but did not fully explain the association between unique identity group and burnout. Non-white and LGB students had higher average disengagement scores than their white and heterosexual counterparts (0.28, 0.19 to 0.37; and 0.73, 0.52 to 0.94; respectively). Female students, in contrast, had lower average disengagement scores irrespective of the other identities they held. After adjusting for mistreatment and discrimination among female students, the effect among female students became larger, indicating a negative confounding association.

CONCLUSION

In this study population of US medical students, those with multiple marginalized identities reported more mistreatment and discrimination during medical school, which appeared to be associated with burnout.

Internal Reliability and Validity of Copenhagen Burnout Inventory and Oldenburg Burnout Inventory Compared with Maslach Burnout Inventory among Nigerian Resident Doctors: A Pilot Study

Introduction: Copyrighted Maslach Burnout Inventory (MBI) is perhaps the most widely used and validated tool in assessing burnout among different occupations and health care professionals compared to the free to use Copenhagen Burnout Inventory (CBI) and Oldenburg Burnout Inventory (OLBI). This study aimed to determine the reliability and validity of these tools in comparison with MBI among a subset of Nigerian resident doctors. Methods: A cross-sectional survey with reliability of the burnout scales calculated using Cronbach’s alpha. Construct validity was assessed by principal component analysis and correlating dimensions within each burnout tool with one another using Pearson’s correlation coefficient. The criterion validity of each dimension was assessed for the ability of independent variables to predict their scores using multiple linear regression. Results: Copenhagen Personal Burnout dimension had the highest Cronbach’s alpha score of 0.91. MBI-Emotional Exhaustion had the highest correlations with Copenhagen Work-related, Copenhagen Personal-related, and Oldenburg Exhaustion burnout dimensions. Only the multiple regression models for Copenhagen personal (p = 0.04) and work-related (p = 0.02) burnout dimensions were significant, with the specialty of the residents being the significant independent variable in both models. Conclusion: CBI and OLBI have high internal consistency and reliability among the subset of resident doctors recruited into this study, CBI dimensions had the best predictive and construct validity and can be used as valid alternative to MBI.

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

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

Assessment of the impact of COVID-19 pandemic on the mental health and wellbeing of pharmacists: A nationwide survey

Objectives

To explore the impact of the COVID-19 pandemic and work on the mental health and wellbeing of pharmacists in Nigeria and investigate the risk of exhaustion, disengagement, burnout, and their associated factors.

Methods

This was an online cross-sectional study among pharmacists that involved the use of mental health and wellbeing questionnaire including a 16-item OLBI questionnaire. Descriptive statistical analyses were performed to determine the study distribution. Chi-square test was used to compare categorical variables, while independent sample t-test and one-way ANOVA were used to compare the mean values of two and three groups, respectively. Tukey posthoc test was used to compare various practice settings based on significant factors, while a two-sided Dunnett t-test was used to compare between groups for other significant factors. A p-value less than 0.05 was considered statistically significant.

Results

Of the 612 pharmacists invited to participate in the survey, 426 completed and submitted the questionnaire giving a response rate of 69.6%. The Cronbach's alpha for wellness and mental health survey instrument in our study population is 0.74, while the average Cronbach's alpha for a 16-item OLBI questionnaire is 0.62 in our study population. The high risk of exhaustion and disengagement were met by 75.6% and 77.2% of the respondents, respectively. Eighty-three respondents (19.5%) met thresholds for either high risk of exhaustion or disengagement, while 66.2% had both a high risk of exhaustion and disengagement (burnout). Significant proportions of respondents with undergraduate pharmacy degree as the highest qualification obtained (70.6%, p < 0.001), in the hospital practice setting (62.8%, p < 0.001), and in full-time employment type (68.1%, p = 0.004) had the higher risk of burnout compared to their counterparts.

Conclusion

The COVID-19 pandemic and work significantly impacted the mental health and wellbeing of a considerable proportion of the respondents. Burnout affects the majority of pharmacists in Nigeria and is linked to undergraduate pharmacy degrees as the highest qualification obtained, hospital practice settings, and full-time employment. Thus, mitigating strategies from employees, government, and organizations are recommended to help improve working conditions and promote the well-being of pharmacists in Nigeria.

Psychometric Properties of the Oldenburg Burnout Inventory in a Portuguese Sample of Aircraft Maintenance Technicians

From its initial conceptualization as emotional exhaustion, cynicism, and reduced personal efficacy for the help professions, burnout has received increasing attention in modern times, especially after the 2019 WHO's inclusion of this syndrome in the ICD-11 list. Burnout can be measured using several psychometric instruments that range in dimensionality, number of items, copyrighted, and free use formats. Here, we report the psychometric properties of data gathered with the Oldenburg Burnout Inventory (OLBI) in a sample of Portuguese Aircraft maintenance technicians. As far as we know, this is the first study addressing the burnout syndrome in this occupational group. Data gathered with the OLBI displayed good evidence of validity related to internal structure, to other variables, with good evidence of reliability. We showed that burnout significantly correlated with mental and physical fatigue emphasizing the vital critical role that these variables play with safety in the aviation industry.

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.

Within- and between-person factor structure of the Oldenburg Burnout Inventory: Analysis of a diary study using multilevel confirmatory factor analysis

The study examined the factor structure of burnout, as measured with the Oldenburg Burnout Inventory. The participants were 235 employees of a public administration agency who assessed their burnout online for 10 consecutive working days. Two models were tested with multilevel confirmatory factor analysis, assuming the same one or two-factor structure at the within- and between-person levels. Both models showed a reasonable fit to the data, but due to a strong correlation between exhaustion and disengagement and low within-person reliability for disengagement, a unidimensional model seems more valid. A cross-level invariance was not confirmed for either of the structures, showing that factor loadings for the same items differ significantly between the levels. This suggests that burnout is not the same latent variable at each level; rather, there are factors other than daily burnout that influence person-level scores and ignoring these across-level discrepancies may lead to biased conclusions.

Openness Toward Organizational Change Scale (OTOCS): Validity evidence from Brazil and Portugal

Openness toward organizational change is central to employees’ responses to organizations’ strategic actions. This study aims to assess the validity evidence of the Openness Toward Organizational Change Scale (OTOCS) by examining the internal structure of the measure (e.g., dimensionality, reliability, measurement invariance) and its relations with other variables such as quality of work life, burnout, job satisfaction, and work engagement. A cross-sectional study was conducted using total sample of 1,175 workers, with 565 workers from Portugal and 610 from Brazil. The data provided satisfactory validity evidence based on the internal structure: the expected dimensionality was confirmed, acceptable levels of reliability were found, and measurement invariance was achieved among countries and sex. The measure also demonstrated satisfactory validity evidence based on the relations to other variables, being negatively associated with burnout and positively associated with work engagement, job satisfaction and quality of work. The OTOCS proved to be a relatively short self-report measure with satisfactory validity evidence to be used among Brazilian and Portuguese workers.

Mental Health and Burnout Syndrome Among Postgraduate Students in Medical and Multidisciplinary Residencies During the COVID-19 Pandemic in Brazil: Protocol for a Prospective Cohort Study

Background

The COVID-19 pandemic has led to high levels of physical, psychological, and social stress among health care professionals, including postgraduate students in medical and multidisciplinary residencies. This stress is associated with the intense fear of occupational exposure to SARS-CoV-2, the virus known to cause COVID-19. These professionals are at risk of developing physical and mental illnesses not only due to the infection but also due to prolonged exposure to multidimensional stress and continued work overload.

Objective

This study aims to evaluate the prevalence of symptoms suggestive of mental disorders and burnout syndrome and determine the risk factors for burnout among postgraduate students in medical and multidisciplinary residencies in Brazil during the COVID-19 pandemic.

Methods

For this prospective cohort study with parallel groups, participants were recruited between July and September 2020 to achieve a sample size of at least 1144 participants. Research instruments such as Depression, Anxiety, and Stress Scale; Patient Health Questionnaire; Brief Resilient Coping Scale; and Oldenburg Burnout Inventory will be used to collect data. Data will be collected in 2 waves: the first wave will include data related to sample characterization and psychosocial evaluation, and the second wave will be launched 12 weeks later and will include an evaluation of the incidence of burnout as well as correlations with the potential predictive factors collected in the first wave. Additionally, we will collect data regarding participants’ withdrawal from work.

Results

The recruitment took place from July 29 to September 5, 2020. Data analyses for this phase is already in progress. The second phase of the study is also in progress. The final data collection began on December 1, 2020, and it will be completed by December 31, 2020.

Conclusions

We believe the findings of this study will help evaluate the impact of the COVID-19 pandemic on the mental health conditions of health professionals in Brazil as well as contribute to the planning and implementation of appropriate measures that can alleviate these mental health challenges.

International Registered Report Identifier (IRRID)

DERR1-10.2196/24298

Organizational Justice, Professional Identification, Empathy, and Meaningful Work During COVID-19 Pandemic: Are They Burnout Protectors in Physicians and Nurses?

Burnout has been recognized as a serious health problem. In Portugal, before COVID-19 Pandemic, there were strong indicators of high prevalence of burnout in physicians and nurses. However, the Portuguese Health Care Service was able to efficiently respond to the increased demands. This study intends to understand how psychosocial variables might have been protective factors for burnout in physicians and nurses in Portugal. Specifically, we considered several psychosocial variables that have been found to be protective factors for burnout in previous research and we compared their predictive and unique impact in the prediction of burnout. These variables are perceptions of justice (distributive, procedural, justice from colleagues, justice from patients, and their families), professional identification, meaningful work and empathy. We also included workload, as a risk factor, and controlled other variables that can be confounds for burnout, such as socio-demographic variables, ideological variables (religiosity, political orientation), and specific variables related with COVID-19 pandemic. The sample of the present study is composed by 229 physicians (aged between 23 and 70 years old, M = 36.54; SD = 10.72; 48% male and 52% female) and 268 nurses (aged between 22 and 69 years old, M = 34.96; SD = 9.52; 27% male and 73% female). An online survey was created using Qualtrics and participants were recruited via Facebook and LinkedIn. The data were collected during 29 days (between the 45th and the 74th days after the first diagnosed case of COVID-19 in Portugal). The results showed that workload was a significant risk factor, except for disengagement in physicians. The most consistent protectors across samples were procedural justice (for both dimensions of burnout, both in physicians and nurses) and professional identification (for disengagement, both in physicians and nurses; for exhaustion only in physicians). This study suggests that decreasing workload and promoting procedural justice and professional identification are key factors that might be simultaneously and independently addressed in interventions for reducing the risk of burnout or preventing it from occurring in the first place.

Burnout among Portuguese healthcare workers during the COVID-19 pandemic

BACKGROUND

During COVID-19 pandemic, healthcare workers (HCWs) have had high workload and have been exposed to multiple psychosocial stressors. The aim of this study was to evaluate HCWs in terms of the relative contributions of socio-demographic and mental health variables on three burnout dimensions: personal, work-related, and client-related burnout.

METHODS

A cross-sectional study was performed using an online questionnaire spread via social networks. A snowball technique supported by health care institutions and professional organizations was applied.

RESULTS

A total of 2008 subjects completed the survey. Gender, parental status, marriage status, and salary reduction were found to be significant factors for personal burnout. Health problems and direct contact with infected people were significantly associated with more susceptibility to high personal and work-related burnout. Frontline working positions were associated with all three dimensions. Higher levels of stress and depression in HCWs were significantly associated with increased levels of all burnout dimensions. Higher levels of satisfaction with life and resilience were significantly associated with lower levels of all burnout dimensions.

CONCLUSIONS

All three burnout dimensions were associated with a specific set of covariates. Consideration of these three dimensions is important when designing future burnout prevention programs for HCWs.

Psychological distress, burnout, job satisfaction and intention to quit among primary healthcare nurses

Addressing the worldwide challenge of shortage of nurses contributes to the national and international efforts to enhance the health and well-being of the global population. The main aim of this research is to investigate the level and the relationship between psychological distress, burnout, job satisfaction and intention to quit among primary healthcare nurses in public and private practices while accounting for their socio-demographic characteristics. This was a cross sectional study of 173 primary health care nurses. The Oldenburg Burnout Inventory and General Health Questionairre-12 were used to assess burnout and psychological distress among nursing staff. High psychological distress was present in 21.38% of all respondents and was significantly related to intention to quit. The results indicated a mean job satisfaction score of 3.54 with higher job satisfaction among private vs. public sector nurses. Furthermore, nurses with higher burnout levels and lower job satisfaction were more likely to consider leaving the profession compared with those with lower burnout and higher job satisfaction. The study provides valuable insight for managers of general healthcare practice and healthcare policy makers in effectively managing and retaining primary healthcare nurses.

Burnout and Associated Factors Among Health Care Workers in Singapore During the COVID-19 Pandemic

OBJECTIVES

The strain on health care systems due to the COVID-19 pandemic has led to increased psychological distress among health care workers (HCWs). As this global crisis continues with little signs of abatement, we examine burnout and associated factors among HCWs.

DESIGN

Cross-sectional survey study.

SETTING AND PARTICIPANTS

Doctors, nurses, allied health professionals, administrative, and support staff in 4 public hospitals and 1 primary care service in Singapore 3 months after COVID-19 was declared a global pandemic.

METHODS

Study questionnaire captured demographic and workplace environment information and comprised 3 validated instruments, namely the Oldenburg Burnout Inventory (OLBI), Safety Attitudes Questionnaire (SAQ), and Hospital Anxiety and Depression Scale (HADS). Multivariate mixed model regression analyses were used to evaluate independent associations of mean OLBI-Disengagement and -Exhaustion scores. Further subgroup analysis was performed among redeployed HCWs.

RESULTS

Among 11,286 invited HCWs, 3075 valid responses were received, giving an overall response rate of 27.2%. Mean OLBI scores were 2.38 and 2.50 for Disengagement and Exhaustion, respectively. Burnout thresholds in Disengagement and Exhaustion were met by 79.7% and 75.3% of respondents, respectively. On multivariate regression analysis, Chinese or Malay ethnicity, HADS anxiety or depression scores ≥8, shifts lasting ≥8 hours, and being redeployed were significantly associated with higher OLBI mean scores, whereas high SAQ scores were significantly associated with lower scores. Among redeployed HCWs, those redeployed to high-risk areas in a different facility (offsite) had lower burnout scores than those redeployed within their own work facility (onsite). A higher proportion of HCWs redeployed offsite assessed their training to be good or better compared with those redeployed onsite.

CONCLUSIONS AND IMPLICATIONS

Every level of the health care workforce is susceptible to high levels of burnout during this pandemic. Modifiable workplace factors include adequate training, avoiding prolonged shifts ≥8 hours, and promoting safe working environments. Mitigating strategies should target every level of the health care workforce, including frontline and nonfrontline staff. Addressing and ameliorating burnout among HCWs should be a key priority for the sustainment of efforts to care for patients in the face of a prolonged pandemic.

An Investigation of Prevalence and Predictors of Disengagement and Exhaustion in Pharmacy Students

Objective. To determine the prevalence of burnout in first, second, and third professional year (P1, P2, and P3) pharmacy students at a single institution and identify predictors of higher burnout scores. Methods. A 31-question anonymous online survey was developed and administered to a total of 390 P1, P2, and P3 students at the University of Kentucky College of Pharmacy. The survey consisted of a modified version of the 16-question Oldenburg Burnout Inventory (OLBI) and 14 additional questions related to demographic and co-curricular and extracurricular related questions. Descriptive and inferential statistical analyses were conducted as appropriate to determine differences among the variables studied and to identify predictive variables of disengagement and emotional exhaustion. Results. Seventy-five percent of invited students participated in the study. Results of the analyses showed that P1 students had significantly lower engagement scores than both P2 and P3 students, and that P2 students were significantly less exhausted than P1 and P3 students. There was a lack of correlation between burnout scores and students' postgraduate goals, curricular involvement, and work responsibilities. Married students reported being significantly less exhausted than unmarried students. Conclusion. This study added to the growing evidence that pharmacy students have relatively high rates of disengagement and emotional exhaustion. Because the variables expected to contribute to burnout were not found to be predictive in this study, further analyses examining the positive and negative predictive factors associated with burnout scores in pharmacy students are needed. Identifying these factors would allow targeted interventions to be made early in the academic careers of students most susceptible to burnout.

Occupational burnout syndrome and post-traumatic stress among healthcare professionals during the novel coronavirus disease 2019 (COVID-19) pandemic

This comprehensive review aims to explain the potential impact of coronavirus disease 2019 (COVID-19) on mental wellbeing of healthcare professionals (HCPs). Based on up-to-date research and psychological diagnostic manuals of Diagnostic and Statistical Manual of Mental Disorders, 5th edition and International Classification of Diseases, 11th revision, we describe associated psychological disorders and experiences that may arise related to COVID-19. Appropriate psychological measures are introduced, along with potential methodological limitations. Lastly, resilience building and preventative measures with interventions that may mitigate the impact on mental health of HCPs are described.

Burnout and its influencing factors between frontline nurses and nurses from other wards during the outbreak of Coronavirus Disease -COVID-19- in Iran

OBJECTIVES

To assess burnout level during an outbreak of COVID-19 and to identify influencing factors between frontline nurses and nurses from other wards.

METHODS

This cross-sectional study makes comparison between two groups of nurses including frontline (exposure group) and other nurses working in usual wards (non-exposure group) in Torbat Heydariyeh city, Iran. Oldenburg Burnout Inventory (OLBI), Job stress questionnaire (JSQ), and questionnaires of hospital resources, family support, and measuring the fear of COVID-19 were used as research instruments.

RESULTS

The scores of job stress and burnout in the exposure group with COVID-19 infection were significantly higher than in the non-exposure group (p=0.006 and p=0.002, respectively). Although, in univariate linear regression, employment status (p=0.047), experience in taking care of patient confirmed or suspected with COVID-19 infection (p=0.006), hospital resources (p=0.047), and job stress (p < 0.001) were considered as significant risk factors for COVID-19-related burnout. In multivariate regression analysis, job stress (p=0.031, β=0.308) was considered as an only factor that has a significant relationship with COVID-19-related burnout.

CONCLUSIONS

The burnout level in frontline nurses was higher than other nurses, the most important influencing factor was the job stress. Regarding to negative effects of burnout on both physical and mental health nurses, it is suggested that a strong strategy be considered to reduce nurses' burnout to be able to control ongoing and future outbreaks successfully.

Short Index of Job Satisfaction: Validity evidence from Portugal and Brazil

Job satisfaction is an important construct that is known to be associated with workers' performance and wellbeing. As such, to properly measure it, one must use adapted measures that show adequate validity evidence for the desired context. Such measures should preferably be short to allow the parsimonious use of various measures/constructs in the same data collection. The aim of this paper is to adapt the Portuguese version for Brazil and Portugal of the Short Index of Job Satisfaction (SIJS). The SIJS is a psychometric instrument that measures job satisfaction through five items. A cross-sectional study was conducted with two multi-occupational workers samples, one from Brazil (n = 599) and one other from Portugal (n = 572). The SIJS presented good validity evidence based on its internal structure, namely dimensionality, reliability, and measurement invariance across countries and sexes. It also revealed to be positively correlated with work engagement, and quality of work life (convergent evidence). It also has shown to be negatively associated with burnout (discriminant evidence). The SIJS showed promising validity evidence. The SIJS can be useful to be used together with other instruments, due to its small number of items, producing data with good psychometric properties.