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The Maslach Burnout Inventory Manual
... An overall look at the correlations shows that the sufficiency condition seems to be met for the relationships between the ensemble of the need states and the ensemble of outcomes: need satisfaction states significantly positively correlate with well-being outcomes and negatively with ill-being outcomes, while need frustration Ill-being outcomes Participants were asked to report on their level of experienced work stress on a scale ranging from 1 (no stress) to 10 (extreme stress) based on the measure by Stanton et al. (2001). Participants rated their level of emotional exhaustion (five items; e.g., "I feel used up at the end of the workday") based on the Maslach Burnout Inventory (Maslach et al., 1996) on a scale ranging from 1 (never) to 7 (daily). 199, p <.01) are factors that must be low for employees to have a high level of work engagement, whereas autonomy frustration has no significant impact. ...
... Ill-being outcomes Participants rated their level of emotional exhaustion based on the Maslach Burnout Inventory (Maslach et al., 1996) as in the first study. Negative affect was assessed with the short form of the Positive and Negative Affect Scale (Thompson, 2007). ...
... Ill-being outcomes Participants rated their level of emotional exhaustion with the five items from the Maslach Burnout Inventory (Maslach et al., 1996) on a scale ranging from 1 (never) to 7 (daily) as in Studies 1 and 2. In addition, the same instrument and response scale were used to capture respondents' level of cynicism (five items; e.g., "I doubt the significance of my work") and sense of personal accomplishment (six items; e.g., "I have accomplished many worthwhile things in this job"; reversed coded). Participants also rated their experience of somatic symptoms using the Somatic Symptom Scale-8 (Gierk et al., 2014). ...
The purpose of the current study was to test the necessity of basic psychological needs within self-determination theory (SDT) for employee wellbeing. Utilizing necessary condition analysis across three samples (two cross-sectional and one longitudinal), we evaluate whether need satisfaction and need frustration of the basic psychological needs for autonomy, competence, and relatedness are essential for various indicators of well-being and ill-being among employees. The results, although varied across samples and outcomes, generally indicated that autonomy and competence constitute necessities for employee wellbeing. Specifically, both satisfaction and low frustration of autonomy were necessary for promoting well-being and avoiding ill-being, while low frustration of competence emerged as a consistent necessity across a broad spectrum of well-being indicators. In contrast, the need for relatedness did not consistently emerge as necessary across the studied outcomes but was identified as necessary for certain ones. Together these findings validate the necessity assumption of the basic psychological needs posited by SDT and illuminates the dual role of satisfaction and frustration for employee wellbeing.
... The concept of job burnout was first introduced by Freudenberger (1974), in order to describe physical and mental exhaustion among clinical workers. Later, the concept was further studied and expanded by two social psychologists, Maslach and Jackson (Maslach & Jackson, 1986, 1981. Maslach and Jackson (1986) defined burnout as "a syndrome of emotional exhaustion, depersonalisation, and reduced personal accomplishment that can occur among individuals who do "people work" of some kind" and established a multi-dimensional burnout (BO) model consisting of three dimensions: emotional exhaustion, depersonalization, and reduced personal accomplishment. ...
... Later, the concept was further studied and expanded by two social psychologists, Maslach and Jackson (Maslach & Jackson, 1986, 1981. Maslach and Jackson (1986) defined burnout as "a syndrome of emotional exhaustion, depersonalisation, and reduced personal accomplishment that can occur among individuals who do "people work" of some kind" and established a multi-dimensional burnout (BO) model consisting of three dimensions: emotional exhaustion, depersonalization, and reduced personal accomplishment. The emotional exhaustion dimension of BO refers to an individual's feeling of emotional tiredness and being overwhelmed by an excessive workload. ...
... Burnout in the sports setting was first introduced by Caccese and Mayerberg (1984) in their study assessing the levels of burnout in college athletic coaches. The early research on burnout in sport settings was primarily focused on coaches and sport practitioners, using the conceptualization of burnout proposed by Maslach and Jackson (1986). Later, when the scope of the burnout research extended to athletes, the issues concerning the appropriateness and use of Maslach and Jacksons' conceptualization in athlete burnout studies eventually led to the development of athlete-specific burnout measures (Goodger et al., 2007). ...
The psychological well-being of athlete–students during higher education is important in their healthy growth and adaptation to college and social life, and emotional intelligence is one of the key factors linked with psychological well-being. The present study aimed to investigate the relationship between emotional intelligence and psychological well-being among Turkish athlete–students in higher education studying physical education and sports. A total of 226 athlete–students studying physical education and sports participated in this study. The results of our mediation analysis revealed that emotional intelligence was positively related to psychological well-being. Additionally, the results indicated that self-efficacy and burnout act as partial mediators between emotional intelligence and psychological well-being. As a result, academic administrators and instructors should promote strategies that help athlete–students to gain better emotional intelligence skills, which may also help these students to cope with burnout and increase their self-efficacy, thus increasing their psychological well-being.
... As such, the reported prevalence of work-related burnout was recognized as high as 50% among neurosurgeons and neurosurgical trainees with only one-third of neurosurgical doctors recommending a career in neurosurgery [19,25,34,50]. As neurosurgical burnout studies mainly originates from North America and Great Britain, it remains to be established if these observations are generalizable for hospital practice in those cultural environments only or if they reflect general qualities of how neurosurgery is practiced [3,24,25,34,39,50]. Furthermore, previous burnout studies primarily utilized web-based questionnaires with frequently reported low response rates [34]. ...
... 'Burnout' was initially described by Maslach and Jackson as a composite of emotional exhaustion, depersonalization, and reduced personal accomplishment [21,23]. They constructed the "Maslach Burnout Inventory" (MBI) in order to identify and measure the condition [24]. The MBImeasure is somewhat problematic because of circularity and unclear use of how the aggregated composite could be interpreted [18]. ...
... In contrast, levels of patient-related burnout were similar (median 19.6% vs 21% in the current report). Most previous studies used the MBI [3,24,25,39]. MBI was earliest in use but was criticized for methodological problems including circularity and a confusing design with an aggregate composite. Also, the original MBI version defined burnout as a condition restricted to health-care workers [18], but the implementation of MBI in burnout literature reflects over 20 different applications [2,3,12,25,33,47,49]. CBI was constructed to solve the methodological issues and provide a more practical tool for burnout research, management, and, in contrast to MBI, CBI is freely available for use [18]. ...
Background
Burnout is a condition of mental, emotional, and physical enervation affecting personnel working in human services and has been reported high among neurosurgical doctors. However, previous burnout reports are based on low response rates and measured by the Maslach Burnout inventory, which for several reasons has proven problematic. Burnout has not previously been investigated among neurosurgical doctors in Denmark. With this study we measure the prevalence of burnout among neurosurgical doctors in Denmark with sustainable methodology and a clinically relevant burnout interpretation.
Methods
Burnout was measured among neurosurgical doctors in Denmark using the Copenhagen Burnout Inventory (CBI) consisting of three subscales measuring personal burnout, work-related burnout and patient-related burnout. To gain better understanding of factors contributing to burnout, the psychosocial working conditions and moral distress was measured using the Danish Psychosocial Work Environment Questionnaire (DPQ) and a questionnaire of eight items previously used to assess moral distress.
Results
With 73 responders and a response rate of 90.1%, clinically relevant burnout was reported in 27.4% in personal burnout, 16.5% in work-related burnout and 5.5% in patient-related burnout. Cohort members with children living at home experienced a significant higher degree of burnout regarding work-related burnout and patient-related burnout.
Within the DPQ domains of ‘Demands at work’ and ‘Work organization and job content’, several moderate to strong correlations were observed between specific sub-dimensions and both personal and work-related burnout. Higher levels of the domain ‘Interpersonal relations’ was moderately correlated with lower levels of both personal and work-related burnout. In the testing of moral distress, only 2 responders (2.7%) scored as ‘somewhat injured’.
Conclusion
Neurosurgical doctors in Denmark report relatively low prevalence of clinically relevant burnout. However, doctors with children living at home exhibited higher levels of work- and patient-related burnout. Our findings highlight the psychosocial work environment as a significant factor contributing to burnout, while moral distress appears to have a limited impact on the development of burnout in the study population.
... Our study used CBI to determine the prevalence of burnout among our respondents. Another prominent tool to assess burnout is the Maslach Burnout Inventory (MBI), which primarily focuses on three dimensions: emotional exhaustion, depersonalisation, and reduced personal accomplishment [33]. While the MBI provides valuable information, it has encountered criticism for its inadequacies in encapsulating the complex nature of burnout, especially in non-service professions [34,35]. ...
... Burnout is a syndrome associated with long-term fatigue, physical exhaustion, hopelessness, and helplessness in people who are exposed to intense emotional demands due to their job, and who constantly engage with other people, with negative attitudes towards work, life, and/ or other people [1]. In simple terms, burnout can be defined as emotional exhaustion, depersonalization, and low personal accomplishment seen in individuals who have an intense relationship with people as part of their job [2][3][4][5]. Exhaustion, cynicism, and the emotional beliefs around lack of self-efficacy form the triadic symptoms of student burnout [6] with its prevalence higher among medical students relative to those enrolled in other disciplines [7]. The demanding medical curricula expect a higher academic investment, placing a heavy workload on the student leading to burnout [8], and giving rise to certain patterns of behaviour such as self-criticism and demandingness that could manifest in obsessive or self-sabotaging behaviours further aggravating the symptoms of burnout [9]. ...
Introduction
Although curricula teaching skills related to resilience are widely adopted, little is known about needs and attitudes regarding resilience training of undergraduate-medical-trainees in Middle-East-and-North-Africa-region. The purpose of this study is to investigate the value of an innovative curriculum developed through design-based-research to build resilience-skills among undergraduate-medical-trainees in the United-Arab-Emirates.
Methods
Convergent-mixed-methods-study-design was utilized. Quantitative data collection was through controlled random group allocation conducted in one cohort of undergraduate medical students(n = 47). Students were randomly allocated into the respective resilience-skills-building-course(study-group) versus an unrelated curriculum(control-group). All students were tested at baseline(test-1), at end of 8-week course(test-2), and again 8 weeks after end of course(test-3). Then students crossed over to the opposite course and again tested at end of 8 weeks(test-4). Testing at four timepoints consisted of questionnaires related to burnout-Maslach-Burnout-Inventory; anxiety-General-Anxiety-Disorder-7; and resilience- Connor-Davidson-Resilience-Scale. Quantitative data were analysed descriptively and inferentially. Qualitative data, constituting of students’ perception of their experience with the course, was captured using virtual-focus-group-sessions. Qualitative analysis was inductive. Generated primary inferences were merged using joint-display-analysis.
Results
Significant proportion of the students, at baseline, seemed to be at risk for burnout and anxiety, and would benefit from developing their resilience. There appeared to be no statistical differences in measures of burnout, anxiety, and resilience related to course delivery. Overall risk for anxiety among students increased following the COVID-19 lockdown. Qualitative analysis generated the ‘Resilience-Skills’-Building-around-Undergraduate-Medical-Education-Transitions’ conceptual model of five themes: Transitions, Adaptation, Added Value of course, Sustainability of effects of course, and Opportunities for improving course. Merging of findings led to a thorough understanding of how the resilience-skills’-building-course affected students’ adaptability.
Conclusion
This study indicates that a resilience-skills’-building-course may not instantly affect medical trainees’ ratings of burnout, anxiety, and resilience. However, students likely engage with such an innovative course and its content to acquire and deploy skills to adapt to changes.
Introduction
Healthcare workers’ well-being is of utmost importance given persistent high rates of burnout, which also affects quality of care. Minority healthcare workers (MHCW) face unique challenges including structural racism and discrimination. There is limited data on interventions addressing the psychological well-being of MHCW. Thus, this systematic review aims to identify interventions specifically designed to support MHCW well-being, and to compare measures of well-being between minority and non-minority healthcare workers.
Methods
We searched multiple electronic databases. Two independent reviewers conducted literature screening and extraction. The Mixed Methods Assessment Tool (MMAT) or Joanna Briggs Institute (JBI) criteria were utilized to assess the methodological quality of studies, based on the study design. Total scores as percentages of criteria met were used to determine overall quality as low (<40%), moderate (40-80%), or high (>80%). For conflicts, consensus was reached through discussion. Meta-analysis was not possible due to heterogeneity of study designs.
Results
A total of 3,816 records were screened and 43 were included in the review. The majority of included studies (76.7%) were of moderate quality. There were no randomized control trials and only one study included a well-being intervention designed specifically for MHCW. Most (67.4%) were quantitative-descriptive studies that compared well-being measures between minority and non-minority identifying healthcare workers. Common themes identified were burnout, job retention, job satisfaction, discrimination, and diversity. There were conflicting results regarding burnout rates in MHCW vs non-minority workers with some studies citing protective resilience and lower burnout while others reported greater burnout due to compounding systemic factors.
Discussion
Our findings illuminate a lack of MHCW-specific well-being programs. The conflicting findings of MHCW well-being do not eliminate the need for supports among this population. Given the distinct experiences of MHCW, the development of policies surrounding diversity and inclusion, mental health services, and cultural competency should be considered. Understanding the barriers faced by MHCW can improve both well-being among the healthcare workforce and patient care.
Occupational well-being is inherent to physicians’ professional performance and is indispensable for a cost-effective, robust healthcare system and excellent patient outcomes. Increasing numbers of physicians with symptoms of burnout, depression, and other health issues are demonstrating the need to foster and maintain physicians’ well-being. Assessing physicians’ well-being, occupational demands, and resources can help create more supportive and health-promoting working environments. The WellNext Scan (WNS) is a 46-item questionnaire developed to assess (i) physicians’ well-being and (ii) relevant factors related to physicians’ clinical working environment. We collected data to investigate the validity and reliability of the WNS using a non-randomized, multicenter, cross-sectional survey of 467 physicians (staff, residents, doctors not in training, and fellows) from 17 departments in academic and non-academic teaching medical centers in the Netherlands. Exploratory factor analysis detected three composite scales of well-being (energy and work enjoyment, meaning, and patient-related disengagement) and five explanatory factors (supportive team culture, efficiency of practice, job control and team-based well-being practices, resilience, and self-kindness). Pearson’s correlations, item-total and inter-scale correlations, and Cronbach’s alphas demonstrated good construct validity and internal consistency reliability of the scales (α: 0.67–0.90; item-total correlations: 0.33–0.84; inter-scale correlations: 0.19–0.62). Overall, the WNS appears to yield reliable and valid data and is now available as a supportive tool for meaningful team-based conversations aimed at improving physician well-being.
Objective: To contextualize the Conscientiousness Index and determine the relationship between burnout and the Conscientiousness Index as a measure of professionalism in postgraduate students. Methods: This mixed-method study was done in two phases in Lahore from September 2023 to July 2024. The first phase involved contextualization of the Conscientiousness Index (CI) tool. A literature review, feedback from consultants and staff, identification of data sources, expert validation, and cognitive pretesting were conducted to contextualize the CI tool. In the second phase, a correlational study was done by collecting data using a purposive sampling technique (n=134). The CI scores were calculated from administrative records and clinical staff input. Burnout levels were assessed using the Maslach Burnout Inventory, which has three main constructs: Emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA). Burnout and CI scores were compiled and analyzed using SPSS v26.0. The t-test, one-way ANOVA, Chi-square test, and Pearson’s correlation were used for data analysis. Results: A six-item CI scale was contextualized with S-CVI (0.89) and CVR >0.62. Mild burnout was found in 63 (47%) participants, while 71 (53%) exhibited moderate-to-severe burnout. The overall mean CI score was 42.1 ± 5.96 (total score: 50). No significant association was found between burnout and CI scores. However, a moderate negative correlation was observed between EE and CI scores (r=-0.69), and a weak positive correlation (0.19) was found between PA and CI scores, which was statistically significant (p = 0.02). Conclusion: The CI tool had good validity in the local context. There was a high prevalence of burnout among postgraduate students. No statistically significant association was found between burnout severity and CI scores. However, a weak correlation was found between burnout domains and CI scores. Further research is required to understand this weak correlation and validation of CI tool in different settings. doi: https://doi.org/10.12669/pjms.41.3.10906 How to cite this: Tasneem S, Mahboob U, Baig LA, Khan RA. Contextualizing the Conscientiousness Index Tool and Correlating Burnout with Conscientiousness Index as a measure of Professionalism in Postgraduate Students. Pak J Med Sci. 2025;41(3):827-831. doi: https://doi.org/10.12669/pjms.41.3.10906 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Introduction Residency is a unique period in medical professional training, characterized by an imbalance between technical training and care requirements. Evidences have been showing that the rates of problems related to Mental Health are significant in this population and deserve attention.
Methods In this work, specific instruments (DASS-21 and Coping Strategies Inventory ) were used to assess symptoms related to depression, anxiety and stress, as well as coping strategies, among residents enrolled in programs at Fundação Hospital do Estado de Minas Gerais between 2021 and 2023.
Results 116 residents completed the assessment. The prevalence of depression reached 51.3% of the sample; anxiety 36.7%; and stress 56.5%. The presence of depressive, anxious or stress symptoms was correlated with the perception of worse sleep quality. Residents with depressive symptoms tended to adopt certain coping styles (confrontation, avoidance, escape and avoidance and positive reappraisal) differently from those without depression, as well as residents with anxiety or stress-related symptoms showed coping styles significantly different from those without symptoms. (confrontation, avoidance, acceptance of responsibility and escape and avoidance).
Conclusions A high prevalence of psychiatric symptoms was observed among residents, which correlated with poor sleep quality and specific coping strategies. These data can contribute to a better understanding of the phenomenon of mental illness among residents and to the creation of risk screening strategies, interventions and mental health promotion in medical residency programs.
Depression; anxiety; stress; coping; medical residents
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