Can the Maslach Burnout Inventory and Utrecht Work Engagement Scale be used to screen for risk of long-term sickness absence?

OBJECTIVES: To investigate the Maslach Burnout Inventory-General Survey (MBI-GS) and the Utrecht Work Engagement Scale (UWES) for their ability to identify non-sicklisted employees at increased risk of long-term sickness absence (LTSA). METHODS: One-year prospective cohort study including 4,921 employees participating in occupational health surveys in the period 2008-2010. The MBI-GS and UWES were part of the health survey questionnaire and LTSA in the year following the health survey was retrieved from an occupational health register. Associations of baseline MBI-GS and UWES scores with LTSA during 1-year follow-up were stratified by the cause (mental, musculoskeletal, and other somatic illness) of LTSA. Discrimination was assessed by the area (AUC) under the receiver operating characteristic curve and considered practically useful for AUC ≥0.75. RESULTS: During 1-year follow-up, 103 employees (2%) had LTSA due to mental (N = 43), musculoskeletal (N = 31), or other somatic (N = 29) illness. MBI-GS scores were positively and UWES scores negatively associated with mental LTSA, but not musculoskeletal or other somatic LTSA. Discrimination between employees at high and low risk of mental LTSA was moderate: AUC = 0.68 for the MBI-GS and AUC = 0.70 for the UWES. Discrimination did not improve when the MBI-GS and UWES were used simultaneously. CONCLUSION: The MBI-GS and UWES predicted future mental LTSA in non-sicklisted employees, but discrimination was not practically useful for identifying employees at high risk of LTSA. However, both instruments could be used to select employees for further assessment of mental LTSA risk.

Hacia un modelo espiral de las creencias de eficacia en el estudio del burnout y del engagement / Towards a spiral modelo f the efficacy beliefs in the study of burnour and engagement

En este estudio se pone a prueba el modelo espiral 'hacia arriba' y 'hacia abajo' de las creencias de eficacia en muestras de estudiantes universitarios (N=353) de los cuales 203 son españoles y 150 son belgas. Modelos de ecuaciones estructurales muestran apoyo empírico al modelo 'hacia abajo' del burnout como 'crisis de eficacia' y al modelo 'hacia arriba' de la eficacia como 'motor del engagement'. También los resultados muestran apoyo empírico a la mediación de la eficacia percibida entre el éxito pasado y los niveles actuales de burnout y de engagement; que a su vez predicen la autoeficacia en el éxito académico. Por otra parte, aunque distintos ANOVAs muestran diferencias significativas en función del país en algunas variables estudiadas, los análisis multigrupo con modelos de ecuaciones estructurales muestran la invarianza del modelo a través de ambas muestras. Finalmente, análisis estructurales en profundidad con la muestra de estudiantes belgas pone de manifiesto la necesidad de considerar también las creencias de 'ineficacia' en futuros estudios

In this study the Downward and Upward Spiral Model of efficacy beliefs is tested in two samples of Spanish (N=203) and Belgian (N=150) university students respectively. Results from Structural Equations Modeling showed empirical support for the Downward Spiral Model of burnout , which is considered as a "crisis of efficacy", and for the Upward Spiral Model of engagement, which as a 'boost of efficacy '. Results also show empirical support to the mediating role that efficacy beliefs play in the relationship between past success and burnout/engagement on the one hand, and self-efficacy beliefs about academic success on the other hand. Moreover, using multigroup analysis it was shown that the research model was invariant of across both samples

Fatigue in employees with diabetes: its relation with work characteristics and diabetes related burden.

AIMS: To examine the relations between work characteristics as defined by the Job Demand-Control-Support model (JDCS) (that is, job demands, decision latitude, and social support), diabetes related burden (symptoms, seriousness of disease, self care activities, and disease duration), and fatigue in employees with diabetes mellitus. METHODS: Employees (n = 292) aged 30-60 years, with insulin treated diabetes, filled in self administered questionnaires that assess the above mentioned components of the JDCS model and diabetes related burdens. RESULTS: Both work and diabetes related factors are related to fatigue in employees with diabetes. Regression analyses revealed that work characteristics explain 19.1% of the variance in fatigue; lack of support, and the interaction of job demands and job control contribute significantly. Diabetes related factors explain another 29.0% of the variance, with the focus on diabetes related symptoms and the burden of adjusting insulin dosage to circumstances. Fatigue is more severe in case of lack of social support at work, high job demands in combination with a lack of decision latitude, more burden of adjusting insulin dosage to circumstances, and more diabetic symptoms. Furthermore, regression analysis revealed that diabetic symptoms and the burden of adjusting the insulin dosage to circumstances are especially relevant in combination with high job demands. CONCLUSIONS: Both diabetes and work should be taken into consideration-by (occupational) physicians as well as supervisors-in the communication with people with diabetes.

Well-being of intensive care nurses (WEBIC): a job analytic approach.

AIMS OF THE STUDY: This paper presents the results of a validation study of the so-called well-being of intensive care nurses (WEBIC)-questionnaire that is designed to perform a detailed job analysis of intensive care unit (ICU) nurses' jobs. BACKGROUND: The WEBIC-questionnaire is based on modern sociotechnical systems theory, and distinguishes four integrated task categories: (1) operational, (2) organizing, (3) preparatory, and (4) supportive tasks. For each task, the WEBIC assesses (1) how demanding this task is, and (2) how satisfying the performance of this task is. Using the WEBIC, information is gathered about ICU nurses' qualitative workload, and typical job-related risks for ICU nurses' well-being at work can be mapped. METHODS: A cross-sectional survey on work and well-being of almost 2000 ICU-nurses in 13 different European areas was conducted. Exploratory factor analyses were performed to study the validity of the factorial structure of the WEBIC-questionnaire. The construct validity of the WEBIC-questionnaire was studied by performing hierarchical multiple regression analyses of the WEBIC-factors on two types of job-related well-being, i.e. burnout and general job satisfaction. RESULTS: Results of the exploratory factor analyses showed that the hypothesized four-factor structure of the WEBIC is confirmed by our data. Internal consistencies of the different factors varied from 0.77 to 0.91. Intensive care unit nurses' most central (operational) tasks turned out to pose the greatest demands, but also seemed to drive their satisfaction. With respect to the relationships between the four WEBIC-factors, and burnout and general job satisfaction, it was found that, especially for the satisfying tasks, significant relationships with these outcomes were found. CONCLUSION: The reliability and construct validity of the WEBIC-questionnaire can be considered satisfactory. Furthermore, the questionnaire provides a systematical and detailed coverage of ICU nurses' tasks. In relation to this, the questionnaire is not only useful for scientific purposes but also for practical use.

From inequity to burnout: the role of job stress.

This research examined burnout (i.e., emotional exhaustion, depersonalization, and lack of personal accomplishment) among 2 samples of Dutch teachers as a function of inequity and experienced job stress in 3 different exchange relationships (with students, colleagues, and the school). It was hypothesized that inequity would be linked to burnout through the stress resulting from this inequity. Analysis of a cross-sectional sample (N = 271) revealed that this was indeed the case. Findings were replicated longitudinally using an independent sample of 940 teachers. It is concluded that the often-reported effect of inequity on burnout can partly be interpreted in terms of elevated levels of job stress. Implications of the findings are discussed.

Burnout and engagement at work as a function of demands and control.

OBJECTIVES: The present study was designed to test the demand-control model using indicators of both health impairment and active learning or motivation. METHODS: A total of 381 insurance company employees participated in the study. Discriminant analysis was used to examine the relationship between job demands and job control on one hand and health impairment and active learning on the other. RESULTS: The amount of demands and control could be predicted on the basis of employees' perceived health impairment (exhaustion and health complaints) and active learning (engagement and commitment). Each of the four combinations of demand and control differentially affected the perception of strain or active learning. Job demands were the most clearly related to health impairment, whereas job control was the most clearly associated with active learning. CONCLUSIONS: These findings partly contradict the demand-control model, especially with respect to the validity of the interaction between demand and control. Job demands and job control seem to initiate two essentially independent processes, and this occurrence is consistent with the recently proposed job demands-resources model.

The job demands-resources model of burnout.

The job demands-resources (JD-R) model proposes that working conditions can be categorized into 2 broad categories, job demands and job resources. that are differentially related to specific outcomes. A series of LISREL analyses using self-reports as well as observer ratings of the working conditions provided strong evidence for the JD-R model: Job demands are primarily related to the exhaustion component of burnout, whereas (lack of) job resources are primarily related to disengagement. Highly similar patterns were observed in each of 3 occupational groups: human services, industry, and transport (total N = 374). In addition, results confirmed the 2-factor structure (exhaustion and disengagement) of a new burnout instrument--the Oldenburg Burnout Inventory--and suggested that this structure is essentially invariant across occupational groups.

Burnout and inequity among human service professionals: a longitudinal study.

In a composite sample of human service professionals (N = 245), longitudinal relations across 1 year were tested between equity in the professional-recipient relationship and burnout (i.e., emotional exhaustion, depersonalization, and reduced personal accomplishment). The 1st research question was whether inequity influenced burnout across time. The 2nd research question was whether longitudinal relations between equity and burnout were curvilinear, as predicted by equity theory. The results confirmed that inequity affects the central component of burnout (i.e., emotional exhaustion) and that this relation is curvilinear. Feeling more deprived and feeling more advantaged resulted in higher future emotional exhaustion levels. No indication was found for a longitudinal relation between inequity and depersonalization. A synchronous relation was found suggesting that personal accomplishment influences equity.

Job burnout.

Burnout is a prolonged response to chronic emotional and interpersonal stressors on the job, and is defined by the three dimensions of exhaustion, cynicism, and inefficacy. The past 25 years of research has established the complexity of the construct, and places the individual stress experience within a larger organizational context of people's relation to their work. Recently, the work on burnout has expanded internationally and has led to new conceptual models. The focus on engagement, the positive antithesis of burnout, promises to yield new perspectives on interventions to alleviate burnout. The social focus of burnout, the solid research basis concerning the syndrome, and its specific ties to the work domain make a distinct and valuable contribution to people's health and well-being.

Introduction to special issue on burnout and health.

Abstract In recent years, the issue of occupational stress and burnout have received increasing research attention. Given the amount of time people spend on work-related activities and the central importance of work to one's sense of identity and self-worth, it is not surprising that occupational stress is regarded as a central area of study. Although burnout is linked to the extensive literature on occupational health, burnout goes beyond occupational health by focusing on specific stressors in the workplace to emphasize total life and environmental pressures affecting health.

on the clinical validity of the maslach burnout inventory and the burnout measure.

Abstract Current knowledge about burnout suffers from a healthy worker bias since only working - and thus relatively healthy - employees have been investigated. The main objective of this study is to examine - for the first time among employees who sought psychological treatment - the validity of the two most widely used burnout instruments; the Maslach Burnout Inventory (MBI) and the Burnout Measure (BM). Two groups were distinguished: a "burned out" group (n = 71) that suffers from work-related neurasthenia (according to ICD-10 criteria), and a "non-burned out" group (n = 68). Results show that: (1) the validity of the three-factor structure of the MBI and the BM is confirmed; (2) burnout can partly be differentiated from other mental syndromes (e.g., anxiety and depression); and (3) two MBI-scales (Emotional Exhaustion and Depersonalization) and one BM-scale (Exhaustion) are able to discriminate between burned out and non-burned out employees. The practical implications of these results are discussed.

A model of burnout and life satisfaction amongst nurses.

This study, among 109 German nurses, tested a theoretically derived model of burnout and overall life satisfaction. The model discriminates between two conceptually different categories of working conditions, namely job demands and job resources. It was hypothesized that: (1) job demands, such as demanding contacts with patients and time pressure, are most predictive of exhaustion; (2) job resources, such as (poor) rewards and (lack of) participation in decision making, are most predictive of disengagement from work; and (3) job demands and job resources have an indirect impact on nurses' life satisfaction, through the experience of burnout (i.e., exhaustion and disengagement). A model including each of these relationships was tested simultaneously with structural equations modelling. Results confirm the strong effects of job demands and job resources on exhaustion and disengagement respectively, and the mediating role of burnout between the working conditions and life satisfaction. These findings contribute to existing knowledge about antecedents and consequences of occupational burnout, and provide guidelines for interventions aimed at preventing or reducing burnout among nurses.

Effort-reward imbalance and burnout among nurses.

This study among a sample of 204 German nurses tested the hypothesis that an imbalance of high extrinsic efforts spent (i.e. job demands) and low extrinsic rewards obtained (e.g. poor promotion prospects) are associated with the burnout syndrome: the depletion of nurses' emotional resources. The results of a series of analyses of variances confirmed this hypothesis, by showing that those nurses who experienced an effort-reward imbalance (ERI) reported higher levels on two of the three core dimensions of burnout (i.e. emotional exhaustion and depersonalization) than those who did not experience such an imbalance. Moreover - as additionally hypothesized - significant interaction effects indicated that burnout (i.e. emotional exhaustion and reduced personal accomplishment) was particularly prevalent among those nurses who experienced ERI and put relatively high intrinsic effort into their jobs, as reflected by their strong tendency to be personally in control over job conditions.

A Canadian-Dutch comparison of teachers' burnout.

Scores on burnout among 631 Canadian and 1,180 Dutch teachers were compared with various demographic variables (sex and age) and factors related to work (experience in teaching, type of school, and number of hours employed). Burnout was assessed with the Maslach Burnout Inventory of three dimensions, Emotional Exhaustion, Depersonalization, and Personal Accomplishment. Analysis indicated that, over-all, Canadian teachers reported higher scores on Emotional Exhaustion and Depersonalization than their Dutch peers. Differences in the number of hours employed were also significant: full-time Canadian teachers scored higher on Depersonalization than their Dutch colleagues. Across countries, sex and type of school appeared significantly related to burnout. Male teachers rated higher on Emotional Exhaustion and Depersonalization than the women. Especially with regard to the attitudinal components of burnout, i.e., Depersonalization and Personal Accomplishment, secondary school teachers reported higher scores than elementary school teachers. Age was not significantly related to measures.

Youth unemployment and mental health: some Dutch findings.

Two hypotheses were investigated: (1) the causation hypothesis that assumes that unemployment leads to poor mental health and (2) the selection hypothesis that assumes that poor mental health reduces the likelihood of finding a job. A prospective longitudinal design was used in order to study two Dutch samples: 635 college graduates and 767 school-leavers. The causation hypothesis was confirmed for school-leavers but not for college graduates. In addition, as expected, employment and further education increased levels of mental health among school-leavers. The selection hypothesis, that unfortunately could only be studied in the graduate sample, was not confirmed as far as mental health was concerned. However, it appeared that future employment among graduates was predicted by a positive attitude and an active way of dealing with unemployment. Results are interpreted with reference to the favourable Dutch structural and cultural context that existed at the time the research was conducted. In addition, the role of proactivity is discussed.

A cautionary note about the cross-national and clinical validity of cut-off points for the Maslach Burnout Inventory.

In the present study, burnout scores of three samples, as measured with the Maslach Burnout Inventory, were compared: (1) the normative American sample from the test-manual (N = 10,067), (2) the normative Dutch sample (N = 3,892), and (3) a Dutch outpatient sample (N = 142). Generally, the highest burnout scores were found for the outpatient sample, followed by the American and Dutch normative samples, respectively. Slightly different patterns were noted for each of the three components. Probably sampling bias, i.e., the healthy worker effect, or cultural value patterns, i.e., femininity versus masculinity, might be responsible for the results. It is concluded that extreme caution is required when cut-off points are used to classify individuals by burnout scores; only nation-specific and clinically derived cut-off points should be employed.

The evaluation of a burnout workshop for community nurses.

This study evaluates the effects of a burnout workshop that was conducted for community nurses (N = 64). The workshop included relaxation training, didactic and cognitive stress management, interpersonal skills training, and the enhancement of a more realistic professional role. The nurses' symptom levels (i.e., emotional exhaustion, tedium, psychological strain, and somatic complaints decreased significantly. However no significant changes were observed in the attitudinal component of burnout: the nurses' negative attitudes toward their recipients (depersonalization) and toward their performance on the job (reduced personal accomplishment) did not decrease. In addition, personality (i.e., the nurses' level of reactivity) played a moderating role: low reactive nurses who, by definition, are rather resistant to stress benefited more from the workshop than did high reactive nurses who are less resistant to stress. Since no control group was included, the results of this study are tentative and should be confirmed by future research.

Stability and change in psychological distress and their relationship with self-esteem and locus of control: a dynamic equilibrium model.

The proposed model assumes (a) that each person has a stable and characteristic symptom level, (b) that external events act to deflect symptom levels from this stable level, and (c) that adaptive mechanisms tend to normalize these deviations. The model is used to examine (a) the dynamics of psychological distress (PD), (b) the role of personality traits (i.e., self-esteem and locus of control), and (c) the contamination of these traits by the current level of PD. The analyses show that the structural model adequately fits data of 2 longitudinal community studies. Two thirds of the variance in distress could be attributed to differences in stable symptom levels, leaving 1/3 for environmental change agents. Both personality traits were substantially contaminated by PD levels. Finally, high symptom levels were strongly related to low self-esteem and external control. The applications of the model and the origins of stability and change in PD are discussed.