Using a Single Item to Measure Burnout in Primary Care Staff: A Psychometric Evaluation
Using a Single Item to Measure Burnout in Primary Care Staff: A Psychometric Evaluation
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DOI：
10.1007/s11606-014-3112-6
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发表时间：
2015-05-01
影响因子：
5.7
通讯作者：
Helfrich, Christian D.
中科院分区：
文献类型：
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作者：
Dolan, Emily D.;Mohr, David;Helfrich, Christian D.
职业倦怠影响着近一半的美国护士和医生，并与患者安全状况恶化等不良结局有关。最常见的职业倦怠衡量标准是经过充分验证的Maslach职业倦怠量表(MBI)。然而，MBI是专有的，需要支付许可费，这对常规或重复评估构成了挑战。将非专有的单项倦怠测量与MBI情绪衰竭(MBI：EE)子量表中已被确认为独立的倦怠测量的单个条目进行比较。横断面在线调查。初级保健提供者(PCP)、注册护士、临床助理(例如，有执照的执业护士(LPN)、医疗技术员)的样本，在2012年对退伍军人健康管理局的行政职员进行了调查。我们比较了MBI：EE的有效单项版本和医生工作生活研究中使用的非专有单项倦怠测量。计算Kappa统计量、敏感度和特异度、阳性预测值(PPV)和阴性预测值(NPV)以及受试者操作曲线下面积(AUC)。我们进行了按职业分层的分析，以确定两项指标之间相关性的稳定性。我们分析了5,404名参与者的回复，其中包括1,769名提供者和1,380名注册护士。在单一的MBI：EE项目上，职业倦怠的患病率为36.7%，在非专有的单一项目上，职业倦怠的患病率为38.5%。相对于MBI：EE，非专利单项测量的相关性为0.79，敏感性为83.2%，特异性为87.4%，AUC0.93(Se=0.004)。当按受试者的职业分层时，结果是相似的。一个非专有的单项测量可以作为跨职业的MBI：EE的可靠替代品。由于它是非专有的，易于解释，它比单项MBI具有后勤优势。
Burnout affects nearly half of all U.S. nurses and physicians, and has been linked to poor outcomes such as worse patient safety. The most common measure of burnout is the well-validated Maslach Burnout Inventory (MBI). However, the MBI is proprietary and carries licensing fees, posing challenges to routine or repeated assessment.To compare a non-proprietary, single-item burnout measure to a single item from the MBI Emotional Exhaustion (MBI:EE) subscale that has been validated as a standalone burnout measure.Cross-sectional online survey.A sample of primary care providers (PCPs), registered nurses, clinical associates (e.g., licensed practical nurses (LPNs), medical technicians), and administrative clerks in the Veterans Health Administration surveyed in 2012.We compared a validated one-item version of the MBI:EE and a non-proprietary single-item burnout measure used in the Physician Work Life Study. We calculated kappa statistics, sensitivity and specificity, positive predictive (PPV) and negative predictive values (NPV), and area under the receiver operator curve (AUC). We conducted analyses stratified by occupation to determine the stability of the correlation between the two measures.We analyzed responses from 5,404 participants, including 1,769 providers and 1,380 registered nurses. The prevalence of burnout was 36.7 % as measured on the single MBI:EE item and 38.5 % as measured on the non-proprietary single-item measure. Relative to the MBI:EE, the non-proprietary single-item measure had a correlation of 0.79, sensitivity of 83.2 %, specificity of 87.4 %, and AUC of 0.93 (se = 0.004). Results were similar when stratified by respondent occupation.A non-proprietary single-item measure served as a reliable substitute for the MBI:EE across occupations. Because it is non-proprietary and easy to interpret, it has logistical advantages over the one-item MBI.