Using a Single Item to Measure Burnout in Primary Care Staff: A Psychometric Evaluation
Open accessAbstract
Background 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.Objective 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.Design Cross-sectional online survey.Participants 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.Main methods 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.Key results 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.Conclusions 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.
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- Authors
- Dolan, E. D., Mohr, D., Lempa, M., Joos, S., Fihn, S. D., Nelson, K. M., & Helfrich, C. D.
- Affiliations
- United States Department of Veterans Affairs (US)
- Boston University (US)
- Veterans Health Administration (US)
- Oregon Health & Science University (US)
- Corresponding author
- Helfrich, Christian D.
- Venue
- Journal of General Internal Medicine
- Published
- 2014-12-02
- Volume
- 30
- Issue
- 5
- Pages
- 582-587
- ISSN
- 0884-8734 (ISSN-L)
- 1525-1497
- PMC
- PMC4395610
- OpenAlex
- W2083946992
- Cited by
- 599
- References
- 45
- Citations by year
- 2026: 50 · 2025: 86 · 2024: 86 · 2023: 79 · 2022: 85 · 2021: 83 · 2020: 55 · 2019: 23 · 2018: 22 · 2017: 14 · 2016: 12 · 2015: 4
- FWCI
- 17.92
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of General Internal Medicine (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Veterans Affairs
- Office of Patient Care Services, Department of Veterans Affairs
- Topics
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Burnout
- Social Sciences › Psychology › Social Psychology › Stress and Burnout Research
- Keywords
- burnout, Maslach Burnout Inventory, emotional exhaustion, primary care staff, registered nurses, licensed practical nurses, Veterans Health Administration, psychometric validation, diagnostic accuracy, occupational health
- MeSH terms
- Adult, Burnout, Professional, Cross-Sectional Studies, Female, Hospitals, Veterans, Humans, Male, Middle Aged, Patient Care Team, Primary Health Care, Psychometrics, Stress, Psychological, United States, Reproducibility of Results, Prevalence, Logistic Models, Workload, Risk Assessment, Area Under Curve, Young Adult, Physicians, Primary Care
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