Validation of Single-Item Screening Measures for Provider Burnout in a Rural Health Care Network

Eval Health Prof. 2016 Jun;39(2):215-25. doi: 10.1177/0163278715573866. Epub 2015 Feb 24.

Abstract

We validated three single-item measures for emotional exhaustion (EE) and depersonalization (DP) among rural physician/nonphysician practitioners. We linked cross-sectional survey data (on provider demographics, satisfaction, resilience, and burnout) with administrative information from an integrated health care network (1 academic medical center, 6 community hospitals, 31 clinics, and 19 school-based health centers) in an eight-county underserved area of upstate New York. In total, 308 physicians and advanced-practice clinicians completed a self-administered, multi-instrument questionnaire (65.1% response rate). Significant proportions of respondents reported high EE (36.1%) and DP (9.9%). In multivariable linear mixed models, scores on EE/DP subscales of the Maslach Burnout Inventory were regressed on each single-item measure. The Physician Work-Life Study's single-item measure (classifying 32.8% of respondents as burning out/completely burned out) was correlated with EE and DP (Spearman's ρ = .72 and .41, p < .0001; Kruskal-Wallis χ(2) = 149.9 and 56.5, p < .0001, respectively). In multivariable models, it predicted high EE (but neither low EE nor low/high DP). EE/DP single items were correlated with parent subscales (Spearman's ρ = .89 and .81, p < .0001; Kruskal-Wallis χ(2) = 230.98 and 197.84, p < .0001, respectively). In multivariable models, the EE item predicted high/low EE, whereas the DP item predicted only low DP. Therefore, the three single-item measures tested varied in effectiveness as screeners for EE/DP dimensions of burnout.

Keywords: Maslach Burnout Inventory; advanced practice nursing; physician assistants; physicians; professional burnout; validation studies.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Burnout, Professional / diagnosis*
  • Burnout, Professional / epidemiology
  • Cross-Sectional Studies
  • Depersonalization / diagnosis
  • Depersonalization / epidemiology
  • Emotions
  • Health Personnel / psychology*
  • Humans
  • Middle Aged
  • Personal Satisfaction
  • Physicians / psychology
  • Program Evaluation / methods
  • Resilience, Psychological
  • Rural Health Services*
  • Socioeconomic Factors
  • Surveys and Questionnaires / standards*