Burnout among midwives-the factorial structure of the burnout assessment tool and an assessment of burnout levels in a Swedish national sample

Emina Hadžibajramović; Malin Hansson; Magnus Akerstrom; Anna Dencker; Gunnel Hensing

doi:10.1186/s12913-022-08552-8

Burnout among midwives-the factorial structure of the burnout assessment tool and an assessment of burnout levels in a Swedish national sample

BMC Health Serv Res. 2022 Sep 16;22(1):1167. doi: 10.1186/s12913-022-08552-8.

Authors

Emina Hadžibajramović^{1

2}, Malin Hansson³, Magnus Akerstrom^{4

5}, Anna Dencker³, Gunnel Hensing⁵

Affiliations

¹ Institute of Stress Medicine, Region Västra Götaland, Gothenburg, Sweden. Emina.hadzibajramovic@vgregion.se.
² School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden. Emina.hadzibajramovic@vgregion.se.
³ Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
⁴ Institute of Stress Medicine, Region Västra Götaland, Gothenburg, Sweden.
⁵ School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.

Abstract

Background: Many workplaces, within the healthcare sector, experience high rates of mental health problems such as burnout, anxiety, and depression, due to poor psychosocial working conditions and midwives are not an exception. To develop preventive interventions, epidemiologic surveillance of burnout levels, and their relation to professional specific working conditions is needed. Aims of this study is to assess the construct validity of the Burnout Assessment Tool (BAT) in the context of Swedish midwives, to evaluate whether the item responses can be combined into a single score and differential item functioning regarding age. Another aim was to assess the burnout levels of Swedish midwives.

Methods: Data come from a national cohort of Swedish midwives (n = 1664). The construct validity was evaluated using Rasch analysis. Burnout levels were presented by median and first (Q1) and third (Q3) quartiles for the BAT total score and the four subscales (exhaustion, mental distance, cognitive and emotional impairment).

Results: In the analysis including all 23 items the fit to the Rasch model was not obtained. Items within each subscale clustered together in a residual correlation matrix in a pattern consistent with the underlying conceptualization of the BAT, indicating multidimensionality. The Rasch analysis was re-run using the four testlets as input variables which resulted in a good fit. The median burnout level was 2.0 (Q1 = 1.6, Q3 = 2.4). The four subscales differentiated the picture (elevated levels on exhaustion and low levels on the other three subscales).

Conclusions: The construct validity of the BAT for use in the context of Swedish midwives was confirmed. The results indicated a strong general factor, meaning that the responses can be combined into a single burnout score. The scale works invariantly for different age groups. The results of this study secure access to a validated instrument to be used for accurate assessment of the burnout levels among midwives in Sweden.

Keywords: BAT; Burnout; Burnout Assessment Tool; Midwives; Rasch analysis.

MeSH terms

Burnout, Professional* / diagnosis
Burnout, Professional* / epidemiology
Burnout, Professional* / psychology
Burnout, Psychological
Female
Humans
Midwifery*
Pregnancy
Surveys and Questionnaires
Sweden / epidemiology