Tools and scales review

Maslach Burnout Inventory (MBI)

The Maslach Burnout Inventory (MBI) tool is the most commonly used measure of burnout among aged care workers, particularly those in residential settings. [1, 2] The MBI was developed to assess occupational burnout and includes subscales on emotional exhaustion, depersonalisation and personal achievement. [5] The MBI was found to have good validity and reliability properties. It has 16-22 items depending on which version is used and is scored using a 0-6 Likert scale (0 – never, 6 – everyday), relating to the frequency of experiencing the questions listed in tool. Higher scores reflect higher burnout risk. The MBI can be administered by anyone collecting the data for an organisation or can be self-administered. It takes approximately 10 minutes to complete. 

There are several versions that have been developed specific to different groups of population who may need to be assessed for burnout. [6] These include the MBI - Human Services Survey (MBI-HSS), MBI-HSS (MP) for medical personnel, MBI (ES) for educators, MBI- GS for general use and MBI-GS (S) for students. Among aged care workers, the MBI-GS and MBI - Human Services Survey (MBI-HSS) were the ones identified to be more appropriate to use.

Licensed copies of the MBI tools can be purchased via the Mind Garden website available here: https://www.mindgarden.com/117-maslach-burnout-inventory-mbi. 

Oldenburg Burnout Inventory (OLBI)

The Oldenburg Burnout Inventory (OLBI) is another tool that has been used to measure burnout among aged care workers in Australian residential settings. [1, 2] It includes subscales on exhaustion and disengagement but not necessarily occupation specific. [7] The OLBI was found to have good validity and reliability properties. It has 16 items and is scored using a 1-4 Likert scale (1- strongly agree, 4- strongly disagree). Some questions need to be reverse coded before calculating the total score. Higher scores indicate higher levels of burnout. The OLBI can be administered by anyone collecting the data for an organisation or can be self-administered.

The OLBI tool can be used free of charge and accessed here: http://www.goodmedicine.org.uk/sites/default/files/assessment%2C%20burnout%2C%20olbi.pdf 

A pilot tool to assess the perception of nursing staff about stress and burnout in Australian aged care settings

A pilot tool was developed to assess the perception of nursing staff in Australian aged care settings about stress and burnout. [8] The tool was found to have an overall good internal consistency for the stress or burnout subscales which include work environment, burnout, control, job satisfaction, psychosocial stressors and symptoms and personality/behaviour. It has 52 items and items are scored using a Likert Scale which varies in number depending on the item question. Higher scores indicate higher levels of stress and burnout. The tool was sent as questionnaire for respondents to complete. 

This pilot tool was part of a PhD project and can be accessed here: https://ris.cdu.edu.au/ws/portalfiles/portal/22700266/Thesis_CDU_42476_Skinner_V.pdf

Adapted COVI-Prim Survey

The Covi-Prim Survey was developed in Austria to investigate the role played by general practitioners (GPs) in the early phase of the COVID-19 pandemic, their challenges, concerns, and the strategies they have developed to cope with the pandemic. [9] The original version has a total of 58 items that covered eight demographic items, 48 closed items and two items requiring GPs to provide exact numbers. An adapted version of this survey was developed for use in the Australian residential aged care workforce (not only GPs). It has a total of 60 items that included a question about suffering from burnout. [10] The questions are answerable by yes, no or not applicable and some are open-ended questions. It was pre-tested for intelligibility of content and design by four Australian healthcare professionals and researchers. The survey tool was sent as a questionnaire for respondents to complete. 

The survey tool can be used free of charge and accessed here: https://www.ajan.com.au/index.php/AJAN/article/view/490

Burnout Measure (BM)

The Burnout Measure (BM) was developed to measure burnout in terms of exhaustion amongst diverse groups of occupations including health providers. [11] It was found to be a valid and reliable research instrument with high internal consistency and level of stability. It has 21 items scored on a seven-point scale, ranging from never to always and focused on individual's physical, emotional, and mental exhaustion. The higher the score, the higher level of exhaustion and burnout is experienced. 

The BM tool can be used free of charge and accessed here: https://www.wilmarschaufeli.nl/publications/Schaufeli/113.pdf

Copenhagen Burnout Inventory (CBI)

The Copenhagen Burnout Inventory (CBI) tool is a measure of burnout inspired by the Burnout Measure (BM) and the Maslach Burnout Inventory (MBI), where the core considerations are about fatigue and exhaustion. [12] The tool was found to have high validity and internal reliability. It has three subscales that include personal burnout, work-related burnout, and client-related burnout. It has 19 items and scored using a five-point Likert scale focused on the frequency (never to always) and the degree or magnitude (very low to very high degree) of experiencing the questions in the tool. The higher the scores reflect higher burnout levels.

The CBI tool can be used free of charge and accessed here: https://nfa.dk/da/Vaerktoejer/Sporgeskemaer/Sporgeskema-til-maaling-af-udbraendthed/Copenhagen-Burnout-Inventory-CBI

Hamburg Burnout Inventory (HBI)

The Hamburg Burnout Inventory (HBI) is a measure of burnout that aimed to address the shortfalls of the Maslach Burnout Inventory (MBI) and Burnout Measure (BM). [13] The tool was found to have adequate validity and reliability. It includes subscales on emotional exhaustion, distance, personal accomplishment, depressive reaction, helplessness, inner void, tedium, inability to unwind, overtaxing oneself and aggressive reaction. The tool has 40 items and no information about scoring is available.

Copies of the HBI tool can be purchased via the Burnout Institute of North Germany website available here:
https://www.burnout-institut.eu/

Maslach Burnout Toolkit for Medical Personnel

The Maslach Burnout Toolkit for Medical Personnel is a combination of the Maslach Burnout Inventory (MBI) and the Areas of Worklife Survey (AWS). [14] The toolkit measures both the extent and likely cause of burnout.

Licensed copies of the MBI tools can be purchased via the Mind Garden website available here:
https://www.mindgarden.com/329-maslach-burnout-toolkit-for-medical-personnel

Areas of Worklife Survey (AWS)

The Areas of Worklife Survey (AWS) evaluates the workers’ perceptions of workplace attributes that may determine if they experience work engagement or burnout. [15,16] The AWS is a short companion questionnaire to the MBI, with good reliability and validity across a diverse occupational settings. It includes subscales on workload, control, reward, community, fairness and values. The AWS has 29 items scored on a five-point Likert-scale, ranging from strongly disagree to strongly agree. The higher the score, the higher the degree of perceived alignment between the working conditions and the respondent’s preferences. 

Licensed copies of the AWS tools can be purchased via the Mind Garden website available here:
https://www.mindgarden.com/274-areas-of-worklife-survey 

Burnout Assessment Tool (BAT)

The Burnout Assessment Tool (BAT) was developed as measure of burnout appropriate for both individual and group assessment. [17] The BAT includes subscales on core dimensions of burnout (BAT-C; exhaustion, mental distance, cognitive impairment, emotional impairment) and secondary dimensions (BAT-S; psychological complaints, psychosomatic complaints). The tool was found to have good validity and moderate to high reliability. It has 33 items scored on a five-point Likert scale, from never to always. Higher scores reflect higher levels of burnout.

Copies of the BAT can be used free of charge and available here: 
Schaufeli WB, Desart S, De Witte H. Burnout Assessment Tool (BAT)-development, validity, and reliability. Int J Environ Res Public Health. 2020;17(24):9495. doi:10.3390/ijerph17249495

Burnout Measure – Short version

The Burnout Measure Short (BMS) version was developed for ease of use among practitioners and researchers measuring burnout. [18] It was based on the original version of the BM and includes concepts of the experience of burnout on person’s level of physical, emotional and mental exhaustion. It was found to be a valid and reliable measure of burnout. It has 10 items and scored on a seven-point frequency scale, ranging from never to always. Higher scores reflect higher levels of burnout.

Copies of the BMS can be used free of charge and available here: 
Malach-Pines A. The Burnout Measure, short version. Int J Stress Manag. 2005;12 (1): 78-88.

Shirom Melamed Burnout Measure (SMBM)

The Shirom Melamed Burnout Measure (SMBM) is a measure of burnout in relation to exhaustion of the individuals’ energetic coping resources. [19] The SMBM has subscales on physical fatigue (a feeling of tiredness and low energy), cognitive weariness (a feeling of reduced mental agility), and emotional exhaustion (a lack of energy to display empathy to others). The tool was found to have good validity and reliability. It has 14 items scored using a seven-point Likert scale, ranging from almost never to almost always. Higher scores indicate higher levels of burnout.

The SMBM tool can be used free of charge and accessed here: 
Melamed S, Kushnir T, Shirom A. Burnout and risk factors for cardiovascular diseases, Behav Med. 1992;18(2):53-60, doi: 10.1080/08964289.1992.9935172

Utrecht Burn-Out Scale (UBOS-A)

The Utrecht Burn-Out Scale (UBOS) is the Dutch version of the Maslach Burnout Inventory – General Survey (MBI-GS). [20] It has subscales of exhaustion, cynicism and professional efficacy and was found to have high reliability. The UBOS has 15 items scored on a seven-point Likert scale, ranging from never to daily. The higher the score, the higher the burnout levels. 

Refer to the MBI for items in the UBOS tool. Licensed copies of the MBI tools can be purchased via the Mind Garden website.

Burnout Self-Test

The Burnout Self-Test is an online test to check if one is experiencing burnout. [21] The test has not been tested for validity and reliability and therefore not to be used as a diagnostic measure of burnout. The test has 15 items scored on a five-point Likert scale, ranging from not at all to very often. Higher scores indicate burnout.

The Burnout Self-Test is available from Mind Tools free of charge: 
https://www.mindtools.com/auhx7b3/burnout-self-test

Brief Resilience Scale

The Brief Resilience Scale (BRS) is a measure of the ability to bounce back or recover after a stressful situation. [3] The BRS was found to be a reliable measure of resilience. It has six items scored on a five-point Likert scale, ranging from strongly disagree to strongly agree. Higher scores indicate higher resilience.

Copies of the BRS can be used free of charge and available in the What Works Wellbeing website: 

https://measure.whatworkswellbeing.org/measures-bank/brief-resilience-scale/

1. Bywood P, du Plessis K, Moo A, McMillan J. Fatigue and burnout in healthcare: Prevalence, impact and interventions. An Evidence Review on physical, mental and emotional fatigue in healthcare and social assistance workers [Internet]. WorkSafe Victoria; 2020 [cited 2022 Nov 29]. Available from: https://research.iscrr.com.au/__data/assets/pdf_file/0011/2725895/271_ER_Fatigue-FINAL-10.09.2020.pdf 
2. Adelson P, Fish J, Peters MDJ, Corsini N, Sharplin G, Eckert M. COVID-19 and workforce wellbeing: A survey of the Australian nursing, midwifery, and care worker workforce. A report prepared for the Australian Nursing and Midwifery Federation [Internet]. Adelaide, SA: University of South Australia; 2021 [cited 2022 Nov 23]. Available from: https://www.unisa.edu.au/contentassets/0429d3a6ea70464b80a0b37aa664aa0c/covid-19-and-workforce-wellbeing-survey_report_final.pdf   
3. Smith BW, Dalen J, Wiggins K, Tooley E, Christopher P, Bernard J. The Brief Resilience Scale: Assessing the ability to bounce back. Int J Behav Med. 2008;15(3):194-200. 
4. Guo YF, Luo YH, Lam L, Cross W, Plummer V, Zhang JP. Burnout and its association with resilience in nurses: A cross-sectional study. J Clin Nurs. 2018;27(1-2):441-449.Maslach C, Jackson S.E. The Measurement of experienced burnout. J. Organ. Behav. 1981; 2:99–113. doi: 10.1002/job.4030020205  
5. Maslach C, Jackson SE, Leiter MP, Schaufeli WB, Schwab RL. Maslach Burnout Inventory (MBI) [Internet]. Menlo Park, CA: Mind Garden; 2022 [cited 2022 Nov 23]. Available from: https://www.mindgarden.com/117-maslach-burnout-inventory-mbi.  
6. Demerouti E, Bakker AB, Vardakou I, Kantas A. The convergent validity of two burnout instruments. Eur J Psychol Assess. 2003;18:296–307. 
7. Skinner V, Agho K, Lee-White T, Harris J. The development of a tool to assess levels of stress and burnout. Aust J Adv Nurs. 2007;24(4):8-13.
8. Siebenhofer A, Huter S, Avian A, Mergenthal K, Schaffler-Schaden D, Spary-Kainz U, et al. COVI-Prim survey: Challenges for Austrian and German general practitioners during initial phase of COVID-19. PloS One. 2021;16(6): e0251736
9. Krzyzaniak N, Scott A, Bakhit M, Bryant A, Taylor M, Del Mar C. Impact of the COVID-19 pandemic on the Australian residential aged care facility (RACF) workforce. Aust J Adv Nurs. 2021;38(3).
10. Malakh-Pines A, Aronson E, Kafry D. Burnout: From tedium to personal growth. Washington, DC: Free Press; 1981.
11. Kristensen TS, Borritz M, Villadsen E, Christensen KB. The Copenhagen Burnout Inventory: A new tool for the assessment of burnout. Work Stress.2005;19:192–207. 
12. Burisch M. The Hamburg Burnout Inventory (HBI): Background and some early results [internet]. Hamburg, Germany; 2017 [cited 2022 Nov 29]. Available from: https://www.burnout-institut.eu/fileadmin/user_upload/HBI-REP_V2_FINAL.pdf  
13. Mind Garden. Maslach Burnout Tool [internet]. Menlo Park, CA: Mind Garden; 2022 [cited 2022 Nov 23]. Available from: https://www.mindgarden.com/184-maslach-burnout-toolkit 
14. Leiter M, Maslach C. Areas of worklife: A structured approach to organizational predictors of job burnout. In: Perrewe P, Ganster D, Editors. Emotional and Physiological Processes and Positive Intervention Strategies. Bingley, UK: Emerald Publishing; 2004. pp. 91-134. 
15. Leiter M, Maslach C. Areas of Worklife Survey [Internet]. Menlo Park, CA: Mind Garden; 2022 [cited 2022 Nov 23]. Available from: https://www.mindgarden.com/274-areas-of-worklife-survey 
16. Schaufeli WB, Desart S, De Witte H. Burnout Assessment Tool (BAT): Development, validity, and reliability. Int J Environ Res Public Health. 2020;17(24):9495. 
17. Malach-Pines A. The Burnout Measure, short version. Int J Stress Manag. 2005;12 (1): 78-88.
18. Shirom A, Melamed S. A comparison of the construct validity of two burnout measures in two groups of professionals. Int J Stress Manag. 2006;13:176–200. 
19. Schaufeli WB, van Dierendonck D. Utrechtse Burnout Schaal. Test handleiding [Utrecht Burnout Scale. Test Manual]. Lisse, The Netherlands: Swets Test Publishers; 2000.
20. Mind Tools. Burnout Self-Test [Internet]. Edinburgh: Mind Tools; 2022 [cited 2022 Nov 23]. Available from: https://www.mindtools.com/auhx7b3/burnout-self-test