The ultra-short version of the Burnout Assessment Tool (BAT4)-development, validation, and measurement invariance across countries, age and gender.

Given that burnout is a major problem in many societies and that employers are legally obliged to act in preventing job stress, there is a need of validated and reliable short self-report instruments. The Burnout Assessment Tool (BAT) is developed to measure burnout as a syndrome with four core components (exhaustion, mental distance, cognitive and emotional impairment). So far, the BAT was tested in over 40 studies with encouraging results. Although a short, 12-item version of the BAT exists, there is need for an ultra-short version with even less items. The overall aim is to develop an ultra-short 4-item version of the BAT (BAT4) and to evaluate its construct validity using Rasch analysis in samples from various countries along with its measurement invariance regarding country, age and gender. The BAT4 was developed using mixed methods, i.e. combining the results from a Rasch analysis, a subject matter analysis and expert judgements. Construct validity was tested on data from national representative samples from eight countries (the Netherlands, Belgium (Flanders), Austria, Czech Republic, Finland, Germany, Ireland, and Japan) and in a pooled sample combing the data from all eight countries. Differential item functioning regarding age, gender and country was investigated. The BAT4 fulfilled all the criteria required by the Rasch measurement model to constitute a valid measure in the pooled and country specific samples, except Austria and Japan. In the pooled sample, measurement invariance between the eight countries as well as between gender and age was found. Analyses within different countries showed occasional gender and age DIF for some items. The results were promising regarding BAT4's construct validity and measurement invariance. Although the BAT4 includes only four items, its content coverage is acceptable. The BAT4 can be used as a short screening instrument for burnout complaints at the group or organisational level.

The psychometric properties of the Burnout Assessment Tool in Norway: A thorough investigation into construct-relevant multidimensionality.

OBJECTIVE: The World Health Organization recognizes burnout as an occupational issue. Nevertheless, accurately identifying employee burnout remains a challenging task. To complicate matters, current measures of burnout have demonstrated limitations, prompting the development of the Burnout Assessment Tool (BAT). Given these circumstances, conducting an in-depth examination of the BAT's construct-relevant multidimensionality is crucial. METHOD: This study focuses on both the original 23-item BAT and the short 12-item version, using modern factor analytic methods to investigate reliability, validity, and measurement invariance in a representative sample from Norway (n = 493; 49.54% women). RESULTS: Our findings revealed that the bifactor exploratory structural equation modeling solution (burnout global factor and four specific burnout component factors) best explained the data for both BAT versions. All factors demonstrated adequate omega coefficients, with the global factor showing exceptional strength. Both BAT versions correlated highly with each other and with another burnout measure, suggesting convergent validity. Furthermore, both BAT versions achieved full (strict) measurement invariance based on gender. Finally, our results showed that burnout acts as a mediator in our proposed job demands-resources model as preliminary evidence of predictive validity. CONCLUSIONS: The study validates the Burnout Assessment Tool in the Norwegian context. The study supports the reliability, validity, and unbiased nature of the tool across genders. The findings also reinforce the importance of job demands and resources, along with burnout as a key mediator, in understanding workplace dynamics in accordance with job demands-resources theory.

The Polish adaptation of the Burnout Assessment Tool (BAT-PL) by Schaufeli et al. / Polska adaptacja Metody Oceny Wypalenia Zawodowego (BAT-PL) autorstwa Schaufeliego i wspólpracowników.

OBJECTIVES: The study aimed to present the Polish version of the Burnout Assessment Tool (BAT-PL) by W. Schaufeli et al. and to assess its validity and reliability. The tool measures the core symptoms of burnout (BAT-C): exhaustion, mental distance, cognitive and emotional impairment, and its secondary symptoms (BAT-S): psychosomatic complaints and psychological distress. METHODS: The participants were 255 nursing staff members. The construct validity was assessed with a one-point job satisfaction scale, the Utrecht Work Engagement Scale by Schaufeli et al. and the Job-related Affective Well-being Scale by van Katwyk et al. RESULTS: The results of the confirmatory factor analysis supported an assumed bi-factor structure. This applies to both BAT-C as the four core symptoms and a general factor and BAT-S as a set of two secondary symptoms and a general factor. Both scales were strongly correlated with one another and differed from other measures of job-related well-being (job satisfaction, work engagement and negative emotions). The values of Cronbach's alpha and composite reliability indicated BAT-PL as a reliable measurement tool. CONCLUSIONS: BAT-PL by W. Schaufeli et al. has good psychometric characteristics to be used in research on burnout and further validated in clinical practice.

The Greek Burnout Assessment Tool: Examining Its Adaptation and Validity.

Burnout is a significant challenge in the workplace. Its extent is global and its unfavourable consequences are diverse, affecting the individual, the organization, and society. The aim of the present study was to examine the adaptation and assess the validity of the Greek version of the Burnout Assessment Tool (BAT). The adaptation process included the translation and back-translation of the BAT. Data were collected from 356 Greek employees from diverse sectors. Confirmatory factor analysis and item response theory were utilized to assess the validity of the Greek version of the BAT. According to the findings of the present research, the core symptoms scale and the secondary symptoms scale of BAT-23 and BAT-12 models demonstrated adequate structures for the analysis and measurement of burnout in the Greek context. Finally, the psychometric performance of the BAT-GR-12 compared to the BAT-GR-23 establishes it as a more optimum instrument for the assessment of burnout across Greek working adults.

How to assess severe burnout? Cutoff points for the Burnout Assessment Tool (BAT) based on three European samples.

OBJECTIVE: Despite decades of burnout research, clinical validated cut-off scores that discriminate between those who suffer from burnout and those who don't are still lacking. To establish such cut-off scores, the current study uses a newly developed questionnaire, the Burnout Assessment Tool (BAT) that consists of four subscales (exhaustion, mental distancing, and emotional and cognitive impairment). Separate cut-offs were computed for those at risk for burnout and those suffering from severe burnout for the original BAT-23 as well as for the shortened BAT-12. METHODS: Relative operating characteristic (ROC) analyses were carried out using representative samples of healthy employees from The Netherlands (N=1370), Belgium (Flanders; N=1403) and Finland (N=1350). In addition, samples of employees who received a burnout diagnosis were used (N=335, 158 and 50, respectively). RESULTS: The diagnostic accuracy of the BAT (area under the curve) ranges from good to excellent with the exception of mental distancing, which is fair. The country-specific cut-off values as well as their specificity and sensitivity are comparable to those of the pooled sample. CONCLUSIONS: In addition to country-specific cut-offs, general cut-offs can be used tentatively in other similar countries, pending future replication studies. Caution is warranted for using cut-offs for mental distance as the sensitivity and specificity of this subscale is relatively poor. It is concluded that the BAT can be used in organizational surveys for identifying employees at risk for burnout and, in clinical treatment settings, for identifying those with severe burnout, keeping in mind the tentativeness of the present cut-offs.

The psychometric properties and measurement invariance of the Burnout Assessment Tool (BAT-23) in South Africa.

BACKGROUND: Burnout is an increasing public health concern that afflicts employees globally. The measurement of burnout is not without criticism, specifically in the context of its operational definition as a syndrome, also recently designated as such by the World Health Organisation. The Burnout Assessment Tool (BAT-23) is a new measure for burnout that addresses many of the criticisms surrounding burnout scales. The aim of this study is to determine the validity, reliability, and measurement invariance of the BAT-23 in South Africa. METHOD: A quantitative, cross-sectional survey, approach was taken (n = 1048). Latent variable modelling was implemented to investigate the construct-relevant multidimensionality that is present in the BAT. For measurement invariance, the configural, metric, scalar, and strict models were tested. RESULTS: The analyses showed that the hierarchical operationalisation of BAT-assessed burnout was the most appropriate model for the data. Specifically, a bifactor ESEM solution. Composite reliability estimates were all well above the cut-off criteria for both the global burnout factor and the specific factors. The measurement invariance tests showed that gender achieved not only strong invariance, but also strict invariance. However, ethnicity initially only showed strong invariance, but a test of partial strict invariance did show that the mean scores could be fairly compared between the groups when releasing certain constraints. CONCLUSIONS: The BAT-23 is a valid and reliable measure to investigate burnout within the Southern African context.

Italian Validation of the 12-Item Version of the Burnout Assessment Tool (BAT-12).

The Burnout Assessment Tool (BAT) has shown satisfactory validity evidence in several countries, with the 23-item version of the instrument reporting adequate psychometric properties also in the Italian context. This paper is aimed to present results from the Italian validation of the 12-item version of the BAT. Based on a sample of 2277 workers, our results supported the factorial validity of a higher-order model represented by 4 first-order factors corresponding to the core dimensions of burnout, namely exhaustion, mental distance, and emotional and cognitive impairment. The measure invariance of the BAT-12 between data collected before and during the COVID-19 pandemic was supported. However, ANCOVA results suggest a higher score on the second-order burnout factor on data collected during the COVID-19 pandemic in comparison with earlier data. In line with the JD-R model, the BAT-12 total score reported a positive association with job demands (i.e., workload, time pressure, and role conflict) and a negative association with job resources (i.e., job autonomy, coworkers' support) and personal resources (i.e., optimism, social self-efficacy, and task self-efficacy). Additionally, the BAT-12 showed a negative association with work engagement components (i.e., vigor, dedication, and absorption) and positive job attitudes (i.e., job satisfaction, affective commitment). All in all, our results identify the Italian version of the BAT-12 as a brief and reliable tool for measuring burnout among workers.

Shortening of the Burnout Assessment Tool (BAT)-from 23 to 12 items using content and Rasch analysis.

BACKGROUND: Burnout is related to huge costs, for both individuals and organizations and is recognized as an occupational disease or work-related disorder in many European countries. Given that burnout is a major problem it is important to measure the levels of burnout in a valid and reliable way. The Burnout Assessment Tool (BAT) is a newly developed self-report questionnaire to measure burnout. So far, studies concerning the psychometric properties of the original version of the Burnout Assessment Tool (BAT) including 23 items show promising results and suggest that the instrument can be used in many different settings. For various reasons there is a need of a shorter instrument. For example, burnout questionnaires are typically included in employee surveys to evaluate psychosocial risk-factors, which according to the European Occupational Safety and Health Framework Directive, should be carried out in organizations on a regular basis. The aims of this paper are to develop a shorter version of the BAT, including only 12 items (BAT12) and to evaluate its construct validity and differential item functioning regarding age, gender and country. METHODS: Using data from representative samples of working populations in the Netherlands and Belgium (Flanders) a shorter version of the BAT was developed by combining quantitative (Rasch analysis) and qualitative approaches (item content analysis and expert judgements). Construct validity of the new BAT12 was evaluated by means of Rasch analysis. RESULTS: In an iterative procedure, deleting one item from each subscale at each step, a short version of the BAT - BAT12 was developed. The BAT12 fulfils the measurement criteria according to the Rasch model after accounting for local dependency between items within each subscale. The four subscales can be combined into a single burnout score. CONCLUSION: The new BAT12 developed in the present study maintains the breath of item content of the original version of the BAT. The new BAT12 has sound psychometric properties. The scale works invariantly for older and younger, women and men and across two countries. A shorter version of the BAT is timesaving compared to the BAT23 and can be used in e.g. employee surveys.

Burnout Assessment Tool (BAT): Validity Evidence from Brazil and Portugal.

The Burnout Assessment Tool (BAT) has been gaining increased attention as a sound and innovative instrument in its conceptualization of burnout. BAT has been adapted for several countries, revealing promising validity evidence. This paper aims to present the psychometric properties of the Brazilian and Portuguese versions of the BAT in both the 23-item and 12-item versions. BAT's validity evidence based on the internal structure (dimensionality, reliability, and measurement invariance) and validity evidence based on the relations to other variables are the focus of research. A cross-sectional study was conducted with two non-probabilistic convenience samples from two countries (N = 3103) one from Brazil (nBrazil = 2217) and one from Portugal (nPortugal = 886). BAT's original structure was confirmed, and it achieved measurement invariance across countries. Using both classic test theory and item response theory as frameworks, the BAT presented good validity evidence based on the internal structure. Furthermore, the BAT showed good convergent evidence (i.e., work engagement, co-worker support, role clarity, work overload, and negative change). In conclusion, the psychometric properties of the BAT make this freely available instrument a promising way to measure and compare burnout levels of Portuguese and Brazilian workers.

Psychometric Properties of the Italian Version of the Burnout Assessment Tool (BAT).

The most popular instrument to measure burnout is the Maslach Burnout Inventory (MBI). Recently, to overcome some of the limitations of the MBI, a new instrument has been proposed, namely the Burnout Assessment Tool. The purpose of this study is to examine the psychometric properties of the Italian version of the BAT. This tool is comprised of a set of four core dimensions (BAT-C; i.e., exhaustion, mental distance, cognitive and emotional impairment) and two secondary symptom dimensions (BAT-S; i.e., psychological and psychosomatic complaints). Data were collected on a sample of 738 participants from heterogeneous sectors and professional roles. In the sample women were slightly overrepresented (52.9%), the participants had a mean age of 41.57 years (SD = 10.51) and a mean organizational tenure of 9.65 years (SD = 8.50). The reliability and factorial structure of the BAT-C and BAT-S, together with the convergent and discriminant validity of BAT-C and MBI were explored, as well as the incremental validity to the BAT-C, over and beyond the MBI. Our results confirmed the factorial validity of a two-factor second-order factor model (BAT-C and BAT-S) represented by 4 first-order factors in the case of BAT-C and 2 first-order factors for BAT-S. Results also attested that BAT-C explains additional variance of the BAT-S, above and beyond what is explained by the MBI-GS. All in all, this study provided evidence that the Italian version of BAT represents a reliable and valid tool for measuring burnout in the work context.

The Ecuadorian Version of the Burnout Assessment Tool (BAT): Adaptation and Validation.

This study aimed to adapt and show evidence of validity for the Ecuadorian version of the Burnout Assessment Tool (BAT) considering only its "core" dimensions. The adaptation process included its translation and back translation. For content validation, expert reviews and focus groups were carried out. A confirmatory factor analysis was used to identify the psychometric properties and dimensionality of the scale. The reliability of the scale was assessed through the alpha, omega and composite reliability indices. To carry out the study, the questionnaire was applied to a sample of workers with a high level of education in Ecuador. In total, 2237 respondents were considered in the analysis. The results showed that the hierarchical model for BAT-23 and its short version, the BAT-12 scale, is the most adequate structure for analysis of the construct in the Ecuadorian context. The reliability of the general factor of burnout and its dimensions, evaluated by composite reliability, omega and Cronbach's alpha, showed satisfactory indices. The findings obtained provide support for the reliability and validity of the Burnout Assessment Tool for the Ecuadorian context.

Burnout Assessment Tool (BAT)-Development, Validity, and Reliability.

This paper introduces a new definition for burnout and investigates the psychometric properties of the Burnout Assessment Tool (BAT). In a prior qualitative study, 49 practitioners were interviewed about their conceptualization of burnout (part 1). Using a dialectical approach, four core dimensions-exhaustion, mental distance, and impaired emotional and cognitive impairment-and three secondary dimensions-depressed mood, psychological distress, and psychosomatic complaints-emerged, which constitute the basis of the BAT. In the second study, the psychometric characteristics of the BAT were investigated in a representative sample of 1500 Flemish employees, focusing on factorial validity, reliability, and construct validity, respectively. Results demonstrate the assumed four-factor structure for the core dimensions, which is best represented by one general burnout factor. Contrary to expectations, instead of a three-factor structure, a two-factor structure was found for the secondary dimensions. Furthermore, the BAT and its subscales show adequate reliability. Convergent validity and discriminant validity with other burnout measures-including the MBI and OLBI-was demonstrated, as well as discriminant validity with other well-being constructs, such as work engagement and workaholism.

A Rasch analysis of the Burnout Assessment Tool (BAT).

Burnout as a concept indicative of a work-related state of mental exhaustion is recognized around the globe. Numerous studies showed that burnout has negative consequences for both individuals and organizations but also for society at large, especially in welfare states where sickness absence and work incapacitation are covered by social funds. This underlines the importance of a valid and reliable tool that can be used to assess employee burnout levels. Although the Maslach Burnout Inventory is by far the most frequently used questionnaire for assessing burnout, it is associated with several shortcomings and has been criticized on theoretical as well as empirical grounds. Thus, there is a need for an alternative questionnaire with a strong conceptual basis and proper psychometric qualities. This challenge has been taken up by introducing the Burnout Assessment Tool (BAT), according to which burnout is conceived as a work-related state of exhaustion among employees, characterized by extreme tiredness, reduced ability to regulate cognitive and emotional processes, and mental distancing. Given that the BAT is a new measure of burnout, its psychometric properties need to be evaluated. This paper focuses on an evaluation of the internal construct validity of the BAT using Rasch analysis in two random samples (n = 800, each) drawn from larger representative samples of the working population of the Netherlands and Flanders (Belgium). The BAT has sound psychometric properties and fulfils the measurement criteria according to the Rasch model. The BAT score reflects the scoring structure indicated by the developers of the scale and the BAT's four subscales can be summarized into a single burnout score. The BAT score also works invariantly for women and men, younger and older respondents, and across both countries. Hence, the BAT can be used in organizations for screening and identifying employees who are at risk of burnout.

Validation of the Japanese Version of the Burnout Assessment Tool.

The current study aimed to validate the Japanese version of the Burnout Assessment Tool (BAT-J), a new burnout measure. We conducted an Internet survey to confirm the validity and reliability of the BAT-J, using registered monitors from a Japanese survey company. The first-wave survey was conducted in May 2018, with 1,032 monitors. Of these, 498 participated in the second-wave survey in June 2018 to confirm 1-month test-retest reliability. We examined the factorial validity of the BAT-J core symptoms (BAT-JC) and BAT-J secondary symptoms (BAT-JS), as well as their reliability (internal consistency and test-retest reliability) and construct validity. Factorial validity was examined using confirmatory factor analyses and exploratory structural equation modeling bifactor analyses. Convergent and discriminant validity were examined using multitrait-multimethod frameworks well as the average variance explained. Exploratory structural equation modeling bifactor solutions for the BAT-JC, BAT-JS, and BAT-J demonstrated the best fit to the data. They also indicated that the general factor accounted for over two-thirds of the common variance explained. Internal consistency and test-retest reliability were confirmed. Convergent and internal discriminant validity of the BAT-JC were confirmed vis-ȧ-vis burnout, as assessed with the Maslach Burnout Inventory - General Survey. Moreover, external discriminant validity of the BAT-J was demonstrated for work engagement and workaholism. Finally, both BAT scales showed significant positive relationships with job demands and turnover intention. All validity results were in line with the job demands-resources model. The results of the current study provide the first evidence for the BAT-J's reliability and factorial and construct validity.

Measurement Invariance of the Burnout Assessment Tool (BAT) Across Seven Cross-National Representative Samples.

The aim of this study was to investigate the measurement invariance of the Burnout Assessment Tool (BAT) across seven cross-national representative samples. In this study, burnout was modeled as a second-order factor in line with the conceptual definition as a syndrome. The combined sample consisted of 10,138 participants from countries in Europe and Japan. The data were treated as ordered categorical in nature and a series of models were tested to find evidence for invariance. Specifically, theta parameterization was used in conjunction with the weighted least squares (mean- and variance adjusted) estimation method. The results showed supportive evidence that BAT-assessed burnout was invariant across the samples, so that cross-country comparison would be justifiable. Comparison of effect sizes of the latent means between countries showed that Japan had a significantly higher score on overall burnout and all the first-order factors compared to the European countries. The European countries all scored similarly on overall burnout with no significant difference but for some minor differences in first-order factors between some of the European countries. All in all, the analyses of the data provided evidence that the BAT is invariant across the countries for meaningful comparisons of burnout scores.

Testing Demands and Resources as Determinants of Vitality among Different Employment Contract Groups. A Study in 30 European Countries.

The aim of this study was to investigate the relative importance of four job demands and five job resources for employee vitality, i.e., work engagement and exhaustion, in three different employment groups: permanent, temporary and temporary agency workers. We employed data from the sixth European Working Conditions Survey (EWCS) collected in 2015 comprising 28,042 employees from 30 European countries. We used linear regression analyses and dominance analysis (DA). The results showed minor mean differences in work engagement and exhaustion and that temporary agency workers had the highest job insecurity and lowest job control. The associations between job resources and job demands, and work engagement and exhaustion of the groups, did not differ considerably. DA showed that in all three employment groups, job feedback made the strongest contribution to work engagement and workload to exhaustion. In addition, among the temporary agency workers, supervisor support contributed to work engagement and job control (negatively) to exhaustion more than in the other groups. This study suggests that the key determinants of vitality at work may be similar, regardless of contract, and that to have sustainably performing vital workers, organizations should focus on enabling job feedback and preventing high workload in all employment groups.

Trabalho e bem-estar: evidências da relação entre burnout e satisfação de vida / Work and well-being: evidence of the relation between burnout and life satisfaction / Trabajo y bienestar: evidencias de la relación entre burnout y satisfacción con la vida

Esse estudo visa investigar a relação entre Burnout e satisfação de vida em trabalhadores brasileiros pelo modelo teórico Job Demands-Resources (JDR), da Psicologia Positiva. Foram testadas as associações entre Burnout e demandas e recursos de trabalho, satisfação de vida e sintomas depressivos, em 986 participantes das cinco regiões brasileiras, entre 18 e 89 anos (M = 39, DP = 11,1), sendo 87,2% de mulheres. Os resultados demonstram que Burnout prediz sintomas depressivos e é consequente de altas demandas e baixos recursos laborais. O papel de mediação parcial da satisfação de vida se destaca quando associado aos recursos de trabalho, o que diminui a probabilidade de ocorrência do Burnout e sintomas depressivos associados. Conclui-se que recursos de trabalho e satisfação de vida são importantes fatores psicossociais de proteção ao Burnout, que influenciam indireta e negativamente sintomas depressivos. Contribuições desses achados para o trabalho e as organizações são discutidas no texto. (AU)

This study aims to investigate the relationship between burnout and life satisfaction in Brazilian workers through the Job Demands-Resources (JDR) theoretical model of Positive Psychology. The associations between burnout and job demands, job resources, life satisfaction and depressive symptoms were tested in 986 participants, 87.2% women, from the five Brazilian regions, aged between 18 and 89 years (M = 39, SD = 11.1). The results show that high job demands and low job resources are indirectly linked with depressive symptoms via burnout and low life satisfaction. The partial mediation role of life satisfaction stands out when associated with job resources, which reduces the likelihood of burnout and its association with depressive symptoms. It was concluded that job resources and life satisfaction are important psychosocial protective factors for burnout, which impacts indirectly and negatively on depressive symptoms. Contributions of these findings for work and organizations are discussed in the text. (AU)

Este estudio tiene como objetivo investigar la relación entre el burnout y la satisfacción con la vida en los trabajadores brasileños a través del modelo teórico Job Demand Resources (JDR), de la psicología positiva. Las asociaciones entre burnout y demandas y recursos laborales, satisfacción con la vida y síntomas depresivos fueron probadas en 986 participantes de las cinco regiones brasileñas, los participantes poseían edades entre 18 y 89 años (M = 39, DS = 11.1), siendo el 87.2% mujeres. Los resultados demuestran que el burnout predice síntomas depresivos motivados por las altas demandas y bajos recursos laborales. El papel de la mediación parcial de la satisfacción con la vida se destaca cuando se asocia con recursos laborales, lo que reduce la probabilidad de burnout y los síntomas depresivos asociados. Se concluye que los recursos laborales y la satisfacción con la vida son factores psicosociales importantes de protección contra el burnout, que influyen indirectamente y negativamente en los síntomas depresivos. Las contribuciones de estos hallazgos para el trabajo y las organizaciones se discuten en el artículo. (AU)

Good Relationships, Good Performance: The Mediating Role of Psychological Capital - A Three-Wave Study Among Students.

Academic Psychological Capital, or PsyCap, - a set of positive psychological resources encompassing hope, efficacy, resilience, and optimism - has begun to gain attention in academia, showing positive relationships with desirable academic outcomes. However, studies in the field have paid limited attention to the social factors that may increase PsyCap and therefore may lead to positive outcomes. In the present study, we examine whether academic PsyCap mediates between teacher-student relationships and academic performance as assessed by student's GPA, using a three-wave longitudinal design. Through structural equation modeling, as expected, a statistically significant indirect effect was found between teacher-student relationships and academic performance via academic PsyCap. Theoretical and practical implications of the results are discussed; strengths and weaknesses are mentioned; and future research directions are proposed.

Workaholism and negative work-related incidents among nurses.

The present study comprised 1,781 nurses who participated in an investigation about working conditions, sleep, and health. They answered a questionnaire about age, sex, marital status, children living at home, work hours per week, number of night shifts last year, and total sleep duration and that also included a validated instrument assessing workaholism. In addition, they were asked to report on eight items concerning negative work-related incidents (dozed off at work, dozed while driving, harmed or nearly harmed self, harmed or nearly harmed patients/others, and harmed or nearly harmed equipment). Logistic regression analyses identified several predictors of these specific incidents: Low age (dozed at work, harmed and nearly harmed self, harmed and nearly harmed equipment), male sex (harmed and nearly harmed self, nearly harmed equipment), not living with children (harmed patients/others), low percentage of full-time equivalent (nearly harmed self and harmed patients/others), number of night shifts last year (dozed off at work and while driving, nearly harmed patients/others) and sleep duration (inversely related to dozed off at work and while driving, nearly harmed self). However, the most consistent predictor of negative work-related incidents was workaholism which was positively and significantly associated with all the eight incidents.

The interplay between emotional exhaustion, common mental disorders, functioning and health care use in the working population.

OBJECTIVES: Previous research established that emotional exhaustion - the often assumed core dimension of burnout - diminishes job-related functioning, but knowledge of its association with functioning and health care utilization is largely lacking. Moreover, as exhaustion frequently co-occurs with mood and anxiety disorders (i.e. common mental disorders (CMD)), the question should be addressed whether these associations hold after adjustment for CMD, and whether CMD intensifies the burden of exhaustion. METHODS: Cross-sectional data was used from 2902 workers included in the third wave of the Netherlands Mental Health Survey and Incidence Study-2, a nationally representative face-to-face survey. Exhaustion was assessed with the exhaustion scale of the Maslach Burnout Inventory; work loss (including presenteeism and absenteeism) with the WHO Disability Assessment Schedule; and general functioning with the 36-item Short Form. Health care use is defined as ≥1 general or mental health care contact for mental health problems. Confounders included sociodemographics, job characteristics, CMD, and physical health. The Composite International Diagnostic Interview assessed CMD. RESULTS: Mild and severe exhaustion occurred in 14.9% and 2.3% of the workers, respectively, and was significantly associated with work loss, impaired emotional, physical and social functioning, and health care use, even after adjustment for confounders. Co-occurrence of CMD strengthened the association between exhaustion and work loss as well as impaired emotional and social functioning. CONCLUSIONS: Exhaustion is uniquely associated with work loss, impaired functioning and health care use. Moreover, co-occurring CMD intensified impairments in functioning. This stresses the need for clinical attention to the exhaustion dimension of burnout.