Center of Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.
Institute of Work and Organizational Psychology, University of Neuchâtel, Neuchâtel, Switzerland.
Epidemiol Psychiatr Sci. 2021 Jan 13;30:e8. doi: 10.1017/S2045796020001134.
Occupational Burnout (OB) is currently measured through several Patient-Reported Outcome Measures (PROMs) and some of them have become widely used in occupational health research and practice. We, therefore, aimed to review and grade the psychometric validity of the five OB PROMs considered as valid for OB measure in mental health professionals (the Maslach Burnout Inventory (MBI), the Pines' Burnout Measure (BM), the Psychologist Burnout Inventory (PBI), the OLdenburg Burnout Inventory (OLBI) and the Copenhagen Burnout Inventory (CBI)).
We conducted systematic literature searches in MEDLINE, PsycINFO and EMBASE databases. We reviewed studies published between January 1980 and September 2018 following a methodological framework, in which each step of PROM validation, the reference method, analytical technics and result interpretation criteria were assessed. Using the COnsensus-based Standards for the selection of health Measurement Instruments we evaluated the risk of bias in studies assessing content and criterion validity, structural validity, internal consistency, reliability, measurement error, hypotheses testing and responsiveness of each PROM. Finally, we assessed the level of evidence for the validity of each PROM using the GRADE approach.
We identified 6541 studies, 19 of which were included for review. Fifteen studies dealt with MBI whereas BM, PBI, OLBI and CBI were each examined in only one study. OLBI had the most complete validation, followed by CBI, MBI, BM and PBI, respectively. When examining the result interpretation correctness, the strongest disagreement was observed for MBI (27% of results), BM (25%) and CBI (17%). There was no disagreement regarding PBI and OLBI. For OLBI and CBI, the quality of evidence for sufficient content validity, the crucial psychometric property, was moderate; for MBI, BM and PBI, it was very low.
To be validly and reliably used in medical research and practice, PROM should exhibit robust psychometric properties. Among the five PROMs reviewed, CBI and, to a lesser extent, OLBI meet this prerequisite. The cross-cultural validity of these PROMs was beyond the scope of our work and should be addressed in the future. Moreover, the development of a diagnostic standard for OB would be helpful to assess the sensitivity and specificity of the PROMs and further reexamine their validity.The study protocol was registered in PROSPERO (CRD 42019124621).
职业倦怠（OB）目前通过几种患者报告的结局测量（PROMs）进行测量，其中一些已广泛应用于职业健康研究和实践中。因此，我们旨在综述和评估被认为适用于心理健康专业人员的五种 OB PROMs 的心理测量学效度（职业倦怠量表（MBI）、皮恩斯倦怠量表（BM）、心理学家倦怠量表（PBI）、奥尔登堡倦怠量表（OLBI）和哥本哈根倦怠量表（CBI））。
我们在 MEDLINE、PsycINFO 和 EMBASE 数据库中进行了系统的文献检索。我们按照一个方法学框架审查了 1980 年 1 月至 2018 年 9 月期间发表的研究，在该框架中，评估了 PROM 验证的每个步骤、参考方法、分析技术和结果解释标准。使用共识基础的健康测量仪器选择标准，我们评估了评估内容和标准效度、结构效度、内部一致性、可靠性、测量误差、假设检验和每个 PROM 的反应性的研究的偏倚风险。最后，我们使用 GRADE 方法评估了每个 PROM 的效度的证据水平。
我们共确定了 6541 项研究，其中 19 项被纳入综述。15 项研究涉及 MBI，而 BM、PBI、OLBI 和 CBI 每项研究仅涉及一项。OLBI 的验证最完整，其次是 CBI、MBI、BM 和 PBI。在检查结果解释正确性时，MBI（27%的结果）、BM（25%）和 CBI（17%）观察到最强的不一致。PBI 和 OLBI 没有不一致。对于 OLBI 和 CBI，关键心理测量特性的充分内容效度的证据质量为中等；对于 MBI、BM 和 PBI，证据质量为非常低。
为了在医学研究和实践中有效且可靠地使用，PROM 应具有可靠的心理测量学特性。在综述的五个 PROM 中，CBI 和在较小程度上的 OLBI 满足这一前提。这些 PROM 的跨文化有效性超出了我们工作的范围，应在未来予以解决。此外，职业倦怠诊断标准的制定将有助于评估 PROM 的敏感性和特异性，并进一步重新检验其有效性。本研究方案已在 PROSPERO（CRD42019124621）中注册。
