Li Henry, Dance Erica, Poonja Zafrina, Colmers-Gray Isabelle
Faculty of Medicine and Dentistry, Department of Emergency Medicine, University of Alberta, Edmonton, AB, Canada.
Faculty of Medicine, Department of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada.
CJEM. 2025 Apr;27(4):260-267. doi: 10.1007/s43678-024-00849-3. Epub 2025 Feb 5.
Emergency physicians have the highest rates of burnout among all medical specialties. There is a need for accurate and reliable burnout assessment tools to monitor changes and assess the effects of interventions. However, existing tools are typically long and/or costly. We sought to validate an abbreviated Copenhagen Burnout Inventory among emergency physicians and trainees in Canada.
We conducted a planned secondary analysis of a national, cross-sectional survey of emergency physicians and trainees in Canada. Exploratory factor analysis was performed followed by confirmatory factor analysis. Kaiser's eigenvalues rule, a scree plot, and Horn's parallel analysis guided the number of factors to extract. Structural validity fit indices and internal consistency were compared to pre-specified cutoffs. Criterion validity was assessed compared to the full Copenhagen Burnout Inventory (burnout defined as mean ≥ 50/100).
One hundred eighty-two responses were randomly split into separate cohorts for exploratory factor analysis and confirmatory factor analysis. Data were confirmed to be statistically suitable for factor analysis. Using exploratory factor analysis, a ten-item, two-factor abbreviated Copenhagen Burnout Inventory was reached after removing items based on over correlation (≥ 0.80), cross-loading (≥ 75%), and low factor loading (< 0.60). In confirmatory testing, the abbreviated inventory had a good Comparative Fit Index (0.91) though did not meet cutoffs for the remaining fit indices. Internal consistency was 0.92 (95%CI 0.90-0.95). Using a cutoff of 33/50, sensitivity was 0.99, specificity was 0.82, and area under the ROC curve was 0.86.
With further validation, an abbreviated ten-item Copenhagen Burnout Inventory has potential to serve as a short, freely available burnout assessment tool among Canadian emergency physicians and trainees. This abbreviated inventory has evidence to support its internal consistency and criterion validity, albeit with inconsistent structural validity. Future validation with larger samples is required, with special attention paid to content validity, test-retest reliability, and correlation with important outcomes.
在所有医学专科中，急诊医生职业倦怠率最高。需要准确可靠的职业倦怠评估工具来监测变化并评估干预措施的效果。然而，现有工具通常冗长且/或成本高昂。我们试图在加拿大的急诊医生和实习医生中验证简化版哥本哈根职业倦怠量表。
我们对加拿大急诊医生和实习医生的一项全国性横断面调查进行了计划中的二次分析。先进行探索性因素分析，然后进行验证性因素分析。采用凯泽特征值法则、碎石图和霍恩平行分析来指导提取的因素数量。将结构效度拟合指数和内部一致性与预先设定的临界值进行比较。与完整的哥本哈根职业倦怠量表（职业倦怠定义为平均分≥50/100）相比，评估标准效度。
182份回复被随机分为不同队列用于探索性因素分析和验证性因素分析。数据经确认在统计学上适合进行因素分析。通过探索性因素分析，在基于过度相关（≥0.80）、交叉载荷（≥75%）和低因素载荷（<0.60）去除项目后，得到了一个包含十个项目的两因素简化版哥本哈根职业倦怠量表。在验证性测试中，简化版量表的比较拟合指数良好（0.91），但其余拟合指数未达到临界值。内部一致性为0.92（95%CI 0.90 - 0.95）。使用33/50的临界值，敏感性为0.99，特异性为0.82，ROC曲线下面积为0.86。
经过进一步验证，一个包含十个项目的简化版哥本哈根职业倦怠量表有可能成为加拿大急诊医生和实习医生中一种简短、免费可用的职业倦怠评估工具。该简化版量表有证据支持其内部一致性和标准效度，尽管结构效度不一致。未来需要用更大样本进行验证，特别关注内容效度、重测信度以及与重要结果的相关性。
