Unravelling critical burnout syndrome in Chinese hospitals a network analysis of the Maslach burnout inventory human services survey.

Job burnout is widely associated with health professionals' mental and physical health, social functions, and career development. Psychological questionnaires are well-established and widely applied in assessing burnout syndromes in medical settings, for example, the Maslach burnout inventory-human services survey (MBI-HSS). Granted its long format and inconsistent psychometric performances, little is known about the core syndromes of in MBI-HSS, therefore, this study adopted a network analysis to address this research gap. The purpose of this study was to revisit the psychometric performance of the MBI-HSS and to explore its core features in Chinese healthcare settings. All staffs (1925 in total) of a local comprehensive hospital were invited to respond to a battery of surveys containing the translated Chinese MBI-HSS, and demographic and occupational characteristics. The original sample (n = 1196; response rate = 62.13%) was randomly divided into two subgroups by assigning random numbers (0 vs. 1). The first subgroup (n = 596) was used for psychometric tests while the second subgroup (n = 600) was used for scale cross-validation. Multi-group confirmatory factor analysis (MCFA) was performed using the total sample for model invariance test. Finally, Network analysis was adopted to explore the core item(s) of MBI-HSS. All analyses were conducted in SPSS 26.0, SPSS AMOS 26.0 and R (version 4.4.1). The translated and revised Chinese MBI-HSS consisted of three factors (i.e., emotional exhaustion, depersonalization, and personal achievement) with 20 items (with items 12 and 16 excluded), and exhibited acceptable reliability and validity. Furthermore, the MCFA results established structural invariance for the three-factor 20-item model. In the item-level network analysis, item 13 (i.e., "I feel frustrated by my job") exhibits greater expected influence, closeness, and betweenness centrality, while item 10 (i.e., "I have become more callous") demonstrates stronger expected influence and closeness centrality. Additionally, item 8 (i.e., "I feel burned out from my work") has the highest predictability. This study added the psychological properties of the Chinese MBI-HSS and enriched the existing knowledge of job burnout in the Chinese healthcare populations. Despite its pervasive usage, a revised version of the MBI-HSS with 20 items in three dimensions were recommended. Most importantly, network analysis identified frustration and (social or emotional) insensitivity as the most critical syndromes of job burnout for Chinese healthcare professionals, which could inspire new intervention and practice directions. Implications for instrumental refinement was discussed as well.