Bai Mayangzong, Jing Tiantian, Li Sisi, Zhang Zhiruo
School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Sci Rep. 2025 Mar 21;15(1):9870. doi: 10.1038/s41598-025-93627-9.
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.
职业倦怠与医护人员的身心健康、社会功能和职业发展密切相关。心理问卷在评估医疗环境中的倦怠综合征方面已得到广泛认可并被广泛应用，例如，马氏倦怠量表-人类服务调查（MBI-HSS）。鉴于其篇幅较长且心理测量性能不一致，人们对MBI-HSS的核心综合征知之甚少，因此，本研究采用网络分析来填补这一研究空白。本研究的目的是重新审视MBI-HSS的心理测量性能，并探索其在中国医疗环境中的核心特征。邀请了当地一家综合医院的所有员工（共1925人）回答一系列调查，包括翻译后的中文MBI-HSS以及人口统计学和职业特征调查。原始样本（n = 1196；回复率 = 62.13%）通过随机分配数字（0对1）随机分为两个亚组。第一个亚组（n = 596）用于心理测量测试，第二个亚组（n = 600）用于量表交叉验证。使用总样本进行多组验证性因素分析（MCFA）以进行模型不变性测试。最后，采用网络分析来探索MBI-HSS的核心项目。所有分析均在SPSS 26.0、SPSS AMOS 26.0和R（版本4.4.1）中进行。翻译并修订后的中文MBI-HSS由三个因素（即情感耗竭、去个性化和个人成就感）组成，共20个项目（排除项目12和16），并表现出可接受的信度和效度。此外，MCFA结果确立了三因素20项目模型的结构不变性。在项目层面的网络分析中，项目13（即“我对工作感到沮丧”）表现出更大的预期影响力、接近中心性和中介中心性，而项目10（即“我变得更加冷漠”）表现出更强的预期影响力和接近中心性。此外，项目8（即“我感觉工作疲惫不堪”）具有最高的可预测性。本研究补充了中文MBI-HSS的心理特性，丰富了中国医疗人群中职业倦怠的现有知识。尽管MBI-HSS被广泛使用，但建议使用一个修订版，包含三个维度的20个项目。最重要的是，网络分析确定沮丧和（社交或情感）麻木不仁为中国医护人员职业倦怠最关键的综合征，这可能会启发新的干预和实践方向。还讨论了对工具改进的启示。
