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      Internal construct validity of the Shirom-Melamed Burnout Questionnaire (SMBQ)

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          Abstract

          Background

          Burnout is a mental condition defined as a result of continuous and long-term stress exposure, particularly related to psychosocial factors at work. This paper seeks to examine the psychometric properties of the Shirom-Melamed Burnout Questionnaire (SMBQ) for validation of use in a clinical setting.

          Methods

          Data from both a clinical (319) and general population (319) samples of health care and social insurance workers were included in the study. Data were analysed using both classical and modern test theory approaches, including Confirmatory Factor Analysis (CFA) and Rasch analysis.

          Results

          Of the 638 people recruited into the study 416 (65%) persons were working full or part time. Data from the SMBQ failed a CFA, and initially failed to satisfy Rasch model expectations. After the removal of 4 of the original items measuring tension, and accommodating local dependency in the data, model expectations were met. As such, the total score from the revised scale is a sufficient statistic for ascertaining burnout and an interval scale transformation is available. The scale as a whole was perfectly targeted to the joint sample. A cut point of 4.4 for severe burnout was chosen at the intersection of the distributions of the clinical and general population.

          Conclusion

          A revised 18 item version of the SMBQ satisfies modern measurement standards. Using its cut point it offers the opportunity to identify potential clinical cases of burnout.

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          Most cited references15

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          Burnout and risk of cardiovascular disease: evidence, possible causal paths, and promising research directions.

          Burnout is characterized by emotional exhaustion, physical fatigue, and cognitive weariness, resulting from prolonged exposure to work-related stress. The authors review the accumulated evidence suggesting that burnout and the related concept of vital exhaustion are associated with increased risk of cardiovascular disease and cardiovascular-related events. The authors present evidence supporting several potential mechanisms linking burnout with ill health, including the metabolic syndrome, dysregulation of the hypothalamic-pituitary-adrenal axis along with sympathetic nervous system activation, sleep disturbances, systemic inflammation, impaired immunity functions, blood coagulation and fibrinolysis, and poor health behaviors. The association of burnout and vital exhaustion with these disease mediators suggests that their impact on health may be more extensive than currently indicated. Copyright 2006 APA, all rights reserved.
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            Detecting and evaluating the impact of multidimensionality using item fit statistics and principal component analysis of residuals.

            V. Smith (2001)
            The purpose of this research is twofold. First is to extend the work of Smith (1992, 1996) and Smith and Miao (1991, 1994) in comparing item fit statistics and principal component analysis as tools for assessing the unidimensionality requirement of Rasch models. Second is to demonstrate methods to explore how violations of the unidimensionality requirement influence person measurement. For the first study, rating scale data were simulated to represent varying degrees of multidimensionality and the proportion of items contributing to each component. The second study used responses to a 24 item Attention Deficit Hyperactivity Disorder scale obtained from 317 college undergraduates. The simulation study reveals both an iterative item fit approach and principal component analysis of standardized residuals are effective in detecting items simulated to contribute to multidimensionality. The methods presented in Study 2 demonstrate the potential impact of multidimensionality on norm and criterion-reference person measure interpretations. The results provide researchers with quantitative information to help assist with the qualitative judgment as to whether the impact of multidimensionality is severe enough to warrant removing items from the analysis.
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              Burnout and risk factors for cardiovascular diseases.

              The burnout syndrome denotes a constellation of physical fatigue, emotional exhaustion, and cognitive weariness resulting from chronic stress. Although it overlaps considerably with chronic fatigue as defined in internal medicine, its links with physical illness have not been systematically investigated. This exploratory study, conducted among 104 male workers free from cardiovascular disease (CVD), tested the association between burnout and two of its common concomitants--tension and listlessness--and cardiovascular risk factors. After ruling out five possible confounders (age, relative weight, smoking, alcohol use, and sports activity), the authors found that scores on burnout plus tension (tense-burnout) were associated with somatic complaints, cholesterol, glucose, triglycerides, uric acid, and, marginally, with ECG abnormalities. Workers scoring high on tense-burnout also had a significantly higher low density lipoprotein (LDL) level. Conversely, scores on burnout plus listlessness were significantly associated with glucose and negatively with diastolic blood pressure. The findings warrant further study of burnout as a predictor of cardiovascular morbidity and mortality.
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                Author and article information

                Journal
                BMC Public Health
                BMC Public Health
                BioMed Central
                1471-2458
                2012
                3 January 2012
                : 12
                : 1
                Affiliations
                [1 ]Institute of Neuroscience and Physiology, Department of clinical neuroscience and rehabilitation, The Sahlgrenska Academy, University of Gothenburg, Per Dubbsgatan 14, plan 3, 413 45 Göteborg, Sweden
                [2 ]Institute of Stress Medicine (ISM), Gothenburg, Sweden
                [3 ]Rural Health Academic Centre, University of Melbourne, Melbourne, VIC, Australia
                [4 ]Department of Public Health and Community Medicine at the Sahlgrenska Academy, University of Gothenburg, Sweden
                Article
                1471-2458-12-1
                10.1186/1471-2458-12-1
                3307433
                22214479
                81024534-ef2a-46cd-9679-e19b8729feb3
                Copyright ©2011 Åsa et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 31 May 2011
                : 3 January 2012
                Categories
                Research Article

                Public health
                stress,smbq,rasch,psychometrics,work,exhaustion disorder
                Public health
                stress, smbq, rasch, psychometrics, work, exhaustion disorder

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