Factor structure of the Maslach burnout inventory: An analysis of data from large scale cross-sectional surveys of nurses from eight countries
Section snippets
Introduction and background
Investigations of nurse burnout are highly relevant given the global shortage of nurses and the need to retain qualified nurses in clinical care roles (Aiken et al., 2004). Additionally, nurse burnout has been associated with patient dissatisfaction and other measures of deficient care quality (Vahey et al., 2004).
Burnout was first introduced into the literature by Freudenberger in the early 1970s (Freudenberger, 1974). He defined burnout as a state of fatigue or frustration that resulted from
Parent studies
This investigation was conducted using data from the International Hospital Outcomes Study (Aiken et al., 2002a, Aiken et al., 2002b). In 1998–1999, the study was conducted among nurses in four countries (the U.S., Canada, the U.K., and Germany) (Aiken et al., 2001); in 2001 it was replicated in New Zealand (Finlayson et al., 2007); in 2002 it was replicated in Russia and Armenia (Aiken, 2005, Aiken and Poghosyan, in press); in 2005 it was replicated in Japan (Kanai-Pak et al., 2008). The
Factorial structure of the MBI and equivalence of the items
Table 2 provides the goodness-of-fit statistics for the confirmatory factor analysis model for each country. While the values of the root mean square error of approximation (RMSEA) and Bartlett's comparative fit index (CFI) approach the values that are usually considered acceptable (i.e., RMSE < 0.06 and CFI > 0.90, respectively), the RMSEA shows an acceptable fit only in Russia and the CFI value is unacceptable in every country. Moreover, the Chi-square statistic indicating the goodness-of-fit in
Discussion
This study used confirmatory and exploratory factor analyses to investigate the factorial structure of the MBI in eight countries, and while Maslach's initial configuration of the burnout inventory was not completely confirmed, with minor modifications the three-factor structure of the MBI was largely validated. Except for two items, nearly all of the MBI items loaded significantly on the factors they were expected to, in virtually all countries. Even though a few items of the MBI subscales did
Conflict of interest
All authors have no conflicts of interest.
Sources of funding
This work was supported by NINR/NIH grant R01NR04513-11 and P30NR05043-09.
Ethical approval
This study is covered by Institutional Review Board (IRB) of the University of Pennsylvania, protocol 176400, “Outcomes of Nurse Practice Environments” (Aiken, PI), approved through 12/6/08.
Acknowledgments
This research was supported by the National Institute for Nursing Research (R01NR04513-11 and P30NR05043-09, Linda Aiken, principal investigator) and by AMN Healthcare, Inc. We thank Dr. Eileen Lake and Tim Cheney for their assistance. American International Health Alliance funded the study in Armenia and Russia. We thank the investigators from the other countries: Masako Kanai-Pak, Japan, Anne Marie Rafferty, the U.K., Carole Estabrooks, Canada, Mary Finlayson, New Zealand, and Reinhard Busse,
References (41)
Confirmatory factor analysis of the Maslach burnout inventory among Florida nurses
International Journal of Nursing Studies
(2002)- et al.
Burnout in organizational life
Journal of Management
(2004) - et al.
Are work stress relationships universal? A nine-region examination of stressors, general self-efficacy, and burnout
Journal of International Management
(2002) - et al.
Stress, burnout and locus of control in German nurses
International Journal of Nursing Studies
(2000) Extending the Magnet concept to developing and transition countries: journey to excellence
Reflections on Nursing Leadership
(2005)- et al.
Trends in international nurse migration
Health Affairs
(2004) - et al.
Hospital staffing, organization, and quality of care: cross-national findings
International Journal of Quality in Health Care
(2002) - et al.
Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction
The Journal of the American Medical Association
(2002) - et al.
Nurses’ reports on hospital care in five countries
Health Affairs
(2001) - Aiken, L.H., Poghosyan, L., in press. Evaluation of magnet journey to nursing excellence program in Russia and Armenia....
Effects of organizational innovations in AIDS care on burnout among hospital nurses
Work and Occupations
How to conduct research on burnout: advantages and disadvantages of a unidimensional approach in burnout
Occupational and Environmental Medicine
The Maslach burnout inventory: validating factorial structure and invariance across intermediate, secondary, and university teachers
Multivariate Behavioral Research
A First Course in Factor Analysis
Mail and Telephone Surveys: The Total Design Method
The nature of burnout: a study of the three-factor model of burnout in human service and non-human service samples
Journal of Occupational and Organizational Psychology
New Zealand nurses’ reports on hospital care: international comparisons
Nursing Praxis in New Zealand, Inc.
Staff burnout
Journal of Social Issues
Burn-out: The High Cost of High Achievement
Workload and burnout in nurses
Journal of Community and Applied Social Psychology
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