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Study On The Evaluation Of The Nursing Burnout Scale

Posted on:2011-11-28Degree:MasterType:Thesis
Country:ChinaCandidate:S SongFull Text:PDF
GTID:2154360308970258Subject:Nursing
Abstract/Summary:PDF Full Text Request
RESEARCH BACKGROUND:Job Burnout, also known as burnout, is a manifestation of occupational stress and a work-related situations syndrome. The study of clinical psychologist Fredenberger and social psychologist Maslach in the USA in 1970s shows that:nurse, as one of the occupational groups who burden the heaviest pressure in the healthcare career, is very vulnerable to job bournout. National studies in China have shown that the incidence of job burnout of nurses is as high as 42.1%.At present, job burnout is an independent study of area. Along with the development of related research, a number of tools for measuring job burnout gradually developed. The most authoritative assessment of burnout tool is Maslach Burnout Inventory (MBI), which was formulated by Maslach and Jackson in 1981. This tool mainly measures the symptoms of job burnout in three areas:emotional exhaustion, depersonalization and reduced personal accomplishment. The questionnaire was translated into a variety of translation and is widely used in the service industry. Other research has also demonstrated its high reliability and validity Spanish scholars Moreno-Jimenez et al. indicated that the nurse burnout is the results of the interaction of three aspects:a work environment, personality characteristics and the ways of treating stress. He compiled the nursing burnout scale (NBS) and from which he mentioned that the personality is characterized as one of main content of measuring job burnout. According to his theory, positive personality characteristics help to reduce the level of job burnout. NBS is the occupational burnout scale specifically designed for the nurses, by far.The research of job burnout in China started a little late. Thus, there are no a complete theoretical system and the research mainly emphasize in the introduction of foreign and evaluation of the scale. Mostly of occupations including the nurses mainly use the Chinese translation of the MBI, but the description of the frequency after the questionnaire is too complicated and also indistinguishable, thus the choices and judges of the candidates are not accurate using this version of MBI. In addition, there are also psychometric problems:each component used in the tables belongs to the terminology in the same direction. Namely, emotional exhaustion and depersonalization dimensions of the project are negative, but low personal accomplishment projects are positive. This single direction of test is poor in its validity, and easy to result in false result. Therefore, in the high incidence area of job burnout of the nurses, choosing an accuracy measurement of job burnout scale and taking timely and effective measures for prevention and intervention are of great significance.OBJECTIVES:1. Evaluate the clinical performance of nurses of Nursing Burnout Scale (NBS).2. Determine the most appropriate threshold of NBS.3. Forming NBS that is specific for the culture of China.RESEARCH SUBJECTS AND METHODS:Subjects:Randomly selected clinical nurses, patients and administrators from Southern Medical University affiliated Hospital and Zhujiang Hospital from March 1, 2009 to October 10,2009. In this study, a total of 350 questionnaires were issued and 329 of them were returned. The returning rate was 94%, and valid questionnaires were 325. The total efficiency of this survey was 98.78%.Methods:First, perform translation and expert evaluation on NBS after obtaining the authorization of translation and the right of using. Then, perform survey on clinical nurses by using the work of translated NBS and Maslach Burnout Inventory (MBI). All of the clinical nurses have to sign an informed consent form and filling in the questionnaire within 30 minutes, independently. All data were input into computer and analyzed by statistical software SPSS for Windows 13.0. The general information of the nurses was descriptive analyzed; the validity content of scale was evaluated by experts; the reliability of scale was calculated by the Cronbach a coefficient. The construct validity of scale was analyzed by factor analytic technique. The validity of NBS criterion was measured by Pearson correlation method using MBI as the reference. This survey was designed to measure the clinical performance of NBS of nurses in Guangzhou. The most appropriate threshold in Guangzhou was determined by calculation of sensitivity and specificity, and by drawing receiver operating characteristic curve.RESULTS:1. General InformationFor 325 randomly selected nurses, the age ranges from 20 to 45 (mean age is 26.5±4.6); the scope of education ranges from secondary school to graduate school. Specifically, it includes 15 candidates from secondary school (4.6%),138 candidates from junior college (42.5%),167 candidates from college (51.4%), and 5 candidates from graduate school (1.5%). The candidates with length of working year below 10 years have 282 (88.6%) and candidates with length of working year above 10 years have 43 (13.4%). For the title of the candidates, Nurses are 219 (67.4%), and primary nurses are 83 (25.5%), primary nurses in charge or above are 23 (7.1%).2. Translation and back translationThe consistence of the self-translated and other-translated NBS was 95%; when it was translated back into English translation, the consistence was 96.8%, compared with its original version.3. ReliabilityReliability refers to the property or concept of dependability, stability and consistency of the measurements of the scales, and it's used to measure the accuracy of the scales. The Cronbach reliability coefficient a was applied in this study. Generally speaking, scale reliability is very good when Cronbach coefficient arrives 0.70. In this study, the overall scale factor was 0.92, which indicated that the Chinese Scale had a very good consistency between 57 entries.4. ValidityValidity refers to the validity and correctness of measuring instruments (namely, accuracy). It includes content validity, construct validity, criterion validity, discriminant validity, etc.4.1 Content validity:The content validity of scale was evaluated by four experts from College of Nursing, Southern Medical University and its affiliated hospital. All experts are the authority in the field of domestic clinical nursing. They analyzed and compared the content of the various entries in the scale, and demonstrated that too much repeated measurements of entries existed in the scale. Thus they unanimously decided to delete the entries of 2,17,22,27,33,48,52, and 65, under the condition of not affecting the structural integrity and language expression of the scale. Some language expression of individual entries was modified to make it more simple and understandable. For example, "If having job or maternity protection, I would like to change my job" was modified into" If I have job or economic security, I would like to change my job". "I am too intense in mood, and always at the edge of the outbreak "to" I became neurotic, and always on the edge of the outbreak." Generally speaking,0.80 or higher scores of the content validity ratio is considered good for complying with its theoretical framework. This study content validity ratio was 0.9300, which indicated that the scale and job burnout were in high consistency.4.2 Construct validityConstruct validity extracted five common factors by using factor analysis and principal component analysis, with all of characteristic value greater than 1. The overall interpretation of the coefficient of variation was up to 42.446%, greater than 40%. This indicated that five common factors might reflect scale information volume.4.3 Validity of criterionUsing MBI as criterion, the correlation coefficient of NBS dimension scores and the MBI total score was between 0.40 and 0.85 (P<0.01); the correlation coefficient of NBS total score and the MBI total score was 0.60 (P<0.01). This demonstrated a strong relevance between NBS Scale and MBI scales. Also, it indicated that NBS has good criterion validity and good clinical performance and hence it is a good measurement tool for screening nurse burnout.5.Determination of the threshold valueUsing MBI as the golden standard, the most appropriate screening criteria of NBS that used for the burnout of nurses in Guangzhou:the score below 140.5 is considered for no or very minor job burnout, the score between 140.6 and 160.4 is classified into mild and moderate job burnout, the score above 160.5 is classified as severe job burnout. CONCLUSIONS:1. The application of NBS to the nurses in China has good reliability and validity. It is a reliable screening tool for early work burnout.2. There is an appropriate threshold for NBS. It showed a high sensitivity in the early screening of job burnout.3. Suggestions for follow-up studies3.1 The reliability and representativeness of small-scale survey is not convincible enough, and hence the reliability of this study needs to be checked in the future by large-scale survey and analysis, and is open to be modified and improved in future in the use of the scale.3.2 NBS scale is comprehensive, involving many factors related to nursing job burnout, so, future research can make use of this scale to take targeted, systematic interventions.
Keywords/Search Tags:Nurse Burnout Scale, Reliability, Validity, Threshold
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