Frenetic, under-Challenged, and Worn-out Burnout Subtypes among Brazilian Primary Care Personnel: Validation of the Brazilian “Burnout Clinical Subtype Questionnaire” (BCSQ-36/BCSQ-12)
Abstract
:1. Introduction
2. Materials and Methods
2.1. Design
2.2. Study Sample
2.3. Translation/Back Translation Procedure
2.4. Measures
2.4.1. Sociodemographic and Occupational Characteristics
2.4.2. Burnout Clinical Subtypes Questionnaire (BCSQ-36/BCSQ-12)
2.4.3. Maslach Burnout Inventory-General Survey (MBI-GS)
2.4.4. Utrecht Work Engagement Scale (UWES)
2.4.5. Hospital Anxiety and Depression Scale (HADS)
2.4.6. Positive and Negative Affect Schedule (PANAS)
2.4.7. Visual Analogue Scale of Guilt at Work
2.5. Statistical Analysis
3. Results
3.1. Psychometric Properties of the Brazilian BCSQ
3.1.1. Long BCSQ-36
3.1.2. Short BCSQ-12
3.2. Long/Short Brazilian BCSQ and other Constructs
4. Discussion
4.1. Psychometrics of the Brazilian BCSQ
4.2. The BCSQ and other Constructs
4.3. Sociodemographic Related to the Subtypes
4.4. Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Variables | n (%) |
---|---|
Age, mean in years (SD) | 41.09 (10.09) |
<35 | 119 (29.2) |
35–50 | 191 (46.9) |
>50 | 97 (23.8) |
Sex, female | 344 (84.5) |
Relationship, partnership/married | 286 (70.3) |
Number of children, none | 160 (39.3) |
Category | |
Volunteer | 158 (38.8) |
Professional with a salary | 249 (61.2) |
Job position | |
Physician | 72 (17.7) |
Nurse | 102 (25.1) |
CHW | 233 (57.2) |
Hours worked per week, mean in hours (SD) | 39.25 (26.81) |
<40 | 72 (17.7) |
40 | 268 (65.8) |
>40 | 64 (15.7) |
Length of service, mean in years (SD) | 17.19 (9.81) |
<6 | 56 (13.8) |
6–16 | 153 (37.6) |
>16 | 197 (48.4) |
Years at the same job, mean (SD) | 5.47 (5.53) |
<6 | 265 (65.1) |
6–16 | 123 (30.2) |
>16 | 18 (4.4) |
Contract period | |
Temporary | 39 (9.6) |
Permanent | 368 (90.4) |
Contract type | |
Full-time | 366 (89.9) |
Part-time | 41 (10.1) |
Economic difficulties | |
Never | 65 (16.0) |
Sometimes | 153 (37.6) |
Almost always | 112 (27.5) |
Always | 77 (18.9) |
Sick leave in the past year, yes | 145 (35.6) |
Sick leave days ‡ | 19.00 (51.83) |
Scales/models | χ2 | df | χ2/df | CFI | TLI | RMSEA | SRMR | AIC |
---|---|---|---|---|---|---|---|---|
Frenetic | ||||||||
One factor (ref) | 520.07 | 54 | 9.63 | 0.722 | 0.660 | 0.146 (0.134‒0.157) | 0.094 | 15,581.45 |
Three correlated | 168.00 | 51 | 3.29 | 0.930 | 0.910 | 0.075 (0.063‒0.088) | 0.049 | 15,085.41 |
Bifactor model | 127.87 | 42 | 3.04 | 0.949 | 0.920 | 0.071 (0.057‒0.085) | 0.035 | 15,043.73 |
Under-challenged | ||||||||
One factor (ref) | 265.28 | 54 | 4.91 | 0.865 | 0.835 | 0.098 (0.086‒0.110) | 0.061 | 16,362.76 |
Three correlated | 186.93 | 51 | 3.67 | 0.913 | 0.887 | 0.081 (0.069‒0.094) | 0.061 | 16,232.99 |
Bifactor model | 97.21 | 42 | 2.31 | 0.965 | 0.944 | 0.057 (0.042‒0.072) | 0.033 | 16,078.12 |
Worn-out | ||||||||
One factor (ref) | 736.77 | 54 | 13.64 | 0.582 | 0.489 | 0.176 (0.165‒0.188) | 0.121 | 16,744.43 |
Three correlated | 122.27 | 51 | 2.40 | 0.956 | 0.943 | 0.059 (0.045‒0.072) | 0.053 | 15,937.22 |
Bifactor model | 87.93 | 42 | 2.09 | 0.972 | 0.956 | 0.052 (0.037‒0.067) | 0.042 | 15,907.40 |
BCSQ-12 * | ||||||||
One factor (ref) | 1280.25 | 54 | 23.71 | 0.215 | 0.041 | 0.236 (0.225‒0.248) | 0.243 | 17,493.23 |
Three correlated | 85.97 | 51 | 1.69 | 0.978 | 0.971 | 0.041 (0.025‒0.056) | 0.035 | 15,923.81 |
3-Factors | Bifactor | ||||||||
---|---|---|---|---|---|---|---|---|---|
Scale/Subscale/Item | Mn | SD | skew | kurt | λ | δ | G | δ | |
Frenetic | 4.66 | 0.97 | −0.28 | 1.20 | |||||
Ambition | 4.65 | 1.24 | −0.32 | 0.22 | |||||
Item 1 | 4.54 | 1.55 | −0.42 | −0.19 | 0.67 * | 0.55 | 0.55 * | 0.48 * | 0.47 |
Item 4 | 4.78 | 1.50 | −0.52 | −0.08 | 0.73 * | 0.47 | 0.39 * | 0.53 * | 0.48 |
Item 7 | 4.76 | 1.41 | −0.28 | −0.22 | 0.83 * | 0.31 | 0.27 † | 0.62 * | 0.29 |
Item 10 | 4.54 | 1.50 | −0.24 | −0.40 | 0.83 * | 0.31 | 0.57 * | 0.61 * | 0.26 |
Overload | 4.13 | 1.32 | −0.04 | −0.43 | |||||
Item 2 | 4.63 | 1.56 | −0.20 | −0.56 | 0.66 * | 0.57 | 0.37 * | 0.61 * | 0.58 |
Item 5 | 3.85 | 1.64 | 0.18 | −0.61 | 0.81 * | 0.35 | 0.50 * | 0.66 * | 0.37 |
Item 8 | 3.98 | 1.67 | 0.03 | −0.69 | 0.80 * | 0.37 | 0.65 * | 0.80 * | 0.32 |
Item 11 | 4.05 | 1.56 | 0.03 | −0.58 | 0.77 * | 0.41 | 0.61 * | 0.51 * | 0.38 |
Involvement | 5.21 | 0.96 | −0.83 | 3.16 | |||||
Item 3 | 5.37 | 1.20 | −0.69 | 0.52 | 0.75 * | 0.44 | 0.39 * | 0.62 * | 0.46 |
Item 6 | 5.34 | 1.20 | −0.71 | 1.50 | 0.77 * | 0.40 | 0.40 * | 0.65 * | 0.41 |
Item 9 | 5.13 | 1.22 | −0.80 | 1.81 | 0.75 * | 0.44 | 0.42 * | 0.50 * | 0.43 |
Item 12 | 4.99 | 1.11 | −0.59 | 1.70 | 0.66 * | 0.56 | 0.51 * | 0.49 * | 0.50 |
Under-challenged | 3.35 | 1.20 | 0.14 | −0.01 | |||||
Indifference | 2.88 | 1.13 | 0.45 | 0.51 | |||||
Item 13 | 2.77 | 1.46 | 0.65 | 0.28 | 0.69 * | 0.53 | 0.59 * | 0.47 * | 0.44 |
Item 16 | 2.59 | 1.39 | 0.84 | 0.82 | 0.83 * | 0.32 | 0.54 * | 0.59 * | 0.30 |
Item 19 | 3.88 | 1.70 | −0.02 | −0.60 | 0.60 * | 0.64 | 0.02 | 0.74 * | 0.53 |
Item 22 | 2.28 | 1.27 | 0.99 | 1.39 | 0.71 * | 0.50 | 0.46 * | 0.63 * | 0.49 |
L. Development | 3.71 | 1.46 | 0.07 | −0.44 | |||||
Item 14 | 3.72 | 1.77 | 0.18 | −0.72 | 0.72 * | 0.48 | 0.68 | 0.67 * | 0.20 |
Item 17 | 3.42 | 1.61 | 0.36 | −0.25 | 0.70 * | 0.52 | 0.16 ‡ | 0.76 * | 0.53 |
Item 20 | 4.12 | 1.89 | −0.10 | −0.97 | 0.81 * | 0.34 | 0.42 | 0.68 * | 0.31 |
Item 23 | 3.60 | 1.79 | 0.21 | −0.82 | 0.82 * | 0.34 | 0.10 | 0.72 * | 0.35 |
Boredom | 3.45 | 1.40 | 0.27 | −0.18 | |||||
Item 15 | 3.65 | 1.73 | 0.20 | −0.72 | 0.76 * | 0.42 | 0.11 | 0.77 * | 0.44 |
Item 18 | 3.46 | 1.71 | 0.29 | −0.71 | 0.71 * | 0.50 | 0.15 | 0.55 * | 0.40 |
Item 21 | 3.27 | 1.63 | 0.43 | −0.31 | 0.81 * | 0.35 | 0.25 | 0.80 * | 0.35 |
Item 24 | 3.42 | 1.71 | 0.31 | −0.61 | 0.80 * | 0.36 | 0.45 ‡ | 0.76 * | 0.22 |
Worn-out | 3.74 | 1.02 | −0.11 | 0.76 | |||||
L. Acknowledgement | 4.04 | 1.38 | 0.07 | −0.29 | |||||
Item 25 | 3.68 | 1.73 | 0.25 | −0.66 | 0.71 * | 0.50 | 0.42 * | 0.55 * | 0.53 |
Item 28 | 3.82 | 1.81 | 0.19 | −0.80 | 0.41 * | 0.83 | 0.20 ‡ | 0.46 * | 0.85 |
Item 31 | 4.39 | 1.74 | −0.10 | −0.81 | 0.79 * | 0.37 | 0.46 * | 0.62 * | 0.42 |
Item 34 | 4.27 | 1.75 | −0.08 | −0.75 | 0.94 * | 0.11 | 0.78 * | 0.34 * | 0.02 |
Neglect | 2.64 | 1.14 | 0.64 | 1.24 | |||||
Item 26 | 2.76 | 1.39 | 0.57 | 0.13 | 0.79 * | 0.37 | 0.64 * | 0.41 * | 0.38 |
Item 29 | 2.73 | 1.30 | 0.69 | 1.03 | 0.80 * | 0.36 | 0.69 * | 0.73 * | 0.36 |
Item 32 | 2.30 | 1.16 | 0.72 | 1.24 | 0.80 * | 0.36 | 0.70 * | 0.60 * | 0.35 |
Item 35 | 2.78 | 1.41 | 0.79 | 0.88 | 0.86 * | 0.27 | 0.68 * | 0.41 * | 0.27 |
L. Control | 4.53 | 1.29 | −0.67 | 0.32 | |||||
Item 27 | 4.97 | 1.66 | −0.72 | 0.04 | 0.73 * | 0.47 | 0.51 * | 0.73 * | 0.36 |
Item 30 | 4.62 | 1.68 | −0.54 | −0.29 | 0.76 * | 0.42 | 0.20 | 0.65 * | 0.43 |
Item 33 | 3.60 | 1.56 | 0.13 | −0.51 | 0.67 * | 0.55 | 0.01 | 0.51 * | 0.47 |
Item 36 | 4.95 | 1.59 | −0.63 | 0.01 | 0.71 * | 0.49 | 0.45 † | 0.61 * | 0.43 |
Scale/Subscale | ω/ωS | ωH/ωHS | H | FDI | ECV |
---|---|---|---|---|---|
Frenetic | 0.93 | 0.76 | 0.88 | 0.87 | 0.62 |
Ambition | 0.81 | 0.32 | 0.54 | 0.56 | |
Overload | 0.91 | 0.37 | 0.65 | 0.61 | |
Involvement | 0.81 | 0.30 | 0.48 | 0.54 | |
Under-challenged | 0.94 | 0.87 | 0.92 | 0.93 | 0.76 |
Indifference | 0.84 | 0.26 | 0.55 | 0.51 | |
L. Development | 0.88 | 0.17 | 0.53 | 0.41 | |
Boredom | 0.85 | 0.09 | 0.26 | 0.29 | |
Worn-out | 0.92 | 0.72 | 0.87 | 0.85 | 0.53 |
L. Acknowledgement | 0.79 | 0.37 | 0.68 | 0.61 | |
Neglect | 0.93 | 0.57 | 0.77 | 0.76 | |
L. Control | 0.80 | 0.14 | 0.39 | 0.38 |
Subscale/Item | ωS | H | FDI | AVE | λ | δ |
---|---|---|---|---|---|---|
Overload | 0.85 | 0.86 | 0.93 | 0.58 | ||
Item 2 | 0.64 * | 0.60 | ||||
Item 5 | 0.79 * | 0.38 | ||||
Item 8 | 0.82 * | 0.33 | ||||
Item 11 | 0.78 * | 0.39 | ||||
L. Development | 0.85 | 0.88 | 0.94 | 0.59 | ||
Item 14 | 0.78 * | 0.39 | ||||
Item 17 | 0.66 * | 0.56 | ||||
Item 20 | 0.85 * | 0.28 | ||||
Item 23 | 0.76 * | 0.43 | ||||
Neglect | 0.89 | 0.89 | 0.95 | 0.66 | ||
Item 26 | 0.79 * | 0.37 | ||||
Item 29 | 0.80 * | 0.36 | ||||
Item 32 | 0.81 * | 0.35 | ||||
Item 35 | 0.85 * | 0.28 |
Psychological Health-Related Variables | Frenetic (Overload) | Under-Challenged (L. Development) | Worn-out (Neglect) |
---|---|---|---|
Exhaustion | 0.19 * (0.36 *) | 0.41 * (0.34 *) | 0.51 * (0.28 *) |
Cynicism | 0.04 (0.15 †) | 0.60 * (0.52 *) | 0.42 * (0.44 *) |
Efficacy | 0.31 * (0.11 ‡) | −0.21 * (-0.14 †) | −0.20 * (−0.26 *) |
Vigour | 0.31 * (0.09) | −0.44 * (−0.36 *) | −0.40 * (−0.39 *) |
Dedication | 0.25 * (0.08) | −0.54 * (−0.45 *) | −0.37 * (−0.33 *) |
Absorption | 0.38 * (0.24 *) | −0.45 * (−0.38 *) | −0.28 * (−0.32 *) |
Anxiety | 0.14 † (0.35 *) | 0.35 * (0.29 *) | 0.42 * (0.28 *) |
Depression | 0.10 ‡ (0.34 *) | 0.29 * (0.24 *) | 0.35 * (0.31 *) |
Positive Affect | 0.31 * (0.08) | −0.41 * (−0.31 *) | −0.35 * (−0.37 *) |
Negative Affect | 0.26 * (0.38 *) | 0.35 * (0.31 *) | 0.49 * (0.32 *) |
Guilt at work | 0.12 ‡ (0.22 *) | 0.30 * (0.33 *) | 0.38 * (0.31 *) |
DV/IVs | ΔR2 | R2 | Se | F | df | pa | ||
---|---|---|---|---|---|---|---|---|
Exhaustion | Step 1 | ref. | 0.05 | 8.18 | 4.57 | 5/400 | <0.001 | |
Step 2 | 0.24 | 0.29 | 7.12 | 20.25 | 8/397 | <0.001 | ||
Step 3 | 0.30 | 0.35 | 6.83 | 26.34 | 8/397 | <0.001 | ||
b | Se | Beta | t | pb | ||||
Step 2: BCSQ-12 | Overload | 2.64 | 0.40 | 0.29 | 6.68 | <0.001 | ||
L. Development | 1.89 | 0.32 | 0.29 | 5.83 | <0.001 | |||
Neglect | 0.90 | 0.39 | 0.11 | 2.32 | 0.021 | |||
Step 3: BCSQ-36 | Frenetic | 1.75 | 0.52 | 0.14 | 3.34 | 0.001 | ||
Under-challenged | 3.23 | 0.66 | 0.25 | 4.88 | <.001 | |||
Worn-out | 3.28 | 0.50 | 0.33 | 6.51 | <.001 | |||
DV/IVs | ΔR2 | R2 | Se | F | df | pa | ||
Cynicism | Step 1 | ref. | 0.02 | 6.11 | 1.64 | 5/400 | 0.149 | |
Step 2 | 0.32 | 0.34 | 5.03 | 25.60 | 8/397 | <0.001 | ||
Step 3 | 0.37 | 0.39 | 4.84 | 31.52 | 8/397 | <0.001 | ||
b | Se | Beta | t | pb | ||||
Step 2: BCSQ-12 | Overload | 0.36 | 0.28 | 0.05 | 1.28 | 0.203 | ||
L. Development | 2.03 | 0.23 | 0.42 | 8.84 | <0.001 | |||
Neglect | 1.34 | 0.27 | 0.23 | 4.91 | <0.001 | |||
Step 3: BCSQ-36 | Frenetic | 0.28 | 0.37 | 0.03 | 0.75 | 0.452 | ||
Under-challenged | 5.36 | 0.47 | 0.57 | 11.41 | <0.001 | |||
Worn-out | 0.59 | 0.36 | 0.08 | 1.65 | 0.100 | |||
DV/IVs | ΔR2 | R2 | Se | F | df | pa | ||
Efficacy | Step 1 | ref. | 0.09 | 5.91 | 7.62 | 5/400 | <0.001 | |
Step 2 | 0.08 | 0.17 | 5.67 | 9.79 | 8/397 | <0.001 | ||
Step 3 | 0.14 | 0.23 | 5.44 | 14.95 | 8/397 | <0.001 | ||
b | Se | Beta | t | pb | ||||
Step 2: BCSQ-12 | Overload | 0.85 | 0.32 | 0.13 | 2.70 | 0.007 | ||
L. Development | −0.11 | 0.26 | −0.02 | −0.43 | 0.670 | |||
Neglect | −1.50 | 0.31 | −0.26 | −4.88 | <0.001 | |||
Step 3: BCSQ-36 | Frenetic | 3.00 | 0.42 | 0.32 | 7.19 | <0.001 | ||
Under-challenged | −0.86 | 0.53 | −0.09 | −1.62 | 0.106 | |||
Worn-out | −1.25 | 0.40 | −0.17 | −3.12 | 0.002 |
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Demarzo, M.; García-Campayo, J.; Martínez-Rubio, D.; Pérez-Aranda, A.; Miraglia, J.L.; Hirayama, M.S.; de Salvo, V.M.A.; Cicuto, K.; Favarato, M.L.; Terra, V.; et al. Frenetic, under-Challenged, and Worn-out Burnout Subtypes among Brazilian Primary Care Personnel: Validation of the Brazilian “Burnout Clinical Subtype Questionnaire” (BCSQ-36/BCSQ-12). Int. J. Environ. Res. Public Health 2020, 17, 1081. https://doi.org/10.3390/ijerph17031081
Demarzo M, García-Campayo J, Martínez-Rubio D, Pérez-Aranda A, Miraglia JL, Hirayama MS, de Salvo VMA, Cicuto K, Favarato ML, Terra V, et al. Frenetic, under-Challenged, and Worn-out Burnout Subtypes among Brazilian Primary Care Personnel: Validation of the Brazilian “Burnout Clinical Subtype Questionnaire” (BCSQ-36/BCSQ-12). International Journal of Environmental Research and Public Health. 2020; 17(3):1081. https://doi.org/10.3390/ijerph17031081
Chicago/Turabian StyleDemarzo, Marcelo, Javier García-Campayo, David Martínez-Rubio, Adrián Pérez-Aranda, Joao Luiz Miraglia, Marcio Sussumu Hirayama, Vera Morais Antonio de Salvo, Karen Cicuto, Maria Lucia Favarato, Vinicius Terra, and et al. 2020. "Frenetic, under-Challenged, and Worn-out Burnout Subtypes among Brazilian Primary Care Personnel: Validation of the Brazilian “Burnout Clinical Subtype Questionnaire” (BCSQ-36/BCSQ-12)" International Journal of Environmental Research and Public Health 17, no. 3: 1081. https://doi.org/10.3390/ijerph17031081
APA StyleDemarzo, M., García-Campayo, J., Martínez-Rubio, D., Pérez-Aranda, A., Miraglia, J. L., Hirayama, M. S., de Salvo, V. M. A., Cicuto, K., Favarato, M. L., Terra, V., de Oliveira, M. B., García-Toro, M., Modrego-Alarcón, M., & Montero-Marín, J. (2020). Frenetic, under-Challenged, and Worn-out Burnout Subtypes among Brazilian Primary Care Personnel: Validation of the Brazilian “Burnout Clinical Subtype Questionnaire” (BCSQ-36/BCSQ-12). International Journal of Environmental Research and Public Health, 17(3), 1081. https://doi.org/10.3390/ijerph17031081