These recommendations obtained greater empirical evidence after the systematic and meta-analytical review conducted among female nurses 22. The original version of MBI-HSS recommended the exclusion of items 12 (PA) and 16 (EE) for internal structure verification purposes, as these presented significant factor loadings in EE and DE dimensions, respectively 11. This has occurred mainly in Spanish-speaking contexts, thus resulting in a deviation from the instrument's conception and understanding the construct 21. MBI-HSS, however, poses questions that affect its usefulness, associated with its translations and the divergence between theory and practice 20. In the case of Peru, is one ofthe countries that continuously reports its application in investigating burnout. MBI-HSS is one of the most widely used instruments globally 18, 19. MBI-HSS was the first version of the instrument developed from clinical experiences and comprised 22 items referring to the constant worker-client (patient) interaction explaining the burnout symptomatology through three dimensions: Emotional Exhaustion (EE, the feeling of being exhausted and overwhelmed physically and psychologically it represents the burnout central dimension), Depersonalization (DE, a cynical and detached attitude towards work and colleagues), and Low Personal Accomplishment (PA, tendency to negatively assess personal achievements at work this dimension is positively assessed) 17. In its third edition, three versions were created targeting a) health professionals and social service workers (MBi-Human Service Survey, MBI-HSS), b) teachers (MBi-Educators Survey, MBI-ED), and c) general workers (MBi-General Survey, MBI-GS) 11. The MBI is a psychological measurement instrument used to assess burnout. This study specifically assessed the Maslach Burnout Inventory (MBI). This emerging situation is associated with insufficient methodological accuracy of publications addressing this subject as well as low number of studies on the metric evidence concerning the validity of the instruments used 16. Therefore, detecting this psychosocial risk is especially important in medical contexts, particularly where research reports on this topic are still considered to be on the rise (e.g., Peru). Demands at work may vary based on the socio-cultural and working scenario for physicians however, in the particular case of burnout, there is agreement on its high prevalence across different regions of the world 15. This iterative process gives rise to overloading work demands, and work-family conflicts, job insecurity, and interpersonal problems emerge, which are considered sources of burnout 12 - 14. As an analogy to the typical teacher-student relationship, medical work also requires constant interaction with patients 7, 11. In addition, the effects resulting from burnout have proven to cause issues in workers' physiological (e.g., heart disease) and psychological (e.g., insomnia) conditions, in addition to affecting their performance at work (e.g., increased absenteeism) 10.īurnout is particularly sensitive in jobs where health care activities are inherent to the position. Highly demanding jobs together with decreasing resources enable the onset of burnout, and its consequences impact workers' health and organizations' growth 8, 9. Considered a chronic response to work-related stress, burnout is explained as a progressive symptomatology of emotional exhaustion, depersonalization, and low personal accomplishment 1 - 7. Freudenberger and Maslach formally began the study of burnout syndrome during the 1970s.
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