Burnout (psychology)

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Template:Otheruses4 Template:DiseaseDisorder infobox

Burnout is a concept in industrial and organizational psychology for "an excessive stress reaction to one's occupational or professional environment. It is manifested by feelings of emotional and physical exhaustion coupled with a sense of frustration and failure".[1] Burnout has three dimensions[2]:

* Emotional exhaustion
* Depersonalization (cynicism)
* Diminished personal accomplishment (inefficacy)

Subsequent research suggests the third dimension, personal accomplishment, better fits with the concept of professional engagement rather than with burnout.[3]

Workaholism more closely correlates with burnout than with engagement, although workaholism correlated with both (weakly negatively with engagement [via absorption])[4].

Engagement may not simply be the opposite of burnout[5]. Engagement and burnout may be related more specifically[6]:

* Emotional exhaustion may be the opposite of vigor
* Cynicism may be the opposite of dedication

"Vigor and dedication are the direct positive opposites of exhaustion and cynicism, respectively."[5]

According to Schaufeli[5] , the "Energetic Process" is based on Hockey's model of compensatory control and when "perceived demands are too high to be met by the usual working effort, two options are open:

* Strain coping mode leading to fatigue and irritability
* Passive coping mode leading to disengagement

The distinction between burnout and depression is not clear[7].

## Contents

* 1 Prevalence
* 1.1 Health care workers
* 2 Causes
* 2.1 Job demands-resources model of burnout
* 2.2 Areas of Worklife Survey (AWS)
* 2.3 Leadership quality
* 3 Measurement
* 3.1 Maslach Burnout Inventory
* 3.1.1 2-item Maslach Burnout Inventory
* 3.2 Single item burnout question (SIBOQ) or Mini Z
* 3.3 Burnout Assessment Tool
* 3.4 Copenhagen Burnout Inventory
* 3.5 Oldenburg Burnout Inventory
* 3.6 Professional Fulfillment Index (PFI) (Stanford)
* 3.7 Physician Well-Being Index (PWBI)
* 3.8 Professional Quality of Life (ProQOL)
* 4 Prevention
* 4.1 Religion, spirituality
* 5 Consequences
* 5.1 Clinical symptoms
* 5.2 Clinical care
* 5.3 Finances of an organization
* 6 Treatment
* 6.1 Meditation and Dhyana
* 6.2 Art therapy
* 7 See also
* 8 References

## Prevalence

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The prevalence of burnout in the general, employed population of the United States, aged is (measured by MBI except where noted)[8][9][10]:

* General, employed U.S. population
* (2010): aged 31-47 30%[8], aged 29-65 29%[9]
* (2014): aged 31-65 28%[10]
* (2017): aged 29-65 28%[11]
* (2021): during COVID epidemic in Japan: 31% (measured by Mini-Z)[12]

* College graduates 2010: aged 31-47 36%[8]

### Health care workers

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As of 2017, 44% of physicians have have burnout[11] Previously, in 2014, as many as 50% of physicians in practice may have burnout.[10] General practitioners seem to have low job control and the highest proportion of burnout cases[13].

For physicians in training, rates of burnout (emotional exhaustion) for students, residents and fellows is about 50% while the rate is 36% in similarly aged college graduates.[8]

## Causes

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Burnout is due to loss of control at work, and also "burnout is mainly predicted by job demands but also by lack of job resources"[14].

Curiously, a study of physicians found, "High levels of personal accomplishment increased stress levels (beta=0 080), whereas depersonalisation lowered stress levels (beta=-0 105)"[15] The study also found that

Different underlying factors may lead to varying phenotypes of burnout[16][17] One study found[16]:

* Burnout (high on all three dimensions)
* Engagement (low on all three)
* Overextended (high on exhaustion only)
* Disengaged (high on cynicism only). Also called depersonalization by Leiter[16] which may be the same as mental distance used by the World Health Organization[18].
* Ineffective (high on inefficacy only)

Regarding the possible connection of burnout with autonomy, burnout is more common in[19]:

* chaotic practices[19]
* larger practices[19]
* accountable care organizations[19]

Burnout in physicians in training is associated with perceived harassment[20]. In one survey of 24 American medical schools, harassment occurring at least one time was reported by 83% of students[20]. In this study, harassment was more commonly reported being perpetrated by residents[20]. The rates of burnout among students responding to the survey were[20]:

* All students 34%
* Those reporting recurrent harassment by faculty 57%
* Those not reporting recurrent harassment by faculty 32%

### Job demands-resources model of burnout

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Several items, specifically workload, are reflected in the job demands-resources model of burnout[21].

These findings are reflected in the Demand-Control theory of job stress. [22]

### Areas of Worklife Survey (AWS)

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Leiter and Maslach found the following antecedents from the Areas of Worklife Survey (AWS) using factor analysis:[23]

* Workload
* Fairness
* Control
* Community
* Values
* Rewards

Of these causes, workload is the strongest correlate of emotional exhaustion[23] but loss of control may be the initial factor. Perceived control or autonomy and fairness correlate with cynicism.[23][24]

* 16% of burnout is attributed to perceived control at the worksite.[25]

Leiter et al found that workload relates more to exhaustion while values incongruency relates more to cynicism[26].

### Leadership quality

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Leadership affects both burnout and work fulfillment.

* A study at the Mayo Clinic found a rate of burnout by the MBI of 40% and that at the departmental level, the "average leadership behaviour score of physicians’ work unit supervisor explained 11% of the variation in burnout and 47% of the variation in workplace satisfaction"[27].
* The University of Ottawa which found a weaker relationship when correlating rates at the departmental level[28]. During the COVID pandemic, a study at the University of Ottawa reported burnout of 42% by the 2-item MBI. Ottawa found an r = -0.371 (r2 = 14%) for departmental rates of leadership and burnout and an insignificant r = 0.199 (r2 = 0.04, p = 0.300) for satisfaction.[28]. Ottawa found higher associations between leadership and burnout at the individual respondent level.

In a second study across 11 healthcare organizations, the rates of burnout by tercile of leadership ratings of effectiveness by their direct reports[29]:

* 18%
* 35%
* 47%

According to the yearly survey of recent medical school graduates by the Association of American Medical Colleges, the following are reported [30]:

* Occasional public embarrassment 20%
* Occasional public humiliation 8%

Burnout is now being studied in its reported antitheses, job satisfaction, job engagement and thriving. Thriving may protect against burnout[31][32]. Engagement is both negatively associated with burnout[14], but also unhealthy engagement may lead to burnout.[33]

## Measurement

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Several burnout inventories are available including the Maslach, Copenhagen, and Oldenburg[34][35].

A serum S100B level has also been correlated with emotional exhaustion.[36]

The validity of available scales has been compared by a systematic review[37]. The review found the CBI to have the strongest validity, followed by the Oldenburg Burnout Inventory.

### Maslach Burnout Inventory

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The Maslach Burnout Inventory is a well-studied measurement of burnout that was first published in 1981. Maslach and her colleague Jackson first identified the construct "burnout" in the 1970s, and developed a measure that weighs the effects of on three scales[2]:

* Emotional exhaustion (nine items)
* Depersonalization (five items)
* Personal accomplishment (eight items)

The Maslach Burnout Inventory (MBI) has several versions:

* Human Services Survey (MBI-HSS) is 22-tems and for jobs such as 'clergy, police, therapists, social workers, medical'[38]
* MBI-HSS without the Personal Accomplishment subscale is 14 items.

* General Survey (MBI-GS) a 16-items for more general, non-social jobs as well[39]
* MBI-GS without the Professional Efficacy subscale is 10 items.

Eckleberry-Hunt in 2017 raised the question that burnout is being over-reported by deeming burnout present if either emotional exhaustion or depersonalization are present.[40]

#### 2-item Maslach Burnout Inventory

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In this short survey, abnormal is defined as symptoms weekly or more on either item by West[41][42][43] and other[44][45] researchers.

1\. I feel burned out from my work[43] or How often do you feel burned out from your work?[42]

* Never
* A few times a year or less
* Once a month
* A few times a month
* Once a week
* A few times a week
* Every day

This item correlates with emotional exhaustion subscale of the Maslach Burnout Inventory (minus the single item being tested)[41]:

* 0.76 to 0.83 across the four samples[41]

2\. I have become more callous toward people since I took this job[43] or How often do you feel you’ve become more callous toward people since you started your residency?[42]

* Never
* A few times a year or less
* Once a month
* A few times a month
* Once a week
* A few times a week
* Every day

This item correlates with depersonalization subscale of the Maslach Burnout Inventory (minus the single item being tested)[41]:

* 0.61 to 0.72 across the four samples[41]

The two-item score correlates with the overall MBI with a correlation of 0.65[46] which is under the threshold recommended for group crrelations[47]

The two-item format has been used in national surveys in 2011[9] and its follow-up survey in 2014[10].

### Single item burnout question (SIBOQ) or Mini Z

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Single item burnout question (SIBOQ) variations[48][48][49] Schmoldt, 1994[48] | AMA / STEPSforward[49]

|

Most studies do not report the stem. Veninga using a 1 to 10 scale used for the stem,
"On the following scale, indicate by circling a number where you feel you are."[50] | "Using your own definition of “burnout,” please circle one of the answers below"

“Overall, based on your definition of burnout, how would you rate your level of burnout?”[51]
I enjoy my work. I have no symptoms of burnout.  | I enjoy my work. I have no symptoms of burnout.
Occasionally I am under stress, and I don’t always have as much energy as I once did, but I don’t feel burned out.  | I am under stress, and don’t always have as much energy as I did, but I don’t feel burned out.
I am definitely burning out and have one or more symptoms of burnout, such as physical and emotional exhaustion.  | I am definitely burning out and have one or more symptoms of burnout, e.g., emotional exhaustion.
The symptoms of burnout that I’m experiencing won’t go away. I think about frustration at work a lot.  | The symptoms of burnout that I am experiencing won’t go away. I think about work frustrations a lot.
I feel completely burned out and often wonder if I can go on. I am at the point where I may need some changes or may need to seek some sort of help.  | I feel completely burned out. I am at the point where I may need to seek help.

The 10‑item Zero Burnout Program survey, or called the Mini Z[52], was adapted from the earlier Northwest Permanente (NWP) and Ohio Permanente Medical Group (OPMG) by Freeborn[53] and Schmoldt[48] which based this single question on earlier work by Veninga[50]. The SIBOQ was then used by later version of the Physician Worklife Survey[54]. The SIBOQ was first validated against the MBI by Rohland in 2004[55]. The SIBOQ was later used by the Minimizing Error, Maximizing Outcomes (MEMO)[56] studies used the self-definition format.

The Mini Z is a single item (burnout is defined as answers c, d, or e) that correlates with the emotional exhaustion scale of the Maslach[55]:

* The Northwest Permanente (NWP) and Ohio Permanente Medical Group (OPMG) by Schmoldt, Freeborn and Klevit[53][48] stated[48] that the NWP also used the self-diagnosis item of Veninga that started in 1991 used the format:
* The tedium index of Pines[57]
* The self-diagnosis of burnout item of Veninga where the respondent chooses a number between 1 ("Not burned out") and 10 ("completely burned out").[50]

Structure

1\. Using your own definition of “burnout,” please circle one of the answers below: a. I enjoy my work. I have no symptoms of burnout. b. I am under stress, and don’t always have as much energy as I did, but I don’t feel burned out. c. I am definitely burning out and have one or more symptoms of burnout, e.g., emotional exhaustion. d. The symptoms of burnout that I am experiencing won’t go away. I think about work frustrations a lot. e. I feel completely burned out. I am at the point where I may need to seek help.

2\. The Mini-Z also contains the relevant dimensions:

* Workload
* My control over my workload is...
* Sufficiency of time for documentation is...
* The amount of time I spend on the electronic health record (EHR) at home is...
* Cynicism:
* My professional values are well aligned with those of my department leaders...

The Mini Z is promoted by the American Medical Association's Steps Forward campaign.[49]

The Mini Z may report lower prevalence of burnout than when measured by the full Maslach Burnout Inventory (MBI).[58][59][60]

### Burnout Assessment Tool

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A newer survey is the Burnout Assessment Tool (BAT)[61] developed by Schaufeli and others[62]. The BAT has four subscales:

* Exhaustion
* Mental distance
* Emotional impairment
* Cognitive impairment

The BAT versions are:

* Full version with 23 items
* Short version with 12 items[63]

### Copenhagen Burnout Inventory

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The Copenhagen Burnout Inventory has 19 items and was developed in 2005.[64] It has three scales with Likert anchors that as subjective severity but not frequency:

* personal burnout

* work burnout
* client-related burnout

A systematic review comparing the quality of burnout scales has been published and found the CBI to have validity.[37] However, this review did not measure correlations between scales.

A second systematic review found that the Copenhagen reported an absolute 18% higher rate of burnout than did the MBI report.[65]

More recently, and a cross-sectional study by Li et al that compared the Copenhagen to one-item versions of the MBI scales and found very similar rates of burnout.[66] However, Li also found 21% disagree between the Copenhagen and the two-item MBI - especially among younger respondents and trainees.

None of these three studies reported correlations between scales. However, the two-by-two table summary of agreement suggests a correlation of less than 0.5 would does not meet acceptable criteria that prefers a correlation of at least 0.7[67].

### Oldenburg Burnout Inventory

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The Oldenburg Burnout Inventory has 16 items and was developed by Demerouti and others and has two scales with Likert anchors that as subjective severity but not frequency:[68][69]:

* Disengagement scale. The highest loading item is "I find my work to be a positive challenge" and the second highest loading item is "I always find new and interesting aspects in my work"[70].
* Exhaustion scale. The highest loading item is "After my work, I usually feel worn out and weary"[70].

### Professional Fulfillment Index (PFI) (Stanford)

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The PFI contains relevant dimensions including interpersonal disengagement[71]:

* "Less empathetic with my patients"
* "Less empathetic with my colleagues"

### Physician Well-Being Index (PWBI)

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The PWBI contains 7 items, one of which queries burnout in a yes/no response format. Its development[72] and application[73] have been reported.

Scales include disengagement:

* "Have you worried that your work is hardening you emotionally?"

### Professional Quality of Life (ProQOL)

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The ProQOL has 30 items over three scales[74]:

* Compassion satisfaction (CS)
* Burnout (BO)
* Compassion fatigue (CF)

The ProQOL does not include depersonalization.

The ProQO moderately correlates with the single-item burnout question from the Mini-Z[75].

The ProQOL is available at https://proqol.org/.

## Prevention

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Thriving[31][32] and engagement[76][3] are negatively correlated with, and thus may be protective, against burnout. However, unhealthy engagement may lead to burnout.[33]

Perceived control or autonomy and fairness correlate with cynicism.[23][24]

Successful teamwork may be important[77][78].

### Religion, spirituality

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Spirituality may be projective against burnout in medical students[79][80], medical residents/faculty[81][82], nurses[83] UK general practioners[84], and emergency medicine physicians[85].

## Consequences

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### Clinical symptoms

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Schaufeli found, consistent with Hockley’s State Regulation Model of Compensatory Control[86] that burnout can lead to somatic symptoms and that "burnout fully mediates the relationship between job demands and health problems."[87]

### Clinical care

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Burnout is associated with many clinical outcomes and personnel outcomes, but the relationships have much statistical heterogeneity[88].

### Finances of an organization

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Burnout may be associated with operating margins[89].

## Treatment

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Institutional and individual strategies to reduce burnout have been reviewed[90]. Of 15 studies, 12 were "individual-focused" and only 3 addressed " structural interventions within the work environment"ref name="pmid27692469"/>.

Physicians may not be aware that they are burned out and providing awareness may increase engagement with addressing burnout[91].

### Meditation and Dhyana

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Trauma-informed yoga may help[92].

Transcendental Meditation may help[93].

### Art therapy

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Main article: Art therapy

Randomized controlled trials of art therapy yield mixed and heterogeneous results[94][95].

## See also

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* Job satisfaction
* Stress (medicine)
* Compassion fatigue
* The poetry of Edna St. Vincent Millay: "My candle burns at both ends/It will not last the night."

## References

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1. ↑ Anonymous (2026), Professional Burnout (English). Medical Subject Headings. U.S. National Library of Medicine.
2. ↑ 2.0 2.1 Maslach, Christina; Jackson, Susan E. (1981). "The measurement of experienced burnout". Journal of Organizational Behavior. Wiley-Blackwell. 2 (2): 99–113. doi:10.1002/job.4030020205. ISSN 0894-3796.
3. ↑ 3.0 3.1 Schaufeli, Wilmar B.; Bakker, Arnold B.; Salanova, Marisa (2016). "The Measurement of Work Engagement With a Short Questionnaire". Educational and Psychological Measurement. 66 (4): 701–716. doi:10.1177/0013164405282471. ISSN 0013-1644.
4. ↑ Schaufeli, Wilmar B.; Taris, Toon W.; van Rhenen, Willem (April 2008). "Workaholism, Burnout, and Work Engagement: Three of a Kind or Three Different Kinds of Employee Well-being?". Applied Psychology. 57 (2): 173–203. doi:10.1111/j.1464-0597.2007.00285.x. eISSN 1464-0597. ISSN 0269-994X.
5. ↑ 5.0 5.1 5.2 Schaufeli, W.B. and Bakker, A.B. (2004), Job demands, job resources, and their relationship with burnout and engagement: a multi‐sample study. J. Organiz. Behav., 25: 293-315. doi:10.1002/job.248
6. ↑ González-Romá, Vicente; Schaufeli, Wilmar B.; Bakker, Arnold B.; Lloret, Susana (February 2006). "Burnout and work engagement: Independent factors or opposite poles?". Journal of Vocational Behavior. 68 (1): 165–174. doi:10.1016/j.jvb.2005.01.003. ISSN 0001-8791.
7. ↑ Sen S (2022). "Is It Burnout or Depression? Expanding Efforts to Improve Physician Well-Being". N Engl J Med. 387 (18): 1629–1630. doi:10.1056/NEJMp2209540. PMID 36317749 Check `|pmid=` value (help).
8. ↑ 8.0 8.1 8.2 8.3 Dyrbye LN, West CP, Satele D, Boone S, Tan L, Sloan J; et al. (2014). "Burnout among U.S. medical students, residents, and early career physicians relative to the general U.S. population". Acad Med. 89 (3): 443–51. doi:10.1097/ACM.0000000000000134. PMID 24448053.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)
9. ↑ 9.0 9.1 9.2 Shanafelt TD, Boone S, Tan L, Dyrbye LN, Sotile W, Satele D; et al. (2012). "Burnout and satisfaction with work-life balance among US physicians relative to the general US population". Arch Intern Med. 172 (18): 1377–85. doi:10.1001/archinternmed.2012.3199. PMID 22911330.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)
10. ↑ 10.0 10.1 10.2 10.3 Shanafelt TD, Hasan O, Dyrbye LN, Sinsky C, Satele D, Sloan J; et al. (2015). "Changes in Burnout and Satisfaction With Work-Life Balance in Physicians and the General US Working Population Between 2011 and 2014". Mayo Clin Proc. 90 (12): 1600–13. doi:10.1016/j.mayocp.2015.08.023. PMID 26653297.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)
11. ↑ 11.0 11.1 Shanafelt TD, West CP, Sinsky C, Trockel M, Tutty M, Satele DV | display-authors=etal (2019) Changes in Burnout and Satisfaction With Work-Life Integration in Physicians and the General US Working Population Between 2011 and 2017. Mayo Clin Proc 94 (9):1681-1694. DOI:10.1016/j.mayocp.2018.10.023 PMID: 30803733
12. ↑ Matsuo T, Yoshioka T, Okubo R, Nagasaki K, Tabuchi T (2022) Burnout and its associated factors among healthcare workers and the general working population in Japan during the COVID-19 pandemic: a nationwide cross-sectional internet-based study. BMJ Open 12 (11):e064716. DOI:10.1136/bmjopen-2022-064716 PMID: 36424113
13. ↑ Taris TW, Stoffelsen J, Bakker AB, Schaufeli WB, van Dierendonck D (2005). "Job control and burnout across occupations". Psychol Rep. 97 (3): 955–61. doi:10.2466/pr0.97.3.955-961. PMID 16512316.CS1 maint: Multiple names: authors list (link)
14. ↑ 14.0 14.1 Schaufeli, W. B., & Bakker, A. B. (2004). Job demands, job resources, and their relationship with burnout and engagement: A multi‐sample study. Journal of Organizational Behavior: The International Journal of Industrial, Occupational and Organizational Psychology and Behavior, 25(3), 293-315doi:10.1002/job.248
15. ↑ McManus IC, Winder BC, Gordon D (2002). "The causal links between stress and burnout in a longitudinal study of UK doctors". Lancet. 359 (9323): 2089–90. doi:10.1016/s0140-6736(02)08915-8. PMID 12086767.CS1 maint: Multiple names: authors list (link)
16. ↑ 16.0 16.1 16.2 Leiter, Michael P.; Maslach, Christina (2016-12-01). "Latent burnout profiles: A new approach to understanding the burnout experience". Burnout Research. 3 (4): 89–100. doi:10.1016/j.burn.2016.09.001. ISSN 2213-0586. Retrieved 2022-06-26.
17. ↑ Leiter MP, Frank E, Matheson TJ (2009). "Demands, values, and burnout: relevance for physicians". Can Fam Physician. 55 (12): 1224–1225, 1225.e1–6. PMC 2793232. PMID 20008605.CS1 maint: Multiple names: authors list (link)
18. ↑ Amonymous (2019). Burn-out an "occupational phenomenon": International Classification of Diseases Available at https://www.who.int/news/item/28-05-2019-burn-out-an-occupational-phenomenon-international-classification-of-diseases
19. ↑ 19.0 19.1 19.2 19.3 Edwards ST, Marino M, Solberg LI, Damschroder L, Stange KC, Kottke TE; et al. (2021). "Cultural And Structural Features Of Zero-Burnout Primary Care Practices". Health Aff (Millwood). 40 (6): 928–936. doi:10.1377/hlthaff.2020.02391. PMID 34097508 Check `|pmid=` value (help).CS1 maint: Multiple names: authors list (link)
20. ↑ 20.0 20.1 20.2 20.3 Cook AF, Arora VM, Rasinski KA, Curlin FA, Yoon JD (2014). "The prevalence of medical student mistreatment and its association with burnout". Acad Med. 89 (5): 749–54. doi:10.1097/ACM.0000000000000204. PMC 4401419. PMID 24667503.CS1 maint: Multiple names: authors list (link)
21. ↑ Demerouti E, Bakker AB, Nachreiner F, Schaufeli WB (2001). "The job demands-resources model of burnout". J Appl Psychol. 86 (3): 499–512. PMID 11419809.CS1 maint: Multiple names: authors list (link)
22. ↑ Karasek, Robert (1990). Healthy work : stress, productivity, and the reconstruction of working life. New York: Basic Books. ISBN 0-465-02897-7.
23. ↑ 23.0 23.1 23.2 23.3 Leiter, Michael P., and Christina Maslach. "Areas of worklife: A structured approach to organizational predictors of job burnout." Emotional and physiological processes and positive intervention strategies. Emerald Group Publishing Limited, 2003. 91-134. doi:10.1016/S1479-3555(03)03003-8
24. ↑ 24.0 24.1 Fernet, Claude; Austin, Stéphanie; Trépanier, Sarah-Geneviève; Dussault, Marc (2013). "How do job characteristics contribute to burnout? Exploring the distinct mediating roles of perceived autonomy, competence, and relatedness". European Journal of Work and Organizational Psychology. Informa UK Limited. 22 (2): 123–137. doi:10.1080/1359432x.2011.632161. ISSN 1359-432X.
25. ↑ Taris, Toon W., et al. "Job control and burnout across occupations." Psychological Reports 97.3 (2005): 955-961. doi:10.2466/pr0.97.3.955-961
26. ↑ Leiter, Michael P; Maslach, Christina. "AREAS OF WORKLIFE: A STRUCTURED APPROACH TO ORGANIZATIONAL PREDICTORS OF JOB BURNOUT". Research in Occupational Stress and Well-being. Emerald (MCB UP ). pp. 91–134. doi:10.1016/S1479-3555(03)03003-8. ISSN 1479-3555.
27. ↑ Shanafelt TD, Gorringe G, Menaker R, Storz KA, Reeves D, Buskirk SJ; et al. (2015). "Impact of organizational leadership on physician burnout and satisfaction". Mayo Clin Proc. 90 (4): 432–40. doi:10.1016/j.mayocp.2015.01.012. PMID 25796117.CS1 maint: Multiple names: authors list (link)
28. ↑ 28.0 28.1 Spilg, Edward G.; McNeill, Kylie; Dodd-Moher, Melanie; Dobransky, Johanna Suzanne; Sabri, Elham; Maniate, Jerry M.; Gartke, Kathleen A. (2025). "Physician Leadership and Its Effect on Physician Burnout and Satisfaction During the COVID-19 Pandemic". Journal of Healthcare Leadership. 17: 49–61. doi:10.2147/JHL.S487849. ISSN 1179-3201. PMC 11874771 Check `|pmc=` value (help). PMID 40034467 Check `|pmid=` value (help).
29. ↑ Mete M, Goldman C, Shanafelt T, Marchalik D (2022). "Impact of leadership behaviour on physician well-being, burnout, professional fulfilment and intent to leave: a multicentre cross-sectional survey study". BMJ Open. 12 (6): e057554. doi:10.1136/bmjopen-2021-057554. PMC 9171269 Check `|pmc=` value (help). PMID 36691255 Check `|pmid=` value (help).CS1 maint: Multiple names: authors list (link)
30. ↑ Association of American Medical Colleges. Medical School Graduation Questionnaire: All Schools Summary Report. Association of American Medical Colleges; Washington, DC
31. ↑ 31.0 31.1 Porath, Christine, et al. "Thriving at work: Toward its measurement, construct validation, and theoretical refinement." Journal of Organizational Behavior 33.2 (2012): 250-275. doi:10.1002/job.756
32. ↑ 32.0 32.1 Hildenbrand K, Sacramento CA, Binnewies C (2016). "Transformational Leadership and Burnout: The Role of Thriving and Followers' Openness to Experience". J Occup Health Psychol. doi:10.1037/ocp0000051. PMID 27631555.CS1 maint: Multiple names: authors list (link)
33. ↑ 33.0 33.1 Vinje HF, Mittelmark MB (2007). "Job engagement's paradoxical role in nurse burnout". Nurs Health Sci. 9 (2): 107–11. doi:10.1111/j.1442-2018.2007.00310.x. PMID 17470184.
34. ↑ Dyrbye L et al (2018). A Pragmatic Approach for Organizations to Measure Health Care Professional Well-Being. National Academy of Medicine
35. ↑ Anonymous, Valid and Reliable Survey Instruments to Measure Burnout, Well-Being, and Other Work-Related Dimensions, retrieved 3 October 2021
36. ↑ Gulen B, Serinken M, Eken C, Karcıoglu Ö, Kucukdagli OT, Kilic E, Akpinar G, Nogay S, Kuh M (July 2016). "Serum S100B as a Surrogate Biomarker in the Diagnoses of Burnout and Depression in Emergency Medicine Residents". Acad Emerg Med. 23 (7): 786–9. doi:10.1111/acem.12973. PMID 27018399.
37. ↑ 37.0 37.1 Shoman Y, Marca SC, Bianchi R, Godderis L, van der Molen HF, Guseva Canu I (January 2021). "Psychometric properties of burnout measures: a systematic review". Epidemiol Psychiatr Sci. 30: e8. doi:10.1017/S2045796020001134. PMC 8057391 Check `|pmc=` value (help). PMID 33436137 Check `|pmid=` value (help).
38. ↑ Maslach, C. T., Jackson, S. E. (1 April 1981). "The measurement of experienced burnout". Journal of Organizational Behavior. 2 (2): 99–113. doi:10.1002/job.4030020205. ISSN 1099-1379. Retrieved 1 May 2017.
39. ↑ Taris, T. W., Schreurs, P. J. G., Schaufeli, W. B. (July 1999). "Construct validity of the Maslach Burnout Inventory-General Survey: A two-sample examination of its factor structure and correlates". Work & Stress. 13 (3): 223–237. doi:10.1080/026783799296039. ISSN 1464-5335 0267-8373, 1464-5335 Check `|issn=` value (help). Retrieved 18 September 2022.
40. ↑ Eckleberry-Hunt J, Kirkpatrick H, Barbera T (2017). "The Problems With Burnout Research". Acad Med. doi:10.1097/ACM.0000000000001890. PMID 28817432.CS1 maint: Multiple names: authors list (link)
41. ↑ 41.0 41.1 41.2 41.3 41.4 West CP, Dyrbye LN, Sloan JA, Shanafelt TD (2009). "Single item measures of emotional exhaustion and depersonalization are useful for assessing burnout in medical professionals". J Gen Intern Med. 24 (12): 1318–21. doi:10.1007/s11606-009-1129-z. PMC 2787943. PMID 19802645.CS1 maint: Multiple names: authors list (link)
42. ↑ 42.0 42.1 42.2 West CP, Shanafelt TD, Kolars JC (2011). "Quality of life, burnout, educational debt, and medical knowledge among internal medicine residents". JAMA. 306 (9): 952–60. doi:10.1001/jama.2011.1247. PMID 21900135.CS1 maint: Multiple names: authors list (link)
43. ↑ 43.0 43.1 43.2 West CP, Dyrbye LN, Satele DV, Sloan JA, Shanafelt TD (2012). "Concurrent validity of single-item measures of emotional exhaustion and depersonalization in burnout assessment". J Gen Intern Med. 27 (11): 1445–52. doi:10.1007/s11606-012-2015-7. PMC 3475833. PMID 22362127.CS1 maint: Multiple names: authors list (link)
44. ↑ Ong J, Lim WY, Doshi K, Zhou M, Sng BL, Tan LH; et al. (2021). "An Evaluation of the Performance of Five Burnout Screening Tools: A Multicentre Study in Anaesthesiology, Intensive Care, and Ancillary Staff". J Clin Med. 10 (21). doi:10.3390/jcm10214836. PMC 8584380 Check `|pmc=` value (help). PMID 34768357 Check `|pmid=` value (help).CS1 maint: Multiple names: authors list (link)
45. ↑ Yellowlees P, Coate L, Misquitta R, Wetzel AE, Parish MB (2021). "The Association Between Adverse Childhood Experiences and Burnout in a Regional Sample of Physicians". Acad Psychiatry. 45 (2): 159–163. doi:10.1007/s40596-020-01381-z. PMID 33409937 Check `|pmid=` value (help).CS1 maint: Multiple names: authors list (link)
46. ↑ Li-Sauerwine S, Rebillot K, Melamed M, Addo N, Lin M (2020). "A 2-Question Summative Score Correlates with the Maslach Burnout Inventory". West J Emerg Med. 21 (3): 610–617. doi:10.5811/westjem.2020.2.45139. PMC 7234685 Check `|pmc=` value (help). PMID 32421508 Check `|pmid=` value (help).CS1 maint: Multiple names: authors list (link)
47. ↑ HealthMeasures. PROMIS® Instrument Development and Validation Scientific Standards Version 2.0 (revised May 2013). Available at https://www.healthmeasures.net/images/PROMIS/PROMISStandards_Vers2.0_Final.pdf
48. ↑ 48.0 48.1 48.2 48.3 48.4 48.5 Schmoldt RA, Freeborn DK, Klevit HD (1994). "Physician burnout: recommendations for HMO managers". HMO Pract. 8 (2): 58–63. PMID 10135263.CS1 maint: Multiple names: authors list (link)
49. ↑ 49.0 49.1 49.2 Linzer, Mark; Guzman-Corrales, Laura; Poplau, Sara. "Preventing physician burnout - STEPS Forward". STEPSforward.org. Retrieved 2017-05-24.
50. ↑ 50.0 50.1 50.2 Veninga, Robert L.; Spradley, James P. (1981). The work/stress connection : how to cope with job burnout. Boston, Mass.: Little, Brown. ISBN 0-316-80747-8. OCLC 7205249.
51. ↑ Dolan ED, Mohr D, Lempa M, Joos S, Fihn SD, Nelson KM; et al. (2015). "Using a single item to measure burnout in primary care staff: a psychometric evaluation". J Gen Intern Med. 30 (5): 582–7. doi:10.1007/s11606-014-3112-6. PMC 4395610. PMID 25451989.CS1 maint: Multiple names: authors list (link)
52. ↑ Linzer M, Poplau S, Babbott S, Collins T, Guzman-Corrales L, Menk J; et al. (2016). "Worklife and Wellness in Academic General Internal Medicine: Results from a National Survey". J Gen Intern Med. 31 (9): 1004–10. doi:10.1007/s11606-016-3720-4. PMC 4978678. PMID 27138425.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)
53. ↑ 53.0 53.1 Freeborn DK (2001). "Satisfaction, commitment, and psychological well-being among HMO physicians". West J Med. 174 (1): 13–8. doi:10.1136/ewjm.174.1.13. PMC 1071220. PMID 11154654.
54. ↑ Williams ES, Konrad TR, Linzer M, McMurray J, Pathman DE, Gerrity M; et al. (2002). "Physician, practice, and patient characteristics related to primary care physician physical and mental health: results from the Physician Worklife Study". Health Serv Res. 37 (1): 121–43. PMID 11949917.CS1 maint: Multiple names: authors list (link)  PMC1430344
55. ↑ 55.0 55.1 Rohland, Barbara M.; Kruse, Gina R.; Rohrer, James E. (2004). "Validation of a single-item measure of burnout against the Maslach Burnout Inventory among physicians". Stress and Health. 20 (2): 75–79. doi:10.1002/smi.1002. ISSN 1532-3005.
56. ↑ Linzer M, Manwell LB, Williams ES, Bobula JA, Brown RL, Varkey AB; et al. (2009). "Working conditions in primary care: physician reactions and care quality". Ann Intern Med. 151 (1): 28–36, W6–9. doi:10.7326/0003-4819-151-1-200907070-00006. PMID 19581644.CS1 maint: Multiple names: authors list (link)
57. ↑ Malakh-Pines, Ayala; Aronson, Elliot; Kafry, Ditsa (1981). Burnout : from tedium to personal growth. New York: Free Press. ISBN 0-02-925350-0. OCLC 6486538.
58. ↑ Linzer M, Poplau S (2017). "Building a Sustainable Primary Care Workforce: Where Do We Go from Here?". J Am Board Fam Med. 30 (2): 127–129. doi:10.3122/jabfm.2017.02.170014. PMID 28379818.
59. ↑ Thakore NL, Lan M, Winkel AF, Vieira DL, Kang SK (October 2024). "Best Practices: Burnout Is More Than Binary". AJR Am J Roentgenol: 1–20. doi:10.2214/AJR.24.31111. PMID 39016454 Check `|pmid=` value (help).
60. ↑ Hagan G, Okut H, Badgett RG (April 2024). "A Systematic Review of the Single-Item Burnout Question: Its Reliability Depends on Your Purpose". J Gen Intern Med. 39 (5): 818–828. doi:10.1007/s11606-024-08685-y. PMID 38424346 Check `|pmid=` value (help).
61. ↑ Burnout Assessment Tool. Available at https://burnoutassessmenttool.be/project_eng/
62. ↑ Schaufeli, Wilmar B.; Desart, Steffie; De Witte, Hans (2020-12-18). "Burnout Assessment Tool (BAT)—Development, Validity, and Reliability". International Journal of Environmental Research and Public Health. 17 (24): 9495. doi:10.3390/ijerph17249495. ISSN 1660-4601. Retrieved 2022-06-25.
63. ↑ Hadžibajramović E, Schaufeli W, De Witte H (2022). "Shortening of the Burnout Assessment Tool (BAT)-from 23 to 12 items using content and Rasch analysis". BMC Public Health. 22 (1): 560. doi:10.1186/s12889-022-12946-y. PMC 8939057 Check `|pmc=` value (help). PMID 35313849 Check `|pmid=` value (help).CS1 maint: Multiple names: authors list (link)
64. ↑ Kristensen T, Borritz M, Villadsen E, Christensen KB. The Copenhagen Burnout Inventory: a new tool for the assessment of burnout. Work Stress. 2005;19(3):192–207 doi:10.1080/02678370500297720
65. ↑ Alahmari MA, Al Moaleem MM, Hamdi BA, Hamzi MA, Aljadaani AT, Khormi FA, Darraj MA, Shrwani RJ, AlOmar AA, Tahhah MK, Alyousefy MA, Al Sanabani FA (December 2022). "Prevalence of Burnout in Healthcare Specialties: A Systematic Review Using Copenhagen and Maslach Burnout Inventories". Med Sci Monit. 28: e938798. doi:10.12659/MSM.938798. PMC 9789675 Check `|pmc=` value (help). PMID 36536586 Check `|pmid=` value (help).
66. ↑ Li H, Dance E, Poonja Z, Aguilar LS, Colmers-Gray I (July 2024). "Agreement between the Maslach Burnout Inventory and the Copenhagen Burnout Inventory among emergency physicians and trainees". Acad Emerg Med. doi:10.1111/acem.14994. PMID 39082466 Check `|pmid=` value (help).
67. ↑ Anonymous. PROMIS® Instrument Development and Validation Scientific Standards, Version 2.0, (revised May 2013). HealthMeasures. Published May 2013. Accessed June 5, 2022. https:// www.healthmeasures.net/images/PROMIS/PROMISStandards_Vers2.0_Final.pdf
68. ↑ Demerouti, E; Bakker, AB; Vardakou, I; Kantas, A (March 2003). "The Convergent Validity of Two Burnout Instruments". European Journal of Psychological Assessment. 19 (1): 12–23. doi:10.1027//1015-5759.19.1.12. eISSN 2151-2426. ISSN 1015-5759.
69. ↑ Demerouti, E., Mostert, K., Bakker, A. B. (July 2010). "Burnout and work engagement: A thorough investigation of the independency of both constructs". Journal of Occupational Health Psychology. 15 (3): 209–222. doi:10.1037/a0019408. ISSN 1076-8998 1939-1307, 1076-8998 Check `|issn=` value (help). Retrieved 18 September 2022.
70. ↑ 70.0 70.1 Demerouti E, Bakker AB. The Oldenburg Burnout Inventory: A good alternative to measure burnout and engagement. Handbook of stress and burnout in health care. 2008 Jan;65(7). https://www.isonderhouden.nl/doc/pdf/arnoldbakker/articles/articles_arnold_bakker_173.pdf
71. ↑ Trockel M, Bohman B, Lesure E, Hamidi MS, Welle D, Roberts L; et al. (2018). "A Brief Instrument to Assess Both Burnout and Professional Fulfillment in Physicians: Reliability and Validity, Including Correlation with Self-Reported Medical Errors, in a Sample of Resident and Practicing Physicians". Acad Psychiatry. 42 (1): 11–24. doi:10.1007/s40596-017-0849-3. PMC 5794850. PMID 29196982.CS1 maint: Multiple names: authors list (link)
72. ↑ Dyrbye LN, Satele D, Sloan J, Shanafelt TD. Utility of a brief screening tool to identify physicians in distress. J Gen Intern Med. 2013 Mar;28(3):421-7. doi: doi:10.1007/s11606-012-2252-9. PMID: PMID 23129161
73. ↑ Dyrbye LN, Satele D, Shanafelt T. Ability of a 9-Item Well-Being Index to Identify Distress and Stratify Quality of Life in US Workers. J Occup Environ Med. 2016 Aug;58(8):810-7. doi: doi:10.1097/JOM.0000000000000798. PMID: PMID 27294444
74. ↑ De La Rosa GM, Webb-Murphy JA, Fesperman SF, Johnston SL (2018). "Professional quality of life normative benchmarks". Psychol Trauma. 10 (2): 225–228. doi:10.1037/tra0000263. PMID 28383935.CS1 maint: Multiple names: authors list (link)
75. ↑ Wolf C, Schwarz J, Thurstone C, Rylander M (2021). "Agreement between a single, self-defined burnout item and the ProQOL burnout subscale for behavioural health staff". Int J Ment Health Nurs. 30 (1): 326–333. doi:10.1111/inm.12788. PMID 32959486 Check `|pmid=` value (help).CS1 maint: Multiple names: authors list (link)
76. ↑ Mason VM, Leslie G, Clark K, Lyons P, Walke E, Butler C; et al. (2014). "Compassion fatigue, moral distress, and work engagement in surgical intensive care unit trauma nurses: a pilot study". Dimens Crit Care Nurs. 33 (4): 215–25. doi:10.1097/DCC.0000000000000056. PMID 24895952.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)
77. ↑ Lu MA, O'Toole J, Shneyderman M, Brockman S, Cumpsty-Fowler C, Dang D; et al. (2022). ""Where You Feel Like a Family Instead of Co-workers": a Mixed Methods Study on Care Teams and Burnout". J Gen Intern Med. doi:10.1007/s11606-022-07756-2. PMC 9422940 Check `|pmc=` value (help). PMID 36038756 Check `|pmid=` value (help).CS1 maint: Multiple names: authors list (link)
78. ↑ Kjaer, K., Kowalsky, R., Rubin, L. A., Willis, L., Mital, R. C., Kazam, J., Stracher, A. (17 November 2021). "A Grassroots Approach to Protecting Physicians Against Burnout and Building an Engaging Practice Environment". NEJM Catalyst. 2 (12): CAT.21.0275. doi:10.1056/CAT.21.0275. ISSN 2642-0007. Retrieved 12 June 2022.
79. ↑ Ray C, Wyatt TR (2018). "Religion and Spirituality as a Cultural Asset in Medical Students". J Relig Health. 57 (3): 1062–1073. doi:10.1007/s10943-017-0553-3. PMID 29357045.
80. ↑ Wachholtz A, Rogoff M (2013). "The relationship between spirituality and burnout among medical students". J Contemp Med Educ. 1 (2): 83–91. doi:10.5455/jcme.20130104060612. PMC 4255468. PMID 25485165.
81. ↑ Doolittle BR, Windish DM (2015). "Correlation of burnout syndrome with specific coping strategies, behaviors, and spiritual attitudes among interns at Yale University, New Haven, USA". J Educ Eval Health Prof. 12: 41. doi:10.3352/jeehp.2015.12.41. PMC 4536357. PMID 26201403.
82. ↑ Schmidt C, Roffler M (2021). "Coping with the Practice of Medicine: Religion, Spirituality, and Other Personal Strategies". J Relig Health. 60 (3): 2092–2108. doi:10.1007/s10943-020-01098-1. PMID 33118137 Check `|pmid=` value (help).
83. ↑ Harris S, Tao H (2022). "The Impact of US Nurses' Personal Religious and Spiritual Beliefs on Their Mental Well-Being and Burnout: A Path Analysis". J Relig Health. 61 (3): 1772–1791. doi:10.1007/s10943-021-01203-y. PMC 7905975 Check `|pmc=` value (help). PMID 33630228 Check `|pmid=` value (help).
84. ↑ Whitehead IO, Moffatt S, Jagger C, Hanratty B (2022). "A national study of burnout and spiritual health in UK general practitioners during the COVID-19 pandemic". PLoS One. 17 (11): e0276739. doi:10.1371/journal.pone.0276739. PMC 9629610 Check `|pmc=` value (help). PMID 36322555 Check `|pmid=` value (help).CS1 maint: Multiple names: authors list (link)
85. ↑ Salmoirago-Blotcher E, Fitchett G, Leung K, Volturo G, Boudreaux E, Crawford S; et al. (2016). "An exploration of the role of religion/spirituality in the promotion of physicians' wellbeing in Emergency Medicine". Prev Med Rep. 3: 189–95. doi:10.1016/j.pmedr.2016.01.009. PMC 4929145. PMID 27419014.CS1 maint: Multiple names: authors list (link)
86. ↑ Robert J. Hockey, G. (1997). "Compensatory control in the regulation of human performance under stress and high workload: A cognitive-energetical framework". Biological Psychology. 45 (1–3): 73–93. doi:10.1016/S0301-0511(96)05223-4.
87. ↑ Schaufeli, Wilmar B.; Bakker, Arnold B. (2004). "Job demands, job resources, and their relationship with burnout and engagement: a multi‐sample study". Journal of Organizational Behavior. 25 (3): 293–315. doi:10.1002/job.248. ISSN 0894-3796.
88. ↑ Hodkinson A, Zhou A, Johnson J, Geraghty K, Riley R, Zhou A; et al. (2022). "Associations of physician burnout with career engagement and quality of patient care: systematic review and meta-analysis". BMJ. 378: e070442. doi:10.1136/bmj-2022-070442. PMC 9472104 Check `|pmc=` value (help). PMID 36104064 Check `|pmid=` value (help).CS1 maint: Multiple names: authors list (link)
89. ↑ Muller IR, Eldakar-Hein ST, Ames SE, Rosen LD, Urman RD, Tsai MH (2017). "Potential Association Between Physician Burnout Rates and Operating Margins: Specialty-Specific Analysis". J Med Pract Manage. 32 (4): 233–238. PMID 29969540.CS1 maint: Multiple names: authors list (link)
90. ↑ West CP, Dyrbye LN, Erwin PJ, Shanafelt TD (2016). "Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis". Lancet. 388 (10057): 2272–2281. doi:10.1016/S0140-6736(16)31279-X. PMID 27692469.CS1 maint: Multiple names: authors list (link)
91. ↑ Shanafelt TD, Kaups KL, Nelson H, Satele DV, Sloan JA, Oreskovich MR; et al. (2014). "An interactive individualized intervention to promote behavioral change to increase personal well-being in US surgeons". Ann Surg. 259 (1): 82–8. doi:10.1097/SLA.0b013e3182a58fa4. PMC 4333681. PMID 23979287.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)
92. ↑ Mulvihill, Tracey; Bradbury, Joanne; Grace, Sandra; Doran, Frances (September 2022). "Trauma-informed yoga (online) for positive mental health: A pilot study". Advances in Integrative Medicine. doi:10.1016/j.aimed.2022.09.001. ISSN 2212-9588.
93. ↑ Joshi SP, Wong AI, Brucker A, Ardito TA, Chow SC, Vaishnavi S; et al. (2022). "Efficacy of Transcendental Meditation to Reduce Stress Among Health Care Workers: A Randomized Clinical Trial". JAMA Netw Open. 5 (9): e2231917. doi:10.1001/jamanetworkopen.2022.31917. PMC 9486450 Check `|pmc=` value (help). PMID 36121655 Check `|pmid=` value (help).CS1 maint: Multiple names: authors list (link)
94. ↑ Ho AHY, Tan-Ho G, Ngo TA, Ong G, Chong PH, Dignadice D; et al. (2021). "A Novel Mindful-Compassion Art-Based Therapy for Reducing Burnout and Promoting Resilience Among Healthcare Workers: Findings From a Waitlist Randomized Control Trial". Front Psychol. 12: 744443. doi:10.3389/fpsyg.2021.744443. PMC 8566679 Check `|pmc=` value (help). PMID 34744918 Check `|pmid=` value (help).CS1 maint: Multiple names: authors list (link)
95. ↑ Kline JA, VanRyzin K, Davis JC, Parra JA, Todd ML, Shaw LL; et al. (2020). "Randomized Trial of Therapy Dogs Versus Deliberative Coloring (Art Therapy) to Reduce Stress in Emergency Medicine Providers". Acad Emerg Med. 27 (4): 266–275. doi:10.1111/acem.13939. PMID 32266765 Check `|pmid=` value (help).CS1 maint: Multiple names: authors list (link)

* ”Sources of Management of Excessive Job Stress and Burnout”, In P. Warr (Ed.), Psychology at Work Fourth Edition. Penguin.
* “Tailoring treatment strategies for different types of burnout” Farber, B. A. (1998). Paper presented at the Annual Convention of the American Psychological Association, 106th, San Francisco California, August 14-18. ED 424 517
* “Staff burnout”, Freudenberger, H. J. (1974). Journal of Social Issues, 30(1), 159-165.
* “Authentic leaders creating healthy work environments for nursing practice”, Shirey MR. American Journal of Critical Care May 2006. Vol. 15, Iss. 3; p. 256
* “Taming burnout's flame”, Krista Gregoria Lussier, Nursing Management Chicago: Apr 2006. Vol. 37, Iss. 4; p. 14
* “A Scientific Solution To Librarian Burnout”, Craig S. Shaw New Library World Year 1992 Volume: 93 Number: 5
* Stress and Burnout in Library Service, Caputo, Janette S. Phoenix, AZ: Oryx Press, 1991.
* An assessment of burnout in academic librarians in America using the Maslach Burnout Inventor (the MBI) Ray, Bernice, Ph.D., Rutgers University - New Brunswick, 2002, 90 pages; AAT 3066762