# Assessment of Burnout in the General Population of France: Comparing the Maslach Burnout Inventory and the Copenhagen Burnout Inventory

Lucia Romo, Oulmann Zerhouni, Stéphanie Nann, Erwan Rebuffe, Samantha Tessier, Chloé Touzé, Laurent Cruchet, Clément Duret

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Lucia Romo, Oulmann Zerhouni, Stéphanie Nann, Erwan Rebuffe, Samantha Tessier, et al.. Assessment of Burnout in the General Population of France: Comparing the Maslach Burnout Inventory and the Copenhagen Burnout Inventory. Mental Health Science, 2025, 3 (2), 10.1002/mhs2.97 . hal-05059807

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RESEARCH ARTICLE

OPEN ACCESS

# Assessment of Burnout in the General Population of France: Comparing the Maslach Burnout Inventory and the Copenhagen Burnout Inventory

Lucia Romo<fnref n="1" />,²,³ ID | Oulmann Zerhouni⁴,⁵ ID | Stéphanie Nann<fnref n="1" />,² ID | Erwan Rebuffe² ID | Samantha Tessier<fnref n="1" />,² ID |
Chloé Touzé⁴ ID | Laurent Cruchet²,⁶ ID | Clément Duret² ID

**Correspondence:** Lucia Romo (lromodes@parisnanterre.fr)

**Received:** 27 March 2024 | **Revised:** 28 October 2024 | **Accepted:** 18 November 2024

**Funding:** The authors received no specific funding for this work.

**Keywords:** burnout | Copenhagen Burnout Inventory | general population | Maslach Burnout Inventory

## ABSTRACT

Burnout is an occupational phenomenon that arises from the unsuccessful management of chronic job stress. Accurate measures of burnout are vital for the implementation of effective interventions. However, existing tools, such as the Maslach Burnout Inventory (MBI) and the Copenhagen Burnout Inventory (CBI), have demonstrated variability in their assessments. This study aims to compare the MBI and CBI to determine which tool provides a more reliable and comprehensive measure of burnout in the general population of France. The secondary objective was to identify key predictors of work exhaustion in the general population. Residents of mainland France participated in an online anonymous survey that collected data on their demographic and job-related characteristics, including job satisfaction and work exhaustion. The data collected were analyzed using Pearson correlation and regression analyses. Emotional exhaustion (in the MBI) was strongly associated with work exhaustion and personal, work-related and client-related burnout dimensions of the CBI. Correlations of participants' perceptions of work exhaustion with the CBI, MBI, and their dimensions showed a stronger correlation with CBI (r = 0.408 vs. 0.296; *p* < 0.001). Regression analysis revealed that emotional exhaustion (MBI) and personal burnout (CBI) were significant predictors of work exhaustion, while depersonalization (MBI) was negatively associated, highlighting the distinct contributions of MBI and CBI in assessing burnout. This study provides valuable insights into the complex relationships among the MBI, CBI, and work exhaustion and highlights the need for a comprehensive approach to better understand and address the phenomenon of burnout.

## 1 | Background

The World Health Organization (WHO) conceptualizes burnout as an occupational phenomenon arising from chronic work-place stress that has not been successfully managed. It comprises three dimensions: (1) feelings of energy depletion or

exhaustion, (2) increased cynicism or mental distance from one's job, and (3) reduced sense of personal achievement (World Health Organization n.d.). The WHO included burnout in the tenth revision of the International Classification of Diseases. However, in the eleventh revision, the WHO specified that burnout is a phenomenon and not a disease.

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

© 2025 The Author(s). *Mental Health Science* published by Wiley Periodicals LLC.

<footnote n="1">¹UR 4430 Departement of Psychology, Université Paris Nanterre, Nanterre, France | ²Hôpital Universitaire Raymond-Poincaré, Service de Pathologies Professionnelles (AP-HP), Garches, France | ³Inserm CESP 1018 UPS, Villejuif, France | ⁴Laboratoire Parisien de Psychologie Sociale, Université Paris Nanterre, Nanterre, France | ⁵Centre de Recherche sur les Fonctionements et Dysfonctionnements Psychologiques, Université de Rouen Normandie, Mont-Saint-Aignan, France | ⁶GHU Paris Psychiatrie et Neurosciences, Clinique des Maladies Mentales et de l'Encéphale (CMME), Paris, France</footnote>
## 1.1 | Defining Burnout

xBurnout is a complex and multifaceted psychological phenomenon that has attracted the attention of clinicians and researchers over the past several decades. Originally conceptualized as a unique form of job stress primarily seen in human services professions, burnout is now recognized as a pervasive problem affecting a wide range of occupational groups (Freudenberger 1974; Maslach and Jackson 1981). Its core dimensions—emotional exhaustion, depersonalization, and reduced sense of personal accomplishment—reflect not only the occupational hazards of specific occupations but also the systemic challenges present in many modern work environments (Maslach and Jackson 1981). Hence, the definition of burnout remains multifaceted, as evidenced by its multifaceted representation in literature. A wide range of symptoms, theories, and models have attempted to capture its essence, but a universally accepted measure remains elusive despite the availability of tools such as the Maslach Burnout Inventory (MBI) (Korczak, Huber, and Kister 2010). Such variability in definitions and measures may hinder timely interventions, particularly in high-stress professions such as emergency medicine (Alahmari et al. 2022). For example, the MBI, conceptualizes it as a three-dimensional syndrome consisting of emotional exhaustion, depersonalization, and diminished personal accomplishment, with a primary focus in service occupations (Maslach and Jackson 1981). In contrast, the Copenhagen Burnout Inventory (CBI) offers a broader approach by assessing personal burnout, work-related burnout, and client-related burnout, making it applicable to both professional and non-professional populations (Kristensen et al. 2005). In addition, there are alternative models that contrast burnout with engagement. These models emphasize dimensions such as energy exhaustion versus vitality, and cynicism versus engagement (Schaufeli, Bakker, and Van Rhenen 2009). Furthermore, there is debate as to whether burnout should be considered a distinct construct or whether there is significant overlap with related conditions such as depression and general stress (Bianchi, Schonfeld, and Laurent 2015). These conceptual discrepancies result in different approaches to diagnosing and treating burnout. This may hinder the development of effective interventions (Schaufeli, Leiter, and Maslach 2009).

## 1.2 | The Impact of Burnout: Economic and Societal Costs and Implications for All Professions

Burnout has profound detrimental effects. It not only decreases job performance and satisfaction but also causes serious health problems, such as sleep disturbances, cardiovascular disease, and depression (Melamed et al. 2006; Toppinen-Tanner, Kalimo, and Mutanen 2002). Given its serious implications for individual health and organizational productivity, accurate measures of burnout are of paramount importance. Reliable and valid instruments enable organizations to detect and mitigate burnout, and, consequently, create healthy work environments. Recent neurobiological studies have elucidated the mechanisms underlying burnout. They have found that changes in brain regions are associated with emotional processing, motivation, and executive function (Hölzel et al. 2010). This finding holds promise for targeted

therapeutic interventions and underscores the need for reliable tools for measuring burnout.

The systemic nature of burnout necessitates the development of measurement tools that can accurately capture burnout across a range of occupational contexts. The prevalence of burnout and its significant economic and societal costs, including decreased productivity, increased absenteeism, and higher healthcare expenditures, have been widely documented (Toppinen-Tanner, Kalimo, and Mutanen 2002). Hence, burnout has significant economic implications beyond individual suffering. Direct and indirect costs, such as decreased productivity, increased absenteeism, and increased healthcare expenditures, underscore that burnout is not just a personal problem; it is also a societal problem (Schaufeli, Bakker, and Van Rhenen 2009). Moreover, the emotional toll of burnout can decrease job satisfaction and increase turnover rates, which can affect the quality of care or service provided and impact patient or client outcomes (Tarafdar, Cooper, and Stich 2019). A systematic review focusing on paramedics (Reardon et al. 2020) demonstrated the variability in burnout measurement tools and prevalence. Studies that employed the CBI reported a higher prevalence of burnout than those that used the MBI and the General Burnout Measure (GBM). Thus, an accurate measurement tool is required to determine the prevalence, subjective experience, consequences, and cause of burnout.

## 1.3 | A Need to Clarify the Strengths and Weaknesses of Measurement Tools

The initial research on burnout was largely concentrated on professions where direct human services are a significant aspect, such as healthcare, education, and social work, where the emotional demands are most evident. However, as research extended into other fields such as information technology, finance, and engineering, the understanding of burnout evolved to include factors such as work-related stress, workload, and organizational factors that contribute to burnout across all professions (Schaufeli, Bakker, and Van Rhenen 2009). The MBI has been the primary instrument for assessing burnout, providing a comprehensive three-dimensional model (Maslach and Jackson 1981). However, its applicability is limited to service-oriented professions. This resulted in the creation of the CBI. The CBI was developed as a more comprehensive assessment of burnout. The inventory comprises three dimensions: personal burnout (general feelings of exhaustion), work-related burnout (exhaustion related to work), and client-related burnout (exhaustion related to working with clients) (Kristensen et al. 2005). Although the CBI has greater applicability, its properties have been less investigated than those of the MBI. While there is a high correlation between the MBI and CBI in assessing burnout dimensions, there is also divergence, particularly in the area of personal accomplishment. The CBI's comprehensive approach makes it suitable for a wider range of occupational groups, but it lacks the extensive validation of the MBI.

The primary objective of this study is to assess the efficacy of the MBI and CBI in measuring burnout among the general French population. Additionally, scales scores will be compared with
the participants' self-reported perceptions of burnout with a
single item Likert scale.

**1.4 | Study Rationale**

This study aims to conduct a comparative analysis of the MBI and CBI in the French general population. A recent study (María Diaz Vizcaya et al. 2023) used an anonymous online survey to assess burnout levels among healthcare workers in the National Health System. It assessed the burnout levels of 448 participants using both the MBI and CBI. The two instruments were found to be highly correlated in the exhaustion and cynicism dimensions but diverged in the personal achievement dimension. To increase the reliability of burnout measurements, Diaz Vizcaya et al (María Diaz Vizcaya et al. 2023) suggested using a combination of validated instruments. However, studies comparing the two instruments are scant in the French context with participants' subjective perceptions of burnout, which will be assessed using a Likert scale, with differences in the effectiveness of burnout measurement tools, such as the MBI and CBI, across various contexts and populations (María Diaz Vizcaya et al. 2023). Despite its comprehensive scope, the CBI has not yet undergone the same degree of validation as the MBI, particularly in diverse occupational settings. A comparison of these two instruments is necessary for several reasons. First, as occupational environments become increasingly complex and diverse, it is essential to have measurement tools that accurately reflect burnout across a range of settings. Although the MBI has historically been a significant instrument, the CBI's broader dimensions potentially offer a more comprehensive assessment. Second, if the MBI and CBI yield markedly disparate results, selecting the most appropriate instrument for addressing burnout and promoting employee well-being becomes a crucial decision.

Hence, we derived two hypotheses: (i) The CBI will demonstrate stronger correlations with subjective perceptions of burnout compared to the MBI, indicating its broader applicability across diverse professions and (ii) the MBI, while robust in service-oriented contexts, will show limitations in capturing burnout dimensions relevant to non-service professions.

**2 | Methods**

**2.1 | Participants**

This study was designed as an observational online survey to
comprehensively assess burnout and related mental health
dimensions among participants. It was conducted between May
and June 2022, and the participants were residents of mainland
France. The participants completed a 15-min voluntary online
survey on the Qualtrics platform, which anonymizes responses.
Consent from all participants was obtained before they partic-
ipated in the study. Participants in this study were residents of
mainland France, aged 18–60 years. The recruitment process
was conducted through the dissemination of online advertise-
ments via social media platforms and professional networks.
Potential participants were provided with information about the

study's purpose, procedures, and informed consent. They were
informed that participation was voluntary and that they could
withdraw at any time without any consequences. The informed
consent process was conducted electronically and included
detailed information about the study's purpose, procedures,
confidentiality assurances, and withdrawal rights. The term
"missing responses" refers to participants who did not complete
at least one item of the questionnaires.

**2.2 | Measures**

**Maslach Burnout Inventory (MBI, α = 0.88).** The MBI is a widely accepted burnout assessment tool introduced by Maslach & Jackson (Maslach and Jackson 1981). It was originally developed to assess burnout in support and service professionals. The instrument assesses burnout along three dimensions: (i) Emotional exhaustion, which describes as an overwhelming sense of emotional exhaustion (α = 0.70) (ii) Depersonalization, which is characterized by detachment from work, others experiencing burnout, and colleagues (α = 0.70), and (iii) Personal accomplishment, which reflects feelings of incompetence or a perceived inability to perform tasks efficiently (α = 0.62). A higher score indicates higher burnout.

**Copenhagen Burnout Inventory (CBI, α = 0.93).** Developed by the Danish Institute for Workplace Health, the CBI assesses burnout not only in work settings but also across multiple contexts (Kristensen et al. 2005). This comprehensive approach addresses the limitations of the MBI, making the CBI particularly suitable for a wider range of occupations. The CBI consists of three scales: (i) Personal Burnout, which measures general feelings of exhaustion and fatigue, (α = 0.86) (ii) Job Burnout, which focuses on exhaustion directly related to work (α = 0.81), and (iii) Client-Related Burnout, which assesses burnout feelings related to interactions with clients or patients. A higher score indicates higher burnout.

**Patient Health Questionnaire (PHQ-9, α = 0.88).** The PHQ-9 is a module of the self-administered Patient Health Questionnaire (PHQ) used to diagnose common mental disorders, particularly depression (Kroenke, Spitzer, and Williams 2001). It scores each of the 9 DSM-IV criteria on a scale from “0” (not at all) to “3” (almost every day). The scores interpret the severity of depression from minimal (1–4) to severe (20–27). A higher score indicates poorer mental health. Cut-off scores were used to categorize participants into different levels of depression severity: 0–4 (None), 5–9 (Mild), 10–14 (Moderate), 15–19 (Moderately severe), and 20–27 (Severe).

**Generalized Anxiety Disorder Scale (GAD-7, α = 0.91).** The GAD-7 is an instrument used to assess generalized anxiety disorder, one of the most common mental disorders (Ruiz et al. 2011). The scale consists of 7 items rated on a frequency scale ranging from “never” (0) to “almost every day” (3). Total scores range from 0 (minimal anxiety) to 21 (severe anxiety). A higher score indicates higher anxiety. Cut-off scores for the GAD-7 were 0–4 (Minimal anxiety), 5–9 (Mild anxiety), 10–14 (Moderate anxiety), and 15–21 (Severe anxiety).
**Brief Resilience Scale (BRS, α = 0.60).** BRS was employed to evaluate the participants' resilience levels. The BRS is a self-report measure designed to assess an individual's capacity to cope with stress and adversity (Smith et al. 2008). It comprises six items, each rated on a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). Higher scores indicate greater resilience. Participants' resilience levels were categorized based on their scores: 1.00–2.99 (Low resilience), 3.00–4.30 (Normal resilience), and 4.31–5.00 (High resilience).

**Demographics and job-related information:** We collected information on participants' demographic and job-related characteristics, more specifically about their age, sex, relationship status, job type, employment status, number of years of working in the current position, and number of hours spent at work weekly.

**Job satisfaction and exhaustion:** Participants were asked to rate their job satisfaction on a scale ranging from “very dissatisfied” to “very satisfied” and how often they felt exhausted at work, with response options ranging from “never” to “always” on a 1–10 Likert scale. This last evaluation served as a filter question, by selecting participants who reported an experienced work exhaustion higher than 6 on a 1–10 rating scale.

## 2.3 | Procedure

After completing the MBI and CBI, the participants filled in the demographic section of the survey. In this section, the participants were asked to provide information about their age, sex, and relationship status. They were also asked to provide information about their professional lives, more specifically about their employment status, number of years of working in the current position, and number of hours spent at work weekly. Finally, they were asked to rate their level of job satisfaction and the frequency of experiencing feelings of exhaustion at work.

Next, the participants were thanked for their participation, informed of the broader research goals, and provided with resources on mental well-being and strategies to manage burnout. Participants' confidentiality and anonymity were ensured during data collection and its subsequent storage for analysis.

## 2.4 | Ethical Considerations

This study adhered to the recommendations of the Declaration of Helsinki. It followed the criteria of the Ethics Committee of the Université Paris Nanterre. Participants were invited to participate anonymously. They were contacted by a panel with no possibility of the researchers tracing the e-mails of the participants.

## 2.5 | Data Analysis

Data were analyzed using the Jamovi statistical software, version 2.5.7 (Jamovi Computer Software 2023). We first obtained descriptive statistics to determine central tendencies and dispersion of scores on the MBI and CBI. Then, we performed a Pearson correlation analysis to determine linear relationships

between scores on the MBI, CBI, and the Likert scale that measured participants' perceptions of work exhaustion. To further quantify the relationship between scores on the MBI, CBI, and participants' perceptions of work exhaustion, a regression analysis was performed with scores on the Likert scale as the dependent variable and with Sex, Age, Job Status, CBI, MBI dimensions and BRS scores as predictors. We hypothesize that higher scores on the emotional exhaustion and personal burnout scales will be significant predictors of work exhaustion, while lower social support and ineffective coping strategies will also be associated with higher levels of work exhaustion.

# 3 | Results

## 3.1 | Participants' Demographic and Job-Related Characteristics

Table 1 presents demographic and job-related information of the participants. A total of 660 individuals participated in the study, with their ages ranging from 18 to 60 years and a mean age of 39.7 years (SD = 11.2). Approximately half participants were female (52.7%). In terms of their relationship status, individuals who were in a relationship were the highest in number (36.2%). Most participants (87.4%) were employed, and participants had spent an average of 10.6 years (SD = 8.9) in their current position. Among currently employed participants, 83.4% declared working more than 35 h per week. The mean score for job satisfaction, which was measured on a 0–10 scale, was 6.2 (SD = 2.3). The mean score for work exhaustion was 7.5 out of 10 (SD = 1.6). Finally, most participants reported not receiving mental health counseling (70%).

## 3.2 | Descriptive Statistics of Scores on the MBI and CBI

For the MBI, the sample consisted of 624 participants, as there were 36 missing responses. Scores for emotional exhaustion ranged from 9 to 63, with a mean score of 38.04 (SD = 12.29) and a median score of 39. Scores for depersonalization ranged from 5 to 35, with a mean score of 17.00 (SD = 7.69) and a median score of 17. Scores for personal accomplishment ranged from 8 to 56, with a mean score of 34.71 (SD = 10.00) and a median score of 35.

There were five missing responses in the CBI, making the sample 655 participants. Scores for personal burnout ranged from 1 to 24, with a mean score of 14.77 (SD = 4.06) and a median score of 15. Scores for work-related burnout ranged from 0 to 28, with a mean score of 16.26 (SD = 5.34) and a median score of 16. Scores for client-related burnout ranged from 0 to 24, with a mean score of 12.99 (SD = 5.59) and a median score of 13.

## 3.3 | Correlation Between Scores on the MBI, CBI, and Work Exhaustion

Table 2 presents the results of Pearson correlation analyses. Significant relationships were found between scores on the
<table><caption>TABLE 1 | Demographic and job-related characteristics of the participants.</caption><thead><tr><th></th><th>N</th><th>Mean</th><th>Standard deviation</th><th>%</th></tr></thead><tbody><tr><td>Age</td><td>658</td><td>39.723</td><td>11.249</td><td></td></tr><tr><td>Sex</td><td></td><td></td><td></td><td></td></tr><tr><td>Male</td><td>311</td><td></td><td></td><td>47.121</td></tr><tr><td>Female</td><td>348</td><td></td><td></td><td>52.727</td></tr><tr><td>Other</td><td>1</td><td></td><td></td><td>0.152</td></tr><tr><td>Relationship status</td><td></td><td></td><td></td><td></td></tr><tr><td>Single</td><td>186</td><td></td><td></td><td>28.225</td></tr><tr><td>Dating</td><td>239</td><td></td><td></td><td>36.267</td></tr><tr><td>Married</td><td>233</td><td></td><td></td><td>35.357</td></tr><tr><td>Widowed</td><td>1</td><td></td><td></td><td>152</td></tr><tr><td>Employment status</td><td></td><td></td><td></td><td></td></tr><tr><td>Employed</td><td>576</td><td></td><td></td><td>87.405</td></tr><tr><td>Student</td><td>2</td><td></td><td></td><td>0.303</td></tr><tr><td>Self-employed</td><td>51</td><td></td><td></td><td>7.739</td></tr><tr><td>Searching for employment</td><td>9</td><td></td><td></td><td>1.366</td></tr><tr><td>Not working</td><td>4</td><td></td><td></td><td>0.607</td></tr><tr><td>Sick leave</td><td>17</td><td></td><td></td><td>2.580</td></tr><tr><td>Number of years of working in the current position</td><td></td><td>10.554</td><td>8.930</td><td></td></tr><tr><td>Time Worked</td><td></td><td></td><td></td><td></td></tr><tr><td>Less than 35 h per week</td><td>108</td><td></td><td></td><td>16.590</td></tr><tr><td>35-45 h per week</td><td>473</td><td></td><td></td><td>72.657</td></tr><tr><td>45-55 h per week</td><td>47</td><td></td><td></td><td>7.220</td></tr><tr><td>More than 55 h per week</td><td>23</td><td></td><td></td><td>3.533</td></tr><tr><td>Job satisfaction</td><td></td><td>6.178</td><td>2.271</td><td></td></tr><tr><td>Work exhaustion</td><td></td><td>7.476</td><td>1.592</td><td></td></tr><tr><td>Psychological follow-up</td><td></td><td></td><td></td><td></td></tr><tr><td>Yes</td><td>197</td><td></td><td></td><td>29.985</td></tr><tr><td>No</td><td>460</td><td></td><td></td><td>70.015</td></tr></tbody></table>

MBI, CBI, and work exhaustion. Specifically, the emotional exhaustion dimension of the MBI was significantly correlated with work exhaustion (r = 0.386, *p* < 0.001), the personal burnout dimension of the CBI (r = 0.650, *p* < 0.001), the work-related burnout dimension of the CBI (r = 0.722, *p* < 0.001), and the client-related burnout dimension of the CBI (r = 0.588, *p* < 0.001). The depersonalization dimension of the MBI was significantly correlated with work exhaustion (r = 0.170, *p* < 0.001), the personal burnout dimension of the CBI (r = 0.381, *p* < 0.001), the work-related burnout dimension of the CBI (r = 0.491, *p* < 0.001), and the client-related burnout dimension of the CBI (r = 0.449, *p* < 0.001). Finally, the personal accomplishment dimension of the MBI had a weak but significant correlation with work exhaustion (r = 0.085, *p* = 0.034), the personal burnout dimension of the CBI (r = 0.146, *p* < 0.001), the work-related burnout dimension of the CBI (r = 0.112, *p* = 0.005), and the client-related burnout dimension of the CBI (r = 0.128, *p* = 0.001, see Table 2). Correlations of participants' perceptions of work exhaustion with the CBI, MBI,

and their dimensions showed a stronger correlation with CBI (r = 0.408 vs. 0.296; *p* < 0.001). To compare the correlations of participants' perceptions of work exhaustion with the CBI and MBI, we employed Fisher's r-to-z transformation. The difference between the correlation coefficients was found to be marginally statistically significant (z = -1.75, *p* = 0.079), indicating that the CBI personal burnout scale may be more strongly correlated with work exhaustion than the MBI emotional exhaustion scale.

### 3.4 | Predictors of Work Exhaustion

Table 3 presents the results of regression analyses. Age had a small but significant positive relationship with work exhaustion (B = 0.016, SE = 0.005, *β* = 0.116, *t* = 3.162, *p* = 0.002), suggesting that work exhaustion increases slightly with age. The emotional exhaustion dimension of the MBI was positively and significantly associated with work exhaustion (B = 0.030, SE = 0.008, *β* = .235,
<table><caption>TABLE 2 | Correlation between scores on the MBI, CBI, and work exhaustion.</caption><thead><tr><th>Variable</th><th>MBI</th><th>CBI</th><th>Work exhaustion</th><th>CBI—Personal burnout</th><th>CBI—Work-related burnout</th><th>CBI—Client-related burnout</th><th>MBI—Emotional exhaustion</th><th>MBI—Depersonalization</th><th>MBI—Personal accomplishment</th></tr></thead><tbody><tr><td>1. MBI</td><td>Pearson's r</td><td>—</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td>p value</td><td>—</td><td></td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>2. CBI</td><td>Pearson's r</td><td>0.619</td><td>—</td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td>p value</td><td>&lt; 0.001</td><td>—</td><td></td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>3. Work exhaustion</td><td>Pearson's r</td><td>0.296</td><td>0.408</td><td>—</td><td></td><td></td><td></td><td></td><td></td></tr><tr><td></td><td>p value</td><td>&lt; 0.001</td><td>&lt; 0.001</td><td>—</td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>4. CBI—Personal burnout</td><td>Pearson's r</td><td>0.530</td><td>0.860</td><td>0.401</td><td>—</td><td></td><td></td><td></td><td></td></tr><tr><td></td><td>p value</td><td>&lt; 0.001</td><td>&lt; 0.001</td><td>&lt; 0.001</td><td>—</td><td></td><td></td><td></td><td></td></tr><tr><td>5. CBI—Work-related burnout</td><td>Pearson's r</td><td>0.589</td><td>0.928</td><td>0.401</td><td>0.804</td><td>—</td><td></td><td></td><td></td></tr><tr><td></td><td>p value</td><td>&lt; 0.001</td><td>&lt; 0.001</td><td>&lt; 0.001</td><td>&lt; 0.001</td><td>—</td><td></td><td></td><td></td></tr><tr><td>6. CBI—Client-related burnout</td><td>Pearson's r</td><td>0.512</td><td>0.853</td><td>0.290</td><td>0.538</td><td>0.654</td><td>—</td><td></td><td></td></tr><tr><td></td><td>p value</td><td>&lt; 0.001</td><td>&lt; 0.001</td><td>&lt; 0.001</td><td>&lt; 0.001</td><td>&lt; 0.001</td><td>—</td><td></td><td></td></tr><tr><td>7. MBI—Emotional exhaustion</td><td>Pearson's r</td><td>0.875</td><td>0.741</td><td>0.386</td><td>0.650</td><td>0.722</td><td>0.588</td><td>—</td><td></td></tr><tr><td></td><td>p value</td><td>&lt; 0.001</td><td>&lt; 0.001</td><td>&lt; 0.001</td><td>&lt; 0.001</td><td>&lt; 0.001</td><td>&lt; 0.001</td><td>—</td><td></td></tr><tr><td>8. MBI—Depersonalization</td><td>Pearson's r</td><td>0.768</td><td>0.506</td><td>0.170</td><td>0.381</td><td>0.491</td><td>0.449</td><td>0.647</td><td>—</td></tr><tr><td></td><td>p value</td><td>&lt; 0.001</td><td>&lt; 0.001</td><td>&lt; 0.001</td><td>&lt; 0.001</td><td>&lt; 0.001</td><td>&lt; 0.001</td><td>&lt; 0.001</td><td>—</td></tr><tr><td>9. MBI—Personal accomplishment</td><td>Pearson's r</td><td>0.670</td><td>0.144</td><td>0.085</td><td>0.146</td><td>0.112</td><td>0.128</td><td>0.316</td><td>0.229</td></tr><tr><td></td><td>p value</td><td>&lt; 0.001</td><td>&lt; 0.001</td><td>0.034</td><td>&lt; 0.001</td><td>0.005</td><td>0.001</td><td>&lt; 0.001</td><td>&lt; 0.001</td></tr></tbody></table>
<table><caption>TABLE 3 | Results of regression analysis of participants' perceptions of work exhaustion.</caption><thead><tr><th rowspan="2">Names</th><th rowspan="2">Effect</th><th rowspan="2">Estimate</th><th colspan="5">95% Confidence Interval</th></tr><tr><th>SE</th><th>Lower</th><th>Upper</th><th>β</th><th>df</th><th>t</th><th>p</th></tr></thead><tbody><tr><td>(Intercept)</td><td>(Intercept)</td><td>7.0082</td><td>0.3096</td><td>6.4000</td><td>7.6165</td><td>0.0000</td><td>534</td><td>22.6337</td><td>&lt; 0.001</td></tr><tr><td rowspan="2">CBI—Personal Relationships</td><td>Vigilance—No worries</td><td>0.1749</td><td>0.1809</td><td>-0.1803</td><td>0.5302</td><td>0.1112</td><td>534</td><td>0.9673</td><td>0.334</td></tr><tr><td>Alarming—No worries</td><td>0.8582</td><td>0.2466</td><td>0.3737</td><td>1.3427</td><td>0.5455</td><td>534</td><td>3.4798</td><td>&lt; 0.001</td></tr><tr><td rowspan="2">CBI—Professional Relationships</td><td>Vigilance—No worries</td><td>0.3427</td><td>0.1829</td><td>-0.0166</td><td>0.7020</td><td>0.2178</td><td>534</td><td>1.8737</td><td>0.062</td></tr><tr><td>Alarming—No worries</td><td>0.7810</td><td>0.2411</td><td>0.3075</td><td>1.2545</td><td>0.4964</td><td>534</td><td>3.2400</td><td>0.001</td></tr><tr><td rowspan="2">CBI—Relational burnout</td><td>Vigilance—No worries</td><td>0.1115</td><td>0.1575</td><td>-0.1978</td><td>0.4208</td><td>0.0709</td><td>534</td><td>0.7081</td><td>0.479</td></tr><tr><td>Alarming—No worries</td><td>0.1876</td><td>0.1934</td><td>-0.1923</td><td>0.5674</td><td>0.1192</td><td>534</td><td>0.9701</td><td>0.332</td></tr><tr><td rowspan="2">MBI—Emotional Exhaustion</td><td>Moderate—Low</td><td>0.0184</td><td>0.3232</td><td>-0.6164</td><td>0.6532</td><td>0.0117</td><td>534</td><td>0.0570</td><td>0.955</td></tr><tr><td>High—Low</td><td>0.4855</td><td>0.3406</td><td>-0.1835</td><td>1.1546</td><td>0.3086</td><td>534</td><td>1.4255</td><td>0.155</td></tr><tr><td rowspan="2">MBI—Depersonalization Dehumanization</td><td>Moderate—Low</td><td>-0.0193</td><td>0.2252</td><td>-0.4617</td><td>0.4230</td><td>-0.0123</td><td>534</td><td>-0.0859</td><td>0.932</td></tr><tr><td>High—Low</td><td>-0.0912</td><td>0.2264</td><td>-0.5359</td><td>0.3536</td><td>-0.0580</td><td>534</td><td>-0.4027</td><td>0.687</td></tr><tr><td rowspan="2">MBI—Loss Professional Accumulation</td><td>Moderate—Low</td><td>-0.0710</td><td>0.1738</td><td>-0.4124</td><td>0.2704</td><td>-0.0451</td><td>534</td><td>-0.4085</td><td>0.683</td></tr><tr><td>High—Low</td><td>-0.0889</td><td>0.1464</td><td>-0.3765</td><td>0.1987</td><td>-0.0565</td><td>534</td><td>-0.6070</td><td>0.544</td></tr><tr><td>Age</td><td>Age</td><td>0.0160</td><td>0.0069</td><td>0.0025</td><td>0.0295</td><td>0.1147</td><td>534</td><td>2.3335</td><td>0.020</td></tr><tr><td>Sex</td><td>Men—Women</td><td>0.2465</td><td>0.1257</td><td>-0.0005</td><td>0.4935</td><td>0.1567</td><td>534</td><td>1.9604</td><td>0.050</td></tr><tr><td>Job Satisfaction</td><td>Job Satisfaction</td><td>0.0259</td><td>0.0305</td><td>-0.0341</td><td>0.0858</td><td>0.0373</td><td>534</td><td>0.8473</td><td>0.397</td></tr><tr><td rowspan="2">Job Status</td><td>Student—Employee</td><td>-0.7335</td><td>1.0133</td><td>-2.7239</td><td>1.2570</td><td>-0.4662</td><td>534</td><td>-0.7239</td><td>0.469</td></tr><tr><td>Independant—Employee</td><td>0.1514</td><td>0.2242</td><td>-0.2890</td><td>0.5918</td><td>0.0962</td><td>534</td><td>0.6752</td><td>0.500</td></tr><tr><td>Search for employment—Employee</td><td></td><td>-0.3941</td><td>0.7202</td><td>-1.8088</td><td>1.0206</td><td>-0.2505</td><td>534</td><td>-0.5472</td><td>0.584</td></tr><tr><td>Not currently working—Employee</td><td></td><td>0.1831</td><td>0.8302</td><td>-1.4478</td><td>1.8140</td><td>0.1164</td><td>534</td><td>0.2205</td><td>0.826</td></tr><tr><td rowspan="2">Psychological follow-up</td><td>Sick Leave—Employee</td><td>0.4064</td><td>0.3840</td><td>-0.3479</td><td>1.1607</td><td>0.2583</td><td>534</td><td>1.0584</td><td>0.290</td></tr><tr><td>Non—Oui</td><td>0.0732</td><td>0.1418</td><td>-0.2052</td><td>0.3517</td><td>0.0465</td><td>534</td><td>0.5165</td><td>0.606</td></tr><tr><td>Seniority in the Job</td><td>Seniority in the Job</td><td>0.0050</td><td>0.0084</td><td>-0.0115</td><td>0.0215</td><td>0.0287</td><td>534</td><td>0.5985</td><td>0.550</td></tr><tr><td rowspan="2">Group_Depression</td><td>Minimum Depression—No Depression</td><td>2.3920</td><td>0.4827</td><td>1.4438</td><td>3.3402</td><td>1.5205</td><td>534</td><td>4.9556</td><td>&lt; 0.001</td></tr><tr><td>Low Depression—No Depression</td><td>2.0007</td><td>0.5044</td><td>1.0098</td><td>2.9915</td><td>1.2717</td><td>534</td><td>3.9663</td><td>&lt; 0.001</td></tr><tr><td rowspan="2">Moderate Depression—No Depression</td><td>Moderate Depression—No Depression</td><td>2.1328</td><td>0.5290</td><td>1.0936</td><td>3.1719</td><td>1.3557</td><td>534</td><td>4.0318</td><td>&lt; 0.001</td></tr><tr><td>Moderately severe depression—No Depression</td><td>1.6010</td><td>0.5442</td><td>0.5320</td><td>2.6699</td><td>1.0177</td><td>534</td><td>2.9422</td><td>0.003</td></tr><tr><td>Severe Depression—No Depression</td><td></td><td>1.9659</td><td>0.5757</td><td>0.8350</td><td>3.0968</td><td>1.2496</td><td>534</td><td>3.4149</td><td>&lt; 0.001</td></tr></tbody></table>

(Continues)
<table><caption>TABLE 3 | (Continued)</caption><thead><tr><th rowspan="2">Names</th><th rowspan="2">Effect</th><th rowspan="2">Estimate</th><th colspan="5">95% Confidence Interval</th></tr><tr><th>SE</th><th>Lower</th><th>Upper</th><th>β</th><th>df</th><th>t</th><th>p</th></tr></thead><tbody><tr><td rowspan="3">Group_Anxiety</td><td>Low Anxiety–No Anxiety</td><td>0.1377</td><td>0.2097</td><td>-0.2743</td><td>0.5497</td><td>0.0875</td><td>534</td><td>0.6566</td><td>0.512</td></tr><tr><td>Moderate Anxiety–No Anxiety</td><td>-0.0307</td><td>0.2532</td><td>-0.5282</td><td>0.4668</td><td>-0.0195</td><td>534</td><td>-0.1213</td><td>0.904</td></tr><tr><td>Severe Anxiety–No Anxiety</td><td>0.1498</td><td>0.3014</td><td>-0.4422</td><td>0.7419</td><td>0.0952</td><td>534</td><td>0.4972</td><td>0.619</td></tr><tr><td rowspan="3">Group_Resilience</td><td>Normal Resilience–Low Resilience</td><td>-0.0785</td><td>0.2029</td><td>-0.4770</td><td>0.3200</td><td>-0.0499</td><td>534</td><td>-0.3870</td><td>0.699</td></tr><tr><td>High Resilience–Low Resilience</td><td>0.0680</td><td>0.4890</td><td>-0.8925</td><td>1.0285</td><td>0.0432</td><td>534</td><td>0.1391</td><td>0.889</td></tr></tbody></table>

$t=3.623, p < 0.001)$. In contrast, the depersonalization dimension of the MBI was negatively associated with work exhaustion ($B = -0.028, SE = 0.010, \beta = -0.136, t = -2.734, p = 0.006)$. The personal accomplishment dimension of the MBI had no significant effect ($B = -0.002, SE = 0.006, \beta = -0.014, t = -0.365, p = 0.715)$. Sex was found to be a significant predictor, with being female associated with higher levels of work exhaustion ($B = 0.284, SE = 0.120, t = 2.364, p = 0.018)$. Employment status represented by different categories had different effects. While students and unemployed did not significantly predict work exhaustion ($B = -0.738, SE = 0.990, t = -0.745, p = 0.456$ and $B = -0.074, SE = 0.811, t = -0.091, p = 0.927$, respectively), individual looking for employment showed a negative association, although not statistically significant ($B = -0.989, SE = 0.575, t = -1.721, p = 0.086)$.

Meanwhile, the dimensions of the CBI showed mixed results. Personal burnout positively and significantly predicted work exhaustion ($B = 0.083, SE = 0.024, \beta = .212, t = 3.416, p < 0.001)$. Work-related burnout also positively predicted work exhaustion but to a lesser extent ($B = 0.045, SE = 0.021, \beta = 0.152, t = 2.138, p = 0.033)$. However, client-related burnout did not have a significant effect ($B = 0.001, SE = 0.014, \beta = 0.005, t = 0.103, p = 0.918)$.

## 4 | Discussion

Burnout is a critical issue that has received considerable attention in occupational health research, but data on its prevalence and characteristics in the general population remain scarce. The inconsistent definitions of burnout and the variable effectiveness of current measurement tools have made it difficult to develop universal interventions. To address this, we investigated the applicability of the CBI to a general population, which led us to compare its performance with that of the MBI. In the current study, we aimed to examine the relationships among the MBI, CBI, and participants' perceptions of work exhaustion. Our findings revealed robust correlations among these constructs. Specifically, the emotional exhaustion dimension of the MBI was strongly associated with work exhaustion and all burnout dimensions of the CBI. The depersonalization dimension of the MBI was also significantly correlated with these constructs. Interestingly, the personal accomplishment dimension of the MBI had a weak but statistically significant relationship with work exhaustion.

Our results indicated that the CBI personal burnout scale category and the professional burnout scale were significant predictors of work exhaustion. The CBI personal relationships category demonstrated a robust correlation with work exhaustion, indicating that personal relationships exert a considerable influence on burnout levels. Similarly, the CBI professional burnout scale was identified as a significant predictor, underscoring the pivotal role of professional context in understanding burnout. The findings indicated that younger employees may be more susceptible to burnout due to the pressures associated with their career advancement. Additionally, the data revealed that women tend to report higher levels of exhaustion, which aligns with the findings of previous gender-based burnout research (Purvanova and Muros 2010).

The variability in burnout experiences across different professions indicates that individual differences, such as personality traits, may exert a considerable influence on the manner in
which burnout is experienced and reported. For example, research has demonstrated that personality traits such as neuroticism, extraversion, and conscientiousness can influence an individual's vulnerability to burnout (Swider and Zimmerman 2010; Alarcon, Eschleman, and Bowling 2009). For example, individuals high in neuroticism may report higher levels of burnout, while those high in extraversion may report lower levels of burnout due to enhanced resilience (Kim, Shin, and Umbreit 2007). We found a correlation between the CBI and subjective perceptions of burnout, indicating that the CBI may be a more effective measure of the personal and work-related stressors influenced by personality traits, although this remains to be tested. This finding is consistent with the view that burnout may not be solely a result of job demands, but may also be influenced by self-regulation and personality traits (Bakker and Demerouti 2017).

A notable aspect of our sample was that approximately 30% of the participants were receiving psychological counseling, underscoring the significant impact of burnout on quality of life. In addition, the participants were asked about their perceptions of burnout, allowing for a comparison of perceived burnout with the measured levels of burnout, as indicated by the MBI and CBI.

Shoman et al (Shoman et al. 2021). stated that while examining burnout, one can oscillate between exaggerating it as a 21st-century epidemic and underestimating it. To provide valid and reliable results, patient-reported outcome measures (PROMs) should exhibit robust psychometric properties. Among the five PROMs, they found that only the CBI and, to a lesser extent, the Oldenburg Burnout Inventory could meet this prerequisite (Shoman et al. 2021). As shown in this study, the possibility of assessing perceived burnout using a single item could be of great interest. It could be used as a screening measure to facilitate further assessment and management of the problem.

Our results suggest that the CBI may be a more appropriate measure for assessing burnout in the general population. Very few studies have been conducted on the general population, and most studies on these scales have focused on specific groups of healthcare professionals. The structure and items of the CBI may be more relatable and applicable to individuals from diverse occupational backgrounds, making it a versatile tool for assessing burnout in the general population.

In line with Guthier et al.'s (Guthier, Dormann, and Voelkle 2020) meta-analysis, our findings highlight the need to expand job stress theories by focusing on the role personality plays in burnout (Angelini 2023). The Network on the Coordination and Harmonization of European Occupational Cohorts has decided to prioritize this issue and propose a harmonized definition of occupational burnout for its use as a health outcome in future longitudinal studies (Guseva Canu et al. 2021).

## 4.1 | Limitations

Despite its contributions, this study had some limitations. First, the research design was based on a survey that relied on self-reported data. The study did not include interviews or other

forms of face-to-face assessments, which could have provided a more comprehensive understanding of participants' burnout experiences. Self-reported measures, while convenient, are subject to biases, including social desirability and recall biases, which may affect the accuracy of the data collected. Second, our study focused on the general population rather than healthcare professionals or students in health-related fields, which are common populations in burnout research. However, this approach allowed for a broader understanding of burnout, as it also occurs in the general population, and provided widely applicable insights. For instance, while quantitative data may indicate a high prevalence of burnout in a specific profession, qualitative data can elucidate the underlying causes and provide context-specific solutions. Future research should address these limitations to obtain a more comprehensive and accurate understanding of burnout (Soares et al. 2023).

## 5 | Conclusion

The accurate measurement of burnout is essential for the development of effective interventions and the improvement of workplace well-being. Our findings revealed that the CBI exhibited stronger correlations with subjective perceptions of burnout in comparison to the MBI, suggesting that CBI is a more versatile tool. While both scales capture the core dimensions of burnout, there appear to be additional nuances and dimensions that these instruments can uncover. This underscores the importance of a comprehensive approach to assessing burnout to ensure that all potential facets are considered. The results of this study suggest that the CBI may be more appropriate for assessing burnout in the general population because its structure and items may be more relatable to individuals of diverse occupational backgrounds. Our results are informative but should be interpreted with the study's limitations in mind. Future studies should explore burnout within different professional settings, with the goal of elucidating its multifaceted nature and contributing to the development of effective and targeted interventions.

### Acknowledgements

The authors have nothing to report.

### Ethics Statement

All procedures involving human participants performed in this study were in accordance with the Ethics Committee of the University of Paris Nanterre and the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

### Consent

Informed consent was obtained from all participants included in the study.

### Conflicts of Interest

The authors declare no conflicts of interest.

### Data Availability Statement

The data that support the findings of this study are available at the Open Science Framework link: https://osf.io/58e2u/.
The peer review history for this article is available at https://www.webofscience.com/api/gateway/wos/peer-review/10.1002/mhs2.97.

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## Supporting Information

Additional supporting information can be found online in the Supporting Information section.

## Appendix A

### CBI Items—French

Répondez aux questions suivantes en vous positionnant sur l'échelle suivante de 0 jamais/presque jamais à 4 toujours, les chiffres intermédiaires vous permettent de nuancer votre réponse.
1. Vous sentez vous fatigué(e)?

2. Vous arrive-t-il d'être épuisé(e) physiquement?

3. Vous arrive-t-il d'être épuisé(e) émotionnellement?

4. Combien de fois pensez-vous « je n'en peux plus »?

5. Vous sentez-vous exténué(e)?

6. Vous arrive-t-il de vous sentir faible ou prédisposé(e) à être malade?

7. Vous sentez vous usé à la fin de la journée de travail?

8. Êtes-vous fatigué le matin à la pensée d'une nouvelle journée de travail?

9. Pensez-vous que chaque heure de travail est fatigante?

10. Manquez-vous d'énergie pour la famille et les amis durant vos loisirs?

11. Votre travail est-il épuisant émotionnellement?

12. Est-ce que votre travail vous frustre?

13. Vous sentez-vous épuisé à cause de votre travail?

14. Trouvez-vous difficile de travailler avec des patients/clients/collègues?

15. Trouvez-vous frustrant de travailler avec des patients/clients/collègues?

16. Travailler avec des patients/clients/collègues vous vide-t-il de votre énergie?

17. Avez-vous l'impression de donner davantage que vous ne recevez lorsque vous travaillez?

18. Êtes-vous fatigué de travailler avec des patients/clients/collègues?

19. Vous demandez-vous parfois combien de temps vous allez être capable de continuer à travailler avec des patients/clients/collègues?

# Appendix B

## MBI Items—French

Les 22 phrases ci-dessous représentent des sentiments (ou des idées, des impressions) que l'on peut éprouver à propos de son travail. Pour chaque sentiment (ou idée ou impression) merci d'indiquer selon quelle fréquence vous l'avez ressenti au cours des derniers mois. Merci d'indiquer votre réponse sur l'échelle allant de Jamais à chaque jour.

1. Je me sens émotionnellement vidé(e) par mon travail.

2. Je me sens à bout à la fin de ma journée de travail.

3. Je me sens fatigué(e) lorsque je me lève le matin et que j'ai à affronter une autre journée de travail.

4. Je peux comprendre facilement ce que mes patients/clients/élèves ressentent.

5. Je sens que je m'occupe de certains patients/clients/élèves de façon impersonnelle comme s'ils étaient des objets.

6. Travailler avec des gens tout au long de la journée me demande beaucoup d'effort.

7. Je m'occupe très efficacement des problèmes de mes patients/clients/élèves.

8. Je sens que je craque à cause de mon travail.

9. J'ai l'impression, à travers mon travail, d'avoir une influence positive sur les gens.

10. Je suis devenu(e) plus insensible aux gens depuis que j'ai ce travail.

11. Je crains que ce travail ne m'endurcisse émotionnellement.

12. Je me sens plein(e) d'énergie.

13. Je me sens frustré(e) par mon travail.

14. Je sens que je travaille « trop dur » dans mon travail.

15. Je ne me soucie pas vraiment de ce qui arrive à certains de mes patients/clients/élèves.

16. Travailler en contact direct avec les gens me stresse trop.

17. J'arrive facilement à créer une atmosphère détendue avec mes patients/clients/élèves18-Je me sens ragaillard(e) lorsque dans mon travail j'ai été proche de mes patients/clients/élèves.

18. J'ai accompli beaucoup de choses qui en valent la peine dans ce travail.

19. Je me sens au bout du rouleau.

20. Dans mon travail, je traite les problèmes émotionnels très calmement.

21. J'ai l'impression que mes patients/clients/élèves me rendent responsable de certains de leurs problèmes.

# Appendix A'

## CBI Items—English

Answer the following questions using the following scale from 0 never/ almost never to 4 always. The figures in between allow you to qualify your answer.

1. Do you feel tired?

2. Do you ever feel physically exhausted?

3. Do you ever feel emotionally exhausted?

4. How often do you think "I can't take it any more"?

5. Do you feel exhausted?

6. Do you ever feel weak or prone to illness?

7. Do you feel worn out at the end of the working day?

8. Are you tired in the morning at the thought of a new working day?

9. Do you think that every hour you work is tiring?

10. Do you lack energy for family and friends in your free time?

11. Is your work emotionally draining?

12. Does your work frustrate you?

13. Do you feel exhausted because of your work?

14. Do you find it difficult to work with patients/clients/colleagues?

15. Do you find working with patients/clients/colleagues frustrating?

16. Does working with patients/clients/colleagues drain your energy?

17. Do you feel that you give more than you receive when you work?

18. Are you tired of working with patients/clients/colleagues?

19. Do you ever wonder how long you will be able to continue working with patients/clients/colleagues?

# Appendix B'

## MBI Items—English

The 22 sentences below represent feelings (or ideas, impressions) that you may have about your work. For each feeling (or idea or impression), please indicate how often you have experienced it over the last
few months. Please indicate your answer on the scale from Never to Every day.

1. I feel emotionally drained by my work.

2. I feel exhausted at the end of my working day.

3. I feel tired when I get up in the morning and have to face another day at work.

4. I can easily understand how my patients/clients/students feel.

5. I feel that I deal with some patients/clients/students in an impersonal way as if they were objects.

6. Working with people throughout the day takes a lot of effort.

7. I deal very effectively with my patients'/clients'/students' problems.

8. I feel I'm cracking up because of my work.

9. I have the impression, through my work, that I have a positive influence on people.

10. I've become more insensitive to people since I've had this job.

11. I fear that this job will harden me emotionally.

12. I feel full of energy.

13. I feel frustrated by my work.

14. I feel that I work “too hard” at my job.

15. I don't really care what happens to some of my patients/clients/students.

16. Working in direct contact with people stresses me out too much.

17. I find it easy to create a relaxed atmosphere with my patients/clients/students.

18. I feel refreshed when in my work I have been close to my patients/clients/students.

19. I have achieved many worthwhile things in this job.

20. I feel at the end of my rope.

21. In my job, I deal with emotional problems very calmly.

22. I feel that my patients/clients/students blame me for some of their problems.