题名

臨床護理師職業倦怠雙元三因子效度研究

并列篇名

A Validation Study of Bi-factor Structure of Chinese Nurses Burnout with ESEM

DOI

10.6251/BEP.201912_51(2).0002

作者

趙燕(Yan Zhao)；王郁琮(Y. Lawrence Wang)；王智弘(Chi-Hung Wang)

关键词

探索性結構方程模式 ； 職業倦怠 ； 雙元因子模式 ； 護理師 ； Bi-factor Model ； Burnout ； Exploratory Structural Equation Model ； Nurses

期刊名称

教育心理學報

卷期/出版年月

51卷2期（2019 / 12 / 01）

页次

207 - 230

内容语文

繁體中文
中文摘要

本研究採用Moreno-Jime'nez等人編製之護理師職業倦怠量表（Nursing Burnout Scale, NBS）中文簡版為測量工具，以分層隨機抽樣方式選取江蘇省523名臨床護理師爲研究對象，以Mplus8.1統計軟體進行資料分析，比較職業倦怠一因子、三因子、高階因子以及雙元因子四模式，應用CFA與ESEM進行參數估計，旨在探討華人臨床護理師職業倦怠因素結構。研究結果顯示，臨床護理師職業倦怠雙元三因子ESEM模式之適配度最佳，護理師職業倦怠除了「情緒衰竭」、「低成就感」與「對人冷漠」等三種特定倦怠因子之外，還蘊含著一個「整體倦怠」因素。唯，整體因子與「對人冷漠」特定因子能夠有效解釋對應觀察變項之變異，而「情緒衰竭」、「低成就感」特定因子只能解釋小部分觀察變項的變異。本研究結果呼應了由Mészáros Ádám、Szabó、Szigeti與Urbán（2014）提出的職業倦怠雙元因子結構，顯示職業倦怠雙元因子模式具有跨文化、跨情境、跨行業的類推性。比起CFA，在參數估計上ESEM提供了更合理精準的雙元因子參數估計值。本研究結果可提升心理計量研究對於護理師職業倦怠多維度潛在結構之認識。並可提示醫院管理者，在為處於危機中之臨床護理師提供干預時應考慮其職業倦怠總分。然而，因「情緒衰竭」與「低成就感」分量表之題項並未完全反應對應之特定因子，因而在實務或研究中需慎用此二分量表因子分。未來研究可進一步探討諸如性別、年資等背景變項在職業倦怠雙元三因子模式的測量恆等性。
英文摘要

This study validated the bi-factor structural construct of the Nursing Burnout Scale (NBS) by using a stratified sample of 523 nurses from Jiang Shu, China, who completed the short version of the NBS survey in Chinese. Mplus software (version 8.1) provided the statistical outputs for all analyses conducted in this study. The findings for four alternative burnout constructs-single-, three-, high-order, and bi-factor models-employing confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM) approaches improved our understanding of work burnout among nurses in the hospitals in China. Statistical comparison among a series of nested CFA and ESEM models revealed that a bi-factor model with a global burnout factor and three content-specific factors-emotional exhaustion (EE), depersonalization (DP), and reduced personal accomplishment (PA)-involving the ESEM approach outperformed all other models in terms of the model data fit. Only global burnout factor and the content-specific DP factor explained the considerable unique proportion of variance in the observed scores. The content-specific factors EE and PA only explained a small unique proportion of variance in the observed scores. The findings support the bi-factor structure of the NBS that was originally proposed by Mészáros et al. in Hungary (2014). Moreover, the findings provide insights into understanding the cross-culture and cross-situation factorial consistency of nursing burnout. Compared with CFA, ESEM is a better approach for validating the bi-factor factorial structure. The findings improve our understanding of the complexity of the multidimensional structure of job burnout among nurses. Moreover, the proposed method provides hospital administrators with the total burnout score to ensure timely intervention for the staff who are at risk. However, the EE and PA scores should be interpreted carefully because these scores reflect a very small proportion of the burnout content. Further investigation on invariance measurement based on gender and time will provide insights into the generalizability of the bi-factor nursing burnout structure.
主题分类 社會科學 > 心理學
社會科學 > 教育學
参考文献
  1. Ming, J. L.,Tseng, L. H.,Huang, H. M.,Hong, S. P.,Chang, C. I.,Tung, C. Y.(2019).Clinical simulation teaching program to promote the effectiveness of nurses in coping with workplace violence.Journal of Nursing,66(3),59-71.
    連結：
  2. 黃寶園, B.-Y.(2009)。工作壓力對工作滿足、職業倦怠影響之研究：統合分析取向。教育與心理學報，40(3)，439-462。
    連結：
  3. 葉婉榆, W.-Y.,鄭雅文, Y.-W.,陳美如, M.-J.,邱文祥, W.-H.(2008)。職場疲勞量表的編製與信效度分析。台灣公共衛生雜誌，27(5)，349-364。
    連結：
  4. Ádám, S.,Mészáros, V.(2012).Psychometric properties and health correlates of the Hungarian version of the Maslach burnout inventory-human services survey (MBI-HSS) among physicians.Mentálhigiéné es Pszichoszomatika,13(2),127-143.
  5. Adriaenssens, J.,De Gucht, V.,Maes, S.(2012).The impact of traumatic events on emergency room nurses: Findings from a questionnaire survey.International Journal of Nursing Studies,49(11),1411-1422.
  6. Aiken, L. H.,Clarke, S. P.,Sloane, D. M.,Sochalski, J. A.,Busse, R.,Clarke, H.,Shamian, J.(2001).Nurses’ reports on hospital care in five countries.Health Affairs,20(3),43-53.
  7. Asparouhov, T., & Muth´en, B. O. (2006). Robust chi-square difference testing with mean and variance adjusted test statistics. Los Angeles, CA: Muth´en & Muth´en. Retrieved from http://www.statmodel.com/examples/webnote. shtml #web10
  8. Asparouhov, T.,Muthén, B. O.(2009).Exploratory structural equation modeling.Structural Equation Modeling,16,397-438.
  9. Asparouhov, T.,Muthén, B. O.,Morin, A. J. S.(2015).Bayesian structural equation modeling with cross-loadings and residual covariances.Journal of Management,41,1561-1577.
  10. Barrett, L.,Yates, P.(2002).Oncology/haematology nurses: A study of job satisfaction, burnout, and intention to leave the specialty.Australian Health Review,25(3),109-121.
  11. Brookings, J. B.,Bolton, B.,Brown, C. E.,Mcevoy, A.(1985).Self-reported job burnout among female human-service professionals.Journal of Occupational Behaviour,6(2),143-150.
  12. Browne, M. W.(2001).An overview of analytic rotation in exploratory factor analysis.Multivariate Behavioral Research,36,111-150.
  13. Brunner, M.,Nagy, G.,Wilhelm, O.(2012).A tutorial on hierarchically structured constructs.Journal of Personality,80(4),796-846.
  14. Cai, L.,Yang, J. S.,Hansen, M.(2011).Generalized full-information item bifactor analysis.Psychological Methods,16,221-248.
  15. Chen, F. F.(2007).Sensitivity of goodness of fit indexes to lack of measurement invariance.Structural Equation Modeling,14,464-504.
  16. Chen, F. F.,West, S. G.,Sousa, K. H.(2006).A comparison of bifactor and second-order models of quality of life.Multivariate Behavioral Research,41(2),189-225.
  17. Cheng, S. Y.,Lin, P. C.,Chang, Y. K.,Lin, Y. K.,Lee, P. H.,Chen, S. R.(2019).Sleep quality mediates the relationship between work-family conflicts and the self-perceived health status among hospital nurses.Journal of Nursing Management,27(2),381-387.
  18. Chou, L. P.,Li C. Y,Hu, S. C.(2014).Job stress and burnout in hospital employees: comparisons of different medical professionsin a regional hospital in Taiwan.BMJ Journals,4(2),1-7.
  19. Clausen, T.,Nielsen, K.,Carneiro, I. G.,Borg, V.(2012).Job demands, job resources and long-term sickness absence in the Danish eldercare services: A prospective analysis of register-based outcomes.Journal of Advanced Nursing,68(1),127-136.
  20. Densten, I. L.(2001).Rethinking burnout.Journal of Organizational Behavior,22(8),833-847.
  21. Denton, E.,Chaplin, W. F.,Wall, M.(2016).Teacher burnout: A comparison of two cultures using confirmatory factor and item response models.International Journal of Quantitative Research in Education,1(2),147-166.
  22. Eid, M.,Geiser, C.,Koch, T.,Heene, M.(2017).Anomalous results in G-factor models: Explanations and alternatives.Psychological Methods,22(3),541-562.
  23. Garrosaa, E.,Moreno-Jime´neza, B.,Liang, Y. X.,Gonza´lez, J. L.(2008).The relationship between socio-demographic variables, job stressors, burnout, and hardy personality in nurses: An exploratory study.International Journal of Nursing Studies,45(3),418-427.
  24. Gignac, G. E.,Watkins, M. W.(2013).Bifactor modeling and the estimation of model-based reliability in the WAIS-IV.Multivariate Behavioral Research,48,639-662.
  25. Guay, F.,Morin, A. J. S.,Litalien, D.,Valois, P.,Vallerand, R. J.(2015).Application of exploratory structural equation modeling to evaluate the academic motivation scale.The Journal of Experimental Education,83(1),51-82.
  26. Hancock, G. R.(Ed.),Mueller, R. O.(Ed.)(2013).Quantitative methods in education and the behavioral sciences: Issues, research, and teaching. Structural equation modeling: A second course.Charlotte, NC:IAP Information Age Publishing.
  27. Hawrot, A.,Koniewski, M.(2017).Factor structure of the Maslach burnout inventory-educators survey in a Polish-speaking sample.Journal of Career Assessmen,6,1-16.
  28. Heinen, M. M.,Achterberg, T.,Schwendimann, R.,Zander, B.,Matthews, A.,Kózka, M.,Schoonhoven. L.(2013).Nurses’ intention to leave their profession: A cross sectional observational study in 10 European countries.International Journal of Nursing Studies,50(2),174-184.
  29. Hu, C. J.,Hong, R. M.,Yeh, G. L.,Hsieh, I. C.(2019).Insomnia, work-related burnout, and eating habits affecting the work ability of flight attendants.Aerospace Medicine and Human Performance,90(7),601-605.
  30. Hu, L.,Bentler, P. M.(1999).Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives.Structural Equation Modeling: A Multidisciplinary Journal,6,1-55.
  31. Hu, Q.,Schaufeli, W. B.(2009).The factorial validity of the Maslach burnout inventory-student survey in China.Psychological Reports,105,394-408.
  32. Hyland, P.(2015).Application of bifactor models in criminal psychology research: A guide to researchers.Journal of Criminal Psychology,5,65-74.
  33. Iwanicki, E. F.,Schwab, R. L.(1981).A cross validation-study of the Maslach burnout inventory.Educational and Psychological Measurement,41(4),1167-1174.
  34. Jennrich, R. I.,Bentler, P. M.(2011).Exploratory bi-factor analysis.Psychometerika,76(4),537-549.
  35. Kahn, J. H.(2006).Factor analysis in counseling psychology research, training, and practice: Principles, advances, and applications.The Counseling Psychologist,34,684-718.
  36. Kalliath, T. J.,O’Driscoll, M. P(2000).A test of the Maslach burnout inventory in three samples of healthcare professionals.Work and Stress,14(1),35-50.
  37. Kanste, O.,Miettunen, J.,Kyngäs, H.(2006).Factor structure of the Maslach burn-out inventory among Finnish nursing staff.Nursing & Health Sciences,8(4),201-207.
  38. Kristensen, T. S.,Borritz, M.,Villadsen, E.,Christensen, K. B.(2005).The Copenhagen burnout inventory: A new tool for the assessment of burnout.Work and Stress,19(3),192-207.
  39. Langballe, E. M.,Falkum, E.,Innstrand, S.,Aasland, O.(2006).The factorial validity of the Maslach burnout inventory-general survey in representative samples of eight different occupational groups.Journal of Career Assessment,14,370-384.
  40. Lee, T. S. H.,Tzeng, W. C.,Chiang, H. H.(2019).Impact of coping strategies on nurses’ well-being and practice.Journal of Nursing Scholarship,51(2),195-204.
  41. Lee, T.-S.-H.,Swn, H.-F.,Chiang, H.-H.(2019)。Development and validation of the short-form Ryff's psychological well-being scale for clinical nurses in Taiwan。Journal of Medical Sciences，39(4)，157-162。
  42. Leiter, M. P.(1993).Burnout as a developmental process: Consideration of models.Professional burnout: Recent developments in theory and research,Washington, DC:
  43. Lin, Y. S.,Huang, W. S.,Yang, C. T.,Chiang, M. J.(2014).Work-leisure conflict and its associations with well-being: The roles of social support, leisure participation and job burnout.Tourism Management,45,244-252.
  44. Loera, B.,Converso, D.,Viotti, S.(2014).Evaluating the psychometric properties of the Maslach burnout inventory-human services survey (MBI-HSS) among Italian nurses: How many factors must a researcher consider?.Plos One,9(12),e114987.
  45. Lu, M.,Ruan H.,Xing, W.,Hu, Y.(2015).Nurse burnout in China: A questionnaire survey on staffing, job satisfaction, and quality of care.Journal of Nursing Management,23,440-447.
  46. Mäkikangas, A.,Hätinen, M.,Kinnunen, U.,Pekkonen, M.(2011).Longitudinal factorial invariance of the Maslach burnout inventory-general survey among employees with job-related psychological health problems.Stress and Health,27(4),347-352.
  47. Marsh, H. W.,Lu¨dtke, O.,Muthe´n, B.,Asparouhov, T.,Morin, A. J. S.,Trautwein, U.(2010).A new look at the big five factor structure through exploratory Structural Equation Modeling.Psychological Assessment,22(3),471-491.
  48. Marsh, H. W.,Morin, A. J. S.,Parker,Kaur, G.(2014).Exploratory structural equation modeling: An integration of the best features of exploratory and confirmatory factor analysis.Annual Review of Clinical Psychology,10,85-110.
  49. Marsh, H. W.,Muth´en, B.,Asparouhov, T.,L¨udtke, O.,Robitzsch, A.,Morin, A. J. S.,Trautwein, U.(2009).Exploratory structural equation modeling, integrating CFA and EFA: Application to students’ evaluations of university teaching.Structural Equation Modeling,16,439-476.
  50. Marsh, H. W.,Wen, Z. L.,Hau, K. T.(2004).Structural equation models of latent interactions: Evaluation of alternative estimation strategies and indicator construction.Psychological Methods,9(3),275-300.
  51. Maslach, C.,Jackson, S. E.,Leiter, P.(1996).Maslach burnout inventory manual.Palo Alto, CA:Consulting Psychologists Press.
  52. Maslach, C.,Leiter, M. P.(2016).Understanding the burnout experience: Recent research and its implications for psychiatry.World Psychiatry,15,103-111.
  53. Maslach, C.,Schaufeli, W. B.,Leiter, M. P.(2001).Job burnout.Annual Review of Psychology,52,397-422.
  54. McAbee, S. T.,Oswald, F. L.,Connelly, B. S.(2014).Bifactor models of personality and college student performance: A broad versus narrow view.European Journal of Personality,28,604-619.
  55. McDonald, R. P.(1985).Factor analysis and related methods.Hillsdale, NJ:Lawrence Erlbaum Associates.
  56. McDonald, R. P.,Ho, M. H. R.(2002).Principles and practice in reporting structural equation analyses.Psychological Methods,7,64-82.
  57. Mészáros, V.,Ádám, S.,Szabó, M.,Szigeti, R.,Urbán, R.(2014).The bifactor model of the Maslach burnout inventory-human services survey (MBI-HSS): An alternative measurement model of burnout.Stress and Health,30,82-88.
  58. Moreno-Jime´ nez, B.,Garrosa, E.,Gonza´ lez-Gutie´ rrez, J. L.(2000).El desgaste profesional de enfermerı´a. Desarrolloy validacio´n factorial del CDPE.Archivos de Prevencio´n de Riesgos Laborales,3,18-28.
  59. Morin, A. J. S.,Arens, A. K.,Marsh, H. W.(2016).A bifactor exploratory structural equation modeling framework for the identification of distinct sources of construct-relevant psychometric multidimensionality.Structural Equation Modeling: A Multi-disciplinary Journal,23(1),116-139.
  60. Morin, A. J. S.,Maïano, C.(2011).Cross-validation of the short form of the physical self-inventory (PSI-S) using exploratory structural equation modeling (ESEM).Psychology of Sport and Exercise,12(5),540-554.
  61. Patrick, C. J.,Hicks, B. M.,Nichol, P. E.,Krueger, R. F.(2007).A bifactor approach to modeling the structure of the psychopathy checklist-revised.Journal of Personality Disorders,21(2),118-141.
  62. Pines, A. M. (Ed.)(1993).Burnout: An existential perspective.Philadelphia, PA:Taylor & Francis.
  63. Pisanti, R.,Lombardo, C.,Lucidi, F.,Violani, C.,Lazzari, D.(2013).Psychometric properties of the Maslach burnout inventory for human services among Italian nurses: A test of alternative models.Journal of Advanced Nursing,69,697-707.
  64. Reise, S. P.(2012).The rediscovery of bifactor measurement models.Multivariate Behavioral Research,47,667-696.
  65. Reise, S. P.,Bonifay, W. E.,Haviland, M. G.(2013).Scoring and modeling psychological measures in the presence of multidimensionality.Journal of Personality Assessment,95(2),129-140.
  66. Reise, S. P.,Morizot, J.,Hays, R. D.(2007).The role of the bifactor model in resolving dimensionality issues in health outcomes measures.Quality of Life Research,16,19-31.
  67. Richardsen, A. M.,Martinussen, M.(2004).The Maslach burnout inventory: Factorial validity and consistency across occupational groups in Norway.Journal of Occupational and Organizational Psychology,77,377-384.
  68. Rodriguez, A.,Reise, S. P.,Haviland, M. G.(2016).Evaluating bifactor models: Calculating and interpreting statistical indices.Psychological Methods,21,137-150.
  69. Sass, D. A.,Schmitt, T. A.(2010).A comparative investigation of rotation criteria with in exploratory factor analysis.Multivariate Behavioral Research,45(1),73-103.
  70. Schermelleh-Engel, K.,Moosbrugger, H.,Muller, H.(2003).Evaluating the it of structural equation models: tests of significance and descriptive goodness-of-fit measures.Methods of Psychological Research Online,8(2),23-74.
  71. Shirom, A.,Ezrachi, J.(2003).On the discriminant validity of burnout, depression and anxiety.Anxiety, Stress & Coping: An International Journal,16,83-99.
  72. Shirom, A.,Melamed, S.(2006).A comparison of the construct validity of two burnout measures in two groups of professionals.International Journal of Stress Management,13(2),176-200.
  73. Simms, L. J.,Grös, D. F.,Watson, D.,O’Hara, M.(2008).Parsing general and specific components of depression and anxiety with bifactor modeling.Depression and Anxiety,25,34-46.
  74. Szigeti, R.,Balázs, N.,Bikfalvi, R.,Urbán, R.(2016).Burnout and depressive symptoms in teachers: Factor structure and construct validity of the Maslach burnout inventory-educators survey among elementary and secondary school teachers in Hungary.Stress and Health,33,530-539.
  75. Tenen-baum, G.(Ed.),Eklund, R. C.(Ed.)(2007).Handbook of Sport Psychology.Hoboken, NJ:Wiley.
  76. Van Droogenbroeck, F.,Spruyt, B.,Vanroelen, C.(2014).Burnout among senior teachers: Investigating the role of workload and interpersonal relationships at work.Teaching and Teacher Education,43,99-109.
  77. Vanheule, S.,Rosseel, Y.,Vlerick, P.(2007).The factorial validity and measurement invariance of the Maslach burnout inventory for human services.Stressand Health,23(2),87-91.
  78. Vargas, P. C.,Cañadas, G. A.,Aguayo, R.,Fernández, C. R.,Fuente, E. I.(2014).Which occupational risk factors are associated with burnout in nursing? A meta-analytic study.International Journal of Clinical and Health Psychology,14,28-38.
  79. Wang, S. S.,Liu, Y. H.,Wang, L. L.(2015).Nurse burnout: Personal and environmental factors as predictors.International Journal of Nursing Practice,21,78-86.
  80. Worley, J. A.,Vassar, M.,Wheeler, D. L.,Barnes, L. L. B.(2008).Factor structure of scores from the Maslach Burnout Inventory: A review and meta-analysis of 45 exploratory and confirmatory factor-analytic studies.Educational and Psychological Measurement,68,797-823.
  81. 余民寧, M.-N.(2006).潛在模式變項：SIMPLIS 的應用.臺北市=Taipei, Taiwan:高等教育=Gao Jiao.
  82. 宋雙, S.,張立力, L.-L.(2010)。中文版護理師職業倦怠量表的信度和效度。廣東醫學，4，501-502。
  83. 唐穎, Y.,Garrosa, Eva,雷玲, L.,梁友信, Y.-X.(2007)。護理師職業倦怠量表簡介。中國職業醫學，34(2)，151-153。
  84. 黃芳銘, F.-M.(2007).結構方程模式：理論與用.臺北市=Taipei, Taiwan:五南=Wu Nan.
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