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Journal of Patient-Reported Outcomes

Table 2 Item Parameter Estimates and Standard Errors (SE) for Calibrated Emotional Exhaustion (EE), Depersonalization (DP), and Personal Accomplishment (PA) IRT Models a

From: Describing the emotional exhaustion, depersonalization, and low personal accomplishment symptoms associated with Maslach Burnout Inventory subscale scores in US physicians: an item response theory analysis

  

Item Discrimination Estimates

Item Threshold Estimates and SEs

 

IRT Model (n)

Item

aj (se)

\( {b}_{1_j} \) (se)

\( {b}_{2_j} \) (se)

\( {b}_{3_j} \) (se)

\( {b}_{4_j} \) (se)

\( {b}_{5_j} \) (se)

\( {b}_{6_j} \) (se)

Item Symptom Severity b

EEc

(n = 6264)

EE1: emotionally drained

4.32 (.09)

−1.84 (0.03)

− 1.02 (0.02)

−0.60 (0.02)

− 0.07 (0.02)

0.29 (0.02)

1.19 (0.02)

−0.34

EE2: used up

3.92 (.08)

−1.83 (0.03)

−1.17 (0.02)

−0.75 (0.02)

− 0.26 (0.02)

0.09 (0.02)

0.98 (0.02)

−0.49

EE3: fatigued

3.14 (.06)

−1.33 (0.03)

−0.70 (0.02)

−0.27 (0.02)

0.20 (0.02)

0.57 (0.02)

1.39 (0.03)

−0.02

EE5: burned out

4.36 (.09)

−1.18 (0.02)

−0.44 (0.02)

−0.10 (0.02)

0.27 (0.02)

0.60 (0.02)

1.23 (0.02)

0.07

EE6: frustrated

2.73 (.05)

−1.98 (0.04)

−1.09 (0.02)

−0.67 (0.02)

−0.18 (0.02)

0.20 (0.02)

1.02 (0.02)

−0.45

EE7: working too hard

2.44 (.05)

−1.71 (0.03)

−1.08 (0.02)

−0.66 (0.02)

−0.18 (0.02)

0.18 (0.02)

0.97 (0.02)

−0.41

EE9: end of rope

2.43 (.05)

−0.41 (0.02)

0.31 (0.02)

0.65 (0.02)

1.00 (0.02)

1.34 (0.03)

2.06 (0.04)

0.83

DP

(n = 6403)

DP1: treat patients as objects

1.76 (.05)

−0.02 (0.02)

0.73 (0.02)

1.18 (0.03)

1.64 (0.04)

2.08 (0.05)

3.31 (0.09)

1.49

DP2: more callous

3.98 (.13)

−0.52 (0.02)

0.19 (0.02)

0.54 (0.02)

0.92 (0.02)

1.26 (0.02)

2.03 (0.04)

0.74

DP3: job hardening me

2.67 (.06)

−0.55 (0.02)

0.12 (0.02)

0.46 (0.02)

0.78 (0.02)

1.11 (0.02)

1.64 (0.03)

0.59

DP4: don’t care

1.56 (.05)

0.49 (0.02)

1.32 (0.04)

1.83 (0.05)

2.27 (0.06)

2.71 (0.07)

3.62 (0.11)

2.04

DP5: patients blame me

1.07 (.03)

−1.70 (0.05)

−0.21 (0.03)

0.44 (0.03)

1.07 (0.04)

1.69 (0.05)

2.98 (0.09)

0.71

PA

(n = 6201)

PA1: easily understand patients

1.09 (.04)

−4.95 (0.20)

−4.22 (0.15)

−3.66 (0.13)

−2.73 (0.09)

−2.15 (0.07)

−0.80 (0.04)

−3.08

PA2: deal effectively with patient problems

1.63 (.05)

−3.49 (0.11)

−3.16 (0.09)

− 2.91 (0.08)

− 2.44 (0.06)

−1.98 (0.05)

−0.79 (0.03)

− 2.46

PA3: positively influencing others

2.55 (.07)

−2.97 (0.08)

−2.46 (0.05)

− 2.08 (0.04)

−1.54 (0.03)

−1.14 (0.03)

−0.24 (0.02)

− 1.74

PA4: feel energetic

1.45 (.04)

−3.09 (0.08)

−2.49 (0.06)

−1.80 (0.04)

−0.94 (0.03)

−0.38 (0.02)

1.25 (0.04)

−1.24

PA5: can create relaxed atmosphere

1.88 (.05)

−2.91 (0.08)

−2.54 (0.06)

− 2.26 (0.05)

−1.79 (0.04)

−1.43 (0.03)

−0.40 (0.02)

− 1.89

PA6: exhilarated

1.95 (.05)

−2.54 (0.06)

−1.89 (0.04)

−1.40 (0.03)

−0.76 (0.02)

−0.29 (0.02)

0.93 (0.03)

−0.99

PA7: accomplished many things

2.53 (.07)

−3.13 (0.09)

−2.28 (0.05)

−1.77 (0.04)

−1.22 (0.03)

−0.79 (0.02)

0.19 (0.02)

−1.50

PA8: deal with problems calmly

1.21 (.04)

−4.88 (0.19)

−3.83 (0.13)

−3.05 (0.09)

−2.19 (0.06)

−1.54 (0.05)

−0.10 (0.03)

−2.60

  1. aHigher scores on each scale indicate more of each construct; higher scores on the EE and DP scales indicate more burnout symptoms; lower scores on the PA scale indicate more burnout symptoms. “ aj ” parameter for the EE, DP, and PA IRT models = item discrimination parameter estimate, which indicates the degree to which an item discriminates between physicians with high versus low underlying EE, DP, or PA levels. Higher discrimination estimates indicate that the item is more discriminating compared to items with lower discrimination estimates. Item threshold estimates (\( {\mathrm{b}}_{1_{\mathrm{j}}} \) to \( {\mathrm{b}}_{6_{\mathrm{j}}} \)) indicate the IRT score at which a randomly selected physician among those with that score would have a 50% chance of endorsing the particular response category or a higher response category. For items in each model: “ \( {\mathrm{b}}_{1_{\mathrm{j}}} \) ” = threshold parameter for endorsing “few times a year or less” or more; “ \( {\mathrm{b}}_{2_{\mathrm{j}}} \) ” = threshold parameter estimate for endorsing “once a month or less” or more; “ \( {\mathrm{b}}_{3_{\mathrm{j}}} \) ” = threshold parameter estimate for endorsing “a few times a month” or more; “ \( {\mathrm{b}}_{4_{\mathrm{j}}} \) ” = threshold parameter estimate for endorsing “once a week” or more; “ \( {\mathrm{b}}_{5_{\mathrm{j}}} \) ” = threshold parameter estimate for endorsing “a few times a week” or more; “ \( {\mathrm{b}}_{6_{\mathrm{j}}} \) ” = threshold parameter estimate for endorsing “every day”. b Item symptom severity is the mean of item threshold parameter estimates (i.e., item difficulty). On the EE and DP subscales, items with lower item symptom severity values indicate that an item is easier to endorse and represents less severe burnout symptoms; higher item symptom severity values indicate that the item is harder to endorse and represents more severe burnout symptoms. On the PA subscale, items with lower symptom severity values indicate an item is harder to endorse and represents more severe burnout symptoms; items with higher symptom severity values indicate the item is easier to endorse and represents less severe burnout symptoms. c Item parameter estimates and associated SEs for the combined EE4EE8 item included in the EE IRT model are: a = 1.52 (.03); \( {\mathrm{b}}_{1_{\mathrm{j}}} \) = − 1.23 (.03), \( {\mathrm{b}}_{2_{\mathrm{j}}} \) = − 0.68 (.03), \( {\mathrm{b}}_{3_{\mathrm{j}}} \) = − 0.13 (.02), \( {\mathrm{b}}_{4_{\mathrm{j}}} \) = 0.28 (.02), \( {\mathrm{b}}_{5_{\mathrm{j}}} \) = 0.63 (.03), \( {\mathrm{b}}_{6_{\mathrm{j}}} \) = 0.96 (.03), \( {\mathrm{b}}_{7_{\mathrm{j}}} \) = 1.31 (.03), \( {\mathrm{b}}_{8_{\mathrm{j}}} \) = 1.57 (.04), \( {\mathrm{b}}_{9_{\mathrm{j}}} \) = 1.90 (.05), \( {\mathrm{b}}_{10_{\mathrm{j}}} \) = 2.23 (.05), \( {\mathrm{b}}_{11_{\mathrm{j}}} \) = 2.76 (.07), \( {\mathrm{b}}_{12_{\mathrm{j}}} \) = 3.35 (.09). Item symptom severity for EE4EE8 = 1.08
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