Psychometric properties of the arabic version of the maslach burnout inventory-human services survey (MBI-HSS) among lebanese dentists

Bassam et al. BMC Oral Health (2023) 23:451 https://doi.org/10.1186/s12903-023-03169-7 BMC Oral Health Open Access RESEARCH Psychometric properties of the arabic version of the maslach burnout inventory-human services survey (MBI-HSS) among lebanese dentists Sanaa Bassam1, Heba Mohsen1,2,3, Zainab Barakat1 and Linda Abou-Abbas1,4* Abstract Background Dentists are at risk of burnout syndrome, which can have negative impacts on their work environment and productivity. Assessing burnout is crucial for maintaining the well-being and effectiveness of dentists in their profession. The present study aims to evaluate the psychometric properties of the Arabic version of the Maslach Burnout Inventory Human Services Survey (MBI-HSS) among dentists. Methods The original English version of the MBI-HSS was translated into Arabic, and then back-translated into English by experienced bilingual professionals. Lebanese dentists were asked to participate in the study between February and June 2019. Data collected included demographic information and items from the Arabic version of the MBI-HSS. Results A total of 441 people participated in the study, of whom 58.3% were men. The mean age of the sample was 39.6 years (SD = 12.8), with a range of 23 to 68 years old. Approximately 60% of dentists were specialists. Cronbach’s alphas were as follows: emotional exhaustion (alpha = 0.855), depersonalization (alpha = 0.823), and personal achievement (alpha = 0.667). The results of the test-retest reliability assessment demonstrated the strong reproducibility of the MBI-HSS [EE, ICC = 0.927 (0.845, 0.966), p-value < 0.0001; PA, ICC = 0.963 (0.921–0.983), p-value < 0.001; DP, ICC = 0.764 (0.497–0.889), p-value < 0.0001]. The exploratory factor analysis of the MBI-HSS yielded three psychometrically robust sub-domains representing dimensions of “emotional exhaustion,” “depersonalization,” and “personal achievement,” which explained 57.8% of the scale’s total variance. The confirmatory factor analysis revealed that the 15-item model (excluding items 4, 5, 12, 13, 16, 20, and 22) was the most fitting for the data. Conclusions The Arabic version of the MBI-HSS scale demonstrated good psychometric properties in Lebanese dentists. However, it would be important to conduct further research to confirm its reliability and validity in other Arab countries. Keywords Arabic Version, Burnout, Dentists, Lebanon, Maslach Burnout Inventory-Human Services Survey, Psychometrics *Correspondence: Linda Abou-Abbas Full list of author information is available at the end of the article © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Bassam et al. BMC Oral Health (2023) 23:451 Introduction Research has shown that dentistry is one of the most stressful professions among healthcare workers, with dentists facing a variety of work-related stressors that can negatively impact their physical and mental well-being [1]. These stressors include prolonged working hours, time and scheduling pressures, high noise levels, posture maintenance for long periods, income dissatisfaction, patient demands, and social isolation [2, 3]. Studies have found that the work environment of dentists can greatly influence their health, and that chronic stress can lead to significant psychological issues such as anxiety, depression, and burnout [4]. Burnout refers to gradual depletion of a person manifested by emotional exhaustion, depersonalization, and diminished work efficacy [5]. It is a psychological syndrome that results from prolonged interpersonal stress in workplace [6]. Workers who develop burnout syndrome may show signs of personality change, memory disturbances, and concentration problems [7]. Dentists are particularly susceptible to this condition due to the nature of their work [8, 9], including dealing with anxious patients and managing staff [10, 11]. If left unaddressed, prolonged burnout can lead to serious health problems such as cardiovascular diseases, musculoskeletal problems, and mental illnesses like depression [9, 12–14]. In severe cases, depression could culminate in suicide [15]. Numerous research studies have assessed burnout among dentists worldwide [16–18]. One study conducted in the United States found that one in eight dentists suffers from burnout [19], while another study in Northern Ireland revealed that more than 26% of dental staff are at high risk of burnout [20]. Moreover, a study in the Netherlands found that 21% of participants had a certain level of burnout risk, 13% had high overall levels of burnout, and 2.5% were highly burned out [21]. Burnout is considered a serious risk in dentistry that should be measured frequently among all dentists [22]. Being aware of burnout and managing its symptoms, consequently, improves job satisfaction, patient care, and organizational outcomes [23, 24]. The Maslach Burnout Inventory (MBI) is widely recognized as the “gold standard” for burnout assessment and estimation [25]. There are three main versions of the MBI that measure same burnout dimensions (depersonalization, emotional exhaustion, and personal accomplishment), but are tailored to different occupations. These forms are MBI-General Survey, MBI-Educators Survey, and MBI-Human Services Survey (MBI-HSS) [26]. The MBI-HSS is a commonly used instrument for assessing burnout across three dimensions: emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA) [27]. The EE subscale includes nine items that measure feelings of exhaustion and frustration Page 2 of 8 towards work. The DP subscale comprises five items that assess feelings of detachment or cynicism towards patients. Finally, the PA subscale includes eight items that measure a sense of achievement and fulfillment from work. The MBI-HSS has proven to be a reliable and valid instrument for assessing burnout in a variety of human service professions such as dentists [28, 29], nurses [30], and medical personnel [31–3 (...truncated)