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    Burn Out Questionnaire

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    The Relief Worker Burnout Questionnaire is a 13-item self-assessment tool intended to help detect burnout among relief workers. Scores of 0-15 suggest adequate coping, 16-25 suggest work stress and need for preventative action, and 26-35 suggests possible burnout. A score over 35 indicates probable burnout. The questionnaire consists of statements about fatigue, irritability, cynicism, sadness, forgetfulness, social withdrawal, effort, physical complaints, disorientation, loss of interest, work negativity, inefficiency, and changes in habits, each rated on a 5-point scale.

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    Burn Out Questionnaire

    Uploaded by

    sjblora
    450 views1 page
    The Relief Worker Burnout Questionnaire is a 13-item self-assessment tool intended to help detect burnout among relief workers. Scores of 0-15 suggest adequate coping, 16-25 suggest work stress and need for preventative action, and 26-35 suggests possible burnout. A score over 35 indicates probable burnout. The questionnaire consists of statements about fatigue, irritability, cynicism, sadness, forgetfulness, social withdrawal, effort, physical complaints, disorientation, loss of interest, work negativity, inefficiency, and changes in habits, each rated on a 5-point scale.

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    Burn Out Questionnaire

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    The Relief Worker Burnout Questionnaire is a 13-item self-assessment tool intended to help detect burnout among relief workers. Scores of 0-15 suggest adequate coping, 16-25 suggest work stress and need for preventative action, and 26-35 suggests possible burnout. A score over 35 indicates probable burnout. The questionnaire consists of statements about fatigue, irritability, cynicism, sadness, forgetfulness, social withdrawal, effort, physical complaints, disorientation, loss of interest, work negativity, inefficiency, and changes in habits, each rated on a 5-point scale.

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    450 views1 page

    Burn Out Questionnaire

    Uploaded by

    sjblora
    The Relief Worker Burnout Questionnaire is a 13-item self-assessment tool intended to help detect burnout among relief workers. Scores of 0-15 suggest adequate coping, 16-25 suggest work stress and need for preventative action, and 26-35 suggests possible burnout. A score over 35 indicates probable burnout. The questionnaire consists of statements about fatigue, irritability, cynicism, sadness, forgetfulness, social withdrawal, effort, physical complaints, disorientation, loss of interest, work negativity, inefficiency, and changes in habits, each rated on a 5-point scale.

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    of 1

    (COPING WITH DISASTERS: A GUIDEBOOK TO PSYCHOSOCIAL INTERVENTION (Revised Edition)

    by John H. Ehrenreich, Ph.D. October 2001)

    The Relief Worker Burnout Questionnaire is intended to help detect burn out among relief workers. Even
    relief workers not showing signs of acute distress (e.g., as indicated by a high score on the Self Reporting
    Questionnaire) may develop burnout, with loss of efficiency and potential long term consequences.

    Interpretation: No formal norms are available for this measure. Based on the content of the items, a score of
    0 15 suggests the worker is probably coping adequately with the stress of his or her work. A score of 16-25
    suggests the worker is suffering from work stress and would be wise to take preventive action. A score of 26-
    35 suggests possible burn out. A score above 35 indicates probable burnout.

    Relief Worker Burn Out Questionnaire


    Name: ____________________________________________ Date: _________
    Instructions: Rate each of the following items in terms of how much the symptom was true of you in the last
    month.
    0 = Never
    1 = Occasionally (less than one time per week)
    2 = Somewhat often (one or two times a week)
    3 = Frequently (three or four times a week)
    4 = Almost always (almost every day)
    __________________________________________________________________________________

    ____ 1. Do you tire easily? Do you feel fatigued a lot of the time, even when you have gotten enough sleep?

    ____ 2. Are people annoying you by their demands and stories about their daily activities? Do minor
    inconveniences make you irritable or impatient?

    ____ 3. Do you feel increasingly critical, cynical, and disenchanted?

    ____ 4. Are you affected by sadness you cant explain? Are you crying more than usual?

    ____ 5. Are you forgetting appointments, deadlines, personal possessions? Have you become absent-
    minded?

    ____ 6. Are you seeing close friends and family members less frequently? Do you find yourself wanting to be
    alone and avoiding even your close friends?

    ____ 7. Does doing even routine things seem like an effort?

    ____ 8. Are you suffering from physical complaints such as stomachaches, headaches, lingering colds,
    general aches and pains?

    ____ 9. Do you feel confused or disoriented when the activity of the day stops?

    ____ 10. Have you lost interest in activities that you previously were interested in or even enjoyed?

    ____ 11. Do you have little enthusiasm for your work? Do you feel negative, futile, or depressed about your
    work?

    ____ 12. Are you less efficient than you think you should be?

    ____ 13. Are you eating more or less, smoking more cigarettes, are using more alcoholl or drugs to cope
    with your work?

    _______ TOTAL SCORE (Add up scores for items 1 13)

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