Measuring Well-Being Influencers: Development and Validation of the WISH Inventory.

Abstract

Background: Improving healthcare professional well-being and reducing burnout requires improving work ecosystems and cultures. Current well-being metrics focus on distal outcomes within individuals (e.g., professional fulfillment or burnout). In this study, we developed and evaluated the performance of an inventory measuring perceptions of modifiable workplace dimensions-termed influencers-that shape healthcare professionals' well-being.

Methods: A core team developed the Well-Being Influencers Survey for Healthcare (WISH), an inventory designed to measure these systemic, occupational well-being influencers (e.g., leadership support, psychological safety, working conditions). Following content validation and refinement, 223 healthcare professionals from an academic department of anesthesiology completed WISH alongside established well-being measures, including the Maslach Burnout Inventory (MBI), Professional Fulfillment Index (PFI), Perceived Stress Scale (PSS), PROMIS short forms for meaning, purpose, and life satisfaction, as well as standard items of affective commitment (AC, a measure of engagement) and a standard item assessing intention to leave (ITL). Factor analysis was used to assess WISH's internal structure, while correlation and regression analyses assessed its criterion-related validity using the above established measures.

Results: WISH showed expected relationships with established well-being measures, and outperformed established metrics in predicting AC and ITL after adjusting for those measures and/or covariates. Factor analysis indicated that most WISH variance reflects a single common factor, supporting the use of an instrument-level score. Unique variance at the influencer level highlights the added value of examining influencer scores.

Conclusions: WISH fills a key gap in healthcare professional well-being improvement science by assessing causal factors of well-being and burnout, rather than the conditions themselves. Here, we established initial validity of this unique inventory and further reinforce the relevance of system-level and cultural factors in influencing healthcare professionals' well-being. WISH is well suited to assist healthcare professional well-being improvement efforts driven by system-improvement mindsets.