Mini-Z validation for burnout and stress evaluation: an observational study.

Background: The Mini-Z is a questionnaire created to evaluate the levels of burnout in healthcare workers. It consists of 10 items rated using a 5-point Likert scale and one open question. It explores three outcomes (burnout, stress and satisfaction) and seven drivers of burnout (work control, work chaos, teamwork, values alignment with leadership, documentation time pressure, EMR use at home, and EMR proficiency). The aim of this study is to validate the Italian version of the Mini-Z, comparing it with the other most used scales.

Materials and methods: We recruited a sample of 120 healthcare professionals and administered all three questionnaires to each of them, after which we compared the answers and the scores of the results. A cross-sectional study among healthcare workers was conducted from May to July 2022. An online questionnaire was sent, by e-mail, to 120 healthcare workers (60.8% male, 39.2% female), aged between 18 and 60 years old (26.8% between 25 and 38 years old). They were invited to answer to an anonymous survey, consisting of three assessment instruments: Copenhagen Burnout Inventory (CBI), Maslach Burnout Inventory (MBI) and Mini-Z Inventory 2.0. The Mini-Z 2.0 is a new and easier tool to assess burnout syndrome, actually validated only in English. It was translated into Italian by reverse translation. Cronbach's Alpha coefficient, a statistical index, was used to assess its reliability. The last phase of the study compared the Mini-Z, the CBI and the MBI, by means of Pearson's coefficient, to highlight the Mini-Z's ability to be used for Burnout assessment.

Results: The analysis of the results showed that 18.3% of the interviewed healthcare professionals scored equal (2.5%) or higher (15.8%) than 40. The average percentage value was 33.35%, with a standard deviation of 6.3%. This emphasises, therefore, that this portion of employees is more or less satisfied with their working environment. The remaining portion of employees, on the other hand, 81.7%, scored below 40, emphasising an unpleasant and unjoyful working environment.

Discussion and conclusions: Burnout is very common among employees and especially among healthcare workers and a routine assessment seems to be necessary to be able to prevent the syndrome. The Italian version of the Mini-Z includes ten items, is more user-friendly and aims to assess not only Burnout subscales, as in the previous tests, but also well-being factors and has applied a rigorous approach, including forward translation, back translation and cognitive debriefing.