Methodological considerations when translating “burnout”

• No study has systematically examined how translations of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) have occurred.
• An integrative review and Content Validity Indexing data illustrates several important issues for cross-cultural adaptation of the MBI-HSS.
• Seven out of 22 items in the MBI-HSS have the potential to be problematic in the cross-cultural adaptation process.
• We recommend careful examination of the cross-cultural adaptation process for studies that have not used official translations of the MBI-HSS.

No study has systematically examined how researchers address cross-cultural adaptation of burnout. We conducted an integrative review to examine how researchers had adapted the instruments to the different contexts. We reviewed the Content Validity Indexing scores for the Maslach Burnout Inventory-Human Services Survey from the 12-country comparative nursing workforce study, RN4CAST. In the integrative review, multiple issues related to translation were found in existing studies. In the cross-cultural instrument analysis, 7 out of 22 items on the instrument received an extremely low kappa score. Investigators may need to employ more rigorous cross-cultural adaptation methods when attempting to measure burnout.