Form 0920- Maslach Burnout

Attachment D7

Maslach Burnout

Form Approved

OMB No. 0920-xxxx

Exp. Date xx/xx/20xx

Maslach Burnout

V. Below are 16 statements of job-related feelings. Please read each statement carefully and decide if you ever feel this way about your job. If you never had this feeling, circle the “0” (zero). If you have had this feeling, indicate how often you feel it by circling the number that best describes how frequently you feel that way. How often:

0 = Never

1 = A few times a year or less

2 = Once a month or less

3 = A few times a month

4 = Once a week

5 = A few times a week

6 = Every day

1	I feel emotionally drained from my work	0	1	2	3	4	5	6
2	I feel used up at the end of the work day	0	1	2	3	4	5	6
3	I feel tired when I get up in the morning and have to face another day on the job	0	1	2	3	4	5	6
4	Working all day is really a strain for me	0	1	2	3	4	5	6
5	I can effectively solve the problems that arise in my work	0	1	2	3	4	5	6
6	I feel burned out from my work	0	1	2	3	4	5	6
7	I feel I am making an effective contribution to what this organization does	0	1	2	3	4	5	6
8	I have become less interested in my work since I started this job	0	1	2	3	4	5	6
9	I have become less enthusiastic about my work	0	1	2	3	4	5	6
10	In my opinion, I am good at my job	0	1	2	3	4	5	6
11	I feel exhilarated when I accomplish something at work	0	1	2	3	4	5	6
12	I have accomplished many worthwhile things in this job	0	1	2	3	4	5	6
13	I just want to do my job and not be bothered	0	1	2	3	4	5	6
14	I have become more cynical about whether my work contributes anything	0	1	2	3	4	5	6
15	I doubt the significance of my work	0	1	2	3	4	5	6
16	At my work, I feel confident that I am effective at getting things done	0	1	2	3	4	5	6

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