Well-Being Index

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Well-Being Index
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The Well-Being Index is an online self-assessment tool invented by researchers at Mayo Clinic that measures mental distress and well-being in seven-nine items. [1] [2] The Well-Being Index is an anonymous tool that allows participants to reassess on a monthly basis, track their well-being scores over time, compare their results to peers' and national averages, and access customized resources based on their assessment results. [3] There are six clinically-validated versions of the Well-Being Index: Advanced Practice Provider, [4] Employee, [5] Medical Student, [6] Nurse, [7] Physician, [8] and Resident/Fellow. [9]

Contents

Overview

The Well-Being Index takes around one minute to complete [10] and measures six dimensions of distress and well-being specific to the Well-Being Index version. Possible dimensions include: [11]

History

The Well-Being Index was invented by Dr. Liselotte (Lotte) N. Dyrbye, MD, MHPE and Dr. Tait Shanafelt, MD of Mayo Clinic. [12] [13] It was originally developed to address physician burnout and distress internally at Mayo Clinic. [10]

Uses

The Well-Being Index has been used by a variety of hospitals, universities, academic medical centers, and associations, including:

Versions

There are six clinically-validated versions of the Well-Being Index. Each version offers national benchmark comparative data. [20]

Advanced Practice Provider Well-Being Index

The nine-item Advanced Practice Provider Well-Being Index measures distress and well-being among APPs, including nurse practitioners and physician assistants. This version of the Well-Being Index has been validated as a useful screening tool to measure likelihood of burnout, severe fatigue, prevalence of suicidal ideation, risk of medical error, meaning in work, and work-life integration among APPs. [4]

Employee Well-Being Index (eWBI)

The eWBI was developed to identify distress and well-being among U.S. workers. The assessment consists of nine-items and measures six dimensions of distress and well-being, including quality of life, meaning in work, likelihood of burnout, severe fatigue, work-life integration, and suicidal ideation. [5]

Medical Student Well-Being Index (MSWBI)

The MSWBI consists of seven items and is a version of the Well-Being Index designed to assess psychological distress in medical students. The MSWBI measures similar dimensions of distress and well-being as other versions of the Well-Being Index but includes dropout risk as a unique dimension. [6]

Nurse Well-Being Index

The Nurse Well-Being Index is a nine-item assessment that measures likelihood of burnout, severe fatigue, suicidal ideation, quality of life, meaning in work, and work-life integration. This version of the Well-Being Index has been validated in stratifying distress and well-being and identifying the risk of reduced quality of care among U.S. nurses. [7]

Physician Well-Being Index (PWBI)

The PWBI consists of nine items and is the original version of the Well-Being Index. It is designed as a brief screening tool for physicians in all specialties and measures the following six dimensions of distress and well-being: Likelihood of burnout, severe fatigue, suicidal ideation, risk of medical error, meaning in work, and work-life integration. [8]

Resident & Fellow Well-Being Index

The Resident & Fellow Well-Being Index is designed specifically for physicians in training. This version consists of seven items that measure risk of medical error, sense of meaning in work, quality of life, suicidal ideation, severe fatigue, and likelihood of burnout. [9]

Scoring

The Well-Being Index calculates a total well-being score for participants based on their assessment responses. Assessments contain seven or nine items depending on the Well-Being Index version. The seven-item versions consist of yes/no response categories and calculate scores by adding the number of 'yes' responses. The nine-item versions contain an additional two Likert scale items that add or subtract points from the score of the first seven items.

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References

  1. National Academy of Medicine. "Valid and Reliable Survey Instruments to Measure Burnout" . Retrieved January 16, 2020.
  2. "Well-Being Index". Well-Being Index. Retrieved 15 January 2020.
  3. Department of Psychiatry, UNC School of Medician. "Mayo Clinic Well-Being Index" . Retrieved January 16, 2020.
  4. 1 2 Dyrbye, Liselotte N.; Johnson, Pamela O.; Johnson, Leann M.; Halasy, Michael P.; Gossard, Andrea A.; Satele, Daniel; Shanafelt, Tait (July 31, 2019). "Efficacy of the Well-Being Index to identify distress and stratify well-being in nurse practitioners and physician assistants". Journal of the American Association of Nurse Practitioners. 31 (7): 403–412. doi:10.1097/JXX.0000000000000179. PMID   30829967. S2CID   73501286.
  5. 1 2 Dyrbye, Liselotte N.; Satele, Daniel; Shanafelt, Tait (August 2016). "Ability of a 9-Item Well-Being Index to Identify Distress and Stratify Quality of Life in US Workers". Journal of Occupational and Environmental Medicine. 58 (8): 810–7. doi:10.1097/JOM.0000000000000798. PMID   27294444. S2CID   1835584.
  6. 1 2 Dyrbye, Liselotte N.; Schwartz, Alan; Downing, Steven M.; Szydlo, Daniel W.; Sloan, Jeff A.; Shanafelt, Tait D. (July 2011). "Efficacy of a brief screening tool to identify medical students in distress". Journal of the Association of American Medical Colleges. 86 (7): 907–14. doi: 10.1097/ACM.0b013e31821da615 . PMID   21642810.
  7. 1 2 Dyrbye, Liselotte N.; Johnson, Pamela O.; Johnson, Leann M.; Satele, Daniel V.; Shanafelt, Tait D. (November 2018). "Efficacy of the Well-Being Index to Identify Distress and Well-Being in U.S. Nurses". Nursing Research. 67 (6): 447–455. doi:10.1097/NNR.0000000000000313. PMID   30138124. S2CID   52074148.
  8. 1 2 Dyrbye, Liselotte N.; Satele, Daniel; Sloan, Jeff; Shanafelt, Tait D. (March 2013). "Utility of a brief screening tool to identify physicians in distress". Journal of General Internal Medicine. 28 (3): 421–7. doi:10.1007/s11606-012-2252-9. PMC   3579983 . PMID   23129161.
  9. 1 2 Dyrbye, Liselotte N.; Satele, Daniel; Sloan, Jeff; Shanafelt, Tait D. (March 2014). "Ability of the physician well-being index to identify residents in distress". Journal of Graduate Medical Education. 6 (1): 78–84. doi:10.4300/JGME-D-13-00117.1. PMC   3963800 . PMID   24701315.
  10. 1 2 "Program on Physician Well-Being - Mayo Clinic Well-Being Index". Mayo Clinic. Retrieved 15 January 2020.
  11. Solutions, MedEd Web. "Well-Being Index Invented by Mayo Clinic".
  12. Shanafelt, Tait D.; Dyrbye, Lotte N.; West, Colin P. (7 March 2017). "Addressing Physician Burnout". JAMA. 317 (9): 901–902. doi:10.1001/jama.2017.0076. PMID   28196201.
  13. Solutions, Meded Web. "Invented by Mayo Clinic | Mayo Clinic Well-Being Index". www.mededwebs.com. Retrieved 15 January 2020.
  14. "Physician Wellness Program". www.henryford.com. Retrieved 2020-01-16.
  15. "Dean's Letter - May 2019 | Weill Cornell Medicine". weill.cornell.edu. Retrieved 2020-01-16.
  16. "Ascension Medical Group - Clinician Well-Being". ascension.org. Retrieved 2020-01-16.
  17. "CLER". Baylor College of Medicine. Retrieved 2020-01-16.
  18. Devitt, Michael. "AAFP Rolls Out New Well-being Assessment Tool". www.aafp.org. Retrieved 2020-01-16.
  19. "APhA Launches New Well-Being Tool to Evaluate Pharmacists' Stress, Burnout Levels". www.pharmacist.com. Retrieved 2020-01-16.
  20. "Well-Being Index Overview | Invented by Mayo Clinic" . Retrieved January 16, 2020.