Professional Quality of Life and Burnout Assessment (ProQOL-12)
Background
An individual's professional quality of life (ProQOL) is defined as the value they receive as a result of working as a helping professional. The ProQOL, last updated in 2010 in version 5 by Beth Stamm, has been a valuable, widely-used tool for assessing compassion satisfaction and fatigue (Stamm, 2002, 2010). As conceptualized by Stamm, professional quality of life includes the benefits of Compassion Satisfaction (CS), the liabilities of Compassion Fatigue (CF), and its two constructs—Burnout and Secondary Traumatic Stress. This instrument has been widely used in research with various helping professionals. However, during language translations and validation studies, there have been reports of factorial and internal structure problems with the ProQOL due to no factorial validation being completed before deployment (Hotchkiss & Wong, 2024). Moreover, several researchers across the world have recommended that the Burnout and Secondary Traumatic Stress scales be revisited psychometrically (Arrows, 2018; Galiana et al., 2017; Hemsworth et al., 2018; Heritage et al., 2018; Keesler & Fukui, 2020; Marks, 2016; Samson et al., 2016).
ProQOL-12
The ProQOL-5 (30-item) reliability and validity concerns were resolved in this 12-item measure and refined to include a more realistic time context of seven days and definite Likert ranges (Hotchkiss & Wong, 2024). These enhancements increased validity, as evidenced by the improvement in all model fit indicators in the excellent range in Study 2. Transcending culture and ethnicity with proven psychometric robustness, the Brief ProQOL-12 is valuable for evaluating burnout risk and well-being across heterogeneous ethnic, cultural, and occupational landscapes.
Consent to Use
Researchers must seek consent by contacting the lead researcher, Dr. Jason T. Hotchkiss. The measure must be used as a whole, all 12 items, no modifications are permitted. Please email jjhotchkiss@gmail.com to request permission to use the Brief ProQOL-12. Intercultural and interethnic validation study is here:
Note. CS = Compassion Satisfaction (Items 3, 6, 9, 12); BO = Burnout (Items 4, 7, 8, 11); ST = Secondary Traumatic Stress (Items 1, 4, 5, 10).
ProQOL-5 scores can be calculated by applying x10/4 to the Brief ProQOL-12
Citation
Hotchkiss JT, Wong CMY. Truth on ProQOL and Burnout Assessment—Development and Intercultural Validation of the Brief ProQOL-12 from the Professional Quality of Life, Version 5. American Journal of Hospice and Palliative Medicine®. 2024;0(0). doi:10.1177/10499091241260284
Psychometrics
In our first study, eight intercultural samples of helping professionals from four continents (n = 4,129) were used in a step-wise appraisal and multi-group invariance testing. Then, in our second study, an ethnically and occupationally balanced sample (n = 453) was leveraged for Rasch modeling, factor analysis, analysis of measure correlates, and scale refinements. Results indicated that Original ProQOL-5 (30-item) did not fit among any continental samples, including North America. Brief ProQOL-12 had an excellent fit in the interculturally, ethnically, and occupationally diverse samples.
The reliability and validity of the Brief ProQOL-12 were significantly improved over the 30-item measure. Rasch modeling and factor analysis indicated the measure was reliable and valid interculturally and occupationally. The ProQOL-5 (30-item) reliability and validity concerns were resolved in this 12-item measure and refined to include a more realistic time context of seven days and definite Likert ranges. These enhancements increased validity, as evidenced by the improvement in all model fit indicators in the excellent range in Study 2. Transcending culture and ethnicity with proven psychometric robustness, the Brief ProQOL-12 is valuable for evaluating burnout risk and well-being across heterogeneous ethnic, cultural, and occupational landscapes.
Acknowledgments
We wish to acknowledge Beth Stamm and Charles Figley as the pioneers of the ProQOL. We are especially thankful to the authors who responded to requests for ProQOL item-level data, including Dr. Yen-Chin Chen, Dr. Leona Cilar, Dr. Rachel Depner, Dr. Takaki Fukumori, Dr. Brian Hughes, Dr. Evdokia Missouridou, and Chaplain Sarah Stanford. Finally, grateful to Dr Jasmeet Singh, Dr. David Hemsworth, and Dr. Tiffany Arrows for initial testing of the 12-item version in samples from their studies.
“Burnout occurs when your body and mind can no longer keep up with the tasks you demand of them. Don’t try to force yourself to do the impossible. ”
References
Arrows, T. D. (2018). Validation of the Professional Quality of Life Model among Correctional Officers [ProQuest Dissertations Publishing].
Galiana, L., Arena, F., Oliver, A., Sansó, N., & Benito, E. (2017). Compassion Satisfaction, Compassion Fatigue, and Burnout in Spain and Brazil: ProQOL Validation and Cross-cultural Diagnosis. Journal of pain and symptom management, 53(3), 598. https://doi.org/10.1016/j.jpainsymman.2016.09.014
Hemsworth, D., Baregheh, A., Aoun, S., & Kazanjian, A. (2018). A critical enquiry into the psychometric properties of the professional quality of life scale (ProQol-5) instrument. Applied nursing research, 39, 81. https://go.exlibris.link/9yMTTmGy
Heritage, B., Rees, C. S., & Hegney, D. G. (2018). The ProQOL-21: A revised version of the Professional Quality of Life (ProQOL) scale based on Rasch analysis. PLOS ONE, 13(2), e0193478-e0193478. https://doi.org/10.1371/journal.pone.0193478
Hotchkiss, J. T., & Wong, C. (2024). Truth and validity on ProQOL and Burnout Assessment—Development and intercultural validation of the Brief ProQOL-12. American Journal of Hospice and Palliative Medicine, 10499091231185593. https://doi.org/10.1177/10499091231185593
Hotchkiss, J. T., & Wong, C. (2022). Factorial Structure of the ProQOL: Systematic Review and Integration of 27 International Factor Analysis Studies. Trends in Psychology, Advance Online Publication. https://doi.org/10.1007/s43076-022-00184-5
Keesler, J. M., & Fukui, S. (2020). Factor structure of the professional quality of life scale among direct support professionals: factorial validity and scale reliability. Journal of intellectual disability research, 64(9), 681-689. https://doi.org/10.1111/jir.12766
Marks, M. (2016). Re-Conceptualizing Compassion Fatigue: A Confirmatory Factor Analysis [Electronic Theses and Dissertations. 5278] United States.
Samson, T., Iecovich, E., & Shvartzman, P. (2016). Psychometric Characteristics of the Hebrew Version of the Professional Quality-of-Life Scale. Journal of pain and symptom management, 52(4), 575. https://go.exlibris.link/vFvMdK9M
Stamm, B. H. (2010). The Concise ProQOL Manual, ProQOL Version 5. http://www.proqol.org/
Stamm, B. H. (2002). Measuring compassion satisfaction as well as fatigue: Developmental history of the Compassion Satisfaction and Fatigue Test. In C. R. Figley (Ed.), Treating compassion fatigue (pp. 107-119): New York: Brunner-Routledge.