Essay Grade

2010
The Concise ProQOL Manual
Beth Hudnall Stamm, PhD
Proqol.org
BethHudnallStamm.com and
CompassionSatisfactionAndCompassionFatigue.com
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THE CONCISE MANUAL FOR THE
PROFESSIONAL QUALITY OF LIFE SCALE
THE ProQOL
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The Concise ProQOL Manual, 2nd Edition
Reference
Stamm, B.H. (2010). The Concise ProQOL Manual, 2nd Ed. Pocatello, ID:
ProQOL.org.
Copyright  Beth Hudnall Stamm. All rights reserved.
12345679890
Published The ProQOL.org, P.O. Box 4362. Pocatello, ID 83205-4362
Cover design by Beth Hudnall Stamm
Images copyright 2008 Henry E. Stamm, IV
Printed in Trebuchert MS font for the headers and 11 point Calibri font for the body.
ISSN to be applied for
Reference
Stamm, B.H. (2010). The Concise ProQOL Manual. Pocatello, ID: ProQOL.org.
Acknowledgements
I here provide acknowledgements for their faithful contributions to the development of the ProQOL
go to Joseph M. Rudolph, Edward M. Varra, Kelly Davis, Debra Larsen, Craig Higson‐Smith, Amy C.
Hudnall, Henry E. Stamm, and to all those from around the world who contributed their raw data to
the databank. I am forever indebted to Charles F. Figley who originated the scale, and in 1996,
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handed the scale off to me saying “I put a semicolon there; you take it and put a period at the end of
the sentence.” No one could have wished for a better mentor, colleague, and friend.
This material may be freely copied as long as (a) author is credited, (b) no changes are made, & (c)
it is not sold except for in agreement specifically with the author.
TABLE OF CONTENTS
The ProQOL………………………………………………………………………………………………………………………………………. 3
Section 1: Compassion Satisfaction and Compassion Fatigue ………………………………………………………………….. 8
Figure 1: Diagram of Professional Quality of Life ……………………………………………….. 8
Background ……………………………………………………………………………………………………………………………. 8
Figure 2: Theoretical path analysis …………………………………………………………………. 10
Section 2: Scale Definitions ………………………………………………………………………………………………………………. 12
Compassion Satisfaction ……………………………………………………………………………….. 12
Compassion Fatigue……………………………………………………………………………………… 12
Section 3: Scale Properties ………………………………………………………………………………………………………………..13
Scale Distribution ………………………………………………………………………………………………………………….. 13
Table 1: ProQOL Moments ……………………………………………………………………………. 13
Reliability……………………………………………………………………………………………………………………………… 13
Validity 13
Section 4: Administration of the ProQOL ……………………………………………………………………………………………. 14
Individual Administration ……………………………………………………………………………………………………….. 14
Group Administration ……………………………………………………………………………………………………………. 15
Research Administration ………………………………………………………………………………………………………… 15
Section 5: Proqol scoring …………………………………………………………………………………………………………………..15
Calculating the Scores on The proqol ………………………………………………………………………………………. 15
Scale Definitions and Scores …………………………………………………………………………………………………… 17
Cut Scores ……………………………………………………………………………………………………………………………. 18
Table 2: Cut Scores for the ProQOL ………………………………………………………………… 18
Section 6: Interpreting the ProQOL ……………………………………………………………………………………………………. 18
The ProQOL Is Not Diagnostic …………………………………………………………………………………………………. 18
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The Importance of Knowing More than Just the ProQOL Scores ………………………………………………….. 19
Scores Across Demographic Categories ……………………………………………………………………………………. 19
Table 3: Gender ………………………………………………………………………………………….. 19
Table 4: Age Group ……………………………………………………………………………………… 20
Table 4: Race ………………………………………………………………………………………………. 20
Table 5: Income Group ………………………………………………………………………………… 20
Table 6: Years at Current Employer ……………………………………………………………….. 20
Table 7: Years in Field ………………………………………………………………………………….. 21
Interpreting Individual Scales ………………………………………………………………………………………………….. 21
Compassion Satisfaction ………………………………………………………………………………. 21
Compassion Fatigue …………………………………………………………………………………….. 21
Interpreting Scale Scores in Combination …………………………………………………………………………………. 22
High Compassion Satisfaction, Moderate to Low Burnout and
Secondary Traumatic Stress………………………………………………………………………….. 22
High Burnout, Moderate to Low Compassion Satisfaction and
Secondary Traumatic Stress………………………………………………………………………….. 22
High Secondary Traumatic Stress with Low Burnout and Low
Compassion Satisfaction ………………………………………………………………………………. 22
High Secondary Traumatic Stress and High Compassion
Satisfaction with Low Burnout ………………………………………………………………………. 23
High Secondary Traumatic Stress and High Burnout with Low
Compassion Satisfaction ………………………………………………………………………………. 23
Interpreting the ProQOL at a Group Level ………………………………………………………. 23
Section 7: Using the ProQOL for Decision Making ……………………………………………………………………………….. 24
Changing the Person‐Event Interaction ……………………………………………………………………………………. 24
Monitoring Change Across Time ……………………………………………………………………………………………… 25
Section 8: The ProQOL Test and Handout ………………………………………………………………………………………….. 26
Professional Quality of Life Scale (ProQOL) ………………………………………….. Error! Bookmark not defined.
ProQOL Self Scoring Worksheet ………………………………………………………. Error! Bookmark not defined.
Scoring …………………………………………………………………………………………………… Error! Bookmark not defined.
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Your Scores on The ProQOL: Professional Quality Of Life Scale …………… Error! Bookmark not defined.
SECTION 9: Converting from the ProQOL IV to the ProQOL 5 ………………………………………………………………… 31
Table for Determining ProQOL t‐Score from Raw Scores …………………………………… 31
SECTION 10: Bibliography ………………………………………………………………………………………………………………….35
SECTION 11: Frequently Asked Questions …………………………………………………………………………………………… 73
About the Author……………………………………………………………………………………………………………………………..77
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SECTION 1: COMPASSION SATISFACTION AND COMPASSION FATIGUE
Professional quality of life is the quality one feels n relation to their work as a helper. Both the positive and
negative aspects of doing one’s job influence ones professional quality of life. People who work in helping
professions may respond to individual, community, national, and even international crises. Helpers can be
found in the health care professionals, social service workers, teachers, attorneys, police officers, firefighters,
clergy, airline and other transportation staff, disaster site clean‐up crews, and others who offer assistance at
the time of the event or later.
Professional quality of life incorporates two aspects, the positive (Compassion Satisfaction) and the negative
(Compassion Fatigue). Compassion fatigue breaks into two parts. The first part concerns things such like
exhaustion, frustration, anger and depression typical of burnout. Secondary Traumatic Stress is a negative
feeling driven by fear and work‐related trauma. Some trauma at work can be direct (primary) trauma. In other
cases, work‐related trauma be a combination of both primary and secondary trauma.
FIGURE 1: DIAGRAM OF PROFESSIONAL QUALITY OF LIFE
Professional Quality of Life
Compassion
Satisfaction
Compassion
Fatigue
Burnout
Secondary
Trauma
BACKGROUND
Professional quality of life for those providing care has been a topic of growing interest over the past twenty
years. Research has that shown those who help people that have been exposed to traumatic stressors are at
risk for developing negative symptoms associated with burnout, depression, and posttraumatic stress
disorder. In this body of literature, typically known as secondary traumatization or vicarious traumatization,
the positive feelings about people’s ability to help are known as Compassion Satisfaction (CS). The negative,
secondary outcomes have variously been identified as burnout, countertransference, Compassion Fatigue (CF)
and Secondary Traumatic Stress (STS), and Vicarious Traumatization (VT).
While the incidence of developing problems associated with the negative aspects of providing care seems to
be low, they are serious and can affect an individual, their family and close others, the care they provide, and
their organizations. The positive aspects of helping can be viewed as altruism; feeling good that you can do
something to help. The negative effects of providing care are aggravated by the severity of the traumatic
material to which the helper is exposed, such as direct contact with victims, particularly when the exposure is
of a grotesque and graphic nature. The outcomes may include burnout, depression, increased use of
substances, and symptoms of posttraumatic stress disorder.
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In 1995, three books introduced the concepts of the negative effects on caregivers who provide care to those
who have been traumatized.1 2 3 The terminology was at that time, and continues to be, a taxonomical
conundrum. However, since that time, Figley, Stamm, and Pearlman together have produced over 50
additional scientific writings on the topic. Casting a broad net across the topic, over 500 papers, books and
articles have been written, including nearly 200 peer‐reviewed papers, 130 dissertations along with various
unpublished studies. Among which there are and a hundred research papers using a type of measurement of
the negative effects of secondary exposure to traumatic stress. Research has been conducted across multiple
cultures worldwide, and across multiple types of traumatic event exposures.
As noted above, there are issues associated with the various terms used to describe negative effects. There
are three accepted terms: compassion fatigue, secondary traumatic stress, and vicarious trauma. There do
seem to be nuances between the terms but there is no delineation between them sufficient to say that they
are truly different. There have been some papers that have tried to ferret out the specific differences between
the names and the constructs.4 These papers have been largely unsuccessful in identifying real differences
between the concepts as presented under each name. The three terms are used often, even in writing that
combines Figley (compassion fatigue), Stamm (secondary traumatic stress) and Pearlman (vicarious
traumatization). The various names represent three converging lines of evidence that produced three
different construct names. As the topic has matured, reconfiguration of the terms seems timely.
In general, looking beyond issues of taxonomy, there has been little negative critique of the topic as a whole.
Nonetheless, there are articles that question in its entirety the concept of secondary negative effects due to
work with people who have been traumatized.56 Both articles point to a lack of research, perhaps allowable in
some part given the nascent nature of the construct, particularly in the Arvay paper, which was published in
2001. Four years later, at the core of Kadambi & Ennis’ (2005) suggestion to re‐examine the credibility of the
topic are measurement issues, that is, refined definitions of the characteristics and reliable and valid measures
of the constructs. These critiques seem well earned at the point that they were written. Whether in response
to the critiques, or as natural evolution, over half of the research articles that exist were written after these
critiques reviews were conducted. In addition, as the authors pointed out, there were varied means of
assessing the negative effects.
Based on experience and some research, organizational prevention programs are believed to help maximize
helpers’ well‐being (CS) and reduce the risks for developing compassion fatigue and secondary trauma. At a
minimum, organizational programs show the worker that they have formally addressed the potential for the
work to affect the worker. Good programs do not identify to other workers or supervisors, specific information
about the worker’s professional quality of life unless the information is shared by the worker. In some cases,
1
Figley, C. R. (Ed.) (1995). Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized. New
York: Brunner/Mazel.
Pearlman, L. A., & Saakvitne, K. W. (1995). Trauma and the therapist: Countertransference and vicarious traumatization in psychotherapy
with incest survivorsNew York: Norton.
3
Stamm, B. H. (.Ed). (1995). Secondary traumatic stress: Self‐care issues for clinicians, researchers, and educators. Maryland: Sidran Press:
Lutherville.
4
cf Baird, K., & Kracen, A. C. (2006). Vicarious traumatization and secondary traumatic stress: A research synthesis. Counselling
Psychology Quarterly, 19(2), 181‐188.
5
Kadambi, M. A., & Ennis, L. (2004). Reconsidering vicarious trauma: A review of the literature and its’ limitations. Journal of Trauma
Practice, 3(2), 1‐21.
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Arvay, M. J. (2001). Secondary traumatic stress among trauma counsellors: What does the research say? International Journal for the
Advancement of Counselling, 23(4), 283‐293.
2
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supervisors address performance issues that they believe may be negative aspects of helping but in those
cases, the principals of organizational human resources suggest that these performance issues should be
handled as such, not as a flaw in the character of the employee, but a performance issue.
The overall concept of professional quality of life is complex because it is associated with characteristics of the
work environment (organizational and task‐wise), the individual’s personal characteristics and the individual’s
exposure to primary and secondary trauma in the work setting. This complexity applies to paid workers (e.g.
medical personnel) and volunteers (e.g. Red Cross disaster responders).
The diagram below helps illustrate the elements of Professional Quality of Life. In the center of the diagram
are compassion satisfaction and compassion fatigue. Compassion Satisfaction is the positive aspects of helping
others and Compassion Satisfaction are the negative one. As can be seen, one work environment, client (or
the person helped) environment and the person’s environment all have a roll to play. For example, a poor
work environment may contribute to Compassion Fatigue. At the same time, a person could feel compassion
satisfaction that they could help others despite that poor work environment. Compassion Fatigue contains
two very different aspects. Both have the characteristic of being negative. However, work‐related trauma has
a distinctive aspect of fear associated with it. While it is more rare than overall feelings of what we can call
burnout, it is very powerful in its effect on a person. When both burnout and trauma are present in a person’s
life their life can be very difficult indeed. The diagram below shows a theoretical path analysis of positive and
negative outcomes of helping those who have experienced traumatic stress.
FIGURE 2: THEORETICAL PATH ANALYSIS
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Four scales emerged in the early research. Two of them (the Impact of Event Scale and the Traumatic Stress
Institute Belief Scale) were not specific to secondary exposure. They were used equally for people who were
the direct victims of trauma as well as for those who were secondarily exposed in their role as helpers.7 8 Two
measures emerged as specific measures for secondary exposure. The Compassion Fatigue Test in its various
versions 9 10 11 12 and the Secondary Traumatic Stress Scale.13
The Professional Quality of Life Scale, known as the ProQOL, is the most commonly used measure of the
positive and negative effects of working with people who have experienced extremely stressful events. Of the
100 papers in the PILOTS database (the Published Literature in Posttraumatic Stress Disorder), 46 used a
version of the ProQOL. The measure was originally called the Compassion Fatigue Self Test and developed by
Charles Figley in the late 1980s Stamm and Figley began collaborating in 1988. In 1993, Stamm added the
concept of compassion satisfaction and the name of the measure changed to the Compassion Satisfaction and
Fatigue Test, of which there were several versions. These versions in the early 1990s were Figley and Stamm,
then Stamm and Figley. Through a positive joint agreement between Figley and Stamm the measure shifted
entirely to Stamm in the late 1990s and was renamed the Professional Quality of Life Scale. The ProQOL,
originally developed in English, is translated into Finnish, French, German, Hebrew, Italian, Japanese, Spanish,
Croat. European Portuguese and Russian translations are in process.
SECTION 2: SCALE DEFINITIONS
COMPASSION SATISFACTION
Compassion satisfaction is about the pleasure you derive from being able to do your work well. For example,
you may feel like it is a pleasure to help others through your work. You may feel positively about your
colleagues or your ability to contribute to the work setting or even the greater good of society.
COMPASSION FATIGUE
Professional quality of life incorporates two aspects, the positive (Compassion Satisfaction) and the negative
(Compassion Fatigue). Compassion fatigue breaks into two parts. The first part concerns things such as such as
exhaustion, frustration, anger and depression typical of burnout. Secondary Traumatic Stress is a negative
feeling driven by fear and work‐related trauma. It is important to remember that some trauma at work can be
direct (primary) trauma. Work‐related trauma be a combination of both primary and secondary trauma.
7
Kadambi, M. A., & Ennis, L. (2004). Reconsidering vicarious trauma: A review of the literature and its’ limitations. Journal of Trauma
Practice, 3(2), 1‐21.
8
Arvay, M. J. (2001). Secondary traumatic stress among trauma counsellors: What does the research say? International Journal for the
Advancement of Counselling, 23(4), 283‐293.
9
Figley, C.R (Ed.). (1995) Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized. New
York: Brunner/Mazel.
10
Figley, C.R., & Stamm, B.H. (1996). Psychometric Review of Compassion Fatigue Self Test. In B.H. Stamm (Ed), Measurement of Stress,
Trauma and Adaptation. Lutherville, MD: Sidran Press.
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Stamm, B.H. (2002). Measuring Compassion Satisfaction as Well as Fatigue: Developmental History of the Compassion Fatigue and
Satisfaction Test. In C.R. Figley (Ed.), 107‐119.
12
nd
Stamm, B. H. (2008). The ProQOL Test Manual, 2 Ed. Towson, MD: Sidran Press and the ProQOL.org.
13
Bride, B. E., Robinson, M. M., Yegidis, B. L., & Figley, C. R. (2004). Development and validation of the secondary traumatic stress scale.
Research on Social Work Practice, 14(1), 27‐35.
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BURNOUT
Burnout is one element of the negative effects of caring that is known as Compassion Fatigue. Most people
have an intuitive idea of what burnout is. From the research perspective, burnout is associated with feelings of
hopelessness and difficulties in dealing with work or in doing your job effectively. These negative feelings
usually have a gradual onset. They can reflect the feeling that your efforts make no difference, or they can be
associated with a very high workload or a non‐supportive work environment.
SECONDARY TRAUMATIC STRESS
Secondary Traumatic Stress (STS) is an element of Compassion fatigue (CF). STS is about work‐related,
secondary exposure to people who have experienced extremely or traumatically stressful events. The negative
effects of STS may include fear sleep difficulties, intrusive images, or avoiding reminders of the person’s
traumatic experiences. STS is related to Vicarious Trauma as it shares many similar characteristics.
SECTION 3: SCALE PROPERTIES
SCALE DISTRIBUTION
TABLE 1: PROQOL MOMENTS
N
Mean
Std. Error of Mean
Median
Mode
Std. Deviation
Skewness
Kurtosis
CS t score
BO t score
STS t score
1187
50
0.29
51
53
10
‐0.92
1.51
1187
50
0.29
49
51
10
0.25
‐0.31
1187
50
0.29
49
49
10
0.82
0.87
RELIABILITY
VALIDITY
There is good construct validity with over 200 published papers. There are also more than 100,000 articles on
the internet. Of the 100 published research papers on compassion fatigue, secondary traumatic stress and
vicarious traumatization, nearly half have utilized the ProQOL or one of its earlier versions. The three scales
measure separate constructs. The Compassion Fatigue scale is distinct. The inter‐scale correlations show 2%
shared variance (r=‐.23; co‐σ = 5%; n=1187) with Secondary Traumatic Stress and 5% shared variance (r=.‐.14;
co‐σ = 2%; n=1187) with Burnout. While there is shared variance between Burnout and Secondary Traumatic
Stress the two scales measure different constructs with the shared variance likely reflecting the distress that is
common to both conditions. The shared variance between these two scales is 34% (r=.58;; co‐σ = 34%;
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n=1187). The scales both measure negative affect but are clearly different; the BO scale does not address fear
while the STS scale does.
SECTION 4: ADMINISTRATION OF THE PROQOL
Perhaps the most important part of administration of the ProQOL, or for that matter any psychological test, is
for people to understand what they are being asked to do. If they feel like they are being “observed” and
measured for their (bad) behavior, they are unlikely to want to participate or, if they do, to provide reliable
answers. It is important to explain the logic of the measure and to engage the person’s desire to take the test.
It is also important to establish if the person has a right to refuse to take the test or if it is required as a
condition of some situation such as employment.
INDIVIDUAL ADMINISTRATION
In this type of administration, a person typically takes the test and either self‐scores or receives scores
computed by a computer. In this situation, the data are not recorded elsewhere and the person does not
discuss his or her results unless they choose to do so. Individual administration may also be initiated by an
outside source. The data may or may not be archived. For example, a person may take the ProQOL as part of
job counseling or an employee assistance program. They may take the ProQOL as part of their ongoing self‐
care plan. It is important to establish with the individual exactly what will happen with his or her data because
data security and privacy are very important issues. In many cases, the required standards exceed those of
general medical records.
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GROUP ADMINISTRATION
In this type of administration, a group of people complete the ProQOL simultaneously. This may be in a
classroom setting or something like individual computer workstations in a computer lab. The key aspect of the
group administration is that there are others present who are doing the same activity. In a group
administration it is important to consider the group effect on scores. If a few people are quite vocal about
their unwillingness to participate, there is an effect on all of the participants. If people feel they are being
watched by others, or are embarrassed to be in the group, the scores are unlikely to be valid and privacy rights
may have been violated. People should not be singled out so as to cause embarrassment. For example, you
should not set up a group administration for all people who made medical errors if the administration is based
on the assumption that their mistakes occurred because of burnout.
In the case of a self‐test, people may be given general information such as “others who score similarly to
you…” By contrast, in the case of individual administration, feedback may be much more specific. Feedback in
group settings should not be about a single individual but about things that apply to more than one person.
The most important thing about giving feedback is to be prepared. Be prepared to give specific and clear
information appropriate to the setting and be prepared to answer questions. You will always get that one
question you most don’t want to answer!
When working in group settings, it is not uncommon for one or two individuals to provide revealing personal
information that are not appropriate to the group setting. In these cases it is incumbent on the test
administrator to contain and refocus the attention of the class. Good ethical behavior suggests the test
administrator follow up with the person in a more appropriate setting. In situations such as these, it is usually
appropriate to provide a referral for employee assistance or other help such as mental or physical health care.
In the case that the administrator believes that there is an imminent danger, they should take emergency
actions such as calling 911 and protecting the person, themselves, and others from harm in the best way that
they can.
RESEARCH ADMINISTRATION
The ProQOL is frequently used in research. The test may be collected as part of a survey packet in which the
participant receives no information regarding their answers, or it may be given as a combined research and
training activity. In either case, the data are generally recorded and scored by computer. Group results may be
published. In some cases, a copy of the raw data are donated to the ProQOL databank where they are
combined with other research data to support developmental work on the ProQOL.
SECTION 5: PROQOL SCORING
CALCULATING THE SCORES ON THE PROQOL
There are three steps to scoring the ProQOL. The first step is to reverse some items. The second step is to sum
the items by subscale and the third step is to convert the raw score to a t‐score. The first set below shows the
scoring actions in detail. Two methods for scoring are presented. The first is to follow Steps 1‐2 and then use
the table at the end of this section to convert raw scores to t‐scores. The second method uses computer
15
scoring. The computer code presented below is written for SPSS that can be converted by the user to other
statistical programs if needed.
Step 1: Reverse items 1, 4, 15, 17, and 29 into 1r, 4r, 15r, 17r and 29r (1=5) (2=4) (3=3) (4=2) (5=1)
Step 2: Sum the items for each subscale.
CS = SUM(pq3,pq6,pq12,pq16,pq18,p20,pq22,pq24,pq27,pq30).
BO = SUM(pq1r,pq4r,pq8,pq10,pq15r,pq17r, pq19, pq21, pq26, pq29r).
STS = SUM(pq2,pq5,pq7,pq9,pq11,pq13,pq14,pq23, pq25,pq28).
Step 3: Convert the Z scores to t‐scores with raw score mean = 50 and the raw score standard deviation = 10.
Below is the SPSS Code for Scoring the ProQOL, including routines to compute the raw and t‐scores.
COMMENT: Step 1: Score ProQOL IV. or 5 Variable names in syntax assume pq# for each item. This routine
reverses items 1,14,15, 17 and 29 then scores the three scales of the ProQOL IV; Secondary Traumatic Stress
the new scale name for the old Compassion Fatigue scale.
RECODE pq1 pq4 pq15 pq17 pq29
(1=5) (2=4) (3=3) (4=2) (5=1)
INTO pq1R pq4R pq15R pq17R pq29r .
COMPUTE CS = SUM(pq3,pq6,pq12,pq16,pq18,pq20,pq22,pq24,pq27,pq30) .
COMPUTE BO = SUM(pq1r,pq4r,pq8,pq10,pq15r,pq17r, pq19, pq21, pq26, pq29r) .
COMPUTE STS = SUM(pq2,pq5,pq7,pq9,pq11,pq13,pq14,pq23,pq25,pq28) .
EXECUTE.
COMMENT: Step 2: Convert raw score to Z score. Note that this routine produces an extraneous output file
with n and means that can be deleted.
DESCRIPTIVES
VARIABLES=CS BO STS /SAVE.
COMMENT: Step 3 Convert Z score to t score.
COMPUTE tCS = (ZCS*10)+50 .
VARIABLE LABELS tCS ‘CS t score’ .
EXECUTE .
COMPUTE tBO = (ZBO*10)+50 .
VARIABLE LABELS tBO ‘BO t score’ .
EXECUTE .
COMPUTE tSTS = (ZSTS*10)+50 .
VARIABLE LABELS tSTS ‘STS t score’ .
EXECUTE .
COMMENT: Interpretation of scores: The mean score for any scale is 50 with a standard deviation of 10.
COMMENT: The cut scores for the CS scale are 44 at the 25th percentile and 57 at the 75th percentile.
COMMENT: The cut scores for the BO scale are 43 at the 25th percentile and 56 at the 75th percentile.
COMMENT: The cut scores for the STS scale are at 42 for the 25th percentile and 56 for the 75th percentile.
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SCALE DEFINITIONS AND SCORES
Below are the scale definitions and the average scores. This section is the same as the scoring handout.
Compassion satisfaction is about the pleasure you derive from being able to do your work well. For example,
you may feel like it is a pleasure to help others through your work. You may feel positively about your
colleagues or your ability to contribute to the work setting or even the greater good of society. Higher scores
on this scale represent a greater satisfaction related to your ability to be an effective caregiver in your job.
The average score is 50 (SD 10; alpha scale reliability .88). About 25% of people score higher than 57 and
about 25% of people score below 43. If you are in the higher range, you probably derive a good deal of
professional satisfaction from your position. If your scores are below 40, you may either find problems with
your job, or there may be some other reason—for example, you might derive your satisfaction from activities
other than your job.
Burnout Most people have an intuitive idea of what burnout is. From the research perspective, burnout is one
of the elements of compassion fatigue. It is associated with feelings of hopelessness and difficulties in dealing
with work or in doing your job effectively. These negative feelings usually have a gradual onset. They can
reflect the feeling that your efforts make no difference, or they can be associated with a very high workload or
a non‐supportive work environment. Higher scores on this scale mean that you are at higher risk for burnout.
The average score on the burnout scale is 50 (SD 10; alpha scale reliability .75). About 25% of people score
above 57 and about 25% of people score below 43. If your score is below 18,