The Treatment-Related Burnout Scale for Rheumatic Diseases: Development and Preliminary Validation

To develop and validate the Treatment-Related Burnout Scale for Rheumatic Diseases and to evaluate treatment-related burnout levels and associated factors in patients with rheumatologic diseases.

This methodological and descriptive study was conducted with two independent patient samples with rheumatologic diseases. In the first stage, a draft scale was developed through literature review and expert consultation. Content validity was assessed using the Davis technique. Exploratory factor analysis and reliability analyses were performed in a sample of 260 participants. In the second stage, confirmatory factor analysis and regression analyses were conducted in an independent sample of 248 participants. Internal consistency was evaluated using Cronbach's alpha and composite reliability, while convergent validity was assessed using average variance extracted.

Following item analysis and exploratory factor analysis, the final scale consisted of 28 items and four subdimensions: Emotional and Cognitive Exhaustion, Treatment-Related Exhaustion, Disease-Related Functional Burden, and Healthcare System and Treatment Process Burden. The four-factor structure explained 63.30% of the total variance. Confirmatory factor analysis indicated an acceptable, although not optimal, model fit (χ²/df = 2.86, SRMR = 0.064, RMSEA = 0.087, CFI = 0.875). Cronbach's alpha coefficients ranged from 0.853 to 0.953 for the subscales and were 0.966 for the total scale. Composite reliability and average variance extracted values indicated satisfactory construct validity and internal consistency. Patients demonstrated moderate levels of treatment-related burnout, with emotional and cognitive exhaustion being the most prominent dimension.

The Treatment-Related Burnout Scale for Rheumatic Diseases provides preliminary evidence of validity and reliability as a multidimensional instrument for assessing treatment-related burnout in patients with rheumatologic diseases. The scale may contribute to clinical assessment and future research by providing a comprehensive evaluation of psychosocial burden related to long-term treatment processes. Key Points • The Treatment-Related Burnout Scale for Rheumatic Diseases (TBS-RD) is a newly developed 28-item instrument designed to assess treatment-related burnout in emotional, cognitive, functional, and healthcare system-related domains. •Exploratory and confirmatory factor analyses confirmed a four-factor structure. The total scale showed a Cronbach's alpha of 0.966, with composite reliabilities ranging from 0.81 to 0.95 for the subscales. • Patients with rheumatological diseases experienced moderate treatment-related burnout, with emotional and cognitive exhaustion being the most significant factors. • Gender was significantly associated with emotional and cognitive exhaustion, highlighting the importance of individualized, psychosocially informed clinical management.