MODULE TWO: COUNSELLING - FHI 360 Center for Global Health ...

Burnout Assessment Questionnaire 2
Circle a number for each statement to indicate the degree to which the statement applies to you.
1=Never True 3=Sometimes True 5=Always True
2=Rarely True 4=Usually True
1. I feel tired even when I’ve gotten enough sleep. 1 2 3 4 5
2. I am dissatisfied with my work. 1 2 3 4 5
3. I feel sad for no apparent reason 1 2 3 4 5
4. I am forgetful 1 2 3 4 5
5. I am irritable and snap at people 1 2 3 4 5
6. I avoid people at work and in my private life. 1 2 3 4 5
7. I have trouble sleeping due to worrying about 1 2 3 4 5
work.
8. I get sick more than I used to. 1 2 3 4 5
9. I often get into conflicts. 1 2 3 4 5
10. My job performance is not up to par. 1 2 3 4 5
11. I use alcohol or drugs to feel better. 1 2 3 4 5
12. Communicating with others is a strain. 1 2 3 4 5
13. I can’t concentrate on my work like I once 1 2 3 4 5
could.
14. I am easily bored with my work. 1 2 3 4 5
15. I feel frustrated with my work. 1 2 3 4 5
16. I don’t like going to work. 1 2 3 4 5
17. Social activities are draining. 1 2 3 4 5
18. I don’t have much to look forward to in 1 2 3 4 5
my work.
19. I worry about work during my off hours. 1 2 3 4 5
20. Feelings about my work interfere with my
personal life. 1 2 3 4 5
21. My work seems pointless. 1 2 3 4 5
2 Source : myprimetime : Personal Trainer for Life. ttp://cgi.myprimetime.com/work/burnout/Burnout.jsp10
Session 10 – Pg. 7