Measuring Well-being Influencers: Development and Validation of the Well-Being Influencers Survey for Healthcare (WISH) Inventory.

Abstract

Background: Improving healthcare professional well-being and reducing burnout requires improving work ecosystems and cultures. Current well-being metrics focus on distal outcomes within individuals ( e.g. , professional fulfillment or burnout). This study developed and evaluated the performance of an inventory measuring perceptions of modifiable workplace dimensions-termed "influencers"-that shape healthcare professionals' well-being.

Methods: A core team developed the Well-Being Influencers Survey for Healthcare (WISH), an inventory designed to measure these systemic, occupational well-being influencers ( e.g. , leadership support, psychologic safety, working conditions). After content validation and refinement, 223 healthcare professionals from an academic department of anesthesiology completed WISH alongside established well-being measures, including the Maslach Burnout Inventory; the Professional Fulfillment Index; the Perceived Stress Scale; the Patient-Reported Outcomes Measurement Information System short forms for meaning, purpose, and life satisfaction; as well as standard items of affective commitment (a measure of engagement) and a standard item assessing intention to leave. Factor analysis was used to assess WISH's internal structure, while correlation and regression analyses assessed its criterion-related validity using the above established measures.

Results: WISH showed the expected relationships with established well-being measures and outperformed established metrics in predicting affective commitment and intention to leave after adjusting for those measures and/or covariates. Factor analysis indicated that most WISH variance reflects a single common factor, supporting the use of an instrument-level score. Unique variance at the influencer level highlights the added value of examining influencer scores.

Conclusions: WISH fills a key gap in healthcare professional well-being improvement science by assessing causal factors of well-being and burnout rather than the conditions themselves. This study established initial validity of this unique inventory and further reinforced the relevance of system-level and cultural factors in influencing healthcare professionals' well-being. WISH is well suited to assist healthcare professional well-being improvement efforts driven by system-improvement mindsets.