Step 1 of 333%Name* First Last Today's Date* Date Format: MM slash DD slash YYYY Is this inventory being taken pre or post KAP Training?*PrePostPart one: Personal burnoutDefinition: Personal burnout is a state of prolonged physical and psychological exhaustion.Part one: Personal burnout*AlwaysOftenSometimesSeldomNever/almost never1. How often do you feel tired?2. How often are you physically exhausted?3. How often are you emotionally exhausted?4. How often do you think: “I can’t take it anymore”?5. How often do you feel worn out?6. How often do you feel weak and susceptible to illness?Part two: Work-related burnoutDefinition: Work-related burnout is a state of prolonged physical and psychological exhaustion, which is perceived as related to the person’s work.Part two: Work-related burnout*To a very high degreeTo a high degreeSomewhatTo a low degreeTo a very low degree1. Is your work emotionally exhausting?2. Do you feel burnt out because of your work?3. Does your work frustrate you?4. Do you feel worn out at the end of the working day?5. Are you exhausted in the morning at the thought of another day at work?6. Do you feel that every working hour is tiring for you?7. Do you have enough energy for family and friends during leisure time?Part three: Client-related burnoutDefinition: Client-related burnout is a state of prolonged physical and psychological exhaustion, which is perceived as related to the person’s work with clients*. *Clients, patients, social service recipients, elderly citizens, or inmates.Part three: Client-related burnout*AlwaysOftenSometimesSeldomNever/almost never1. Do you find it hard to work with clients?2. Do you find it frustrating to work with clients?3. Does it drain your energy to work with clients?4. Do you feel that you give more than you get back when you work with clients?5. Are you tired of working with clients?6. Do you sometimes wonder how long you will be able to continue working with clients?Source: Kristensen, T.S., Borritz, M., Villadsen, E., & Christensen, K.B. (2005): The Copenhagen Burnout Inventory: A new tool for the assessment of burnout, Work & Stress: An International Journal of Work, Health & Organisations, 19:3, 192-207
