Attribution required.The ProQOL-5 is free to use, including commercially, under three conditions set by the rights holder. The measure footer states: "This measure may be freely copied as long as (i) the author is credited, (ii) no changes are made, and (iii) that it is not sold." Reformatting into an online instrument is expressly permitted by the ProQOL FAQ provided the content is unchanged. The only sanctioned modification is substituting a more specific term for the bracketed [help] or [helper]; anything further must be labelled "as adapted". Ownership transferred from Beth Hudnall Stamm to the Center for Victims of Torture (CVT) in 2016.
When you [help] people, you have direct contact with their lives. As you may have found, your compassion for those you [help] can affect you in positive and negative ways. Below are some questions about your experiences, both positive and negative, as a [helper]; note that the words [help] and [helper] can be replaced with more specific terms, such as [teach] and [teacher] or [nurse]. Consider each of the following questions about you and your current work situation. Select the number that honestly reflects how frequently you experienced these things in the last 30 days.
Never1
Rarely2
Sometimes3
Often4
Very Often5
Score
01I am happy.
-
02I am preoccupied with more than one person I [help].
-
03I get satisfaction from being able to [help] people.
-
04I feel connected to others.
-
05I jump or am startled by unexpected sounds.
-
06I feel invigorated after working with those I [help].
-
07I find it difficult to separate my personal life from my life as a [helper].
-
08I am not as productive at work because I am losing sleep over traumatic experiences of a person I [help].
-
09I think that I might have been affected by the traumatic stress of those I [help].
-
10I feel trapped by my job as a [helper].
-
11Because of my [helping], I have felt "on edge" about various things.
-
12I like my work as a [helper].
-
13I feel depressed because of the traumatic experiences of the people I [help].
-
14I feel as though I am experiencing the trauma of someone I have [helped].
-
15I have beliefs that sustain me.
-
16I am pleased with how I am able to keep up with [helping] techniques and protocols.
-
17I am the person I always wanted to be.
-
18My work makes me feel satisfied.
-
19I feel worn out because of my work as a [helper].
-
20I have happy thoughts and feelings about those I [help] and how I could help them.
-
21I feel overwhelmed because my case [work] load seems endless.
-
22I believe I can make a difference through my work.
-
23I avoid certain activities or situations because they remind me of frightening experiences of the people I [help].
-
24I am proud of what I can do to [help].
-
25As a result of my [helping], I have intrusive, frightening thoughts.
-
26I feel "bogged down" by the system.
-
27I have thoughts that I am a "success" as a [helper].
-
28I can't recall important parts of my work with trauma victims.
-
29I am a very caring person.
-
30I am happy that I chose to do this work.
-
0-3score item↑↓moveScored locally - nothing leaves this page
0 of 30 answered
ProQOL-50 / 30
When you [help] people, you have direct contact with their lives. As you may have found, your compassion for those you [help] can affect you in positive and negative ways. Below are some questions about your experiences, both positive and negative, as a [helper]; note that the words [help] and [helper] can be replaced with more specific terms, such as [teach] and [teacher] or [nurse]. Consider each of the following questions about you and your current work situation. Select the number that honestly reflects how frequently you experienced these things in the last 30 days.
Scored locally - nothing leaves this page
01I am happy.
02I am preoccupied with more than one person I [help].
03I get satisfaction from being able to [help] people.
04I feel connected to others.
05I jump or am startled by unexpected sounds.
06I feel invigorated after working with those I [help].
07I find it difficult to separate my personal life from my life as a [helper].
08I am not as productive at work because I am losing sleep over traumatic experiences of a person I [help].
09I think that I might have been affected by the traumatic stress of those I [help].
10I feel trapped by my job as a [helper].
11Because of my [helping], I have felt "on edge" about various things.
12I like my work as a [helper].
13I feel depressed because of the traumatic experiences of the people I [help].
14I feel as though I am experiencing the trauma of someone I have [helped].
15I have beliefs that sustain me.
16I am pleased with how I am able to keep up with [helping] techniques and protocols.
17I am the person I always wanted to be.
18My work makes me feel satisfied.
19I feel worn out because of my work as a [helper].
20I have happy thoughts and feelings about those I [help] and how I could help them.
21I feel overwhelmed because my case [work] load seems endless.
22I believe I can make a difference through my work.
23I avoid certain activities or situations because they remind me of frightening experiences of the people I [help].
24I am proud of what I can do to [help].
25As a result of my [helping], I have intrusive, frightening thoughts.
26I feel "bogged down" by the system.
27I have thoughts that I am a "success" as a [helper].
28I can't recall important parts of my work with trauma victims.
29I am a very caring person.
30I am happy that I chose to do this work.
0 of 30 answered
Scoring & cutoffs
How scoring works.
Scoring proceeds in three steps. First, reverse five items - items 1, 4, 15, 17 and 29, all of which sit in the burnout subscale - using the key 1=5, 2=4, 3=3, 4=2, 5=1. Second, sum the ten items belonging to each subscale: compassion satisfaction from items 3, 6, 12, 16, 18, 20, 22, 24, 27 and 30; burnout from items 1, 4, 8, 10, 15, 17, 19, 21, 26 and 29; secondary traumatic stress from items 2, 5, 7, 9, 11, 13, 14, 23, 25 and 28. Each subscale therefore runs from 10 to 50. Third - for group and research use only - the manual converts raw sums to t-scores.
The same three bands are applied to all three subscales: 22 or below is low, 23 to 41 moderate, 42 or above high. Two cautions belong with those numbers. They are percentile cuts drawn from the developer's data bank at roughly the 25th and 75th percentiles, not criterion-referenced thresholds validated against any external standard; the manual itself describes them as "potentially overly inclusive" and warns that "scores near the boarders can be particularly troublesome in that the cut point is an artificially applied criteria". And the manual is internally inconsistent - its narrative section on secondary traumatic stress refers to a score "above 43" while its own band table and scoring handout give 42. Use 42.
A published critique goes further. Hagan (2019) observed that the 99th percentiles of the burnout and secondary traumatic stress raw scores reported in the manual are 37 and 31 respectively, both well below the prescribed cut of 42, and concluded there is an error in the cut scores prescribed for individual scoring. In his sample of 496 nurses, applying the group t-score rules classified 33% as high burnout; applying the individual-administration rules classified none. Treat the bands as a prompt for conversation, not a threshold for action.
Compassion satisfaction
10 items · 10–50
Items 3, 6, 12, 16, 18, 20, 22, 24, 27, 30
Low10–22
Moderate23–41
High42–50
Burnout
10 items · 10–50
Items 1r, 4r, 8, 10, 15r, 17r, 19, 21, 26, 29r
r = reverse-scored before summing
Low10–22
Moderate23–41
High42–50
Secondary traumatic stress
10 items · 10–50
Items 2, 5, 7, 9, 11, 13, 14, 23, 25, 28
Low10–22
Moderate23–41
High42–50
The cut points sit at approximately the 25th and 75th percentiles of the author's databank. They are screening guidance only; the author recommends interpreting the continuous scores rather than the bands, and states that the ProQOL is not a diagnostic instrument.
Attribution & licence
Beth Hudnall Stamm (2009). Professional Quality of Life: Compassion Satisfaction and Fatigue Version 5 (ProQOL). www.ProQOL.org. This measure may be freely copied as long as (i) the author is credited, (ii) no changes are made, and (iii) that it is not sold. Ownership of the ProQOL measures transferred to the Center for Victims of Torture (CVT) in 2016.
Free to use and reproduce, subject to crediting the author, making no changes to the wording, and not selling it. The author's FAQ expressly permits reformatting the measure into an online form.
The ProQOL-5 measures professional quality of life in people whose work brings them into contact with the suffering of others - clinicians, nurses, social workers, first responders, humanitarian staff. It treats that experience as having two sides. Compassion satisfaction captures the pleasure a helper derives from doing the work well. Compassion fatigue, the negative side, is split into two distinct components: burnout, the gradual accumulation of exhaustion, frustration and a sense of ineffectiveness tied to the work environment; and secondary traumatic stress, the intrusion-and-avoidance symptoms that follow exposure to other people's traumatic material. Each is measured by ten items over a thirty-day recall window.
It is important to be precise about what the instrument does not do. There is no total ProQOL score, and the developer is explicit that there should not be one - compassion satisfaction is keyed in the opposite direction to the other two subscales, so a thirty-item sum is not interpretable. The measure is a screening and reflection tool for individuals and a descriptive tool for organisations. It is not diagnostic, it does not distinguish burnout from depression with any precision, and the manual states plainly that it is "impossible, and grievously inappropriate, to diagnose depression or any other disorder from the result of the ProQOL".
02 - Origin & purpose
Where it comes from.
The ProQOL descends from Charles Figley's Compassion Fatigue Self-Test of the late 1980s, which Beth Hudnall Stamm revised across several iterations through the 1990s and 2000s. Version 5, released in 2009 and documented in the Concise ProQOL Manual (2nd edition, 2010), is the current form and the one in general use. The decisive change across those revisions was the separation of compassion fatigue into burnout and secondary traumatic stress as separate constructs - a conceptual claim that much of the subsequent psychometric literature has struggled to confirm.
The instrument occupies an unusual position. It is among the most widely used measures of its kind, translated into more than twenty languages, and yet it has never been the subject of a peer-reviewed validation paper by its own author. Its normative base is a self-published manual built on a convenience data bank of respondents, and no primary publication with a DOI exists to cite. Ownership passed to the Center for Victims of Torture in 2016. Everything known about its measurement properties comes from independent groups working after the fact, and their findings are mixed.
03 - Validation evidence
How well it performs.
The ProQOL-5's evidence base is broad but shallow, and it is weakest exactly where clinical users most want strength. Its three-factor structure has failed confirmatory analysis in Portuguese, Slovak, Romanian, French, Hebrew, Serbian, Brazilian Portuguese, UK English and US English samples. The compassion satisfaction and secondary traumatic stress subscales are reliably internally consistent across studies; burnout is not, with alphas reported as low as .45 and .53. There is no published sensitivity, specificity or ROC analysis for the measure against any external criterion - a systematic review that set out to extract diagnostic-accuracy data from ProQOL studies found none to extract. There is likewise no MCID, no minimal detectable change and no responsiveness estimate in any language, which means the instrument has never been shown to be fit for measuring change, despite being used that way routinely.
CS .87 / STS .80 / BO .73
Internal consistency (pooled, 12 studies)
Compassion satisfaction alpha = 0.866 (SD 0.055); secondary traumatic stress alpha = 0.802 (SD 0.042); burnout alpha = 0.73 (SD 0.083), with individual studies as low as .45. Singh et al. 2024.
r = .94 to .97
Test-retest
Greek nurses, n = 30, 3-week interval - CS r = .968, BO r = .968, STS r = .935 (Misouridou 2021). Vietnamese doctors and nurses, n = 38, 2-week interval - ICC .88 / .89 / .71 (Tran 2023). No English-language test-retest study exists; none is reported in the manual.
None published
Diagnostic accuracy
No study reports sensitivity, specificity, ROC or AUC against an external criterion. Confirmed by a QUADAS-2/COSMIN systematic review that included the ProQOL and found no extractable accuracy data (Emal et al. 2023).
None published
Responsiveness
No MCID, MIC, MDC, SEM or responsiveness estimate published in any language. The NCTSN measure review records "sensitive to change" as not found.
Commercial (Mind Garden, per-administration fee). Reach for it when you need the field-standard three-dimensional burnout construct for benchmarking against published norms. Note that the tertile cut-offs were withdrawn in the 2016 fourth-edition manual for lacking diagnostic validity.
Free, hosted by the Danish National Research Centre for the Working Environment. Nineteen items across personal, work-related and client-related burnout. Reach for it when cost rules out the MBI, or when you want to know whether the exhaustion is attributable to client contact at all. Two scoring conventions circulate; check which one a given paper used.
Burnout Assessment Tool (BAT)
33
Free
Free and non-proprietary, must be cited and not modified. Thirty-three items (23 core plus 10 secondary), with a BAT-12 short form. Reach for it when you want a free instrument that actually offers clinical cut-offs for individual risk stratification, which the MBI no longer provides and the ProQOL does not.
Secondary Traumatic Stress Scale (STSS)
17
Free
Free in practice, distributed by the STS Consortium. Reach for it when the clinical question is specifically PTSD-like secondary trauma. Its items map onto DSM criteria in a way the ProQOL's ten-item secondary traumatic stress subscale does not.
Professional Fulfillment Index (PFI)
16
Free
Free for non-profit use without modification. Reach for it when you are measuring change. Its two-week recall window is designed for it, and it is the right choice for evaluating a wellbeing intervention, where the ProQOL has no responsiveness data at all.
Free with conditions. Reach for it when survey burden is the binding constraint and you want a brief, well-validated general wellbeing screen rather than an occupational one.
05 - When to use it
Right tool, wrong tool.
Reach for it when
-Individual reflection and supervision, where the three subscale scores open a conversation about what the work is doing to someone.
-Organisational description at group level - aggregate profiles across a team or service, reported as continuous scores.
-Research on occupational wellbeing where comparability with a large existing literature matters more than measurement precision.
-Situations where you specifically want to measure the positive side of the work, which most burnout instruments do not capture at all.
Reach for something else when
-Diagnosis of any kind. The manual is explicit; so are we.
-Measuring change after an intervention. There is no responsiveness evidence. Use the Professional Fulfillment Index.
-Evaluating individual staff performance. The NCTSN review advises organisations to refrain from using ProQOL data this way, and we agree.
-Screening family carers. The developer states plainly: "We do not recommend the ProQOL for family caregivers."
-Any high-stakes decision resting on the burnout subscale alone, given its unstable internal consistency and heavy overlap with depression.
-Using a single subscale in isolation, which the developer discourages.
06 - Confidence & precision
Reading the score with care.
Treat individual ProQOL scores as approximate. The bands are percentile conventions from a convenience sample, not validated thresholds, and there is a documented inconsistency between the manual's narrative and its own scoring table. No standard error of measurement has been published, so no confidence interval can be placed around a score - we will not estimate one. Scores near a band boundary should not be read as meaningfully different from scores just the other side of it. The burnout subscale in particular correlates strongly with depression measures (r = .52 to .66 in independent samples), so a high burnout score should prompt a proper assessment of mood rather than being interpreted as an occupational finding on its own.
07 - Limitations
What it cannot tell you.
- The three-factor structure does not replicate. Confirmatory analyses have failed in at least nine language versions; UK English returned CFI .764, Slovak .704, and a US analysis recovered two factors rather than three.
- Compassion satisfaction and burnout may be one construct, not two. A bifactor analysis found that once a general factor is extracted, compassion satisfaction retains almost no unique reliable variance (omega-H = .17) and burnout very little (omega-H = .21); only secondary traumatic stress holds up (omega-H = .81).
- The five reverse-scored burnout items are the identified failure point. A meta-analysis of 27 studies found they did not load on the burnout factor yet cross-loaded on compassion satisfaction in nearly all validation studies.
- Burnout overlaps heavily with depression, to the point that one validation team concluded the distinction "remains conceptually fragile".
- Measurement invariance has never been tested, so comparisons across occupational groups, countries or languages are not on safe ground.
- No peer-reviewed primary publication and no DOI exist for the instrument itself.
- The cut scores carry a documented internal contradiction and a published claim of outright error.
- No administration time has ever been published by the developer.
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