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Abstract

Background: Burnout among healthcare workers, exacerbated by the COVID-19 pandemic, has prompted exploration of effective interventions and assessment tools. The comprehension of burnout assessment scales tailored to healthcare professionals in Malaysia enables the implementation of targeted intervention and the provision of comprehensive healthcare services.

Methods: This systematic review assesses the effectiveness of the burnout assessment scales in Malaysia. Following the PRISMA guidelines, we searched databases including PsycINFO, Embase, and PubMed from January 2015 to June 2023 for studies involving Malaysian healthcare workers and validated burnout assessment scales. We assessed study quality and extracted data to analyse burnout prevalence, influencing factors, and scale validity.

Results: Ten studies met our criteria, covering various healthcare settings, specialties, and roles. Burnout prevalence varied and was influenced by factors such as COVID-19 fears, work-related stress, and demographics. Assessment scale psychometrics varied, emphasizing the need for culturally tailored tools. Social support and problem-focused coping related to lower burnout. Nurses and specific specialties reported higher rates of burnout. Job satisfaction and support systems were vital mitigating factors.

Conclusion: The review reveals the complex interplay of individual, organizational, and contextual elements in Malaysian healthcare workers burnout experiences. It emphasizes the importance of targeted interventions for addressing burnout, enhancing well-being, and improving healthcare quality. Developing culturally sensitive, reliable assessment tools and comprehensive interventions addressing individual and organizational factors is essential. Further research should explore holistic strategies to address burnout among Malaysian healthcare professionals and enhance their well-being.

Keywords: Burnout; Assessment; Healthcare professionals; Malaysia

References

[1] Poghosyan L, Aiken LH, Sloane DM. Factor structure of the Maslach burnout inventory: an analysis of data from large scale cross-sectional surveys of nurses from eight countries. Int J Nurs Stud [Internet]. 2009 Jul [cited 2023 Aug 21];46(7):894–902. Available from: https://pubmed.ncbi.nlm.nih.gov/19362309/

[2] Bria M, Spânu F, Bəban A, Dumitraşcu DL. Maslach Burnout Inventory - General Survey: Factorial validity and invariance among Romanian healthcare professionals. Burn Res. 2014 Dec 1;1(3):103–11.

[3] Leiter MP, Maslach C. Latent burnout profiles: A new approach to understanding the burnout experience. Burn Res. 2016 Dec 1;3(4):89–100.

[4] Maslach C, Leiter MP. Understanding the burnout experience: Recent research and its implications for psychiatry. World Psychiatry. 2016 Jun 1;15(2):103–11.

[5] Maslach C, Leiter MP. Early Predictors of Job Burnout and Engagement. Journal of Applied Psychology [Internet]. 2008 May [cited 2023 Jan 4];93(3):498–512. Available from: /record/2008-05281-002

[6] Mohd Beta RMD. The effect of the job demand and perceived job burnout in the context of academicians’ role performance / Raja Mayang Delima Mohd Beta... [et al.]. 2019;

[7] Brom SS, Buruck G, Horváth I, Richter P, Leiter MP. Areas of worklife as predictors of occupational health – A validation study in two German samples. Burn Res [Internet]. 2015 [cited 2023 Apr 27];2:60–70. Available from: http://dx.doi.org/10.1016/j.burn.2015.05.001

[8] Zakaria MI, Remeli R, Fitri M, Shahamir A, Hafyzuddin M, Yusuf M, et al. Assessment of burnout among emergency medicine healthcare workers in a teaching hospital in Malaysia during COVID-19 pandemic. Hong Kong Journal of Emergency Medicine [Internet]. 2021 [cited 2023 Aug 21];28(4):254–9. Available from: https://doi.org/10.1177/1024907921989499

[9] Hayek S El, Ahmead M, Ebiti N, Macaron MM, Ayomide Segun-Omosehin O, Matar RH, et al. OPEN ACCESS EDITED BY A systematic review and meta analysis on burnout in physicians during the COVID-19 pandemic: A hidden healthcare crisis. Psychiatry. 2023;13:1071397.

[10] Isa MR. How Anxious Our Healthcare Workers during COVID-19 Pandemic: A Cross-sectional Study in Hulu Langat District, Selangor, Malaysia. 2023 [cited 2023 Aug 21]; Available from: http://meddocsonline.org/

[11] Stodolska A, Wójcik G, Barańska I, Kijowska V, Szczerbińska K. Prevalence of burnout among healthcare professionals during the COVID-19 pandemic and associated factors – a scoping review. Int J Occup Med Environ Health [Internet]. 2023 Mar 2 [cited 2023 Aug 21];36(1):21–58. Available from: http://ijomeh.eu/Prevalence-of-burnout-among-healthcare-professionals-during-the-COVID-19-pandemic,155343,0,2.html

[12] Bria M, Spânu F, Bəban A, Dumitraşcu DL. Maslach Burnout Inventory – General Survey: Factorial validity and invariance among Romanian healthcare professionals. Burn Res. 2014 Dec 1;1(3):103–11.

[13] Schaufeli WB, Leiter MP, Maslach C. Burnout: 35 years of research and practice. Career Dev Int. 2009 Jun 19;14(3):204-20.

[14] Maslach C. Stress, burnout, and workaholism. Professionals in distress: Issues, syndromes, and solutions in psychology. 2004 Oct 27;53–75.

[15] Bakker AB, Demerouti E. Towards a model of work engagement. Career Development International. 2008 May 9;13(3):209–23.

[16] Pines A, Aronson E. Career burnout: Causes and cures. Choice Reviews Online. 1988 Nov 1;26(03):26-1580-26–1580.

[17] Melamed S, Kushnir T, Shirom A, Melamed S. Burnout and risk factors for cardiovascular diseases. Behavioral Medicine. 1992;18(2):53–60.

[18] De Silva P, Hewage C, Fonseka P. Burnout: an emerging occupational health problem. Galle Medical Journal. 2009 Oct 8;14(1):52.

[19] Schaufeli W, Enzmann D. The Burnout Companion to Study and Practice: A Critical Analysis. The Burnout Companion to Study and Practice: A Critical Analysis. 2020 Oct 28;

[20] Densten IL. Re-thinking burnout. J Organ Behav [Internet]. 2001 Dec 1 [cited 2023 Aug 21];22(8):833–47. Available from: https://onlinelibrary.wiley.com/doi/full/10.1002/job.115

[21] Poghosyan L, Clarke SP, Finlayson M, Aiken LH. Nurse Burnout and Quality of Care: Cross-National Investigation in Six Countries. Res Nurs Health [Internet]. 2010 [cited 2023 Aug 21];33(4):288. Available from: /pmc/articles/PMC2908908/

[22] Leiter MP, Maslach C. AREAS OF WORKLIFE: A STRUCTURED APPROACH TO ORGANIZATIONAL PREDICTORS OF JOB BURNOUT. Research in Occupational Stress and Well Being. 2003;3:91–134.

[23] Schaufeli W, Enzmann D. The Burnout Companion To Study And Practice : A Critical Analysis. The Burnout Companion to Study and Practice: A Critical Analysis [Internet]. 2020 Oct 28 [cited 2023 Aug 21]; Available from: https://www.taylorfrancis.com/books/mono/10.1201/9781003062745/burnout-companion-study-practice-wilmar-schaufeli-enzmann

[24] Adriaenssens J, De Gucht V, Maes S. Determinants and prevalence of burnout in emergency nurses: a systematic review of 25 years of research. Int J Nurs Stud [Internet]. 2015 Feb 1 [cited 2023 Aug 21];52(2):649–61. Available from: https://pubmed.ncbi.nlm.nih.gov/25468279/

[25] Shanafelt TD, Hasan O, Dyrbye LN, Sinsky C, Satele D, Sloan J, et al. Changes in Burnout and Satisfaction With Work-Life Balance in Physicians and the General US Working Population Between 2011 and 2014. Mayo Clin Proc [Internet]. 2015 [cited 2023 Aug 21];90(12):1600–13. Available from: https://pubmed.ncbi.nlm.nih.gov/26653297/

[26] Marzo RR, Khaled Y, ElSherif M, Abdullah MSAM Bin, Zhu Thew H, Chong C, et al. Burnout, resilience and the quality of life among Malaysian healthcare workers during the COVID-19 pandemic. Front Public Health. 2022 Nov 30;10:1021497.

[27] Elhadi M, Msherghi A, Elgzairi M, Alhashimi A, Bouhuwaish A, Biala M, et al. Burnout Syndrome Among Hospital Healthcare Workers During the COVID-19 Pandemic and Civil War: A Cross-Sectional Study. Front Psychiatry [Internet]. 2020 Dec 11 [cited 2023 Aug 21];11. Available from: https://pubmed.ncbi.nlm.nih.gov/33362600/

[28] Zheng Y, Tang PK, Lin G, Liu J, Hu H, Wu AMS, et al. Burnout among healthcare providers: Its prevalence and association with anxiety and depression during the COVID-19 pandemic in Macao, China. PLoS One [Internet]. 2023 Mar 1 [cited 2023 Jul 25];18(3):e0283239. Available from: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0283239

[29] Mukundan J, Ahour T. Burnout Among Female Teachers In Malaysia. Journal of International Education Research (JIER). 2011 Jul 11;7(3):25–38.

[30] Gan GG, Hue YL. Anxiety, depression and quality of life of medical students in Malaysia. Med J Malaysia [Internet]. 2019 [cited 2023 Aug 21];57–61. Available from: http://dx.doi.org/

[31] Tan L, Cicuttini FM, Fairley J, Romero L, Estee M, Hussain SM, et al. Does aerobic exercise effect pain sensitisation in individuals with musculoskeletal pain? A systematic review. BMC Musculoskelet Disord [Internet]. 2022 Dec 1 [cited 2023 Aug 3];23(1):1–21. Available from: https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-022-05047-9

[32] Kristensen TS, Borritz M, Villadsen E, Christensen KB. The Copenhagen Burnout Inventory: A new tool for the assessment of burnout. https://doi.org/101080/02678370500297720 [Internet]. 2007 Jul [cited 2023 Aug 3];19(3):192–207. Available from: https://www.tandfonline.com/doi/abs/10.1080/02678370500297720

[33] Schaufeli W, Enzmann D. The Burnout Companion to Study & Practice. Syria Studies. 1998;7(1):37–72.

[34] Swartz MK. PRISMA 2020: An Update. 2021 [cited 2023 Oct 23]; Available from: https://doi.org/10.1016/j.pedhc.2021.04.011

[35] Ibrahim F, Samsudin EZ, Chen XW, Toha HR. The Prevalence and Work-Related Factors of Burnout Among Public Health Workforce During the COVID-19 Pandemic. J Occup Environ Med [Internet]. 2022 Jan 1 [cited 2023 Aug 18];64(1):E20–7. Available from: https://pubmed.ncbi.nlm.nih.gov/34789681/

[36] Marzo RR, ElSherif M, Abdullah MSAM Bin, Thew HZ, Chong C, Soh SY, et al. Demographic and work-related factors associated with burnout, resilience, and quality of life among healthcare workers during the COVID-19 pandemic: A cross sectional study from Malaysia. Front Public Health [Internet]. 2022 Dec 16 [cited 2023 Aug 18];10. Available from: /pmc/articles/PMC9800419/

[37] Jiee SF, Jantim A, Mohamed AF, Emiral ME. COVID-19 pandemic: Determinants of workplace preventive practice among primary healthcare workers in Sabah, Malaysia. J Prev Med Hyg. 2021 Sep 1;62(3):E605–12.

[38] Fatimah S, Hussain A, Taib F, Yusoff S, Rahman AA, Othman A, et al. Burnout and Stressor Related Factors among Nurses Caring For Children in Hospital Universiti Sains Malaysia. Malaysian Journal of Medicine and Health Sciences. 2022;18(1):2636–9346.

[39] Siau C, Wee L, Ibrahim N, Visvalingam U, Yeap L, Yeoh SH, et al. Predicting burnout and psychological distress risks of hospital healthcare workers. Malaysian Journal of Public Health Medicine. 2018;

[40] Ching SM, Thurasamy R, Cheong AT, Yee A, Ling Y, Zarina II, et al. UPM. 12 Ministry of health, Malaysia 13 Klinik Kesihatan Seksyen 19, Ministry of Health Malaysia. Malaysia Malaysian Journal of Medicine and Health Sciences. 2023;19(4):265–72.

[41] Zakaria N, Zakaria NH, Bin Abdul Rassip MNA, Lee KY. Burnout and coping strategies among nurses in Malaysia: a national-level cross-sectional study. BMJ Open [Internet]. 2022 Oct 10 [cited 2023 Aug 18];12(10). Available from: https://pubmed.ncbi.nlm.nih.gov/36216421/

[42] Pang NTP, Hadi NMN, Mohaini MI, Kamu A, Ho CM, Koh EBY, et al. Factors Contributing to Burnout among Healthcare Workers during COVID-19 in Sabah (East Malaysia). Healthcare (Basel) [Internet]. 2022 Jun 1 [cited 2023 Aug 18];10(6). Available from: https://pubmed.ncbi.nlm.nih.gov/35742119/

[43] Al-Dubai SAR, Ganasegeran K, Perianayagam W, Rampal KG. Emotional burnout, perceived sources of job stress, professional fulfillment, and engagement among medical residents in Malaysia. The Scientific World Journal. 2013;2013.

[44] Woon LSC, Tiong CP. Burnout, Mental Health, and Quality of Life Among Employees of a Malaysian Hospital: A Cross-sectional Study. Ann Work Expo Health [Internet]. 2020 Nov 1 [cited 2023 Aug 22];64(9):1007–19. Available from: https://pubmed.ncbi.nlm.nih.gov/32918467/

[45] Roslan NS, Saiful M, Yusoff B, Asrenee AR, Morgan K. Burnout Prevalence and Its Associated Factors among Malaysian Healthcare Workers during COVID-19 Pandemic: An Embedded Mixed-Method Study. 2021 [cited 2023 Aug 18]; Available from: http://doi.org/10.3390/healthcare9010090

[46] Khasne RW, Dhakulkar BS, Mahajan HC, Kulkarni AP. Burnout among Healthcare Workers during COVID-19 Pandemic in India: Results of a Questionnaire-based Survey. Indian J Crit Care Med [Internet]. 2020 [cited 2023 Aug 18];24(8):664–71. Available from: https://pubmed.ncbi.nlm.nih.gov/33024372/

[47] Chor WPD, Ng WM, Cheng L, Situ W, Chong JW, Ng LYA, et al. Burnout amongst emergency healthcare workers during the COVID-19 pandemic: A multi-center study. Am J Emerg Med [Internet]. 2021 Aug 1 [cited 2023 Aug 18];46:700. Available from: /pmc/articles/PMC7584488/

[48] Ferry A V., Wereski R, Strachan FE, Mills NL. Predictors of UK healthcare worker burnout during the COVID-19 pandemic. QJM [Internet]. 2021 Jun 1 [cited 2023 Aug 18];114(6):374–80. Available from: https://pubmed.ncbi.nlm.nih.gov/33769545/

[49] Ghulam S, Shah M, Tariq J, Li H, Çelmeçe N, Menekay M. The Effect of Stress, Anxiety and Burnout Levels of Healthcare Professionals Caring for COVID-19 Patients on Their Quality of Life. 2020 [cited 2023 Aug 18]; Available from: www.frontiersin.org

[50] Li Y, Zhang H, Feng Z, Chen S, Liu T, Chen X, et al. Life events, Anxiety and Depression Among Doctors and Nurses in the Emergency Department: A Study From Eleven General Hospital in Hunan Province, China. J Psychiatr Brain Sci. 2016 Apr 25;1(1).

[51] Bakker AB, Demerouti E, Sanz-Vergel AI. Burnout and Work Engagement: The JD–R Approach. https://doi.org/101146/annurev-orgpsych-031413-091235 [Internet]. 2014 Mar 21 [cited 2023 Aug 18];1:389–411. Available from: https://www.annualreviews.org/doi/abs/10.1146/annurev-orgpsych-031413-091235

[52] Marôco J, Marôco AL, Leite E, Bastos C, Vazão MJ, Campos J. [Burnout in Portuguese Healthcare Professionals: An Analysis at the National Level]. Acta Med Port [Internet]. 2016 Jan 29 [cited 2023 Aug 18];29(1):24–30. Available from: https://pubmed.ncbi.nlm.nih.gov/26926895/

[53] Maslach C, Jackson SE, Leiter M. The Maslach Burnout Inventory Manual. [cited 2023 Jan 10]; Available from: https://www.researchgate.net/publication/277816643

[54] Schaufeli WB, Taris TW. The conceptualization and measurement of burnout: Common ground and worlds apart The views expressed in Work & Stress Commentaries are those of the author(s), and do not necessarily represent those of any other person or organization, or of the journal. https://doi.org/101080/02678370500385913 [Internet]. 2007 Jul [cited 2023 Aug 19];19(3):256–62. Available from: https://www.tandfonline.com/doi/abs/10.1080/02678370500385913

[55] Maslach C, Jackson SE. The Measurement of Experienced Burnout Maslach Burnout Inventory Manual, 4th Edition View project. Article in Journal of Organizational Behavior [Internet]. 1981 [cited 2023 Jan 10]; Available from: https://www.researchgate.net/publication/227634716

[56] Kumareswaran S. Burnout among Employees: A Narrative Review. European Journal of Humanities and Social Sciences. 2023 Mar 10;3(2):15–20.

[57] Maslach C, Leiter MP. Early Predictors of Job Burnout and Engagement. Journal of Applied Psychology. 2008 May;93(3):498–512.

[58] Kumareswaran S, Muhadi SUU, Thuraiarasu V. Prevalence of Burnout and Its Detrimental Effects Among Workers. Malaysian Journal of Social Sciences and Humanities (MJSSH) [Internet]. 2022 Sep 30 [cited 2023 Jan 10];7(9):e001743. Available from: https://www.msocialsciences.com/index.php/mjssh/article/view/1743

[59] Figley CR. Compassion fatigue : coping with secondary traumatic stress disorder in those who treat the traumatized. 1995;268.

[60] Dhanani LY, LaPalme ML, Pham CT, Hall TK. The Burden of Hate: How Nonwork Discrimination Experienced During the COVID-19 Pandemic Impacts Asian American Employees. J Bus Psychol. 2023 Jun 1;38(3):621–35.

[61] Grau-Alberola E, Gil-Monte PR, García-Juesas JA, Figueiredo-Ferraz H. Incidence of burnout in Spanish nursing professionals: A longitudinal study. Int J Nurs Stud. 2010 Aug;47(8):1013–20.

[62] Torrente M, Sousa PAC, Sánchez-Ramos A, Pimentao J, Royuela A, Franco F, et al. To burn-out or not to burn-out: a cross-sectional study in healthcare professionals in Spain during COVID-19 pandemic. BMJ Open [Internet]. 2021 Feb 24 [cited 2023 Aug 18];11(2). Available from: https://pubmed.ncbi.nlm.nih.gov/33627353/

[63] Amiri M, Khosravi A, Eghtesadi AR, Sadeghi Z, Abedi G, Ranjbar M, et al. Burnout and its Influencing Factors among Primary Health Care Providers in the North East of Iran. PLoS One [Internet]. 2016 Dec 1 [cited 2023 Aug 18];11(12):e0167648. Available from: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0167648

[64] Abarghouei MR, Sorbi MH, Abarghouei M, Bidaki R, Yazdanpoor S. A study of job stress and burnout and related factors in the hospital personnel of Iran. Electron Physician. 2016 Jul 25;8(7):2625–32.

[65] Masten AS. Ordinary magic. Resilience processes in development. Am Psychol [Internet]. 2001 [cited 2023 Aug 19];56(3):227–38. Available from: https://pubmed.ncbi.nlm.nih.gov/11315249/

[66] Earvolino-Ramirez M. Resilience: A Concept Analysis. Nurs Forum (Auckl) [Internet]. 2007 Apr 1 [cited 2023 Aug 19];42(2):73–82. Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/j.1744-6198.2007.00070.x

[67] Hart PL, Brannan JD, de Chesnay M. Resilience in nurses: an integrative review. J Nurs Manag [Internet]. 2014 [cited 2023 Aug 19];22(6):720–34. Available from: https://pubmed.ncbi.nlm.nih.gov/25208943/

[68] Montero-Marin J, Prado-Abril J, Piva Demarzo MM, Gascon S, García-Campayo J. Coping with Stress and Types of Burnout: Explanatory Power of Different Coping Strategies. PLoS One [Internet]. 2014 Feb 13 [cited 2023 Aug 19];9(2):e89090. Available from: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0089090

[69] Montero-Marín J, Araya R, Blazquez BO, Skapinakis P, Vizcaino VM, García-Campayo J. Understanding burnout according to individual differences: ongoing explanatory power evaluation of two models for measuring burnout types. BMC Public Health [Internet]. 2012 Oct 30 [cited 2023 Aug 19];12(1):922. Available from: https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-12-922

[70] Barford SW, Whelton WJ. Understanding Burnout in Child and Youth Care Workers. Child Youth Care Forum. 2010;39(4):271–87.

[71] Montero-Marín J, Skapinakis P, Araya R, Gili M, García-Campayo J. Towards a brief definition of burnout syndrome by subtypes: Development of the “Burnout Clinical Subtypes Questionnaire” (BCSQ-12). Health Qual Life Outcomes. 2011 Sep 20;9.

[72] Krishnamoorthy Y, Nagarajan R, Saya GK, Menon V. Prevalence of psychological morbidities among general population, healthcare workers and COVID-19 patients amidst the COVID-19 pandemic: A systematic review and meta-analysis. Psychiatry Res. 2020 Nov 1;293:113382.

[73] Ahorsu DK, Lin CY, Imani V, Saffari M, Griffiths MD, Pakpour AH. The Fear of COVID-19 Scale: Development and Initial Validation. Int J Ment Health Addict [Internet]. 2022 Jun 1 [cited 2023 Aug 19];20(3):1537. Available from: /pmc/articles/PMC7100496/

[74] Lee TSH, Tzeng WC, Chiang HH. Impact of Coping Strategies on Nurses’ Well-Being and Practice. J Nurs Scholarsh [Internet]. 2019 Mar 1 [cited 2023 Aug 19];51(2):195–204. Available from: https://pubmed.ncbi.nlm.nih.gov/30806038/

[75] DivinakumarK J, Pookala SB, Das R. Perceived stress, psychological well-being and burnout among female nurses working in government hospitals -. Int J Res Med Sci. 2014;2(4):1511.

[76] Dai J, Sang X, Menhas R, Xu X, Khurshid S, Mahmood S, et al. The Influence of COVID-19 Pandemic on Physical Health–Psychological Health, Physical Activity, and Overall Well-Being: The Mediating Role of Emotional Regulation. Front Psychol. 2021 Aug 16;12:667461.

[77] Tuna R, Baykal Ü. The relationship between job stress and burnout levels of oncology nurses. Asia Pac J Oncol Nurs [Internet]. 2014 Apr [cited 2023 Aug 22];1(1):33–9. Available from: https://pubmed.ncbi.nlm.nih.gov/27981080/

[78] Okwaraji FE, Aguwa EN. Burnout and psychological distress among nurses in a Nigerian tertiary health institution. Afr Health Sci [Internet]. 2014 Mar 1 [cited 2023 Aug 22];14(1):237. Available from: /pmc/articles/PMC4449076/

[79] Boamah SA, Spence Laschinger HK, Wong C, Clarke S. Effect of transformational leadership on job satisfaction and patient safety outcomes. Nurs Outlook [Internet]. 2018 Mar 1 [cited 2023 Aug 22];66(2):180–9. Available from: https://pubmed.ncbi.nlm.nih.gov/29174629/

[80] Honkonen T, Ahola K, Pertovaara M, Isometsä E, Kalimo R, Nykyri E, et al. The association between burnout and physical illness in the general population--results from the Finnish Health 2000 Study. J Psychosom Res [Internet]. 2006 Jul [cited 2023 Aug 22];61(1):59–66. Available from: https://pubmed.ncbi.nlm.nih.gov/16813846/

[81] Mohsen Hosseini S, Habibi E, Barakat S, Ahanchi N, Fooladvand M, Khorasani E. Investigating the relationship of mental health with job stress and burnout in workers of metal industries. 2016 [cited 2023 Aug 22]; Available from: http://www.ijeprjournal.org

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