Development of a Work Climate Scale in Emergency Health Services

Abstract

An adequate work climate fosters productivity in organizations and increases employee satisfaction. Workers in emergency health services (EHS) have an extremely high degree of responsibility and consequent stress. Therefore, it is essential to foster a good work climate in this context. Despite this, scales with a full study of their psychometric properties (i.e., validity evidence based on test content, internal structure and relations to other variables, and reliability) are not available to measure work climate in EHS specifically. For this reason, our objective was to develop a scale to measure the quality of work climates in EHS. We carried out three studies. In Study 1, we used a mixed-method approach to identify the latent conceptual structure of the construct work climate. Thus, we integrated the results found in (a) a previous study, where a content analysis of seven in-depth interviews obtained from EHS professionals in two hospitals in Gibraltar Countryside County was carried out; and (b) the factor analysis of the responses given by 113 EHS professionals from these same centers to 18 items that measured the work climate in health organizations. As a result, we obtained 56 items grouped into four factors (work satisfaction, productivity/achievement of aims, interpersonal relationships, and performance at work). In Study 2, we presented validity evidence based on test content through experts' judgment. Fourteen experts from the methodology and health fields evaluated the representativeness, utility, and feasibility of each of the 56 items with respect to their factor (theoretical dimension). Forty items met the inclusion criterion, which was to obtain an Osterlind index value greater than or equal to 0.5 in the three aspects assessed. In Study 3, 201 EHS professionals from the same centers completed the resulting 40-item scale. This new instrument produced validity evidence based on the internal structure in a second-order factor model with four components (RMSEA = 0.079, GFI = 0.97, AGFI = 0.97, CFI = 0.97; NFI = 0.95, and NNFI = 0.97); absence of Differential Item Functioning (DIF) in 80% of the items; reliability (α = 0.96); and validity evidence based on relations to other variables, specifically the test-criterion relationship (ρ = 0.680). Finally, we discuss further developments of the instrument and its possible implications for EHS workers.

Work Climate Scale in Emergency Services: Abridged Version

“…The instruments used were (a) an instruction sheet reporting on the study objectives and use of information, (b) an ad-hoc questionnaire to assess sociodemographic variables, (c) the original scale (a second-order factor model with four factors (RMSEA = 0.079, GFI = 0.97, AGFI = 0.97, CFI = 0.97, NFI = 0.95, and NNFI = 0.97)) with adequate reliability and validity indexes (α = 0.96, ω = 0.96; ρ XY = 0.68) [ 46 ], consisting of 40 five-point Likert-scale items divided into four factors ((F1) work satisfaction, (F2) productivity/achievement of aims, (F3) interpersonal relations, and (F4) performance at work), and (d) an informed consent sheet.…”

“…Once the data were gathered, an iterative process was used to reduce the number of items. Firstly, the validity of the scale was assessed based on an analysis of differential item functioning (DIF) obtained from the original scale [ 46 ]. A proposal was then made to delete the items that presented DIF according to gender (items 3, 6, 23, 27, and 29), work experience (items 2, 5, and 18), age (items 5, 6, and 18), and the type of working relationship (items 5, 6, and 18) in order to avoid validity threats associated with the degree of generalization of interpretations based on test scores and sample characteristics [ 50 ].…”

“…Subsequently, reliability coefficients were calculated for the original factors with and without the DIF items. The correlation between the original factors and the factors excluding the DIF items, with the criterion, were calculated as follows: ρ XY , where X represents the sum of the item scores and Y represents omnibus item 41, “as a whole, the work climate of my work group is good”, of the original scale [ 46 ]. Steiger’s Z-test for dependent correlations was used to analyze the correlation differences between the original and abridged versions and the criterion.…”

“…Only the last of these proposals report on the psychometric properties of the instruments used, referring to their internal consistency, instrument dimensionality, and concurrent validity. Work climate [ 46 ], which integrates aspects of work groups and the organization, and measures aspects related to job satisfaction, productivity/achievement of aims, interpersonal relations, and performance at work. This scale is the only one developed for emergency services in a Spanish-speaking cultural context that has good psychometric properties (internal consistency study, content validity, construct validity, and concurrent validity).…”

“…The main objective of this study was to develop an abridged version of the previously validated work climate scale in emergency health services [ 46 ], eliminating the biased items detected in the original scale, in order to create a rapid and effective assessment scale of work climate conditions in hospital emergency services (see Table 1 ).…”