The Healthcare Conflict Scale: development, validation and reliability testing of a tool for use across clinical settings

Abstract

Despite the widespread incidence of conflict and its detrimental impact across a range of healthcare settings, there is no validated tool with which to measure it. This paper describes the international innovation of a tool to measure staff-family conflict in paediatrics, intensive care, emergency, palliative care, and nursing homes. Sixty-two healthcare workers contributed to focus group discussions to refine a draft tool developed from the literature. Subsequently, 101 healthcare workers applied the tool to fictionalised vignettes. The psychometric properties (construct validity, internal consistency, repeatability and reliability) were explored using principal component analysis, Cronbach's alpha, and intra-class correlation (ICC) tests. The initial 17-item tool was reduced to seven items within three factors that explained 70.2% of the total variance in overarching construct. The internal consistency of the final overall scale was good (Cronbach's alpha: 0.750); test-retest reliability of each item was excellent with ICCs ≥0.9. This new, methodologically robust, tool can be used to identify and score conflict, making it a key reference point in healthcare conflict work across clinical specialities. Its development and testing across specialities and across countries means it can be used in a variety of contexts. The tool provides healthcare professionals with a new way to identify and measure conflict, and consequently has the potential to transform healthcare relationships across disciplines and settings.

Nurse–Patient/Relatives Conflict and Patient Safety Competence Among Nurses

“…HCS has an acceptable Cronbach’s alpha (.75) and excellent stability reliability with ICC values above .90 for all seven items. 13 The Principal Component Analysis, conducted by Forbat and colleagues, supports the three-factor solution with explained total variance of 70.2%. 13 The dimension “Mistrust of motivation” contributed 34.4% of the total variance, whereas “Threatening language or actions” and “Contradictory communication” contributed 19.3% and 16.5% of the total variance, respectively.…”

“… 13 The Principal Component Analysis, conducted by Forbat and colleagues, supports the three-factor solution with explained total variance of 70.2%. 13 The dimension “Mistrust of motivation” contributed 34.4% of the total variance, whereas “Threatening language or actions” and “Contradictory communication” contributed 19.3% and 16.5% of the total variance, respectively. This indicate the acceptable factorial validity of the HCS and its dimension.…”

“…Nurses’ perceptions of nurse and patients/relatives conflicts are assessed using the “Healthcare Conflict Scale” (HCS) of Forbat et al 13 HCS assesses the conflict between clinicians and patients/relatives using seven items with three factors: “Mistrust of motivation” (4 items), “Threatening language or actions” (2 items), and “Contradictory communication” (1 item). HCS is used in the surveillance of hospital conflicts and is designed for staff use.…”

“… 12 , 13 Dissatisfaction of patients/relatives with the quality of care that they receive, and their overall hospital experience often leads to their unwarranted conflicts with healthcare providers. 12 , 13 …”

Interprofessional science: an international field of study reaching maturity

“…The scholarship of the interprofessional field has grown significantly to represent diverse research methodologies and approaches focusing on students, practitioners and organizations. This led to substantial advances in the pedagogy of interprofessional education as well as innovations in collaborative practice (for the most popular papers of 2019 see, Cohen, Fletcher, Hood, & Patel, 2019;Forbat, Mnatzaganian, & Barclay, 2019;Lee, DeBest, Koeniger-Donohue, Strowman, & Mitchell, 2019). One indicator for this proliferation in interprofessional research activity can be gleaned from the increasing submissions to this Journal, now hailing from over 50 countries.…”