The National Standard of Psychological Health and Safety in the Workplace: A Psychometric and Descriptive Study of the Nursing Workforce in British Columbia Hospitals

Abstract

Background In 2013, the Mental Health Commission of Canada created a National Standard that includes 13 workplace factors associated with employee mental health. Purpose This study (a) examined the psychometric properties of Guarding Minds at Work (GMW), the instrument used to measure the Standard’s 13 workplace factors and (b) assessed BC nurses’ workplace risk factors. Methods A province-wide survey study of 3,077 direct care nurses working in acute care settings was conducted. Results Subscale internal consistencies were acceptable. For most items, the original alphas were greater than the alpha-if-item-deleted. All corrected item-subtotal correlations were moderate to high. The 13-factor structure showed an adequate model fit based on absolute fit indices (SRMR = 0.057 and RMSEA = 0.054) but the relative fit indices were lower than the recommended cutoff (CFI = 0.827 and TLI = 0.815). Nurses identified nine of the 13 GMW factors as serious or significant concern in their workplace. Conclusions The findings were consistent with a plethora of evidence pointing to shortcomings in nurses’ work environments. This was the first study partially supporting the reliability and validity of the GMW. More work is required to refine the GMW and gain a better understanding of its psychometric properties.

Identifying The Most Important Workplace Factors in Predicting Mental Health Among British Columbia Nurses Using Machine Learning Techniques

“…The internal structure of the multi-item mental health outcomes was evaluated using a CFA approach with the following indices used to evaluate model t: Comparative Fit Index (CFI ≥ 0.90), Tucker Lewis Index (TLI≥ 0.95) and Standardized Root Mean Squared Residual (SRMR < 0.08) (35). The internal structure of the GMW scale was recently evaluated using data from BC nurses in different study and therefore not included in the current study (29) Data were further analyzed using random forest (RF) analysis, a supervised machine learning algorithm (36), that nonlinearly regressed each of the seven mental health outcomes on all of the 13 GMW factors after taking into account the impact of control variables including age, years of experience, healthcare sector and geographical region. As is the case with other RF studies (37), a 10-fold cross-validation was applied, and for each fold, a 70% and 30% dataset were respectively used as a training and testing set.…”

“…The GMW was recently validated among 3,077 direct care nurses working in acute care settings in BC (29). This study found that pre-pandemic over half of the nurse respondents were concerned about nine of the 13 workplace factors assessed using the GMW survey (29). The current study examines one key research question: which of the Standard's 13 workplace conditions most strongly predict nurses' mental health?…”

“…Each factor consists of ve statements about a speci c workplace condition, and participants are asked to indicate their level of agreement or disagreement with each statement on a four-point scale ranging from strongly disagree (1) to strongly agree (4). The internal structure of the measure was previously evaluated among BC nurses and yielded a 13-factor structure (29). In this study, because we are interested in the predictive power of each work environment factor, composite factor scores were obtained using CFA (31, 32) with higher factor scores indicating healthier workplace conditions.…”

“…A 13-factor measure, the Guarding Minds at Work (GMW) Survey, was developed to measure workplace conditions important to employee mental health. The GMW was recently validated among 3,077 direct care nurses working in acute care settings in BC (29). This study found that pre-pandemic over half of the nurse respondents were concerned about nine of the 13 workplace factors assessed using the GMW survey (29).…”

“…In recognition of the rising mental injury among nurses and other healthcare providers, in 2016, the British Columbia Nurses Union (BCNU) became the rst and only union in Canada to bargain for implementation of The Standard within the province's health authorities (29). As a result of this bargaining effort, BC health authorities are mandated to protect the mental health of their nursing workers and other healthcare providers in the workplace via the implementation of the Standard.…”