Development of a Scale to Assess the Psychosocial Work Environment of Hospital Nurses: The Social Capital and Ethical Climate at the Workplace

抄録

Objective
Japan is experiencing an influx of foreign healthcare workers, who are members of racial and/or ethnic minority groups and are likely to face ethical challenges. To help address these challenges, we developed a measurement scale to assess the psychosocial work environment of nurses and examined its reliability and validity.
Method
We developed a preliminary measurement scale comprising 40 questions based on discussions with researchers, nursing managers, and published literature. The questions focused on social capital, ethical climate (including social exclusion), and ethical leadership. A three-round Delphi panel survey was conducted with nursing department directors (N = 302) to reach consensus on the items to be included in the new scale, which was tested in a cross-sectional survey of all staff nurses (N = 1,114). First, an exploratory factor analysis was conducted, and examined the construct validity from the results of the factor structure. Next, based on results of the factor analysis, Cronbach's alpha coefficient was calculated to confirm reliability. The validity was further examined and confirmed using the K6 scale confirmed the validity, a screening measure of psychological distress. Desirability of the nursing practice environment was measured using the Practice Environment Scale of the Nursing Work Index.
Result
The nursing department directors agreed on 78% of the original 40 items. Factor analysis revealed three factors, namely “social capital in the workplace,” “ethical leadership,” and “exclusive workplace climate,” with high internal reliability
(Cronbach’s alpha: .87 – .95). Construct validity was established via high factor loadings for each item. Pearson’s correlations and t-tests confirmed criterion-related and construct validity between each variable.
Conclusion
We confirmed the reliability and validity of the Social Capital and Ethical Climate of the Workplace scale. The scale could be a useful tool to help nurse managers and hospital employers maintain a healthy work environment for both native and racial and/or ethnic minority health care providers who face ethical challenges at their workplace.