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Construct validation of a tool for measuring job satisfaction for nurses Faris, M. Dawn 1979

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CONSTRUCT VALIDATION OF A TOOL FOR MEASURING JOB SATISFACTION FOR NURSES by M. DAWN FARIS B.A.Sc. (Nursing), University of B.C., 1955 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF SCIENCE IN NURSING in THE FACULTY OF GRADUATE STUDIES School of Nursing We accept this thesis as conforming to the required standard THE UNIVERSITY OF BRITISH COLUMBIA May, 1979 (c) M. Dawn Faris, 1979 In presenting th i s thesis in par t i a l fu l f i lment of the requirements for an advanced degree at the Univers ity of B r i t i s h Columbia, I agree that the Library shal l make i t f ree ly avai lable for reference and study. I further agree that permission for extensive copying of th i s thesis for scholarly purposes may be granted by the Head of my Department or by his representatives. It i s understood that copying or publ icat ion of th i s thesis for f inanc ia l gain shal l not be allowed without my written permission. Department nf ujr$)*-9]r . The Univers ity of B r i t i s h Columbia 2075 Wesbrook Place Vancouver, Canada V6T 1W5 i i i ABSTRACT CONSTRUCT VALIDATION OF A TOOL FOR MEASURING JOB SATISFACTION FOR NURSES The purpose of t h i s study was to i n v e s t i g a t e the construct v a l i d i t y of the Index of Work S a t i s f a c t i o n developed by S l a v i t t and others (1978) to measure job s a t i s f a c t i o n f o r nurses. Based upon need s a t i s f a c t i o n t h e o r i e s , the s c a l e contained seven subscales which were b e l i e v e d to e x p l a i n job s a t i s f a c t i o n . A g l o b a l s a t i s f a c t i o n l e v e l item was added i n an attempt to obt a i n a separate measure of the dependent v a r i a b l e . A review of the l i t e r a t u r e revealed that a v a l i d t o o l f o r measuring nurses' job s a t i s f a c t i o n does not p r e s e n t l y e x i s t . The instrument was mo d i f i e d , p i l o t - t e s t e d f o r r e l i a b i l i t y and a f t e r a second phase of m o d i f i c a t i o n , was administered to a volunteer sample of 177 s t a f f nurses r e p r e s e n t i n g s e v e r a l h o s p i t a l and community work s e t t i n g s . M u l t i p l e r e g r e s s i o n and d i s c r i m i n a n t f u n c t i o n analyses were performed on the data, and the r e s u l t s of these analyses were i n t e r p r e t e d i n terms of the construct v a l i d i t y of the job s a t i s f a c t i o n s c a l e . R e s ults i n d i c a t e d that the s c a l e i s h i g h l y r e l i a b l e , and that three of the subscales explained approximately 30 percent of the variance i n the scores on the g l o b a l s a t i s f a c t i o n measure of job s a t i s f a c t i o n . High i n t e r c o r r e l a t i o n of the subscales w i t h each other and w i t h the t o t a l scores hindered the i n t e r p r e t a t i o n of the vari a n c e i n the t o t a l scores explained by each of the s i g n i f i c a n t v a r i a b l e s . i v The r e s u l t s of the analyses suggest that the high r e l i a b i l i t y of t h i s version of the t o o l makes i t a psychometrically useful measurement of job s a t i s f a c t i o n f or nurses, to the extent that job s a t i s f a c t i o n i s comprised of the seven components contained i n the scale. Regarding i t s construct v a l i d i t y , there i s conclusive evidence that the l i n e a r additive model of job s a t i s f a c t i o n on which the instrument i s based does not allow a complete view of the construct. Whether the three s i g n i f i c a n t predictors of the t o t a l score, Professional Status, Administration, and Interaction, are part of one broader construct, or whether they i n t e r a c t i n some unique way, could not be determined because of the m u l t i c o l l i n e a r i t y pro-blem. A major d i f f i c u l t y throughout the study was the lack of a r e l i a b l e alternate measure of the c r i t e r i o n . The global s a t i s f a c t i o n item responses did not correlate highly with the t o t a l test scores, and th i s s e l f - r e p o r t , Likert-type item would be subject to the same response bias as the questionnaire i t s e l f . Apart from the demonstration that the Professional Status, Administration, and Interaction components appear to contribute to the measurement of the construct, the study f a i l e d to gather evidence i n support of the construct v a l i d i t y of the modified S l a v i t t scale. I t can be concluded, therefore, that the scale ' r e l i a b l y measures some aspects of job s a t i s f a c t i o n for nurses, but one cannot state with confidence that i t a c t u a l l y measures the complex attitud e which comprises the construct "job s a t i s f a c t i o n . " Recommendations have been made for appropriate use of the t o o l and for further construct v a l i d a t i o n studies. V TABLE OF CONTENTS CHAPTER I INTRODUCTION TO THE STUDY 1 I n t r o d u c t i o n 1 R a t i o n a l e f o r the Study 2 Purpose o f the Study 4 D e f i n i t i o n o f Terms 5 Assumptions 5 D e s c r i p t i o n o f the F o l l o w i n g Chapters 5 I I REVIEW OF LITERATURE 7 I n t r o d u c t i o n 7 Nurses' Job S a t i s f a c t i o n as a S i t u a t i o n a l l y P e r c e i v e d V a r i a b l e 7 Nurses' Job S a t i s f a c t i o n as an I n d i v i d u a l - S i t u a t i o n I n t e r a c t i o n 14 D e v e l o p i n g a Measure of Job S a t i s f a c t i o n f o r Nurses 20 C o n c l u s i o n s 27 I I I RESEARCH METHODOLOGY 29 Overview 29 M o d i f i c a t i o n o f the Index o f Work S a t i s f a c t i o n 29 R e l i a b i l i t y 30 D e c r i p t i o n o f t h e Sample 31 Data C o l l e c t i o n P r o c e d u r e s 33 S t a t i s t i c a l P r o c e d u r e s 34 v i CHAPTER IV ANALYSIS AND DISCUSSION 36 D e s c r i p t i o n of the Sample 36 Psychometric A n a l y s i s 42 M u l t i p l e Regression Analyses 45 Discri m i n a n t Function A n a l y s i s 50 Disc u s s i o n 52 V SUMMARY, LIMITATIONS, CONCLUSIONS, AND RECOMMENDATIONS 5 5 Summary. 55 L i m i t a t i o n s 57 Conclusions. 58 Recommendations Regarding Use of the Questionnaire 61 Recommendations f o r Further Research 62 BIBLIOGRAPHY 64 APPENDIX A^ Cover Page. 69 A£ Demographic Data 71 A^ Questionnaire 73 B C o r r e l a t i o n s of Job S a t i s f a c t i o n Questionnaire Items, Test T o t a l , and Global S a t i s f a c t i o n Rating 80 v i i LIST OF TABLES TABLE PAGE 1 INTERNAL CONSISTENCY RELIABILITIES OF THE SUBSCALE, USING THE PILOT SAMPLE (N = 31) 3 1 2. SAMPLING PLAN 3 2 3. COMPOSITION OF THE SAMPLE (N = 177) 36 4. CROSS-TABULATION OF GLOBAL SATISFACTION RATING WITH "YEARS OF EXPERIENCE" VARIABLE 3 7 5. CROSS-TABULATION OF GLOBAL SATISFACTION RATING WITH "YEARS IN PRESENT POSITION" VARIABLE. 38 6. CROSS-TABULATION OF GLOBAL SATISFACTION RATING WITH "MONTHLY SALARY" VARIABLE 38 7. CROSS-TABULATION OF GLOBAL SATISFACTION RATING WITH 39 "TYPE OF SETTING" VARAIABLE 8. CROSS-TABULATION OF GLOBAL SATISFACTION RATING WITH "WORK SCHEDULE" VARIABLE 39 9. SUMMARY OF ONE-WAY ANALYSES OF VARIANCE OF COMPONENT AND TOTAL SCORES FOR HOSPITAL (GROUP I) AND COMMUNITY 40 (GROUP I I ) NURSES 10. SUMMARY OF SUBTEST AND TOTAL TEST STATISTICS 43 11. CORRELATION MATRIX OF COMPONENT, TOTAL TEST, AND GLOBAL QUESTION SCORES (N = 177) 44 12 SUMMARY OF MULTIPLE REGRESSION OF COMPONENTS ONTO TOTAL SCORES 45 13. CORRELATION MATRIX OF PREDICTED, RESIDUAL, AND ACTUAL VALUES OF TOTAL SCORES 49 14. SUMMARY OF MULTIPLE REGRESSION OF COMPONENTS ONTO GLOBAL QUESTION RESPONSE 50 15. DISCRIMINATING VARIABLES AND CLASSIFICATION OF WORK \ SETTING GROUPS ' ' ' v i i i LIST OF FIGURES PAGE FIGURE 1 SCATTER-PLOT OF PREDICTED VALUES VERSUS RESIDUAL VALUES FOR TOTAL JOB SATISFACTION SCORE 47 ACKNOWLEDGEMENTS I wish to express my thanks to my committee, Marilyn Willman, Bob Conry, and Jack Yensen, f o r t h e i r continued i n t e r e s t , guidance and support throughout this study. Appreciation i s also extended to my classmates, whose encouragement contributed s i g n i f i c a n t l y to the completion of th i s study. . I am g r a t e f u l to a l l the nurses who pa r t i c i p a t e d i n t h i s project by completing the questionnaire or by a s s i s t i n g with i t s administration. Special thanks are due to Don, Ken, Murray, and Peter f o r t h e i r continuing love and i n s p i r a t i o n . CHAPTER I INTRODUCTION TO THE STUDY In t r o d u c t i o n Occupational s a t i s f a c t i o n and methods of measuring t h i s construct are becoming i n c r e a s i n g l y important to the nursing p r o f e s s i o n . Rapid changes i n the h e a l t h care d e l i v e r y system have r e s u l t e d i n a l t e r e d r e s p o n s i b i l i t i e s and r e l a t i o n s h i p s f o r nurses, which may i n turn be r e f l e c t e d i n changes i n t h e i r f e e l i n g s of job s a t i s f a c t i o n and u l t i m a t e l y i n t h e i r performance i n the work s e t t i n g . Nurses have become concerned w i t h high turnover r a t e s , and i t has been reported that d i s s a t i s f a c t i o n w i t h work-related f a c t o r s accounted f o r 32 percent of nurse r e s i g n a t i o n s (Saleh 1964). The cost to U.S. h o s p i t a l s was estimated a t $20 m i l l i o n i n 1974 (McCloskey 1974). The cost i n terms of q u a l i t y of p a t i e n t care and a l s o i n decreased morale of i n d i v i d u a l nurses i s immeasurable (Kramer 1972). S l a v i t t and others (1978) have i d e n t i f i e d the need f o r an instrument which could provide a measure of job s a t i s f a c t i o n f o r nurses, and have developed the Index of Work S a t i s f a c t i o n , a sca l e which measures o v e r a l l job s a t i s f a c t i o n i n terms of various components based upon h i e r a r c h y of needs t h e o r i e s . The t o o l was tested on two samples of nurses employed i n urban h o s p i t a l s , and on one sample of nurses working i n a p r i v a t e c l i n i c . I t s i n t e r s c a l e and i n t r a s c a l e r e l i a b i l i t i e s have been e s t a b l i s h e d . Factor a n a l y s i s was used to assess the content v a l i d i t y of the s c a l e , and to provide d i r e c t i o n f o r m o d i f i c a t i o n of the components and regrouping of the s c a l e items. Further refinement of t h i s 1 s c a l e would r e s u l t i n a t o o l which could be used to determine how the components or f a c t o r s i n t e r c o r r e l a t e w i t h the dependent v a r i a b l e , job s a t i s f a c t i o n . As w e l l as enhancing the p r a c t i c a l i t y of the t o o l , t h i s i n f o r m a t i o n would provide evidence regarding the v a l i d i t y of the constr u c t . Rationale f o r the Study Further v a l i d a t i o n of the Index of Work S a t i s f a c t i o n would increase i t s usefulness i n studying groups of nurses; would provide group and i n d i v i d u a l p r o f i l e s which would have many p r a c t i c a l and t h e o r e t i c a l a p p l i c a t i o n s , and would make the t o o l i t s e l f e a s i e r to administer and score. A v a l i d a t e d measure of before-and-after job s a t i s f a c t i o n l e v e l s of employee nurses would enable management to i d e n t i f y work s i t u a t i o n s where s a t i s f a c t i o n i s low, and to evaluate the e f f e c t i v e n e s s of remedial programs. T o t a l scores and/or component scores could a l s o be stu d i e d i n r e l a t i o n to other v a r i a b l e s known about the s u b j e c t s , such as t h e i r e d u cational p r e p a r a t i o n or a s p e c i f i c job s e t t i n g . Group scores could a l s o be compared w i t h other measures of group c h a r a c t e r i s t i c s , such as a t t i t u d e s towards feminism, or a u t h o r i t a r i a n i s m . I n d i v i d u a l p r o f i l e s of work s a t i s f a c t i o n could provide a h e l p f u l c o n t r i b u t i o n to job s a t i s f a c t i o n theory. Vroom (1964) has suggested that i n d i v i d u a l v a r i a t i o n s may y i e l d a d d i t i o n a l i n f o r m a t i o n , not a v a i l a b l e from group s t u d i e s , regarding f a c t o r s a s s ociated w i t h job s a t i s f a c t i o n . I n d i v i d u a l scores would a l s o be u s e f u l i n i d e n t i f y i n g personnel and placement problems. As new measures of q u a l i t y care and p r o d u c t i v i t y are developed, i n d i v i d u a l job s a t i s f a c t i o n scores could be 3 c o r r e l a t e d w i t h these f a c t o r s to determine the r e l a t i o n s h i p between s a t i s f a c t i o n and d e l i v e r y of nursing care. Refinement of the t o o l would a l s o e l i m i n a t e the need f o r complicated weighting procedures, thereby f a c i l i t a t i n g i t s use and s c o r i n g by the general p u b l i c . In a d d i t i o n , a n a l y s i s of the data obtained i n the study may r e v e a l s p e c i f i c subsets of items which could be used i n an abbreviated s c a l e without l o s s of i n f o r m a t i o n . Construct v a l i d a t i o n i s an on-going e v a l u a t i o n of the extent to which the subject's true r e l a t i o n s h i p to the c h a r a c t e r i s t i c being measured i s a c t u a l l y r e f l e c t e d i n the t e s t score. Due to the t h e o r e t i c a l nature of the construct being s t u d i e d , the researcher i s faced w i t h the problem of p r o v i d i n g evidence that h i s e m p i r i c a l measurement does i n f a c t represent the a b s t r a c t c h a r a c t e r i s t i c being i n v e s t i g a t e d . K e r l i n g e r (1973) s t a t e s that " c o n s t r u c t v a l i d i t y i s one of the most s i g n i f i c a n t advances i n modern measurement theory and practice...because i t u n i t e s psychometric notions w i t h t h e o r e t i c a l n o t i o n s . " ( K e r l i n g e r 1973, p. 461). The measurement of a construct can be v a l i d a t e d i n . many ways, depending upon the nature of the c o n s t r u c t and the a v a i l a b i l i t y of other measures of r e l a t e d and/or component c o n s t r u c t s . The problem becomes one of . d e s c r i b i n g a t h e o r e t i c a l framework f o r the c o n s t r u c t , and then measuring whether the construct behaves according to hypothesized r e l a t i o n s h i p s . Nunnally (1970) has described three major aspects of the process of developing v a l i d measures of constructs "...(1) s p e c i f y i n g the domain of observables; (2) determining to what extent a l l , or some of those observables c o r r e l a t e w i t h one another or are a f f e c t e d a l i k e by experimental treatments; and (3) determining whether or not one, some, or a l l measures of such v a r i a b l e s act as though they measured the c o n s t r u c t . " (Nunnally 1970, p. 141)'. S l a v i t t (1978) used h i e r a r c h y of needs t h e o r i e s developed by Maslow (1954) and modified by Herzberg (1966) to i d e n t i f y a domain of items which were thought to c o n t r i b u t e to job s a t i s f a c t i o n f o r nurses. Through a n a l y s i s of the way i n which t h e i r t o o l behaved on successive a d m i n i s t r a t i o n s , these authors were able to provide evidence that i t i s r e l i a b l e , i . e . that i t w i l l give s t a b l e , dependable and p r e d i c t a b l e r e s u l t s on repeated a d m i n i s t r a t i o n s . Factor a n a l y s i s of the t o o l i n d i c a t e d the exi s t e n c e of seven component subscales which are reasonably s i m i l a r to f a c t o r s p r e v i o u s l y i d e n t i f i e d i n the t h e o r e t i c a l framework. One can assume, t h e r e f o r e , that the co n s t r u c t , job s a t i s f a c t i o n f o r nurses, has seven components and that the Index of Work S a t i s f a c t i o n provides a r e l i a b l e measure of each component and of t o t a l job s a t i s -f a c t i o n . On the b a s i s of these assumptions one can proceed w i t h i n v e s t i g a t i n g the construct v a l i d i t y of the t o o l by determining to what extent the components c o r r e l a t e w i t h one another and w i t h another measure of the co n s t r u c t . One can a l s o i n v e s t i g a t e the i n t e r a c t i o n between the components, because a l i n e a r r e l a t i o n s h i p between the components has not yet been e s t a b l i s h e d . Purpose of the Study The purpose of t h i s study i s to i n v e s t i g a t e the con s t r u c t v a l i d i t y of the Index of Work S a t i s f a c t i o n . The seven components of job satisfaction-which--have been i d e n t i f i e d and defined by S l a v i t t w i l l be analyzed to e s t a b l i s h t h e i r i n t e r c o r r e l a t i o n w i t h the dependent v a r i a b l e , job s a t i s f a c t i o n . 5 D e f i n i t i o n of Terms Job S a t i s f a c t i o n - The a f f e c t i v e response of the nurse towards her j o b , as measured by her t o t a l score on the modified Index of Work S a t i s f a c t i o n . Components of Job S a t i s f a c t i o n (as defined by S l a v i t t ) Pay - D o l l a r remuneration and f r i n g e b e n e f i t s r e c e i v e d f o r work done. Autonomy - Amount of j o b - r e l a t e d independence, i n i t i a t i v e , and freedom e i t h e r permitted or required i n d a i l y work a c t i v i t i e s . Tcuk Re.quAJizme.nt6 - Tasks that must be done as a r e g u l a r part of the job and the o r g a n i z a t i o n of work as i t r e l a t e s to the amount of time a l l o t t e d to p a t i e n t care and a d m i n i s t r a t i o n work. Adm-LnAJ>tACUtl.on - E f f e c t of a d m i n i s t r a t i o n on job procedures, personnel p o l i c y , and the amount of s t a f f p a r t i c i p a t i o n i n making these p o l i c i e s . InteAjCLctton - Opportunities and requirements presented f o r both formal and i n f o r m a l s o c i a l contact during working hours. Vh.o{eJii>i.OnoJl Status - Generated f e e l i n g s toward the p r o f e s s -io n - s k i l l s , u s e f u l n e s s , and s t a t u s of the job. Voctofi-NuAAe. ReJLcittonAktpA - Amount and type of p r o f e s s i o n a l i n t e r a c t i o n among phy s i c i a n s and nurses ( S l a v i t t 1978, p.118). Assumptions For the purposes of t h i s study i t i s assumed that the a t t i t u d e "job s a t i s f a c t i o n " e x i s t s and that i t can be measured. I t i s a l s o assumed that nurses can report t h e i r present l e v e l of s a t i s f a c t i o n by responding to a s i n g l e - i t e m g l o b a l question. D e s c r i p t i o n of the Fol l o w i n g Chapters This t h e s i s i s composed of f i v e chapters. The review of r e l a t e d l i t e r a t u r e i n Chapter I I i s a c r i t i q u e of job s a t i s f a c t i o n research s t u d i e s p e r t a i n i n g to s t a f f nurses. Chapter I I I contains the research methodology, including the r e l i a b i l i t y study, the c r i t e r i a for sample se l e c t i o n , and the procedures for data c o l l e c t i o n and a n a l y s i s . The de s c r i p t i o n of the sample and the r e s u l t s of the s t a t i s t i c a l analyses appear i n Chapter IV. Chapter V includes a summary of the v a l i d a t i o n study and a discussion of the l i m i t a t i o n s and implications of the research fi n d i n g s . CHAPTER I I REVIEW OF RELATED LITERATURE I n t r o d u c t i o n One st r a t e g y f o r e s t a b l i s h i n g the construct v a l i d i t y of a t e s t i s to conduct a c r i t i c a l review of the l i t e r a t u r e r e l a t e d to the co n s t r u c t . I t can then be determined where the t e s t f i t s i n terms of previous research i n measurement and i n the f i e l d . This awareness of previous l o g i c i s necessary i n order to demonstrate how and why the t e s t d i f f e r s from e x i s t i n g measures. While job s a t i s f a c t i o n among i n d u s t r i a l workers has been stud i e d e x t e n s i v e l y , a review of nur s i n g l i t e r a t u r e covering the past two decades rev e a l s a pa u c i t y of research regarding job s a t i s f a c t i o n i n the nursing p r o f e s s i o n . E m p i r i c a l s t u d i e s of job s a t i s f a c t i o n f o r nurses tend to focus on the construct from three d i f f e r e n t p e r s p e c t i v e s : job s a t i s -f a c t i o n as a s i t u a t i o n a l l y perceived v a r i a b l e , as a p e r s o n - s i t u a t i o n i n t e r a c t i o n , and as a measurement problem. The l i t e r a t u r e w i l l be reviewed w i t h i n the framework provided by these c a t e g o r i e s . Nurses' Job S a t i s f a c t i o n as a S i t u a t i o n a l l y Perceived V a r i a b l e Several s t u d i e s of nur s i n g s e r v i c e personnel r e p o r t attempts to i d e n t i f y job c h a r a c t e r i s t i c s which lead to f e e l i n g s of s a t i s f a c t i o n or d i s s a t i s f a c t i o n . White and Maguire (1973) s t u d i e d h o s p i t a l n u r s i n g s u p e r v i s o r s , and Cronin-Stubbs (1977) studied new graduate s t a f f nurses, 7 8 for the purpose of e l i c i t i n g job-related factors consistent with the motivators and hygienes described by Herzberg (1966). These studies did not assess the actual l e v e l of s a t i s f a c t i o n the subjects f e l t i n t h e i r jobs, but .concentrated upon evaluating the r e l a t i v e importance of the factors f o r each group of nurses. Herzberg developed the dual-factor theory of job s a t i s f a c t i o n and motivation, i n which he postulated that s a t i s f a c t i o n and d i s s a t i s f a c t i o n are two unipolar t r a i t s rather than opposite ends of a continuum. He c a l l e d f a c t ors which a r i s e from the content of the work i t s e l f , and which are thus i n t r i n s i c to the job, "motivators." These factors lead to f e e l i n g s of s a t i s f a c t i o n and personal growth, and contribute minimally to d i s s a t i s f a c t i o n . The d i s s a t i s f i e r s are e x t r i n s i c factors which describe the worker's r e l a t i o n s h i p to the environmental context of h i s job, and are termed "hygienes.!1. Herzberg further suggested that h i s motivators are associated with Maslow's hierarchy of human needs, since a worker's a t t i t u d e i s ' c l o s e l y r e l a t e d to h i s needs. Because hygienes cor r e l a t e with animal needs, which serve merely to reduce displeasure, hygiene factors do not possess the q u a l i t i e s necessary f o r psychological growth and thus are not conducive to the g r a t i f i c a t i o n of human needs (Herzberg 1966). White and Maguire (1973) were interested i n assessing the v a l i d i t y of Herzberg's theory f o r a group of nursing supervisors i n general h o s p i t a l s . Using a s t r a t i f i e d random sample of 34 supervisors from s i x ho s p i t a l s , they followed Herzberg's interview schedule to i d e n t i f y the factors the subjects c o n s i s t e n t l y described as leading to f e e l i n g s of job s a t i s f a c t i o n or d i s s a t i s f a c t i o n . They further attempted to assess the consistency of t h e i r f a c t o r s with those described by Herzberg. A p i l o t study was conducted to e s t a b l i s h the i n t e r r a t e r r e l i a b i l i t y of the two i n t e r v i e w e r s and gain p r a c t i c e i n gathering and a n a l y z i n g the data. No c o r r e l a t i o n s are reported, but no changes i n the method were deemed necessary. F o l l o w i n g Herzberg's method of data a n a l y s i s , 13 f a c t o r s were i d e n t i f i e d , of which s i x f e l l i n t o the motivator category, s i x were i n the hygiene category, and one ( e n t i t l e d competence .- commitment contentment) was c a l l e d a "mogiene" because i t occurred e q u a l l y o f t e n i n s t o r i e s of s a t i s f a c t i o n and d i s s a t i s f a c t i o n . The researchers found that the f a c t o r s that produced job s a t i s -f a c t i o n and d i s s a t i s f a c t i o n f o r t h i s group of subjects were notably s i m i l a r to Herzberg's l i s t of motivators and hygienes. Chi-square and F i s h e r ' s exact p r o b a b i l i t y t e s t s were used to assess the v a l i d i t y of the Herzberg model, and found the l a t t e r to be upheld i n r e l a t i o n to three m o t i v a t o r s : work i t s e l f , p o s s i b i l i t y f o r growth, and r e c o g n i t i o n ; and one hygiene, s u p e r v i s i o n - t e c h n i c a l . The authors conclude that more e f f e c t i v e s u p e r v i s i o n of the s u p e r v i s o r s would only decrease t h e i r l e v e l of d i s s a t i s f a c t i o n , whereas s a t i s f a c t i o n could be improved by p r o v i d i n g o p p o r t u n i t i e s f o r more c r e a t i v e work, more r e c o g n i t i o n of a b i l i t i e s , and chances f o r advancement (White and Maguire 1973). Cronin-Stubbs' study i s a p a r t i a l r e p l i c a t i o n of White and Maguire' i n v e s t i g a t i o n . The author proposed that new graduate nurses i n t h e i r f i r s t year of employment would i d e n t i f y d i f f e r e n t s a t i s f y i n g and d i s s a t i s f y i n g f a c t o r s than d i d the sample of s u p e r v i s o r s . Therefore the study was concerned w i t h i d e n t i f y i n g these f a c t o r s and comparing them w i t h the f a c t o r s reported i n the White and Maguire and Herzberg s t u d i e s . T h i r t y subjects were randomly s e l e c t e d , and interviewed using Herzberg's method. Achievement and r e c o g n i t i o n were the f a c t o r s most c o n s i s t e n t l y 10 described as l e a d i n g to job s a t i s f a c t i o n , but only r e c o g n i t i o n could be termed s i g n i f i c a n t using t h i s method of data a n a l y s i s . R e s p o n s i b i l i t y , and White and Maguire's "mogiene," competence-commitment - contentment, were the most d i s s a t i s f y i n g f a c t o r s . I n t e r p e r s o n a l r e l a t i o n s w i t h subordinates, and working c o n d i t i o n s , were a l s o mentioned s i g n i f i c a n t l y more o f t e n i n accounts of job d i s s a t i s f a c t i o n than i n accounts of s a t i s f a c t i o n . Where the s t a t i s t i c a l l y s i g n i f i c a n t f a c t o r s i d e n t i f i e d by the new graduates were compared w i t h those i d e n t i f i e d by Herzberg's accountants and engineers and by White and Maguire's s u p e r v i s o r s , r e c o g n i t i o n was the only common s a t i s f i e r . The three s t u d i e s had no common d i s s a t i s f i e r s . Cronin-Stubbs concludes that new graduate s t a f f nurses d i f f e r from the other two p o p u l a t i o n s , and s t a t e s that because her subjects i d e n t i f i e d four s i g n i f i c a n t d i s s a t i s f i e r s and only one s i g n i f i c a n t s a t i s f i e r , the job context i s as important as the job content f o r t h i s sample (Cronin-Stubbs 1977). One could argue that the method of a n a l y z i n g the data does not permit meaningful f a c t o r s to be considered s i g n i f i c a n t . Achievement, f o r example, was mentioned 27 times i n events d e s c r i b i n g job s a t i s f a c t i o n , and 16 times i n events d e s c r i b i n g d i s s a t i s f a c t i o n . This f a c t o r was mentioned more than twice as o f t e n as any other f a c t o r . However, because " s i g n i f i c a n c e " i n t h i s a n a l y s i s means that i t must appear s i g n i f i c a n t l y more o f t e n i n one category than i n the other, achievement cannot be considered e i t h e r a s a t i s f i e r or a d i s s a t i s f i e r . This same problem occurred i n the White and Maguire study, w i t h competence - commitment -contentment, obviously an important f a c t o r to many s u b j e c t s , but not e x c l u s i v e l y r e l a t e d to one of the two a r b i t r a r y c a t e g o r i e s . 11 A r e c e n t study which i d e n t i f i e d the f a l l a c y o f a t t e m p t i n g to c l a s s i f y a l l the elements o f j o b s a t i s f a c t i o n f o r n u r s e s i n t o the t r a d i t i o n a l i n t r i n s i c - e x t r i n s i c dichotomy was t h a t of E v e r l y and F a l c i o n e (1976). These r e s e a r c h e r s used a b r o a d e r - b a s e d p o p u l a t i o n and employed a f a c t o r a n a l y s i s p r o c e d u r e to determine u n d e r l y i n g dimensions o f f a c t o r s p e r c e i v e d as s a t i s f y i n g . T h e i r sample c o n s i s t e d o f 144 n u r s e s from f o u r m e t r o p o l i t a n h o s p i t a l s . A L i k e r t - t y p e t o o l was d e v e l o p e d , composed o f a l i s t of 18 items s e l e c t e d from H e r z b e r g ' s c o d i n g scheme. Respondents i n d i c a t e d the degree of importance t h a t each i t e m h e l d f o r them i n d e t e r m i n i n g t h e i r s a t i s f a c t i o n w i t h t h e i r work. F a c t o r a n a l y s i s r e v e a l e d f o u r s t a t i s t i c a l l y independent f a c t o r s which accounted f o r 58.8 p e r c e n t of the t o t a l v a r i a n c e : r e l a t i o n s h i p o r i e n t a t i o n , i n t e r n a l work rewards, e x t e r n a l work rewards, and a d m i n i s t r a t i o n p o l i c i e s . The r e l i a b i l i t y o f t h e i r i n s t r u m e n t i s n o t r e p o r t e d ( E v e r l y and F a l c i o n e 1976). The appearance of r e l a t i o n s h i p o r i e n t a t i o n as the f a c t o r a c c o u n t i n g f o r 24 p e r c e n t of the e x p l a i n e d v a r i a n c e l e a d s to s p e c u l a t i o n r e g a r d i n g i t s r e l a t i o n s h i p t o b o t h the achievement f a c t o r i n the C r o n i n - S t u b b s s t u d y , and the competence - commitment - contentment f a c t o r i n the White and Maguire s t u d y . Whether or not these t h r e e f a c t o r s a r e r e l a t e d , t h e i r importance to n u r s e s s u p p o r t s E v e r l y and F a l c i o n e 1 s s u g g e s t i o n t h a t the n a t u r e of j o b s a t i s f a c t i o n f o r n u r s e s r e q u i r e s a more complex e x p l a n a t i o n than the m o t i v a t o r - h y g i e n e or i n t r i n s i c - e x t r i n s i c t h e o r i e s can p r o v i d e . Munson and Heda (1974) have r e p o r t e d t h e i r attempt to modify the P o r t e r i n s t r u m e n t , an a d a p t a t i o n of the needs h i e r a r c h y approach i n which the p h y s i o l o g i c a l need c a t e g o r y i s e l i m i n a t e d and t h e autonomy need i s 12 added between the self-esteem and s e l f - a c t u a l i z a t i o n l e v e l s (Porter 1968). The primary focus of t h i s study was to determine the extent to which nurses share common perceptions of a h i g h l y s i m i l a r job environment. Matched p a i r s and matched groups of nurses were used to provide i n t e r -respondent c o r r e l a t i o n s f o r the 12 items and 4 subscales. Low c o r r e l a -t i o n s occurred i n the matched-pair sample, w h i l e most of the c o r r e l a t i o n s i n the matched group sample were s i g n i f i c a n t , l e a d i n g the researchers to conclude that i t i s important to average out i n d i v i d u a l d i s s i m i l a r i t i e s , and that low interrespondent c o r r e l a t i o n s are a f u n c t i o n of i n d i v i d u a l r a t h e r than o r g a n i z a t i o n a l d i f f e r e n c e s . The e x t r i n s i c subscale (wages, s e c u r i t y , and working c o n d i t i o n s ) showed the highest c o r r e l a t i o n s i n both samples. The Munson and Heda study makes an important p o i n t , that consistency across p a r t i c i p a n t s f o r a s i n g l e o r g a n i z a t i o n a l a t t r i b u t e i s ah aspect of r e l i a b i l i t y which needs to be e s t a b l i s h e d i f job s a t i s f a c t i o n i s c h a r a c t e r i z e d as an o r g a n i z a t i o n v a r i a b l e . The v a l i d i t y of job s a t i s f a c t i o n measures could a l s o b e n e f i t from t h i s type of approach, i n that our present understanding of job s a t i s f a c t i o n does not consider i n d i v i d u a l d i f f e r e n c e s i n the s a t i s f a c t i o n experienced by people w i t h the same job c h a r a c t e r i s t i c s . K a l l e b e r g (1977) suggests that these d i f f e r e n c e s a r i s e because of v a r i a t i o n s 'in;- what people seek to o b t a i n from t h e i r work; i n other words job s a t i s f a c t i o n i s a f u n c t i o n not only of the c h a r a c t e r i s t i c s of the j o b , but a l s o of the motives of the i n d i v i d u a l performing the job. According to Smith, K e n d a l l , and H u l i n (1969), the p e r c e p t i o n of each job c h a r a c t e r -i s t i c may be f u r t h e r complicated by the s u b j e c t i v e anchors or end p o i n t s f e l t by the worker i n r e l a t i o n to h i s a v a i l a b l e a l t e r n a t i v e s . I f a worker f e e l s that h i s job i s very s i m i l a r to the best job he can imagine, 13 then he would experience a high degree of s a t i s f a c t i o n . Another worker i n the same s i t u a t i o n may place the job lower down on h i s perceived s c a l e of a l t e r n a t i v e s , and w i l l t h e r e f o r e f e e l l e s s s a t i s f i e d . To view job s a t i s f a c t i o n as a f u n c t i o n of the d i f f e r e n c e s i n the nature of the jobs people occupy i s to ignore these p o s s i b l e i n f l u e n c e s upon i n d i v i d u a l responses to s i t u a t i o n a l v a r i a b l e s . C l o s e l y r e l a t e d to the above concerns i s the r e l a t i o n s h i p of the time element to the l o n g i t u d i n a l job s a t i s f a c t i o n l e v e l s of the i n d i v i d u a l . I f s a t i s f a c t i o n i s conceptualized as needs r e s o l u t i o n , then, f o l l o w i n g Maslow's theory, the s a t i s f i e d worker i s freed to seek to s a t i s f y a higher l e v e l of needs. Does he then become a d i s s a t i s f i e d worker u n t i l these new needs are resolved? This view would suggest that job s a t i s f a c t -i o n i s a t r a n s i t o r y s t a t e r e l a t i v e to the degree of needs r e s o l u t i o n . Therefore job s a t i s f a c t i o n measures are an i n d i c a t i o n of the respondent's s a t i s f a c t i o n of h i s needs r e l a t i v e to h i s own v a l u a t i o n of the a v a i l a b l e rewards at any given time. A d i f f e r e n t i n t e r p r e t a t i o n of the same measure could r e s u l t i f one views job s a t i s f a c t i o n as a f u n c t i o n of the worker's a b i l i t y to adjust to a given work s i t u a t i o n , or to modify the work s i t u a t i o n to meet-his needs. I f t h i s i s the i n t e r p r e t a t i o n a p p l i e d to the measure, then s a t i s f a c t i o n i s a c t u a l l y the degree of adjustment to the i n e v i t a b l e . Taylor (1977) c a r r i e s t h i s t h i n k i n g a step f u r t h e r . Reporting that job s a t i s f a c t i o n tends to i n c r e a s e f o r people who stay on jobs over a p e r i o d of time, he suggests that the longer a worker spends on a j o b , the more he comes to i d e n t i f y w i t h the job and confuse assessment of the job w i t h assessment of h i m s e l f . To say that h i s job i s u n s a t i s f a c t o r y has i n c r e a s i n g l y more impact, over time, on what he sees himself to be. Smith, K e n d a l l and 14 H u l i n (1969) suggest that i n v e s t i g a t o r s of job s a t i s f a c t i o n may need to decide whether they wish to study the construct i n terms of a long-term or short-term time p e r s p e c t i v e , depending upon the kinds of behavior to be p r e d i c t e d . The time frame decided upon w i l l then i n f l u e n c e the design of the measurement device, as w e l l as i t s a p p l i c a t i o n and i n t e r -p r e t a t i o n . Nurses' Job S a t i s f a c t i o n as an I n d i v i d u a l - S i t u a t i o n I n t e r a c t i o n A few recent s t u d i e s have r e l a t e d job s a t i s f a c t i o n l e v e l s to other v a r i a b l e s i n the nursing s i t u a t i o n . Slocum and others (1972) compared need s a t i s f a c t i o n i n p r o f e s s i o n a l and p a r a p r o f e s s i o n a l nursing employees and c o r r e l a t e d s a t i s f a c t i o n l e v e l s . w i t h job performance l e v e l s . Bullough (1974) i n v e s t i g a t e d job s a t i s f a c t i o n l e v e l s i n r e l a t i o n to one t r a d i t i o n a l and two s p e c i a l i z e d nursing r o l e s and MacEachron (1977) examined the construct i n terms of the i n t e r a c t i v e e f f e c t s of job l e v e l and an i n d i v i d u a l d i f f e r e n c e v a r i a b l e , f i e l d independence. The Slocum study was designed to t e s t the a p p l i c a t i o n of i n d u s t r i a l -based research on Maslow's need theory to a h o s p i t a l s e t t i n g . Based upon h i s own e a r l i e r work w i t h p r o f e s s i o n a l managers, Slocum hypothesized that the higher the worker's p o s i t i o n i n the o r g a n i z a t i o n , the greater the s a t i s f a c t i o n of b a s i c p s y c h o l o g i c a l needs. He was a l s o i n t e r e s t e d i n the magnitude of the d i f f e r e n c e s i n s a t i s f a c t i o n of each need between job l e v e l s , and i n the c o r r e l a t i o n of the s a t i s f a c t i o n of s e l f - a c t u a l i z -a t i o n needs w i t h job performance. He used Lyman P o r t e r ' s adaptation of the needs h i e r a r c h y , i n which the p h y s i o l o g i c a l need category i s el i m i n a t e d v: and-:the::; autonomy- need - i s added between the self-esteem and s e l f - a c t u a l i z a t i o n l e v e l s ( P o r t e r 1968). The sample was composed of 39 15 p r o f e s s i o n a l ( a l l l e v e l s of graduate nurse up to head nurse) and 41 para-p r o f e s s i o n a l employees ( p r a c t i c a l nurses, nurses aides and f l o o r c l e r k s ) . Performance c r i t e r i a were developed f o r each of the two groups of personnel. The need s a t i s f a c t i o n data f o r both groups was obtained by using P o r t e r ' s perceived need d e f i c i e n c y q u e s t i o n n a i r e , which measures the d i f f e r e n c e s between expectations and f u l f i l l m e n t on 12 need items representing the f i v e l e v e l s of the need h i e r a r c h y . Slocum found that the p r o f e s s i o n a l s i n h i s study d i d have lower d e f i c i e n c y scores than the p a r a p r o f e s s i o n a l s f o r a l l b a s i c needs, w i t h three of the f i v e d i f f e r e n c e s s i g n i f i c a n t at p<.05. S e l f - a c t u a l i z a t i o n needs were s i g n i f i c a n t l y l e s s s a t i s f i e d than a l l other needs except autonomy f o r p r o f e s s i o n a l s , and f o r these workers s e l f - a c t u a l i z a t i o n needs had a s i g n i f i c a n t p o s i t i v e c o r r e l a t i o n w i t h performance (Slocum, Susman, and Sheridan 1972). This l a t t e r f i n d i n g r a i s e s questions concerning the r e l a t i o n s h i p between job performance and s e l f - a c t u a l i z a t i o n , and the authors p o i n t out that P o r t e r and Lawler have developed a model which suggests that s u c c e s s f u l job performance leads to gr e a t e r need s a t i s f a c t i o n ( P o r t e r and Lawler 1968). Vroom-(1964),"on. the other hand, has reviewed the research evidence on t h i s r e l a t i o n s h i p and s t a t e s that as yet there i s no simple r e l a t i o n s h i p between job s a t i s f a c t i o n and job performance: "The absence of a marked or c o n s i s t e n t c o r r e l a t i o n ... casts some doubt on the g e n e r a l i t y or i n t e n s i t y of e i t h e r e f f e c t s of s a t i s f a c t i o n on performance or performance on s a t i s f a c t i o n . " (Vroom 1964, p.187). Bullough (1974) c i t e s the Slocum f i n d i n g s as p a r t of her r a t i o n a l e f o r /studying;:- job' fsat'isf a c t i o n - i n ' r e l a t i o n to new nursing r o l e s which -presumably provide the nurse w i t h more o p p o r t u n i t i e s to f u l f i l l her 16 s e l f - a c t u a l i z a t i o n needs. Her sample con s i s t e d of three groups of nurses: 17 students completing a seven-month course which would q u a l i f y them as p e d i a t r i c n u r s e - p r a c t i t i o n e r s ; 18 extended r o l e nurses i n a community h e a l t h s e t t i n g ; and 38 t r a d i t i o n a l r o l e nurses i n the same community s e t t i n g . The n u r s e - p r a c t i t i o n e r students were tested at the beginning as w e l l as at the end of t h e i r course. Four measures of work s a t i s f a c t i o n were included i n the Bullough t o o l . The f i r s t was a f i v e - i t e m L i k e r t - t y p e s c a l e which r e q u i r e d the subjects to r a t e t h e i r job i n terms of f i v e " a l i e n a t i o n " items. These items were adapted from Seeman's (1967) s t u d i e s of i n t r i n s i c job s a t i s -f a c t i o n . The content v a l i d i t y of the s c a l e , however, appears questionable. The f i v e items do not seem to r e f l e c t a c c u r a t e l y the f i v e a l i e n a t i o n f a c t o r s described by Seeman, and i t i s d o u b t f u l whether the meaning of each f a c t o r could be encompassed f o r a l l the subjects i n j u s t one item. A l s o , the items are a l l worded i n the p o s i t i v e d i r e c t i o n , l e a d i n g one to expect some response b i a s . There are two s i n g l e - i t e m measures w i t h four choices on a scaled response f o r each. The "how s a t i s f i e d w i t h your work are you?" question i s a h e l p f u l check on the v a l i d i t y of the other measures, but the question " i f you could s t a r t over again .... would you choose your present occupation?" seems i r r e l e v a n t to the study, and i t a c t u a l l y provided some q u i t e unexpected answers. The f o u r t h measure on the Bullough t o o l was a semantic d i f f e r e n t i a l s c a l e which allowed respondents to describe t h e i r jobs i n terms of eleven b i p o l a r a d j e c t i v e s or phrases. Unfortunately the phrases which were s u b s t i t u t e d f o r the usual a d j e c t i v e p a i r s convey a judgemental meaning, and t h i s could have c o n t r i b u t e d to the f a i l u r e of the s c a l e to 17 separate the three groups of nurses. For example, one p a i r was "high pay — low pay," whereas the subject would have been required to imply more of her own meaning i n t o the job s i t u a t i o n i f the p a i r had been "enough pay — not enough pay." Three of the items i n t h i s p a r t of the t o o l provided the only opportunity f o r the subjects to r a t e the e x t r i n s i c f a c t o r s i n t h e i r j o b s . The pre- and p o s t - t e s t responses of the nurse p r a c t i t i o n e r group showed no s i g n i f i c a n t d i f f e r e n c e s . A three-way comparison of the responses of the three groups, using the p o s t - t e s t responses of the nurse p r a c t i t i o n e r s , showed s i g n i f i c a n t d i f f e r e n c e s i n the l e v e l s of i n t r i n s i c job s a t i s f a c t i o n as measured by the L i k e r t s c a l e . The graduates of the seven-month course scored h i g h e s t , the agency extended r o l e nurses had intermediate scores, and the t r a d i t i o n a l r o l e nurses scored the lowest. The answers to the question about o v e r a l l s a t i s f a c t i o n revealed no s i g n i f i c a n t d i f f e r e n c e s , and "the question regarding choosing a career i n n ursing over again produced the highest scores from the t r a d i t i o n a l nurses and the lowest from the new nurse p r a c t i t i o n e r s . The author concludes that new and expanded r o l e s do increase i n t r i n s i c job s a t i s f a c t i o n f o r nurses, but wonders why t h i s does not r e s u l t i n p o s i t i v e f i n d i n g s regarding o v e r a l l job s a t i s f a c t i o n . Among the p o s s i b l e explanations f o r t h i s discrepancy, she considers such f a c t o r s as pay and more formal r e c o g n i t i o n i n the work s e t t i n g , conclud-in g that focusing on i n t r i n s i c rewards does not provide an adequate measure of the f a c t o r s i n v o l v e d i n job-.-.satisfaction f o r nurses (Bullough 1974). The complex nature of the r e l a t i o n s h i p of job s a t i s f a c t i o n to other s i t u a t i o n a l and personal v a r i a b l e s was i n v e s t i g a t e d by MacEachron (1977). 18 She reasons that each job i s a separate e n t i t y composed of v a r i o u s f a c e t s , and that each i n d i v i d u a l may view and evaluate h i s job from many d i f f e r -ent p e r s p e c t i v e s . Thus i t i s s i m p l i s t i c to s t a t e , f o r ins t a n c e , that job l e v e l should be e m p i r i c a l l y a s s o c i a t e d w i t h a l l types of job s a t i s -f a c t i o n . This leads MacEachron to examine the commonly-used measures of job s a t i s f a c t i o n . She describes the Job D e s c r i p t i o n Index developed by Smith, K e n d a l l and Hulin (1969) as a job-referent measure of s a t i s f a c t i o n , whereas the Porter Need S a t i s f a c t i o n Questionnaire i s a s e l f - r e f e r e n t measure (Por t e r 1968). The former measure was found to support a job l e v e l / j o b s a t i s f a c t i o n hypothesis whereas the l a t t e r d i d not, according to a study reported by Herman and H u l i n (1973). Besides the problem inherent i n measuring job s a t i s f a c t i o n , MacEachron considers the mediating e f f e c t of i n d i v i d u a l d i f f e r e n c e s . She c i t e s s t u d i e s r e l a t i n g job s a t i s f a c t i o n to i n t r i n s i c work values and higher order need s t r e n g t h , and develops two i n t e r a c t i o n models p r e d i c t i n g s a t i s f a c t i o n from i n d i v i d u a l and job c h a r a c t e r i s t i c s . One model p r e d i c t s that i n d i v i d u a l s who p r e f e r "normatively p o s i t i v e " work w i l l achieve high s a t i s f a c t i o n from jobs i n v o l v i n g c h a r a c t e r i s t i c s of normatively p o s i t i v e work, and low s a t i s f a c t i o n from jobs which do not have these c h a r a c t e r i s t i c s , whereas i n d i v i d u a l s who do not p r e f e r normatively p o s i t i v e work w i l l achieve low s a t i s f a c t i o n from jobs i n v o l v i n g norma-t i v e l y p o s i t i v e c h a r a c t e r i s t i c s , and high s a t i s f a c t i o n from jobs which do not have these c h a r a c t e r i s t i c s . The second model i s the same except i t p r e d i c t s that i n d i v i d u a l s who do not p r e f e r normatively p o s i t i v e work w i l l be n e u t r a l i n s a t i s f a c t i o n , r e g a r d l e s s of the job c h a r a c t e r i s t i c s . MacEachron's study i n v o l v e d 70 female n u r s i n g s t a f f i n an urban p e d i a t r i c h o s p i t a l . The s u b j e c t s ' job l e v e l s ranged from n u r s i n g s u p e r v i s o r 19 to n u r s i n g aide and i t was decided to designate the 31 graduate nurses as the top l e v e l , the 17 l i c e n s e d p r a c t i c a l nurses as the intermediate l e v e l , and the 21 nursing aides as the lowest l e v e l . The job s a t i s f a c t i o n v a r i a b l e was measured by Smith, K e n d a l l and H u l i n ' s Job D e s c r i p t i o n Index (1969). Workers who p r e f e r normatively p o s i t i v e work are described as those w i t h high order need strength and low a l i e n a t i o n from middle c l a s s work norms; research was provided to support the n o t i o n that these i n d i v i d u a l s should have a f i e l d independent c o g n i t i v e s t y l e , and there-for e that a measure of t h i s v a r i a b l e could be provided by the P o r t a b l e Rod and Frame Test developed by Oltman (1968). The r e s u l t s of the study i n d i c a t e that f i e l d dependence moderates the r e l a t i o n s h i p between job l e v e l and job s a t i s f a c t i o n f o r t h i s group of employees. I t was a l s o revealed that f o r field-independent workers, the c o r r e l a t i o n s between job l e v e l and a l l s a t i s f a c t i o n dimensions were p o s i t i v e and s i g n i f i c a n t . A c o n s i s t e n t p a t t e r n of r e l a t i o n s h i p between these two v a r i a b l e s was evident f o r f i e l d independent workers. For f i e l d dependent workers, there was a s i g n i f i c a n t negative c o r r e l a t i o n between job l e v e l and s a t i s f a c t i o n w i t h co-workers, i n d i c a t i n g that co-worker s a t i s f a c t i o n decreases as job l e v e l i n c r e a s e s . This was the only c o r r e l a t i o n to support the f i r s t model d e s c r i b i n g the i n d i v i d u a l - j o b f i t assumption f o r f i e l d dependent workers, the remaining i n s i g n i f i c a n t c o r r e l a t i o n s i n d i c a t i n g that both models are r e q u i r e d to provide an adequate explanation of job s a t i s f a c t i o n f o r t h i s group of nursing personnel. The author concludes that i n t e r a c t i o n models are appropriate f o r i n c r e a s i n g our understanding of job s a t i s f a c t i o n (MacEachron 1977). She was not concentrating her study on p r o f e s s i o n a l nurses per se, however. 20 An examination of the r e l a t i o n s h i p between job l e v e l and f i e l d independ-ence scores r e v e a l s that a l l 31 of the graduate nurses were c l a s s i f i e d as f i e l d independent, which would obviate the need f o r i n c l u d i n g t h i s v a r i a b l e i f t h i s study had used only graduate nurse s u b j e c t s . The same reasoning could apply to the job l e v e l v a r i a b l e i n t h i s study, s i n c e a l l the graduate nurses were i n the "high" job l e v e l . However, i t should be p o s s i b l e to r e p l i c a t e t h i s study using a p o p u l a t i o n of p r o f e s s -i o n a l nurses of various job l e v e l s , and a l t e r i n g the a r b i t r a r y score p o i n t used by MacEachron to d i v i d e the subjects i n t o f i e l d independent -f i e l d dependent c a t e g o r i e s . A study of t h i s nature could provide v a l u a b l e i n s i g h t i n t o the i n t e r a c t i o n of job s a t i s f a c t i o n , job l e v e l and p e r s o n a l i t y v a r i a b l e s . Developing a Measure of Job S a t i s f a c t i o n f o r Nurses The foregoing s t u d i e s have a l l i n v o l v e d some measure of the p e r c e p t i o n of or need f o r job s a t i s f a c t i o n . Each has used or adapted an e s t a b l i s h e d t o o l developed f o r use i n i n d u s t r i a l and/or p r o f e s s i o n a l management s e t t i n g s . A l s o , because the research has focused on group rat h e r than i n d i v i d u a l scores, we s t i l l have very l i m i t e d knowledge of the meaning of job s a t i s f a c t i o n f o r i n d i v i d u a l nurses, yroom (1964) has suggested that i t i s too o f t e n assumed that the e x p l a n a t i o n of i n d i v i d u a l d i f f e r e n c e s i n ' r e p o r t e d s a t i s f a c t i o n l i e s i n the nature of the job performed. I n d u s t r i a l research has shown that some persons are s a t i s f i e d and others are d i s s a t i s f i e d , r e g a r d l e s s of the nature of t h e i r work. He p r e d i c t s that more research i n t o the nature of i n d i v i d u a l d i f f e r e n c e s i n job s a t i s f a c t i o n may y i e l d v a l u a b l e i n s i g h t i n t o the meaning of the c o n s t r u c t . Another concern i s that the measures used i n the p r e v i o u s l y described s t u d i e s may not provide an accurate p i c t u r e of the unique meaning of job s a t i s f a c t i o n f o r nurses and the f a c t o r s which c o n t r i b u t e to that meaning. I n a d d i t i o n to these t h e o r e t i c a l c o n s i d e r a t i o n s , a more p r a c t i c a l j u s t i f i c a t i o n f o r developing a measurement of job s a t i s f a c t i o n f o r nurses would be i t s usefulness as a management t o o l . An i d e n t i f i c a t i o n of i n d i v i d u a l and/or group s a t i s f a c t i o n problems could provide d i r e c t i o n f o r remedying d i f f i c u l t i e s r e l a t e d to personnel or s e t t i n g , and h o p e f u l l y lead to improved morale, reduced turnover ra t e s and u l t i m a t e l y to higher q u a l i t y of nursing.care. Two problems r e l a t e d to measuring the c o n s t r u c t are, f i r s t of a l l i d e n t i f y i n g an appropriate t h e o r e t i c a l framework which e x p l a i n s as w e l l as p o s s i b l e the meaning of job s a t i s f a c t i o n f o r nurses, and secondly, d e v i s i n g a v a l i d and r e l i a b l e method of measuring the degree to which the construct i s possessed by each respondent. A t h i r d concern r e l a t e s to the p r a c t i c a l use of the data. I f one of the purposes of the measure i s i t s use as a management t o o l , then i t must be simple to administer, score, and i n t e r p r e t . This would tend to e l i m i n a t e the Herzberg "sequence of.events" i n t e r v i e w approach used by White and Maguire and Cronin-Stubbs. While Herzberg defends t h i s methodology as the one which best assures that a r e a l a t t i t u d e e x i s t s and i s being tapped (Herzberg 1966, p.95), problems of cost and r e l i a b i l i t y would l i m i t i t s a p p l i c a b i l i t y i n a management s e t t i n g . I t becomes apparent that a w e l l - c o n s t r u c t e d q u e s t i o n n a i r e or a t t i t u d e s c a l e would be the most appropriate method of measuring the c o n s t r u c t . Attempts to develop such a measurement t o o l have been reported i n the l i t e r a t u r e . Neumann (1973) attempted to i d e n t i f y the b a s i c f a c t o r 22 s t r u c t u r e of job s a t i s f a c t i o n f o r n u r s i n g s e r v i c e personnel through a f a c t o r - a n a l y t i c study, u s i n g a modified v e r s i o n of a measure developed by Sedlacek (1966). Neumann conceptualized job s a t i s f a c t i o n as a complex multidimensional set of a t t i t u d e s or f e e l i n g s towards one's j o b , determined p a r t l y by the worker's i n d i v i d u a l c h a r a c t e r i s t i c s and p a r t l y by h i s perception of environmental f a c t o r s i n the job s i t u a t i o n . Job s a t i s f a c t i o n i s f u r t h e r i n f l u e n c e d by norms and r o l e s . Respondents were asked to i n d i c a t e t h e i r l e v e l of agreement w i t h 70 items designed to measure t h e i r s a t i s f a c t i o n w i t h t h e i r j o b s , and to i n d i c a t e the l e v e l of importance they attached to each item. The r e s u l t s of t h i s survey, using 760 s u b j e c t s , were submitted to f a c t o r a n a l y s i s to determine the s t r u c t u r a l components of job s a t i s f a c t i o n and of importance responses. These two sets of components were a l s o generated f o r two subsample groups, r e g i s t e r e d nurse (N = 501) and l i c e n s e d p r a c t i c a l nurse (N = 259), thus a l l o w i n g a comparison of the f a c t o r s f o r these two types of workers. The author concludes that the p a t t e r n of a t t i t u d e s toward the job combines the concern f o r rendering s e r v i c e w i t h a seemingly independent f a c t o r , f i n a n c i a l gain f o r the worker. Factors which f o l l o w these i n importance are "workstress," " a u t h o r i t y , " and " i n - s e r v i c e , " the l a t t e r r e f e r r i n g to o p p o r t u n i t i e s to gain a d d i t i o n a l work-related knowledge and s k i l l s . The r e l a t i v e importance of these f a c t o r s changes, however, when the sample i s analyzed as two subsamples, r e g i s t e r e d nurses and l i c e n -sed p r a c t i c a l nurses. Another f a c t o r , " i n t r i n s i c , " emerges as most import-ant f o r each group. This f a c t o r i n c l u d e s those f a c e t s of the job d i r e c t l y r e l a t e d to the work i t s e l f , such as using one's a b i l i t i e s and r e c e i v i n g r e c o g n i t i o n f o r achievement. The only other f a c t o r common to the f i v e 23 most important f o r both groups i s " f i n a n c i a l advancement." More evidence of the r e l i a b i l i t y and v a l i d i t y of Neumann's t o o l would be necessary before one could agree w i t h her conclusions that the f a c t o r loadings on each item i n each f a c t o r a c t u a l l y provide evidence of s a t i s f a c t i o n or d i s s a t i s f a c t i o n w i t h the aspect of work described i n the item. Tools which use the Maslow h i e r a r c h y of needs as a t h e o r e t i c a l framework, along w i t h Herzberg's j u s t i f i c a t i o n f o r e l i m i n a t i n g lower-l e v e l needs ca t e g o r i e s because of the f a i l u r e of unmet needs i n these areas to a f f e c t s a t i s f a c t i o n l e v e l s , have been developed by two groups of researchers (Stember et a l . 1978; S l a v i t t et a l . 1978). Although Maslow's theory i s widely accepted as an explanation f o r personal and o r g a n i z a t i o n a l behavior, a comprehensive l i t e r a t u r e review by Wahba and B r i d w e l l (1976) shows that the theory has a c t u a l l y r e c e i v e d l i t t l e c l e a r or c o n s i s t e n t support from the a v a i l a b l e research f i n d i n g s r e l a t e d to the work s i t u a t i o n . This may b e - p a r t l y due to the u n t e s t a b l e nature of the theory i t s e l f and the l a c k of o p e r a t i o n a l i z a t i o n of i t s u n d e r l y i n g c o n s t r u c t s , r a t h e r than to the i n a b i l i t y of the theory to provide an explanation of needs and t h e i r s a t i s f a c t i o n . The f a c t i s , however, that no other s u i t a b l e a l t e r n a t i v e framework appears to e x i s t at the present time to describe the r e l a t i o n s h i p b e t w e e n the worker and the s a t i s f a c t i o n he obtains from h i s j o b . Recognizing that no appropriate t o o l .existed f o r measuring job s a t i s f a c t i o n f o r p r o f e s s i o n a l and n o n - p r o f e s s i o n a l workers i n a complex community h e a l t h agency, Stember and others (1978) e s t a b l i s h e d twelve c a t e g o r i e s of needs f o r these employees. They constructed an 80 item L i k e r t - t y p e s c a l e on which respondents were to i n d i c a t e t h e i r degree of agreement or disagreement w i t h the statements. A 74 percent response 24 r a t e was obtained from the 298 agency employees, and 80 percent of the 221 respondents were p r o f e s s i o n a l nurses. Sample items are not included i n the r e p o r t , but i t i s apparent; from the scores reported that some kin d of d i f f e r e n c e index was the obtained score f o r each of the 12 v a r i a b l e s , and that averaging each person's scores on the 12 v a r i a b l e s provided the i n d i v i d u a l job s a t i s f a c t i o n scores. R e l i a b i l i t y , face v a l i d i t y , and content v a l i d i t y s t u d i e s are reported. The 12 v a r i a b l e s were grouped according to the degree to which they were s a t i s f i e d f o r a l l employees, and ranked according to the degree to which they were s a t i s -f i e d f o r each'worker c l a s s i f i c a t i o n . The components were al s o c o r r e l a t e d w i t h demographic v a r i a b l e s , i n c l u d i n g years of working experience and l o n g e v i t y w i t h the o r g a n i z a t i o n . - A c o r r e l a t i o n matrix i n d i c a t e s that a l l 12 v a r i a b l e s are s i g n i f i c a n t l y i n t e r - c o r r e l a t e d . Stember and her colleagues recognize that the high degree of i n t e r - c o r r e l a t i o n between t h e i r v a r i a b l e s may be due to the overlapping meaning of the c a t e g o r i e s . They have not included an "autonomy" v a r i a b l e , i n s p i t e of evidence i n the l i t e r a t u r e that t h i s f a c t o r i s important to nurses. Further i n f o r m a t i o n regarding the items and method of s c o r i n g t h i s t o o l would be h e l p f u l i n e v a l u a t i n g i t s c o n t r i b u t i o n to the measure-ment of job s a t i s f a c t i o n f o r nurses. As p r e v i o u s l y mentioned, the Index of Work S a t i s f a c t i o n developed by S l a v i t t and her co-workers (1978) was designed to measure the r e l a t i v e importance of v a r i o u s components of nurses' job s a t i s f a c t i o n , i n d i c a t e a t t i t u d e s towards the components, and provide an o v e r a l l summary score. The o r i g i n a l instrument was a L i k e r t - t y p e s c a l e c o n s i s t i n g of 12 items per component, but subsequent r e v i s i o n s and f a c t o r a n a l y s i s of the items r e s u l t e d i n a 7-component, 48-item s c a l e w i t h as few as three or as many 25 as ten items per component. A weighting procedure had o r i g i n a l l y been included i n an attempt to measure the q u a l i t a t i v e aspect of the components, but when weighted scores were found to c o r r e l a t e .86 w i t h unweighted scores i t was decided that weighting was unnecessary and i n e f f i c i e n t . The Cronbach c o e f f i c i e n t alpha r e l i a b i l i t y of the 48-item questionnaire was .912. The f a c t o r a n a l y s i s i s used to support the v a l i d i t y of the t o o l w i t h s e v e r a l l i m i t a t i o n s i n d i c a t e d : the a n a l y s i s was conducted on responses from a h o s p i t a l s e t t i n g , where 62 percent of the nurses returned the q u e s t i o n n a i r e , l e a d i n g one to suspect a biased group; the low variance of scores showed t h i s to be a homogeneous group; and the seven components were s e l e c t e d from 19 f a c t o r s produced by Varimax r o t a t i o n that accounted f o r 59 percent of the v a r i a n c e among the items ( S l a v i t t et a l . 1978). The authors p o i n t out the d i f f i c u l t y of measuring s e l f - a c t u a l i z a t i o n needs, and f e e l that t h e i r instrument does not adequately cover t h i s need l e v e l . They have a l s o d e l i b e r a t e l y excluded some aspects of other f a c t o r s such as achievement and i n t e r - p e r s o n a l r e l a t i o n s , where these aspects are d i f f i c u l t f o r management to i n f l u e n c e . In a d d i t i o n , they appear to have assumed that because the weighted scores c o r r e l a t e d h i g h l y w i t h the unweighted scores, the components have equally-weighted meaning to the respondents. This r a t h e r dangerous assumption r e s u l t s i n a l i n e a r a d d i t i v e model f o r job s a t i s f a c t i o n . However research has c o n s i s t e n t l y shown that weighting by importance adds l i t t l e to the p r e d i c t i v e power of the job s a t i s f a c t i o n theory being tested (Ewen 1967; Waters 1969; Prvzek and F r e d e r i c k 1978; and M i t c h e l l 1974). Because of the measurement problems inherent i n weighting procedures, the b a s i c co n c l u s i o n that can be drawn from the research i s that an unweighted 26 score on the dependent v a r i a b l e , job s a t i s f a c t i o n , w i l l c o r r e l a t e h i g h l y w i t h a weighted score. •• Thisiis"riot• to~say t h a t c e r t a i n of the components do not have more importance i n the p r e d i c t i v e sense; i t i s simply to say that the importance of the meaning of the components cannot be e s t a b l i s h e d through the use of weighting procedures. Further t e s t i n g and m o d i f i c a t i o n of the S l a v i t t t o o l may lead to a more accurate p i c t u r e of job s a t i s f a c t i o n f o r nurses. I t i s q u i t e p o s s i b l e , however, that the conceptual framework f o r the co n s t r u c t w i l l prove to be inadequate. Hierarchy of needs t h e o r i e s have provided the conceptual framework f o r many of the recent s t u d i e s of job s a t i s f a c t i o n . While t h i s model has been defended on s e v e r a l grounds by i t s proponents, many i n f l u e n c e s upon the i n d i v i d u a l ' s perceived s a t i s f a c t i o n s are l e f t unexplained. These i n c l u d e the a l t e r n a t i v e s a v a i l a b l e i n given s i t u a t i o n s , the expectations and experience of the worker, and long- and short-term time p e r s p e c t i v e s . In a d d i t i o n , i t may be a mistake to assume that any precoded s e l f - r e p o r t s a t i s f a c t i o n measure can provide an understanding of the s t a t e of the worker i n r e l a t i o n to h i s work s i t u a t i o n . Taylor (1977) discusses the question of what job s a t i s f a c t i o n s t u d i e s r e a l l y mean, p o i n t i n g out that regardless of the s o p h i s t i c a t i o n of the measure a p p l i e d , the overwhelming m a j o r i t y of workers r e p o r t s a t i s f a c t i o n w i t h t h e i r work. He c i t e s s t u d i e s which i n d i c a t e that there i s no c o n s i s t e n t c o r r e l a t i o n between job s a t i s f a c t i o n measures and o r g a n i z a t i o n a l " behaviors such as grievances, absenteeism and turnover r a t e s . Nord (1977) s t a t e d that "some of the most i n t e r e s t i n g character-i s t i c s of the e x i s t i n g research are revealed not by the r e s u l t s of what has been s t u d i e d , but by an examination of the t o p i c s that have gone unanalyzed." (Nord 1977, p. 1026). 27 The authors of the n u r s i n g s t u d i e s reviewed here have emphasized that job s a t i s f a c t i o n i s a complex and inadequately understood concept. Ongoing research i s r e q u i r e d i n order to determine whether our present understanding provides a v a l i d measure of the c o n s t r u c t , and to i d e n t i f y new approaches which could shed l i g h t on the meaning and dimensions of nurses' s a t i s f a c t i o n w i t h t h e i r work. Conclusions The f o l l o w i n g conclusions can be drawn from t h i s review of the l i t e r a t u r e : 1. Studies of job s a t i s f a c t i o n as a s i t u a t i o n a l l y perceived v a r i a b l e f a i l to account f o r the nurse's own l e v e l of job s a t i s f a c t i o n . Asking "What i s i t that you f i n d s a t i s f y i n g about your job?" i s not equivalent to i d e n t i f y i n g the degree of s a t i s f a c t i o n f e l t by the worker. These st u d i e s have been h e l p f u l , however, i n p r o v i d i n g i n f o r m a t i o n regarding s i t u a t i o n - r e l a t e d f a c t o r s which are important to nurses. Another b e n e f i t i s that these s t u d i e s a l s o have p r a c t i c a l u t i l i t y , i n the sense that they can suggest ways i n which employers can improve job s a t i s f a c t i o n by manipulating job c h a r a c t e r i s t i c s under t h e i r c o n t r o l . 2. Research t r e a t i n g job s a t i s f a c t i o n as an i n d i v i d u a l - s i t u a t i o n i n t e r a c t i o n has been hampered by the l a c k of a t o o l which a c c u r a t e l y measures t h i s c o n s t r u c t . Researchable problems i n v o l v i n g job s a t i s f a c t i o n as a v a r i a b l e are l i m i t l e s s i n the nursing p r o f e s s i o n , and the usefulness of f u t u r e s t u d i e s depends to a great extent upon the a v a i l a b i l i t y of a v a l i d and r e l i a b l e measure of the c o n s t r u c t . 3. Three recent attempts at addressing the above concerns have been reported. Increased understanding of the u n d e r l y i n g meaning of the 28 construct i s required at t h i s p o i n t . The importance of t h i s approach to job s a t i s f a c t i o n research has been str e s s e d by Locke, who s t a t e s that "To understand a phenomenon, one must begin w i t h a conceptual a n a l y s i s . At l e a s t some of the a t t r i b u t e s or c h a r a c t e r i s t i c s must be i d e n t i f i e d before s p e c i f i c amounts of i t can be measured." (Locke 1969, pp. 333-334). The d e f i n i t i o n and t h e o r e t i c a l model w i l l determine to a great extent the method to be employed i n the measurement of the c o n s t r u c t . While m o d i f i c a t i o n of the method may be i n d i c a t e d i n order to achieve the necessary psychometric p r o p e r t i e s of the measurement t o o l , the b a s i c method w i l l be d i c t a t e d by the conceptual framework. CHAPTER III RESEARCH METHODOLOGY Overview The Index'of"* Work. S a t i s f a c t i o n was revised to consist of an equal number of items i n each subscale i n order to allow f o r further comparisons across subscales i n l a t e r studies. This version of the questionnaire was p i l o t - t e s t e d for r e l i a b i l i t y , modified as indicated, and administered to the selected sample. Several s t a t i s t i c a l procedures were applied to the data i n order to investigate the construct v a l i d i t y of the questionn-a i r e and to obtain evidence regarding the r e l a t i o n s h i p of the subscales to each other, to the t o t a l score, and to the l e v e l of s a t i s f a c t i o n indicated i n the global question. Descriptive c h a r a c t e r i s t i c s of the sample and the psychometric properties of the too l were also investigated. Modification of the Index of Work S a t i s f a c t i o n The S l a v i t t t o o l was modified i n order to provide eight items i n each of the seven components. For those components which o r i g i n a l l y contained more than eight items, a version of the S l a v i t t t o o l which was reported by Stamps and others (1978), and which reported the factor loadings of the 48-item scale, f a c i l i t a t e d decisions regarding which items to omit. Items were constructed where i t was necessary to add to the components, the content of these items being based upon the l i t e r a t u r e and upon the experience of the researcher (Bates 1967; Bullough 1974). 29 I n a d d i t i o n , a g l o b a l question regarding o v e r a l l s a t i s f a c t i o n w i t h work was placed on the demographic page, i n order to provide a check on the v a l i d i t y of the t o t a l t e s t score. This question asked respondents to r a t e t h e i r o v e r a l l s a t i s f a c t i o n , using a 4-point response ranging from "Very d i s s a t i s f i e d " to "Very s a t i s f i e d . " (See Appendix . R e l i a b i l i t y The modified q u e s t i o n n a i r e was p i l o t - t e s t e d , using a sample of t h i r t y - o n e nurses, i n order to e s t a b l i s h the r e l i a b i l i t y of the new items. The sample c o n s i s t e d of nurses from the f o l l o w i n g s e t t i n g s : community h e a l t h , community home care, a 154-bed suburban h o s p i t a l , and a 75-bed extended care u n i t . The Hoyt i n t e r n a l consistency estimate f o r each of the components i s shown i n Table 1. The Hoyt estimate f o r the t o t a l t e s t was 0.84, and the Cronbach's alpha f o r the composite was 0.47, an i n d i c a t i o n that the subscales were a c t u a l l y measuring d i f f e r e n t i a t e d subconstructs. An item a n a l y s i s was performed, and any items which were not s i g n i -f i c a n t l y c o r r e l a t e d (p<.05) w i t h t h e i r subtest t o t a l were r e v i s e d , r e g a r d l e s s of whether they were o r i g i n a l or newly-added items. This f i n a l v e r s i o n appears i n Appendix A^. Items w i t h s i g n i f i c a n t but low c o r r e l a -t i o n s a l s o underwent r e v i s i o n , and comments made by the respondents were taken i n t o c o n s i d e r a t i o n i n t h i s phase of m o d i f i c a t i o n of the t o o l . The pay component items, f o r example, were e d i t e d to r e f l e c t the f a c t that pay schedules f o r nurses i n B r i t i s h Columbia do not vary from one i n s t i -t u t i o n to another. Because the nurses i n the community s e t t i n g s seldom had o p p o r t u n i t i e s to i n t e r a c t w i t h doctors, they f r e q u e n t l y used the 3 1 "non-applicable" response f o r Doctor-Nurse R e l a t i o n s h i p items. Another comment made by a few of the h o s p i t a l nurses was that t h e i r responses might vary from day to day, depending upon the many changeable f a c t o r s i n t h e i r work s i t u a t i o n s . Two sentences were t h e r e f o r e added to the Cover Page, asking respondents to describe t h e i r u s u a l or t y p i c a l f e e l i n g s about t h e i r jobs (See Appendix A^). The g l o b a l s a t i s f a c t i o n - d i s s a t i s f a c t i o n item on the demographic page was a l t e r e d to provide s i x choices i n an attempt to e l i c i t a higher variance on t h i s item (See Appendix A„). TABLE 1 INTERNAL CONSISTENCY RELIABILITIES OF THE SUBSCALES, USING THE PILOT SAMPLE CSI=31) Component Hoyt estimate of r e l i a b i l i t y Pay 0.86 P r o f e s s i o n a l s t a t u s 0.72 A d m i n i s t r a t i o n 0.84 Doctor-Nurse R e l a t i o n s h i p 0.86 Autonomy 0.73 Task Requirements 0.66 I n t e r a c t i o n 0 . 7 1 S e l e c t i o n of the Sample Because of the l a r g e numbers of responses r e q u i r e d i n order to conduct m u l t i p l e r e g r e s s i o n analyses, and because of the r e s t r a i n t s upon the researcher's time and resources, a n o n p r o b a b i l i t y quota sampling 32 plan was used. The number of s t a f f nurses employed i n the area bounded by and i n c l u d i n g Greater Vancouver Regional D i s t r i c t i n the West, the U.S. boundary to the south, and C h i l l i w a c k to the East, was approximated at 5200, using a v a i l a b l e h o s p i t a l s t a t i s t i c s and a telephone survey. This f i g u r e was broken down i n t o types of s e t t i n g s , percentages of nurses working i n each s e t t i n g , and numbers of nurses r e q u i r e d from each s e t t i n g to achieve a sample s i z e of 25 (See Table 2). Agencies were i n v i t e d to p a r t i c i p a t e i n the study,and w i t h i n each agency volunteers were r e c r u i t e d , t a k i n g care to provide an opportunity f o r those on nig h t duty and days o f f to p a r t i c i p a t e . Only f u l l - t i m e s t a f f nurses were included i n the study. Because t h i s i s i n e f f e c t a c l u s t e r sample of convenience, no g e n e r a l i z a t i o n s beyond the sample can be made from t h i s study. TABLE 2 SAMPLING PLAN Type of Agency or % of t o t a l non- No. r e q u i r e d I n s t i t u t i o n management nurses f o r sample General H o s p i t a l s : R u r a l 10 25 Urban ^ 400 beds 48 120 < 400 beds 25 63 P s y c h i a t r i c H o s p i t a l s : 2 5 Chronic, Extended Care and R e h a b i l i t -a t i o n H o s p i t a l s 4.6 12 Community Health: Rural PHN 1.7 4 Home Care 1.7 4 Urban PHN 5.4 13 Home Care 1.6 4 T o t a l 100.0 250 33 Data Collection Procedures Directors of nurses in agencies which agreed to participate in the study were visited by the researcher, and a plan to administer the questionnaire was devised according to each agency's needs and circum-stances. It was found that meetings of staff nurses were seldom held and in some situations were poorly attended, making i t impractical to use these occasions for obtaining data. Some of the agencies allowed small groups of nurses time off to complete the questionnaire, while in other settings the researcher was available at a designated place during meal times and at change of sh i f t . Visits were repeated at dates and times which would ensure as much representativeness as possible in the sample. The concern of the University of British Columbia Screening Committee for Research and Other Studies Involving Human Subjects that supervisory staff should neither be aware of nor involved in the p a r t i c i -pation of the staff nurses was attended to in each setting. Insofar as possible, the nature of the study was explained briefly to the respondents, individually or in groups, and the questionnaire was f i l l e d out at that time. Where this was not possible, the responses were placed in sealed envelopes by the respondents and returned to a staff nurse who took responsibility for collecting them. The number of respondents did not exceed the quotas required for any of the settings, and therefore a selection of volunteers was not necessary. Questionnaires were distributed only to those nurses who volunteered to complete them, and this procedure resulted in 95.4 percent return rate. The data were coded and keypunched for computer analysis. 34 S t a t i s t i c a l Procedures Several multiple regression analyses were applied to the data i n an e f f o r t to investigate the construct v a l i d i t y of the modified S l a v i t t questionnaire. In addition, the psychometric properties of t h i s version of the t o o l as applied to thi s sample were also studied. M u l t i p l e regression i s a method of analyzing the r e l a t i o n s h i p between a dependent v a r i a b l e and a set of optimally combined independent variables (Kerlinger 1973) Using p r i n c i p l e s of c o r r e l a t i o n and regression, an equation i s developed which best explains the r e l a t i v e contributions of the independent variables to the dependent v a r i a b l e . A fixed e f f e c t s l i n e a r regression model was used to determine how the seven component variables combine to form the t o t a l score, and whether ce r t a i n of the components are the best predictors of the t o t a l score. The computer program employed was the Michigan Interactive Date Analysis System (MIDAS), a multipurpose data manipulation and s t a t i s t i c a l analysis program (Fox and Guire 1976). Because i t was anticipated that the independent variables might be highly correlated with each other and with the t o t a l score, t h i s procedure was repeated using the response to the global s a t i s f a c t i o n question as the dependent v a r i a b l e . A s p e c i a l type of multiple regression, discriminant function analysis, was used to determine whether the job s a t i s f a c t i o n scale acts as a discriminator of group membership, for the groups of nurses formed by the "Type of Unit" demographic v a r i a b l e responses. This procedure .. discriminates groups from one another on the basis of sets of measures (Kerlinger 1973). In th i s a n a l y s i s , one or more regression equations, or discriminant functions, are formed, using l i n e a r combinations of the discriminating v a r i a b l e s , with the dependent v a r i a b l e being group membership. The weighting c o e f f i c i e n t which i s a p p l i e d to each d i s c r i m i n a t i n g v a r i a b l e serves to i d e n t i f y that v a r i a b l e ' s c o n t r i b u t i o n to the d i f f e r e n t i a t i o n . Once the respondents had placed themselves i n t o the f i v e groups according to t h e i r response to the item, a d i s c r i m i n a n t f u n c t i o n a n a l y s i s was used to i n d i c a t e which subscales, or d i s c r i m i n -a t i n g v a r i a b l e s , act as p r e d i c t o r s of group membership, and the accuracy of that p r e d i c t i o n . (Nie et a l . 1975). In other words, the a n a l y s i s was used to s p e c i f y which of "the seven components d i s c r i m i n a t e between the groups of nurses according to the f i v e work s e t t i n g s , and to what extent each of these v a r i a b l e s c o n t r i b u t e s to the d i s c r i m i n a t i o n . The MIDA program was used f o r t h i s a n a l y s i s . The psychometric p r o p e r t i e s of the q u e s t i o n n a i r e were analyzed, using the Laboratory of Education Research Test A n a l y s i s Package (LERTAP), a program f o r item and t e s t a n a l y s i s of an a f f e c t i v e t e s t ( U n i v e r s i t y of B r i t i s h Columbia, 1978). The a n a l y s i s provides t e s t - s u b t e s t c h a r a c t e r -i s t i c s ; scores f o r each subject on s u b t e s t s , t o t a l t e s t , an e x t e r n a l c r i t e r i o n and precoded s u b t e s t s ; summary item s t a t i s t i c s , i n c l u d i n g p o i n t b i s e r i a l c o r r e l a t i o n s w i t h the s u b t e s t , t o t a l t e s t and e x t e r n a l c r i t e r i o n ; subtest s t a t i s t i c s , i n c l u d i n g the Hoyt estimate of r e l i a b i l i t y ; t o t a l t e s t s t a t i s t i c s , i n c l u d i n g the Hoyt estimate f o r the t e s t and the Cronbach's alpha f o r the composite; histograms of the t o t a l t e s t and subtest scores; and c o r r e l a t i o n s of a l l subtests and the t e s t t o t a l . CHAPTER IV ANALYSIS AND DISCUSSION D e s c r i p t i o n of the Sample The t o t a l number of responses obtained was 177, f o l l o w i n g the data c o l l e c t i o n procedures described i n Chapter I I I . Considerable d i f f i c u l t y was experienced i n g a i n i n g access to l a r g e numbers of h o s p i t a l nurses, and t h i s i s r e f l e c t e d i n the t o t a l sample s i z e . An adequate represen-t a t i o n from the v a r i o u s s i z e s and types of h o s p i t a l s was obtained. The r e l a t i v e number of community nurses was d e l i b e r a t e l y increased to allow comparisons w i t h h o s p i t a l nurses. The composition of the sample i s presented i n Table 3. TABLE 3 COMPOSITION OF THE SAMPLE (N = 177) Type of Agency or Number of % of Obtained % Proposed I n s t i t u t i o n Cases .. Sample f o r Sample General H o s p i t a l s : R u r a l 18 10.2 10.0 Urban >400 beds 84 47.5 48.0 <400 beds 32 18.0 25.0 P s y c h i a t r i c H o s p i t a l : 6 3.4 2.0 Extended Care H o s p i t a l : 4 2.3 4.6 Community Health R u r a l PHN 9 5.1 1.7 Rural Home Care 8 4.5 1.7 Urban PHN 13 7.3 5.4 Urban Home Care 3 1.7 1.6 177 100.0 100.0 36 37 The demographic variables were cross-tabulated with the response to the global s a t i s f a c t i o n item, and these figures appear i n Tables 4 to 8. Because the sample contained only one male nurse, the sex v a r i a b l e was not included i n the cross-tabulations. The "Type of Unit" v a r i a b l e was treated by c o l l a p s i n g the three h o s p i t a l settings into one group and the two types of community settings into a second group. This v a r i a b l e was further analyzed by performing one-way analyses of variance on the means of the two groups for each component and f o r the t o t a l score. A summary of these r e s u l t s i s shown i n Table 9. TABLE 4 CROSS TABULATION OF GLOBAL SATISACTION RATING WITH "YEARS OF EXPERIENCE" VARIABLE Total Years of Nursing Experience Level of S a t i s f a c t i o n <1 1-4 5-10 11-16 16-20 >20 T o t a l Very d i s s a t i s i f e d 0 2 3 3 0 0 8 Somewhat d i s s a t i s i f e d 3 8 13 7 1 3 35 Rather s a t i s f i e d 8 19 19 14 4 5 69 Very s a t i s f i e d 4 12 24 9 2 4 55 Extremely s a t i s f i e d 0 1 4 1 1 3 10 Total 15 42 63 34 8 15 177 TABLE 5 CROSS TABULATION OF GLOBAL SATISFACTION RATING WITH "YEARS IN PRESENT POSITION" VARIABLE L e v e l of S a t i s f a c t i o n <1 - -1-3 Years i n ."•3-5 Present >5 P o s i t i o n T o t a l Very d i s s a t i s f i e d 2 4 1 1 8 Somewhat d i s s a t i s f i e d 16 9 6 4 35 Rather s a t i s f i e d 30 24 7 7 69 Very s a t i s f i e d 25 16 7 7 55 Extremely s a t i s f i e d 1 4 2 3 10 T o t a l 74 57 23 22 177 TABLE 6 CROSS TABULATION OF GLOBAL SATISFACTION RATING WITH "MONTHLY SALARY" VARIABLE L e v e l of S a t i s f a c t i o n $1200-1399 Current Monthly Salary $1400-1599 $1600-1799 • .Total Very d i s s a t i s i f e d 3 5 0 8 Somewhat d i s s a t i s f i e d 17 15 3 35 Rather s a t i s f i e d 34 28 7 69 Very s a t i s f i e d 25 24 6 55 Extremely s a t i s f i e d 1 7 2 10 T o t a l 80 79 18 ' 177 39 TABLE 7 CROSS TABULATION OF GLOBAL SATISFACTION RATING WITH "TYPE OF SETTING" VARIABLE L e v e l o f S a t i s f a c t i o n HOSPITAL COMMUNITY TOTAL Very d i s s a t i s i f e d 7 1 8 Somewhat d i s s a t i s i f e d 35 0 35 Rather s a t i s f i e d 59 10 69 Very s a t i s f i e d 39 16 55 Ex t r e m e l y s a t i s f i e d 5 5 10 T o t a l 145 32 177 TABLE 8 CROSS TABULATION OF GLOBAL SATISFACTION RATING WITH "WORK SCHEDULE' VARIABLE L e v e l o f S a t i s f a c t i o n Week days o n l y Very d i s s a t i s f i e d 0 Somewhat d i s s a t i s f i e d 1 Rather s a t i s -f i e d 9 Very s a t i s f i e d 17 E x t r e m e l y s a t i s f i e d 7 T o t a l 34 R o t a t i n g 8hr s h i f t Type o f Work Schedule R o t a t i n g R o t a t i n g 12hr s h i f t 8hr days O t h e r * T o t a l 13 23 11 0 49 16 27 17 1 66 9 21 35 69 55 10 177 ^ I n c l u d e s 9-day f o r t n i g h t (N = 5 ) , f l e x - t i m e (N = 4 ) , permanent 8-hour evenings (N = 2 ) , no r e p l y (N = 1 ) , o t h e r s i n g l e v a r i a t i o n s (N = 9 ) . 40 TABLE 9 SUMMARY OF ONE-WAY 'ANALYSES' OF VARIANCE OF COMPONENT AND TOTAL SCORES FOR HOSPITAL (GROUP I) AND COMMUNITY (GROUP I I ) NURSES Component. Group • - fN = I 1451) Group fN = I I F Prob-a b i l i t y X S.D. x" S.D. Pay 25.76 6.85 29.41 8.20 6.91 .009 P r o f e s s i o n a l status 39.59 6.54 43.22 5.15 8.68 .004 • Adminis t r a t i o n •27.81 7.04 30.03 7.58 , 2.55 .112 Doctor-Nurse R e l a t i o n s h i p i 36.81 7.12 33.16 9.33 •;, 6.14 : .014 Autonomy 37.84 5.64 40.88 5.38 7.70 ; .006 Task Require-ments 26.63 6.93 29.78 6.01 ' 5.67 .018 I n t e r a c t i o n 40.09 6.69 41.22 5.46 .79 : .374 T o t a l Test '234.52 30.35 247.69 25.81 5.19 , .024 None of the respondents used the "extremely d i s s a t i s i f e d " response to the g l o b a l s a t i s f a c t i o n item, but a f a i r l y symmetrical unimodal d i s t r i b u t i o n was e l i c i t e d by the other f i v e responses. Nurses who rated themselves most s a t i s f i e d were those who worked week-days only, had 5-10 years of experience, had been l e s s than three years i n t h e i r present 41 p o s i t i o n , and re c e i v e d a monthly s a l a r y of $1400-1599. Table 7 i n d i c a t e s an apparently normal d i s t r i b u t i o n of s a t i s f a c t i o n l e v e l s f o r nurses i n h o s p i t a l s e t t i n g s , whereas only one community agency nurse chose e i t h e r of the d i s s a t i s f i e d c a t e g o r i e s . Nurses working r o t a t i n g 12-hour s h i f t s had wi d e l y v a r y i n g response to the f i v e s a t i s f a c t i o n l e v e l s , f o l l o w i n g a n o r m a l - d i s t r i b u t i o n p a t t e r n . Responses i n d i c a t i n g d i s s a t i s f a c t i o n were most o f t e n s e l e c t e d by nurses i n h o s p i t a l s e t t i n g s , working a r o t a t i n g 12-hour s h i f t . These frequencies do not n e c e s s a r i l y i n d i c a t e greater s a t i s f a c t i o n w i t h these job c h a r a c t e r i s t i c s , but may simply be a r e f l e c t i o n of the variances i n the scores of the l a r g e numbers of nurses i n these p a r t i c u l a r s i t u a t i o n s . The analyses of variance of the h o s p i t a l and community nurses' component and t o t a l scores need to be i n t e r p r e t e d w i t h c a u t i o n due to the i n e q u a l i t y of sample s i z e and the f a c t that the u n i v a r i a t e F s t a t i s t i c i s being used on m u l t i v a r i a t e data, thus v i o l a t i n g the assumption of independence. However, n o r m a l i t y of the d i s t r i b u t i o n s of scores i s apparent from the histograms, the samples are l a r g e , and the variances appear to be approximately equal. I n s p e c t i n g Table 9 f o r trends, i t can be noted that the community nurses scored higher on the t o t a l t e s t and on a l l components except Doctor-Nurse R e l a t i o n s h i p , and that each of these d i f f e r e n c e s i n means was s i g n i f i c a n t at the p-<.05 l e v e l except f o r A d m i n i s t r a t i o n and I n t e r a c t i o n . The mean score f o r the Doctor-Nurse R e l a t i o n s h i p component was s i g n i f i c a n t l y higher a t the p< .05 l e v e l f o r h o s p i t a l nurses than f o r community nurses. I t should be noted that the "0" responses were in c l u d e d i n the computations, and t h i s f a c t would account f o r part of the s i g n i f i c a n c e of the d i f f e r e n c e s . 42 Psychometric A n a l y s i s The item c o r r e l a t i o n s and Hoyt r e l i a b i l i t y estimates provided by the LERTAP a n a l y s i s appear i n Appendix B. I t can be noted that only two of the items f a i l e d to be s i g n i f i c a n t l y c o r r e l a t e d (p<.05) w i t h both t h e i r r e s p e c t i v e subtest and the t e s t t o t a l s , and that i n a d d i t i o n , one item f a i l e d to achieve a s i g n i f i c a n t c o r r e l a t i o n w i t h the t e s t t o t a l . The Hoyt estimates of i n t e r n a l consistency r e l i a b i l i t y were between 0.68 and 0.82 f o r the components, and one can assume that the two u n c o r r e l a t e d items c o n t r i b u t e d to the r a t h e r low estimates f o r the P r o f e s s i o n a l Status and Autonomy components. With two exceptions, the items a l l c o r r e l a t e d more h i g h l y w i t h the component and t o t a l t e s t than w i t h the g l o b a l r a t i n g question, and twenty-one of the items were not s i g n i f i c a n t l y c o r r e l a t e d w i t h the g l o b a l question. The histograms r e v e a l f a i r l y normal d i s t r i b u t i o n s f o r each subtest, w i t h a s l i g h t negative skew apparent f o r the Doctor-Nurse R e l a t i o n s h i p and P r o f e s s i o n a l Status components. The t o t a l t e s t score d i s t r i b u t i o n f o l l o w s a f a i r l y smooth normal curve. Table 10 i s a summary of the component and t o t a l t e s t s t a t i s t i c s . The highest means occurred i n the I n t e r a c t i o n and P r o f e s s i o n a l Status components, and the lowest mean was that f o r the Pay component. One explanation f o r the high standard d e v i a t i o n f o r the Pay component i s that respondents chose the "non-applicable" response f o r some of these items q u i t e f r e q u e n t l y despite the f a c t that the items had been edited to be more r e l e v a n t to the province-wide wage con t r a c t s i t u a t i o n . The same response choice a f f e c t e d the Doctor-Nurse component mean and range. Nurses i n community s e t t i n g s where they had l i t t l e contact w i t h doctors used the zero response on some items, whereas h o s p i t a l nurses tended to 43 f e e l s a t i s f i e d w i t h t h e i r i n t e r a c t i o n w i t h p h y s i c i a n s . The other components seldom e l i c i t e d the "non-applicable" response. TABLE 10 SUMMARY OF SUBTEST AND TOTAL TEST STATISTICS •Component X S.D. Lowest Score Highest Score Pay 26.42 7.22 10.00 45.00 P r o f e s s i o n a l Status 40.24 6.45 18.00 54.00 A d m i n i s t r a t i o n 28.21 7.17 9.00 45.00 Doctor-Nurse R e l a t i o n s h i p 36.15 7.67 9.00 56.00 Autonomy 38.39 5.70 23.00 53.00 Task Requiements 27.20 6.87 10.00 43.00 I n t e r a c t i o n 40.29 6.48 25.00 54.00 T o t a l Test 245.33 30.37 155.00 320.00 The i n t e r c o r r e l a t i o n s of the s u b t e s t s , t o t a l t e s t and g l o b a l item responses are shown i n Table 11. I t i s apparent that a l l of the components are h i g h l y i n t e r c o r r e l a t e d except f o r Doctor-Nurse R e l a t i o n -ships and Pay. Furthermore, the f i v e c o m p o n e n t s c o r r e l a t e w i t h the t o t a l scores w i t h r's of from .603 to .764. These high c o r r e l a t i o n s i n d i c a t e that f i v e of the components share the same meaning to a l a r g e extent, and that the t e s t t o t a l i s l a r g e l y a measure of one meaning r a t h e r than a t o t a l of s e v e r a l r e l a t e d but f a i r l y independent 44 TABLE 11 CORRELATION MATRIX OF COMPONENT, TOTAL TEST, AND GLOBAL QUESTION SCORES (N = 177) Component P PS ' AD DN . AU : TR I TT Pay .79* Professional Status .142 .74 Adminis t r a t i o n .284** .401 . .78 Doctor-Nurse Relationship .022 .353 .300 .82 Autonomy .172 .407 .440 .252 .68 Task Requirements .234 .304 .541 • 1 .284 i ;. 4 n .70 Interaction . .014 .407 .401 .266 • .435 .247 .75 T o t a l Test .446 .665 .764 .573 .674 .681 .603 .89 Global Question .166 .488 .457 .180 .333 .313 ' .341 ;520 *Hoyt estimates (to '2 s i g n i f i c a n t decimals) appear,on the diagonal. **An r of .161 or more with N = 150 leads to r e j e c t i o n of Ho: p = 0 at<* 2 = .05 (Hopkins and Glass 1978, p. 409). meanings. This s i t u a t i o n r e s u l t s i n the problem of m u l t i c o l l i n e a r i t y , i n which i t i s d i f f i c u l t to separate out the r e l a t i v e contribution of each of the independent variables to the dependent v a r i a b l e because of the over-lapping variances i n the scores (Kerlinger 1973, p.622). The global s a t i s f a c t i o n item has s i g n i f i c a n t but rather low co r r e l a t i o n s with the component scores. Its c o r r e l a t i o n with the t o t a l test i s .52, 45 r e s u l t i n g i n a c o e f f i c i e n t of determination f o r t h i s single-item of ; 2 r -" .27." This indicates that the global question i s not measuring the same meaning of job s a t i s f a c t i o n as i s being measured by the questionnaire. M u l t i p l e Regression Analyses The r e s u l t s of the f i x e d model l i n e a r regression of the component subscales onto the t o t a l score are presented i n Table 12. TABLE 12 SUMMARY OF MULTIPLE REGRESSION OF COMPONENTS ONTO TOTAL SCORES Component b 3 t - s t a t i s t i c P r o b a b i l i t y -Pay .023 .014 .295 768 P r o f e s s i o n a l Status .217 .527 2.886 • 004 Adminis t r a t i o n .339 .855 4.684 • 000 Doctor-Nurse Relationship .121 .225 1.589 • 114 Autonomy .044 .122 .575 • 566 Task Require-ments .057 -.132 -.745 • 457 Interaction .254 -.619 -3.407 • 001 Multiple R = .518 R 2 = .268 Standard error = 13.05 Independent variables which contributed s i g n i f i c a n t l y (p< .05) to the dependent v a r i a b l e , the t o t a l score, were Professional Status, Administration, and Int e r a c t i o n . Together these variables explained 26.8 46 percent of the v a r i a n c e i n the scores. This means that these three v a r i a b l e s are the only ones which would appear i n a f i x e d model l i n e a r r e g r e s s i o n equation used to p r e d i c t job s a t i s f a c t i o n scores. The standard e r r o r of 13.05 i n d i c a t e s that on the average, the p r e d i c t e d t o t a l scores w i l l deviate from the a c t u a l t o t a l scores by 13.05 p o i n t s . As mentioned p r e v i o u s l y , m u l t i c o l l i n e a r i t y was expected to cause problems w i t h the i n t e r p r e t a t i o n of the m u l t i p l e r e g r e s s i o n a n a l y s i s . Because three of the h i g h l y i n t e r a c t i v e components were the ones i d e n t i f i e d as the p r e d i c t i v e - v a r i a b l e s , the r e l a t i v e importance of t h e i r p a r t i a l r e g r e s s i o n c o e f f i c i e n t s (b's) may be u n r e l i a b l e (Nie 1975, p.340; K e r l i n g e r and Pedhazur 1973, p.442). One way of confirming whether t h i s problem i n t e r f e r e s w i t h the a b i l i t y of the r e g r e s s i o n equation to p r e d i c t the t o t a l scores i s by examining a s c a t t e r - p l o t of the p r e d i c t e d values versus the r e s i d u a l values f o r the t o t a l scores. These p l o t t e d values are shown i n F i g . 1. The r e s i d u a l s are the d i f f e r e n c e s between the a c t u a l t o t a l s cores and the p r e d i c t e d t o t a l scores. Residuals t h e r e f o r e represent e r r o r s i n measurement, and an examination of a s c a t t e r - p l o t of the p a t t e r n of r e s i d u a l s gives an i n d i c a t i o n of whether t h i s e r r o r i s random or whether i t f o l l o w s some abnormal p a t t e r n (Nie 1975, pp.340-342). The p r e d i c t e d t o t a l score v a l u e s , c a l c u l a t e d w i t h the r e g r e s s i o n equation, are a composite of the weighted values of the independent v a r i a b l e s . The weights are the c o e f f i c i e n t s which give the best p r e d i c t i o n , i n the sense that the sum of the squared d e v i a t i o n s of the p r e d i c t e d scores from the a c t u a l scores i s a minimum. The higher the c o r r e l a t i o n of these two v a l u e s , the more accurate the p r e d i c t i o n ( K e r l i n g e r 1973, p.608). One 47 FIGURE 1 S C A T T E R P L C T O F P R E D I C T E D V A L U E S V E R S U S R E S I D U A L V A L U E S F O R T O T A L J O B S A T I S F A C T I O N S C O R E 2 3 5 . 9 * 9 + * * * * * * 226.49 + * * * * * * * * * * * w * * * * * * * * o + • * * * * *2 * 2 * 2 * * * * w • * * * * * * 2 *2 * * * j * * * 2 2*3* * * H 216.98 + * . * * * * * * * ° * * *2 * 3 * *4 * 2 2* * * . * ' 2 * 2 * * * * * § + * * 222 2 * * * 2 M * 2* * * * * * § * 3 * * 2** ^ 207.48 • * * * * * 2 2 w • * 2 * * J .PM 1 9 7 . 9 8 * * *  * * 2 * 188.47 + * + +— -i __+ + +— + + _ + - 48 .482 -17.7E1 12.920 -33.132 - 2 . 4 3 0 6 28.271 RESIDUAL VALUES FOR TOTAL SCORE Number of Observations = 177 r = —. 0 0 0 Each * represents 1 observation P l o t t e d numbers represent numbers of observations 4.83 would hope, t h e r e f o r e , to f i n d a random c o r r e l a t i o n between the r e s i d u a l s and the p r e d i c t i o n scores and between the r e s i d u a l s and the a c t u a l scores, and a high c o r r e l a t i o n between the a c t u a l and p r e d i c t e d scores. Table 13 i s a c o r r e l a t i o n matrix of these three sets of values. TABLE 13 CORRELATION MATRIX OF PREDICTED, RESIDUAL, AND ACTUAL VALUES OF TOTAL SCORES Score P r e d i c t e d R e s i d u a l A c t u a l P r e d i c t e d 1.000 Residua l - .000 1.000 A c t u a l .518 .855 1.000 Table 13 i n d i c a t e s that there i s no c o r r e l a t i o n between the r e s i d u a l s and the p r e d i c t e d t o t a l score values. As Figure 1 shows, the vari a n c e of the r e s i d u a l s appears to be independent of the p r e d i c t e d scores. Thus, there i s no c l e a r evidence of any abnormality which could l e a d to m o d i f i c a t i o n of the terms i n the equation. The c o r r e l a t i o n between the pr e d i c t e d and a c t u a l scores must be considered low, an i n d i c a t i o n of only moderately accurate p r e d i c t i o n , and a f u r t h e r c o n f i r m a t i o n of the l i m i t a t i o n s of the r e g r e s s i o n equation. The high c o r r e l a t i o n of the r e s i d u a l s w i t h the t o t a l scores i s i n d i c a t i v e of the strong l i n e a r r e l a t i o n -ship to be expected when the a c t u a l score i s a t o t a l of the scores of h i g h l y i n t e r c o r r e l a t e d independent v a r i a b l e s . The a b i l i t y of the independent v a r i a b l e s to p r e d i c t the response to 49 the global question i s shovzn i n Table 14. Comparing these r e s u l t s with those TABLE 14 SUMMARY OF MULTIPLE REGRESSION OF COMPONENTS ONTO GLOBAL QUESTION RESPONSE Component b 3 t - s t a t i s t i c P r o b a b i l i t y Pay .033 .004 .423 .671 P r o f e s s i o n a l Status .327 .050 4.495 .000 Administration .228 .037 3.040 .003 Doctor-Nurse Relationship - .069 - .008 - .907 .366 Autonomy .036 .006 .466 .642 Task Requirements .046 .006 .598 .551 I n t e r a c t i o n .092 .013 1.207 .229 2 M u l t i p l e R = .576 R ..= .332 Standard error = .792 i n Table 12, one must bear i n mind the l i m i t e d variance i n scores on the dependent v a r i a b l e imposed by the s i x response categories. Therefore 2 the higher R and lower standard error i n Table 14 do not nec e s s a r i l y represent an improvement i n the a b i l i t y of the regression equation to ) explain the variance i n global item responses. Two of the three previously selected independent v a r i a b l e s , P r o f e s s i o n a l Status and Administration, contributed s i g n i f i c a n t l y to the pr e d i c t i o n of the dependent v a r i a b l e . 50 Discriminant Function Analysis A ^demonstration of the questionnaire's a b i l i t y to discriminate between groups of nurses according to t h e i r work settings would have implications for modifying the t o o l for use i n assessing a prospective nurse-employee's l i k e l i h o o d of achieving s a t i s f a c t i o n i n the various settings. Table 15 presents the r e s u l t s of t h i s discriminant function analysis. Using the "Type of Unit" demographic response as the dependent va r i a b l e , the analysis i d e n t i f i e s four components, Pro f e s s i o n a l Status, Doctor-Nurse Relationship, Autonomy, and Interaction, as predictors of group membership. Each c o e f f i c i e n t can be interpreted as the r e l a t i v e weight, or importance, of that variable's contribution to the d i f f e r e n t i -a t i o n . Autonomy makes the most important contribution to the p r e d i c t i o n for a l l groups, and Professional Status i s second i n importance for both the community groups. The Doctor-Nurse Relationship component has very l i t t l e weight for the community groups, and no doubt would not have achieved s i g n i f i c a n c e i f these groups had been analyzed separately. These r e s u l t s suggest that the p r o f i l e of job s a t i s f a c t i o n v aries with the type of work s e t t i n g , i n the sense that some of the s i g n i f i c a n t components are more important to nurses i n c e r t a i n s e t t i n g s . In addition to the above procedures, a f a c t o r analysis was performed i n an attempt to gain more information regarding the underlying assumpt-ions of the seven-component l i n e a r additive job s a t i s f a c t i o n model. This analysis proved to be of l i m i t e d use i n addding to the previous findings and therefore i s not discussed or appended. TABLE ,15 DISCRIMINATING VARIABLES AND CLASSIFICATION OF WORK SETTING GROUPS C o e f f i c i e n t s V a r i a b l e F Prob-a b i l i t y Acute Care Extended Care P s y c h i a t r y Community PHN Community Home Care P r o f e s s i o n a l Status 7.11 .000 .513 .315 .210 .615 .688 Doctor-Nurse R e l a t i o n -s h i p 7.13 .000 .184 .280 .386 .059 .078 Autonomy 5.95 .000 .656 1.055 .817 .764 ' .798 I n t e r a c t i o n 3.45 .010 .456 .194 .312 .453 .327 A c t u a l ; groups 134 5 6 25 7 C l a s s i f i e d groups 83 15 16 35 28 Percent of i n d i v i d u a l s c o r r e c t l y c l a s s i f i e d : /52.'5%.' (N = 177) Uii h-1 52 D i s c u s s i o n Before proceeding w i t h a d i s c u s s i o n of the construct v a l i d i t y s t u d i e s , a b r i e f comment should be made regarding the sample. The d i f f i c u l t y i n o b t a i n i n g l a r g e numbers of h o s p i t a l nurses f o r the sample appeared to be due i n part to two f a c t o r s . D i r e c t o r s of nurses were r e l u c t a n t to have job s a t i s f a c t i o n l e v e l s studied i n t h e i r i n s t i t u t i o n s at a time when f i s c a l r e s t r a i n t s and budget cutbacks might be causing abnormal s t r e s s among employees. Once assured that t h e i r h o s p i t a l s would not be analysed, and that high variance i n the scores a c t u a l l y f a c i l i t a t e the study, the nursing d i r e c t o r s became q u i t e w i l l i n g to encourage t h e i r s t a f f nurses to co-operate w i t h the p r o j e c t . However t h e i r enthusiasm was somewhat f r u s t r a t e d by the e t h i c a l r e s t r a i n t on the i n f l u e n c e of supervisory personnel on s t a f f p a r t i c i p a t i o n . Nursing d i r e c t o r s , s u p e r v i s o r s , and head nurses a s s i s t e d by p u b l i c i z i n g the p r o j e c t . A much l a r g e r sample could have been obtained, however, i f they could a l s o have been more a c t i v e l y i n v o l v e d i n r e c r u i t i n g subjects and making arrangements f o r them to p a r t i c i p a t e . The purpose of t h i s study was to i n v e s t i g a t e the construct v a l i d i t y of the modified S l a v i t t job s a t i s f a c t i o n s c a l e . The analyses described have co n t r i b u t e d the f o l l o w i n g to our understanding of the meaning of job s a t i s f a c t i o n as i t i s measured by the t o t a l score on the t e s t . 1. The v e r s i o n of the t o o l which was used on the study sample of 177 s t a f f nurses provided a r e l i a b l e measure of the components and the t o t a l score. 2. The t o t a l score i s not a l i n e a r a d d i t i v e f u n c t i o n of the seven subscales. Three component subscales, P r o f e s s i o n a l Status, A d m i n i s t r a -53 t i o n , and I n t e r a c t i o n , accounted f o r approximately 30 percent of the variance i n the scores, but the nature of t h i s v a r i a n c e cannot be i n t e r p r e t e d due to the f a c t that these v a r i a b l e s are so h i g h l y c o r r e l a t e d . Therefore we can conclude that these three subconstructs are not independ-ent, but we cannot s t a t e whether they are parts of one broader c o n s t r u c t , such as "Feedback" f o r example, or whether they i n t e r a c t i n some unique way. The d i s c r i m i n a n t f u n c t i o n a n a l y s i s i n d i c a t e d that P r o f e s s i o n a l Status i s more important than A d m i n i s t r a t i o n i n p r e d i c t i n g s a t i s f a c t i o n l e v e l s . I t may be p o s s i b l e that nurses who are happy w i t h the a d m i n i s t r a -t i v e aspects of t h e i r work w i l l perceive higher l e v e l s of s t a t u s , or that those whose needs f o r s t a t u s are met do not r e a d i l y become d i s s a t i s -f i e d w i t h a d m i n i s t r a t i o n . A l s o , s i n c e both the P r o f e s s i o n a l Status and A d m i n i s t r a t i o n components co n t a i n items p e r t a i n i n g to i n t e r p e r s o n a l a c t i v i t i e s , the scores on these components could be measuring some of the same meaning as the I n t e r a c t i o n component. The f a c t o r a n a l y s i s supported the existence of an underlying component which c o n s i s t s l a r g e l y of items from these three subscales. The e f f e c t s of the remaining components could be i n v e s t i g a t e d by m u l t i p l e r e g r e s s i o n s t u d i e s which c o n t r o l f o r the variance of the f i r s t three p r e d i c t o r s , but s i n c e both Autonomy and Task Requirements are i n t e r c o r r e l a t e d w i t h the three v a r i a b l e s to be c o n t r o l l e d , a l a r g e p o r t i o n of t h e i r v a r i a n c e could a l s o be c o n t r o l l e d and t h e r e f o r e would not be a v a i l a b l e to enter the r e g r e s s i o n equation. 3. The g l o b a l s a t i s f a c t i o n question measures some, but not a l l , of the meaning measured by the t o t a l score on the t e s t . For the purpose of t h i s study, the item d i d not possess the r e l i a b i l i t y one would have l i k e d for another measure of the dependent v a r i a b l e . Regarding the meaning of job s a t i s f a c t i o n , however, this may be an i n d i c a t i o n that some other dimension of job s a t i s f a c t i o n i s being measured by this item. This question may e l i c i t responses related to the nurse's present state of s a t i s f a c t i o n , whereas the questionnaire i t s e l f may be measuring underlying t r a i t c h a r a c t e r i s t i c s regarding her s a t i s f a c t i o n with her work. 4. The r e s u l t s of the discriminant function analysis using types of work settings as the dependent v a r i a b l e provides a p r o f i l e of the importance of the four predictors f o r each of the s e t t i n g s , f o r t h i s sample. These findings could be applied to the development of an instrument for counselling nurses to seek jobs i n settings which meet t h e i r needs. 55 CHAPTER V SUMMARY, LIMITATIONS, CONCLUSIONS, AND RECOMMENDATIONS Summary T h i s r e p o r t p r e s e n t s an i n v e s t i g a t i o n o f the c o n s t r u c t v a l i d i t y o f a t o o l f o r measuring n u r s e s ' j o b s a t i s f a c t i o n . The s c a l e used f o r the stud y was a m o d i f i e d v e r s i o n o f the Index o f Work S a t i s f a c t i o n d e v e l o p e d by S l a v i t t and o t h e r s (1978). Based upon need s a t i s f a c t i o n t h e o r i e s , the s c a l e c o n t a i n e d seven s u b s c a l e s which were b e l i e v e d to e x p l a i n job s a t i s f a c t i o n . A g l o b a l s a t i s f a c t i o n l e v e l i t e m was added i n an attempt to o b t a i n an o p e r a t i o n a l l y independent measure o f the dependent v a r i a b l e . The l i t e r a t u r e was c r i t i c a l l y reviewed to p r o v i d e a background o f the c u r r e n t s t a t u s o f j o b s a t i s f a c t i o n r e s e a r c h i n n u r s i n g . The i n s t r u m e n t was m o d i f i e d , p i l o t - t e s t e d f o r r e l i a b i l i t y , and a f t e r a second phase o f m o d i f i c a t i o n , was a d m i n i s t e r e d to a v o l u n t e e r sample of 177 s t a f f n u r s e s r e p r e s e n t i n g s e v e r a l h o s p i t a l and community work s e t t i n g s . M u l t i p l e r e g r e s s i o n and d i s c r i m i n a n t f u n c t i o n a n a l y s e s were performed on the d a t a , and the r e s u l t s o f these a n a l y s e s were i n t e r p r e t e d i n terms o f the c o n s t r u c t v a l i d i t y o f the j o b s a t i s f a c t i o n s c a l e . R e s u l t s i n d i c a t e d t h a t the s c a l e i s h i g h l y r e l i a b l e , and t h a t t h r e e o f the s u b s c a l e s e x p l a i n e d a p p r o x i m a t e l y 30 p e r c e n t of the v a r i a n c e i n the s c o r e s on the g l o b a l s a t i s f a c t i o n measure of j o b s a t i s f a c t i o n . H i g h i n t e r c o r r e l a t i o n o f the s u b s c a l e s w i t h each o t h e r and w i t h the t o t a l s c o r e s 56 hindered the i n t e r p r e t a t i o n of the variance i n the t o t a l scores explained by each of the s i g n i f i c a n t v a r i a b l e s . The r e s u l t s of the analyses suggest that the high r e l i a b i l i t y of thi s version of the t o o l makes i t a psychometically u s e f u l measurement of job s a t i s f a c t i o n f o r nurses, to the extent that job s a t i s f a c t i o n i s comprised of the seven components contained i n the scale. Regarding i t s construct v a l i d i t y , there i s conclusive evidence that the l i n e a r a d d i t i v e model of job s a t i s f a c t i o n on which the instrument i s based does not allow a complete view of the construct. Whether the three s i g n i f i c a n t predictors of the t o t a l score, Professional Status, Administration, and-Interaction, are part of one broader construct, or whether they i n t e r a c t i n some unique way, could not be determined because of the mu l t i -c o l l i n e a r i t y problem. A major d i f f i c u l t y throughout the study was the lack of a r e l i a b l e alternate measure of the c r i t e r i o n . The global s a t i s f a c t i o n item responses did not correlate highly with the t o t a l test scores, and t h i s s e l f - r e p o r t , Likert-type item would be subject to the same response bias as the questionnaire i t s e l f . Apart from the demonstration that the Professional Status, Administration, and Interaction components appear to contribute to the measurement of the construct, the study f a i l e d to gather evidence i n support of the construct v a l i d i t y of the modified S l a v i t t s c a le. The l i m i t a t i o n s of the study, and the conclusions which can be drawn, provide d i r e c t i o n f o r future i n v e s t i g a t i o n s into the t h e o r e t i c a l nature and the measurement of the construct. 57 L i m i t a t i o n s This study i s s u b j e c t to the f o l l o w i n g l i m i t a t i o n s : 1. The s i z e and s e l e c t i o n of the sample can be expected to r e s u l t i n biased estimates of the r e g r e s s i o n c o e f f i c i e n t s . K e r l i n g e r and Pedhazur (1973, p.447) s t a t e that m u l t i p l e r e g r e s s i o n a n a l y s i s i n v o l v i n g s e v e r a l independent v a r i a b l e s should have 200 or more subjects i n order to minimize t h i s problem. The l a c k of random s e l e c t i o n can be expected to add to the b i a s of the s t a t i s t i c s . 2. The f i n d i n g s from t h i s study cannot be expected to apply to subjects who are being stu d i e d under d i f f e r e n t circumstances. The data obtained from the same subjects would l i k e l y d i f f e r , f o r example, i f the s c a l e were administered f o r management purposes and the subjects were not anonymous. 3. S e l f - r e p o r t measures of a t t i t u d e s , such as the s c a l e used i n t h i s study, are l i m i t e d to what the respondent knows about h i s a t t i t u d e and i s w i l l i n g to r e l a t e (Nunnally 1970, p.421). Thus, the data from t h i s study may not c o r r e l a t e w i t h behavior p e r t a i n i n g to job s a t i s -f a c t i o n , such as absenteeism, grievances, and r e s i g n a t i o n s . 4. Both measures of the dependent v a r i a b l e , job s a t i s f a c t i o n , u t i l i z e s e l f - r e p o r t , L i k e r t - t y p e responses and are t h e r e f o r e subject to response consistency. In a d d i t i o n , both of these measures are l i m i t e d to the aspects of job s a t i s f a c t i o n which can be reported on a paper-and-p e n c i l t e s t . 58 5. The m u l t i p l e r e g r e s s i o n and d i s c r i m i n a n t f u n c t i o n analyses using the g l o b a l s a t i s f a c t i o n responses as the c r i t e r i o n are subject to the l i m i t e d r e l i a b i l i t y and v a l i d i t y of s i n g l e - i t e m measures. Conclusions The r e s u l t s of t h i s study le a d to the f o l l o w i n g conclusions: 1. The study was s u c c e s s f u l i n demonstrating and improving the psychometric usefulness of the t o o l . The subscales are i n t e r n a l l y con-s i s t e n t , and the t o o l was e a s i l y administered and understood i n a wide v a r i e t y of s e t t i n g s . I t i s c l e a r that the v e r s i o n of the t o o l , as i t i s p r e s e n t l y worded, i s appropriate f o r both h o s p i t a l and community s e t t i n g s i f the Doctor-Nurse R e l a t i o n s h i p items are deleted f o r nurses i n community h e a l t h s e t t i n g s where such i n t e r a c t i o n s are r a r e . 2. The construct v a l i d i t y of the modified v e r s i o n of the S l a v i t t s c a l e has not been c o n c l u s i v e l y demonstrated by t h i s study. Therefore the t o o l should be used w i t h r e s e r v a t i o n u n t i l f u r t h e r evidence of i t s v a l i d i t y i s e s t a b l i s h e d , or u n t i l a more s u i t a b l e a l t e r n a t i v e measure i s developed f o r measuring nurses' job s a t i s f a c t i o n . 3. M u l t i p l e r e g r e s s i o n of the subscale scores onto the t o t a l t e s t scores i s not h e l p f u l i n e s t a b l i s h i n g the construct v a l i d i t y of the qu e s t i o n n a i r e , and t h i s procedure should be avoided i n s t u d i e s which undertake to examine co n s t r u c t v a l i d i t y . 4. I t may not be p o s s i b l e to develop a s i n g l e paper-and-pencil t e s t which can provide a v a l i d measure of job s a t i s f a c t i o n f o r nurses. The l i m i t a t i o n s inherent i n t h i s type of t e s t have been pointed out. One of the strengths of the MacEachron (1977) study was i t s m u l t i -method approach, using a c h e c k - l i s t , the P o r t a b l e Rod and Frame Test, and job l e v e l c l a s s i f i c a t i o n s . A v a r i e t y of methods should be used to measure the job s a t i s f a c t i o n v a r i a b l e s whenever p o s s i b l e , i n an e f f o r t to i ncrease the v a l i d i t y of the measurement of the c o n s t r u c t . 5. The job s a t i s f a c t i o n s c a l e may not be measuring a l l aspects of job s a t i s f a c t i o n f o r t h i s group of workers. Other dimensions of the construct besides needs r e s o l u t i o n should be considered. As pointed out i n the K a l l e b e r g (1977) and Munson and Heda (1974) s t u d i e s , the expectations held f o r a p a r t i c u l a r job w i l l vary from person to person at any given time, and w i l l a l s o vary w i t h time f o r most i n d i v i d u a l workers. Although s a t i s f a c t i o n may be reported i n each i n s t a n c e , i t s meaning could vary w i d e l y . Other v a r i a b l e s such as age, and years of experience, may moderate the e f f e c t s of some or a l l of the independent v a r i a b l e s . Sheridan and Vredenburgh (1978), using s e n i o r i t y and age as moderating v a r i a b l e s i n examining job t e n s i o n , performance, and turnover of nursing.employees, found that age had an i n v e r s e r e l a t i o n s h i p w i t h the nurse's perceived tension the.job. S e l f - a c t u a l -i z a t i o n need strength was reported by Sims and S z i l a g y i (1976) to moderate r e l a t i o n s h i p s i n v o l v i n g autonomy, v a r i e t y , and feedback. 60 A l l of the moderating v a r i a b l e s mentioned are c h a r a c t e r i s t i c s of the worker which i n f l u e n c e e i t h e r s a t i s f a c t i o n l e v e l s or o r g a n i z a t i o n a l behavior. One p o s s i b i l i t y a r i s i n g from the l i t e r a t u r e and from the present study i s that job s a t i s f a c t i o n may have both s t a t e and t r a i t c h a r a c t e r i s t i c s . T r a i t aspects would i n c l u d e such dimensions as the i n d i v i d u a l ' s need strength f o r each p a r t i c u l a r need, task i d e n t i t y , locus of c o n t r o l , the person's s o c i a l and c u l t u r a l work val u e s , and the i n f l u e n c e of length of experience. These c h a r a c t e r i s t i c s would form a p r o f i l e of s a t i s f a c t i o n which would tend to p e r s i s t r e g a r d l e s s of s i t u -a t i o n a l f a c t o r s . The s t a t e of job s a t i s f a c t i o n , on'the other hand, would be the degree of o v e r a l l s a t i s f a c t i o n perceived at any given moment, depending upon the s p e c i f i c needs, t a s k s , r e l a t i o n s h i p s , oppor-t u n i t i e s and rewards immediately f e l t by the worker. In other words, the s t a t e of job s a t i s f a c t i o n i s a t r a n s i e n t , s i t u a t i o n - c o n t i n g e n t a t t i t u d e , whereas the t r a i t aspect of the construct i s a s t a b l e under-l y i n g p r e d i s p o s i t i o n to a c e r t a i n l e v e l of s a t i s f a c t i o n . Two approaches are suggested f o r i n v e s t i g a t i n g these r e l a t i o n s h i p s : the t r a i t aspects could be used as moderator v a r i a b l e s i n i n t e r a c t i o n models such as those hypothesized by MacEachron (1977) and Sims and S z i l a g y (1976); or, the construct i t s e l f could be viewed as two d i s t i n c t c o n s t r u c t s , w i t h separate measures developed f o r s t a t e and f o r t r a i t c o n d i t i o n s . The l a t t e r approach may provide a s o l u t i o n to the weighting problems which remain unanswered i n job s a t i s f a c t i o n research to date. Attempts to weight s t a t e s a t i s f a c t i o n components w i t h i n d i v i d u a l pre-ferences and requirements may have f a i l e d because they have allowed only a fragmented r e c o g n i t i o n of t r a i t s a t i s f a c t i o n . 61 Recommendations Regarding the Use of the Questionnaire I f due c o n s i d e r a t i o n i s given to i t s l i m i t a t i o n s , the t o o l can provide a u s e f u l measure of nurses' job s a t i s f a c t i o n l e v e l s . The f o l l o w i n g recommendations are made regarding i t s use i n work s e t t i n g s : 1. The Doctor-Nurse R e l a t i o n s h i p component should be deleted when using the instrument i n community s e t t i n g s . 2. The Pay component should be r e t a i n e d , but i n s i t u a t i o n s where wages are determined by province-wide or state-wide c o n t r a c t s , a f u r t h e r e f f o r t should be made to e l i m i n a t e any suggestion i n the items that the employer can manipulate pay schedules.. 3. The t o o l i s recommended f o r use by management as a monitoring device f o r assessing s t a f f morale when changes are i n s t i t u t e d . Some of the d i r e c t o r s of nurses who were approached by the i n v e s t i g a t o r expressed the f e e l i n g that job s a t i s f a c t i o n l e v e l s of the nurses i n t h e i r i n s t i -t u t i o n would be low because of the current s t a f f l a y o f f s and cutbacks i n s e r v i c e s . I f they had been able to monitor s a t i s f a c t i o n l e v e l s through-out t h i s c r i s i s , they may have been able to support t h e i r perceptions w i t h e m p i r i c a l evidence. S i m i l a r l y , changes i n nur s i n g care p a t t e r n s and a d m i n i s t r a t i o n are sometimes made on the assumption that s t a f f morale w i l l be increased, or at l e a s t that i t w i l l not d e t e r i o r a t e . A v e r i f i c a t i o n of t h i s assumption would be h e l p f u l i n the e v a l u a t i o n of these programs. 4. The ques t i o n n a i r e i n i t s present form could be used i n personnel c o u n s e l l i n g . An on-going record of an i n d i v i d u a l ' s job s a t i s f a c t i o n l e v e l could provide i n d i c a t i o n s of problems which would then be explored i n r e l a t i o n to the job s i t u a t i o n and/or personal f a c t o r s . 62 Recommendations f o r Further Research Further research i n t o the construct v a l i d i t y of the questionnaire should i n c l u d e the f o l l o w i n g : 1. The study should be r e p l i c a t e d , using a d i f f e r e n t geographical l o c a t i o n and a large random sample. K e r l i n g e r and Pedhazur (1973, p.446) describe., the d i f f i c u l t y of o b t a i n i n g r e l i a b l e r e s u l t s using m u l t i p l e r e g r e s s i o n s t u d i e s . C o r r e l a t i o n between independent v a r i a b l e s and e r r o r s of measurement w i l l always have some i n f l u e n c e upon the magnitude of r e g r e s s i o n c o e f f i c i e n t s . I f s i m i l a r r e s u l t s appear c o n s i s t e n t l y i n other s t u d i e s , then the r e l a t i o n s h i p s between the v a r i a b l e s can be considered r e l i a b l e . 2. The m u l t i p l e r e g r e s s i o n approach to data a n a l y s i s should be pursued f u r t h e r i f a proven measure of the dependent v a r i a b l e , using a method other than s e l f - r e p o r t , can be found. 3. L o n g i t u d i n a l s t u d i e s should be conducted, using the t o o l to i n v e s t i g a t e patterns of needs s a t i s f a c t i o n over time and r e l a t i n g f i n d i n g s to other b e h a v i o r a l i n d i c a t o r s of s a t i s f a c t i o n , such as grievances and r e s i g n a t i o n s . This could provide the d i r e c t i o n necessary f o r developing more s a t i s f a c t o r y models f o r a n a l y s i s . The d i f f i c u l t i e s of using modera-t o r v a r i a b l e s and contingency models to e x p l a i n o r g a n i z a t i o n a l behavior have been described by Korman, Greenhaus, and Baden (1977). The main problem l i e s i n i d e n t i f y i n g a systematic set of moderator v a r i a b l e s , as even the most c a r e f u l l y c o n t r o l l e d s t u d i e s have f a i l e d to produce con-s i s t e n t r e s u l t s upon r e p l i c a t i o n . These authors suggest that i n d u c t i v e , c l i n i c a l - t y p e observation may be more h e l p f u l than a. p r i o r i hypothesis 63 t e s t i n g i n understanding the r e l a t i o n s h i p s of the independent variables to be studied. 4. The v a l i d i t y of the unitary nature of the construct of job s a t i s f a c t i o n should be investigated. The questionnaire should be revised to create a measure of state s a t i s f a c t i o n by rewording the i n s t r u c t i o n s and the items to conform to the theme "...how I f e e l about my work r i g h t now." A measure of t r a i t s a t i s f a c t i o n would need to be developed using a "what I generally prefer" theme and incorporating the moderating variables mentioned previously. Evidence of the discriminant v a l i d i t y of these two measures would lend support to the two-construct view of job s a t i s f a c t i o n . BIBLIOGRAPHY Bates, B. 1967. 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Nord, W.R. 1977. Job s a t i s f a c t i o n reconsidered. American Psychologist 32:1026-1035. Nunnally, J.C. 1970. Introduction to psychological measurement. Toronto: McGraw-Hill. Oltman, P.K. 1968. A portable rod-and-frame t e s t . Perceptual and  Motor S k i l l s 26:503-506. Porter, L.W. 1962. Job atti t u d e s i n management, part I. Perceived deficiences i n need f u l f i l l m e n t as a function of job l e v e l . Journal of Applied Psychology 46:378-384. Porter, L.W. and Lawler, E. 1968. Managerial at t i t u d e s and performance. Homewood, 111.: Richard D. Irwin. Prvzek, R.M., and Frederick, B.C. 1978. Weighting predictors i n l i n e a r models: a l t e r n a t i v e s to l e a s t squares and l i m i t a t i o n of equal weights. Psychological B u l l e t i n 85:254-266. 66 Saleh, S. 1964. Why nurses leave t h e i r jobs — an a n a l y s i s of female turnover. Personnel A d m i n i s t r a t i o n 27:25-28. Sedlacek, W.E. 1966. E m p i r i c a l and t h e o r e t i c a l aspects of job s a t i s -f a c t i o n . Unpublished d o c t o r a l d i s s e r t a t i o n , Kansas State U n i v e r s i t y . C i t e d i n Neumann, E.L. 1973. Communicating Nursing  Research 6:165-176. Seeman, M. 1967. On the personal consequences of a l i e n a t i o n i n work. American S o c i o l o g i s t Review 32:273-285. Sheridan, J.E., and Vredenburgh, D.J. 1978. Usefulness of l e a d e r s h i p behavior and s o c i a l power v a r i a b l e s i n p r e d i c t i n g job t e n s i o n , performance, and turnover of nursing employees. J o u r n a l of A p p l i e d  Psychology 63:89-95. Sims, H.P., and S z i l a g y , A.D. 1976. Job c h a r a c t e r i s t i c r e l a t i o n s h i p s : i n d i v i d u a l and s t r u c t u r a l moderators. O r g a n i z a t i o n a l Behavior and  Human Performance 17:211-230. S l a v i t t , D.B.; Stamps, P.L.; Piedmont, E.B.; and Haase, Ann Marie B. 1978. Nurses' s a t i s f a c t i o n w i t h t h e i r work s i t u a t i o n . Nursing  Research 27:114-120. Slocum, J.W. J r . ; Susman, G.I.; and Sheridan, J.E. 1972. An a n a l y s i s of need s a t i s f a c t i o n and job performance among p r o f e s s i o n a l and p a r a p r o f e s s i o n a l h o s p i t a l personnel. Nursing Research 21:338-341. Smith, P.C., and K e n d a l l , L.M. 1963. R e t r a n s l a t i o n of e x p e c t a t i o n s : an approach to the c o n s t r u c t i o n of unambiguous anchors f o r r a t i n g s c a l e s . J o u r n a l of A p p l i e d Psychology 47:149-155. Smith, P.C., K e n d a l l , L.M.; and H u l i n , C L . 1969. The measurement of  s a t i s f a c t i o n i n work and retirement: a s t r a t e g y f o r the study of  a t t i t u d e s . Chicago: Rand McNally. Stamps, P.L.; Piedmont, E.B.; S l a v i t t , D.B.; and Haase, A.M. 1978. Measurement of work s a t i s f a c t i o n among h e a l t h p r o f e s s i o n a l s . Medical Care 16:337-352. Stember, M.L.; Ferguson, J . ; Conway, K; and Y i n g l i n g , M. 1978. Job s a t i s f a c t i o n research — an a i d i n d e c i s i o n making. Nursing  A d m i n i s t r a t i o n Q u a r t e r l y 2:4, 95-105. Ta y l o r , J.R. 1977. Job s a t i s f a c t i o n and q u a l i t y of working l i f e : a reassessment. Journa l of Occupational Psychology 50:243-252. U n i v e r s i t y of B r i t i s h Columbia F a c u l t y of Education. 1978. ERSC LERTAP. Vancouver: U n i v e r s i t y of B r i t i s h Columbia. Verhonick, P.J., ed. 1977. Nursing research I I . Boston: L i t t l e , Brown. 67-Vroom, V.H. 1964. Work and m o t i v a t i o n . New York: W i l e y . Wahba, M.A., and B r i d w e l l , L.G. 1976. Maslow r e c o n s i d e r e d : a review of r e s e a r c h on the need h i e r a r c h y t h e o r y . O r g a n i z a t i o n a l B e h a v i o r  and Human Performance 15:212-240. Waters, L.K. 1969. The u t i l i t y o f importance w e i g h t s i n p r e d i c t i n g o v e r a l l j o b s a t i s f a c t i o n and d i s s a t i s f a c t i o n . E d u c a t i o n a l and  P s y c h o l o g i c a l Measurement 29:519-522. White, C.H., and Maguire, M.C. 1973. Job s a t i s f a c t i o n and d i s s a t i s f a c t i o n among h o s p i t a l n u r s i n g s u p e r v i s o r s : the a p p l i c a t i o n o f Herz b e r g ' s t h e o r y . N u r s i n g Research 22:25-30. APPENDIX A. APPENDIX A Cover Page The enclosed a t t i t u d e scale and questionnaire have been designed to a s s i s t nurse researchers to define the meaning of job s a t i s f a c t i o n for nurses. The information you provide w i l l be anonymous, the only i d e n t i f i c a t i o n being a number which indicates the order i n which the questionnaire was issued, and a number which designates your type of i n s t i t u t i o n or agency. The voluntary nature of your p a r t i c i p a t i o n i n t h i s study implies your consent to allow the researcher to use the information you provide. Your i n d i v i d u a l responses and the r e p l i e s of your working group w i l l be held i n confidence by the researcher and her three f a c u l t y advisors and w i l l not be made a v a i l a b l e to your employer. The name of your agency w i l l not appear on the data or i n the study. We a l l have day-to-day v a r i a t i o n s i n how we f e e l about our jobs. Please try to describe your usual or t y p i c a l f e e l i n g s when you answer the questions. Your cooperation with t h i s study i s appreciated. M. Dawn F a r i s , B.A.Sc. (Nursing) Graduate Student, M.S.N. Program, Univ e r s i t y of B r i t i s h Columbia. 69 ; APPENDIX A. APPENDIX A, Demographic Data T o t a l y e a r s 1. l e s s than 1 2. 1-4 3. 5-10 4. 11-16 5. 16-20 6. over 20 of n u r s i n g e x p e r i e n c e (7) No. o f y e a r s i n p r e s e n t p o s i t i o n (10) 1. l e s s than 1 2. 1-3 _3. 3-5 4. over 5 Type of u n i t ( c u r r e n t ) (8) Sex (9) C u r r e n t monthly s a l a r y ( I D 1. A c u t e c a r e 2. Extended c a r e 3. P s y c h i a t r y 4. Community-PHN 5. Community-Home Care 1. F 2. M _1. $1200-1399. _2. $1400-1599 3. $1600-1799 4. $1800+ Type o f work s c h e d u l e (12) _1. week days o n l y (may i n c l u d e o n - c a l l o t h e r hours) 2. r o t a t i n g 8 - hour s h i f t _3. r o t a t i n g 12 - hour s h i f t 4. permanent 8 - hour days, r o t a t i n g days o f f 5. permanent 8 - hour evenings _6. permanent 8 - hour n i g h t s 7. permanent 12 - hour days 8. permanent 12 -hour n i g h t s 9. o t h e r ( p l e a s e d e s c r i b e ) : T a k i n g a l l t h i n g s i n t o c o n s i d e r a t i o n , how s a t i s f i e d w i t h your work a r e you? (13) E x t r e m e l y V e r y Somewhat Rather V e r y E x t r e m e l y d i s s a t i s i f e d d i s s a t i s f i e d d i s s a t i s f i e d s a t i s f i e d s a t i s f i e d s a t i s f i e d (CIRCLE ONE NUMBER) 71. APPENDIX A APPENDIX A 3 Questionnaire PLEASE ANSWER EVERY QUESTION USE THIS SCALE FOR ALL RESPONSES: Don't understand or 0 non-applicable Disagree very s t r o n g l y 1 Disagree s t r o n g l y 2 Disagree 3 Ne u t r a l 4 Agree 5 Agree s t r o n g l y 6 Agree very s t r o n g l y 7 1. The nursing personnel on my s e r v i c e 0 1 2 3 4 5 6 7 p i t c h i n and help one another out when things get i n a rush. 2. The amount of time I must spend on t r i v i a l a d m i n i s t r a t i o n d u t i e s i s qu i t e reasonable. 0 1 2 3 4 5 6 7 3. The people I work w i t h are f r i e n d l y and supportive. - 0 1 2 3 4 5 6 7 I am sometimes re q u i r e d to make de c i s i o n s on my job that are not part of my r e s p o n s i b i l i t y . 0 1 2 3 4 5 6 7 5. The present r a t e of increase i n pay f o r nur s i n g s e r v i c e personnel i s not s a t i s f a c t o r y . 0 1 2 3 4 5 6 7 My p a r t i c u l a r job doesn't r e q u i r e much s k i l l or "know-how." 0 1 2 3 4 5 6 7 7. There are p l e n t y of o p p o r t u n i t i e s f o r advancement of nu r s i n g personnel 0 1 2 - 3 4 5 6 7 at t h i s hospital/agency. 8. A d m i n i s t r a t i v e d e c i s i o n a t t h i s hospital/agency i n t e r f e r e too much 0 1 2 3 4 5 6 7 w i t h p a t i e n t care. 9. I t ' s my general impression that most of the nur s i n g s t a f f at t h i s h o s p i t a l / agency r e a l l y l i k e the way the work i s organized and done. 73 74 Don't understand or ^ Non-applicable Disagree very s t r o n g l y 1 Disagree s t r o n g l y 2 Disagree 3 N e u t r a l 4 Agree 5 Agree s t r o n g l y 6 Agree very s t r o n g l y 7 CIRCLE ONE 10. There i s a good de a l of teamwork and cooperation between va r i o u s l e v e l s of n u r s i n g personnel on my s e r v i c e . 11. The only way that nursing personnel at t h i s hospital/agency w i l l ever get a decent pay schedule w i l l be to organize and, i f necessary, s t r i k e . 12. On my s e r v i c e , the superv i s o r s make a l l the de c i s i o n s , and I have l i t t l e d i r e c t c o n t r o l over my own work. 13. I am convinced that what I do on my job i s r e a l l y important. 14. I sometimes f e e l that I don't know who to answer to when I am at work. 15. The p h y s i c i a n s on my u n i t are g e n e r a l l y a v a i l a b l e when I need them f o r c o n s u l t -a t i o n . 16. Considering the high cost of h e a l t h care, every e f f o r t should be made to hold nursing personnel s a l a r i e s about where they are. 17. There i s too much c l e r i c a l and "paper work" re q u i r e d of nur s i n g personnel i n t h i s hospital/agency. 18. I am encouraged to accept r e s p o n s i -b i l i t y f o r making p a t i e n t - c a r e d e c i s i o n s . 0 1 2 3 4 5 6 7 0 1 2 3 4 5 6 7 0 1 2 3 4 5 6 7 0 1 2 3 4 5 6 7 0 1 2 3 4 5 6 7 0 1 2 3 4 5 6 7 0 1 2 3 4 5 6 7 0 1 2 3 4 5 6 7 0 1 2 3 4 5 6 7 75 Don't understand or Q Non-applicable Disagree very s t r o n g l y 1 Disagree s t r o n g l y 2 Disagree 3 N e u t r a l 4 Agree 5 Agree s t r o n g l y 6 Agree very s t r o n g l y 7 . CIRCLE ONE 19. I t s my general impressxon that n u r s i n g i s a r a t h e r low-status 0 1 2 3 4 5 6 7 p r o f e s s i o n . 20. I f e e l that I am supervised more c l o s e l y than I need to be. 0 1 2 3 4 5 6 7 21. I have p l e n t y of time and opportunity to discuss p a t i e n t care problems w i t h 0 1 2 3 4 5 6 other nursing s e r v i c e personnel. 22. There i s a great gap between the admini-s t r a t i o n of t h i s hospital/agency and the d a i l y problems of the nursing s e r v i c e . 26. My work i n t h i s hospital/agency makes me f e e l l i k e a worthwhile person. 27. The p h y s i c i a n s on my u n i t recognize my s p e c i a l knowledge s k i l l s . 28. I could d e l i v e r much b e t t e r care i f I had more time w i t h each p a t i e n t . 3 4 5 6 7 23. The nur s i n g personnel on my s e r v i c e are not as f r i e n d l y and outgoing .as I 0 1 2 3 4 5 6 7 would l i k e them to be. 24. There i s not enough sha r i n g of inform-a t i o n between doctors and nurses on my 0 1 2 3 4 5 6 7 u n i t . 25. Even i f I could make more money i n another n u r s i n g j o b , I would stay here 0 1 2 3 4 5 6 7 because of the working c o n d i t i o n s . 3 4 5 6 7 0 1 2 3 4 5 6 7 0 1 2 3 4 5 6 29. P h y s i c i a n s a t t h i s hospital/agency g e n e r a l l y understand and appreciate 0 1 2 3 4 5 6 7 what the nur s i n g s t a f f does. 76-Don't understand or ^ Non-applicable Disagree very s t r o n g l y 1 Disagree s t r o n g l y 2 Disagree 3 Ne u t r a l 4 Agree 5 Agree s t r o n g l y 6 Agree very s t r o n g l y 7 CIRCLE ONE 30. What I do on my job doesn't add up to 0 1 2 3 4 5 6 7 anything r e a l l y s i g n i f i c a n t . 31. The p h y s i c i a n s have unreasonable expectations of the nursing s t a f f i n 0 1 2 3 4 5 6 7 my work s i t u a t i o n . 32. An up-grading of pay schedules f o r nurs i n g personnel i s needed at t h i s 0 1 2 3 4 5 6 7 hospital/agency. 33. I don't spend as much time as I'd l i k e to t a k i n g care of p a t i e n t s d i r e c t l y . 0 1 2 3 4 5 6 7 34. My work s i t u a t i o n allows me the independ-ence I f e e l I need to care f o r my 0 1 2 3 4 5 6 7 p a t i e n t s . 35. My work r o u t i n e i s f l e x i b l e enough to al l o w me to spend as much time as I 0 1 2 3 4 5 6 7 need to w i t h each p a t i e n t . 36. Considering what i s expected of nursing s e r v i c e personnel, the pay we get i s 0 1 2 3 4 5 6 7 reasonable. 37. There i s enough support s t a f f to allow 0 1 2 3 4 5 6 7 me to delegate r o u t i n e t a s k s . 38. My present s a l a r y i s s a t i s f a c t o r y . 0 1 2 3 4 5 6 7 39. I'm g e n e r a l l y s a t i s f i e d w i t h the way nursing work i s organized and gets 0 1 2 3 4 5 6 7 done at t h i s hospital/agency. 40. From what I hear about other j o b s , the pay we get i s reasonable. 41. The nur s i n g personnel on my s e r v i c e don't o f t e n a c t l i k e "one b i g happy f a m i l y . " 0 1 2 3 4 5 6 7 0 1 2 3 4 5 6 7 77 Don't understand or Non- a p p l i c a t i o n Disagree very s t r o n g l y Disagree s t r o n g l y Disagree N e u t r a l Agree Agree s t r o n g l y Agree very s t r o n g l y 1 2 3 4 5 6 7 42. I am s a t i s f i e d w i t h the types of a c t i v i t i e s that I do on my job 43. There i s a l o t of "rank conscious-ness on my u n i t ; n ursing personnel seldom mingle w i t h others of lower ranks. CIRCLE ONE 0 1 2 3 4 5 6 7 0 1 2 3 4 5 6 7 44. I f e e l that I have enough a u t h o r i t y to c a r r y out the p a t i e n t - c a r e d e c i s i o n s I make. 45. I t makes me proud to t a l k to other people about what I do on my j o b . 46. The nur s i n g a d m i n i s t r a t o r s g e n e r a l l y c o n s u l t w i t h the s t a f f on d a i l y problems and procedures. 47. I have a l l the v o i c e i n planning p o l i c i e s and procedures f o r my work s e t t i n g that I need. 48. P h y s i c i a n s i n general don't cooperate w i t h the nursing s t a f f i n my work s i t u a t i o n . 0 1 2 3 4 5 6 7 0 1 2 3 4 5 6 7 0 1 2 3 4 5 6 7 0 1 2 3 4 5 6 7 0 1 2 3 4 5 6 7 49. There i s ample opportunity f o r nur s i n g s t a f f to p a r t i c i p a t e i n the a d m i n i s t r a t i v e decision-making process. 50. I enjoy working w i t h the doctors i n my work s i t u a t i o n . 0 1 2 3 4 5 6 7 0 1 2 3 4 5 6 7 51. I th i n k I could do a b e t t e r job i f I did n ' t have so much to do a l l the time. 0 1 2 3 4 5 6 7 52. Nursing personnel at t h i s hospital/agency do a l o t of b i c k e r i n g and b a c k - b i t i n g . 0 1 2 3 4 5 6 7 78 Don't u n d e r s t a n d o r Q N o n - a p p l i c a b l e D i s a g r e e v e r y s t r o n g l y 1 D i s a g r e e s t r o n g l y 2 D i s a g r e e 3 N e u t r a l 4 Agree 5 Agree s t r o n g l y 6 Agree v e r y s t r o n g l y 7 53. The p h y s i c i a n s I work w i t h expect n u r s e s to p l a y the "hand-maiden" r o l e . CIRCLE ONE 1 2 3 4 5 6 7 54. E x c l u d i n g m y s e l f , i t i s my i m p r e s s i o n t h a t a l o t o f n u r s i n g p e r s o n n e l a t t h i s h o s p i t a l agency a r e d i s s a t i s f i e d w i t h t h e i r pay. 55. I have the freedom i n my work to make imp o r t a n t d e c i s i o n s as I see f i t , and can count on my s u p e r v i s o r s to back me' up. 56. New employees a r e not q u i c k l y made to f e e l " a t home" i n my work s e t t i n g . 0 1 3 4 5 6 7 0 1 2 3 4 5 6 7 3 4 5 6 7 APPENDIX B APPENDIX B C o r r e l a t i o n s of Job S a t i s f a c t i o n Questionnaire Items* With Subscale T o t a l , Test T o t a l , and Global S a t i s f a c t i o n Rating Pay Component (Hoyt Estimate = 0.79) Subscale Test G l o b a l T o t a l T o t a l Rating 1. (5) The present r a t e of increase i n pay f o r n u r s i n g s e r v i c e personnel i s not s a t i s f a c t o r y 0.512** 0.190 0.001 2. (11) The only way that n u r s i n g personnel a t t h i s h o s p i t a l / agency w i l l ever get a decent pay schedule w i l l be to organize and, i f necessary, s t r i k e . 0.454 0.397 0.145 3. (16) Considering the high cost of h e a l t h care, every e f f o r t should be made to hold nursing personnel s a l a r i e s about where they are. 0.353 0.072 0.106 4. (32) An upgrading of pay schedules f o r n u rsing personnel i s needed 0.512 0.254 0.053 5. (36) Considering what i s expected of nursing s e r v i c e personnel, the pay we get i s reasonable. 0.585 0.375 0.144 6. (38) My present s a l a r y i s s a t i s -f a c t o r y . 0.587 0.585 0.375 7. (40) From what I hear about other j o b s , we i n nur s i n g are being f a i r l y p a i d . 0.523 0.416 0.133 8. (54) Excluding myself, i t i s my impression that a l o t of nurs i n g s e r v i c e personnel at t h i s hospital/agency are d i s s a t i s f i e d w i t h t h e i r pay. 0.472 0.375 0.197 The items are arranged by component; the numbers i n parentheses i n d i c a t e the order of the item on the q u e s t i o n n a i r e . ** An r of 0.161 or more w i t h N=150 leads to r e j e c t i o n of Ho: p=0 a t * =.05 (Hopkins and Glass 1978, p.409). 80-81. P r o f e s s i o n a l Status Component (Hoyt Estimate = 0.74) Subscale Test Glob a l T o t a l T o t a l Rating 1. (6) My p a r t i c u l a r job doesn't r e q u i r e much s k i l l or "know-how." 0.109 -0.000 0.011 2. (13) I am convinced that what I do on my job i s r e a l l y important. 0.487 0.309 0.186 3. (19) I t ' s my general impression that nursing i s a r a t h e r low-status p r o f e s s i o n . 0.400 0.414 0.164 4. (25) Even i f I could make more money i n another nursing j o b , I would stay here because of the working c o n d i t i o n s . 0.396 0.527 0.460 5. (26) My work at t h i s hospital/agency makes me f e e l l i k e a worthwhile person. 0.568 0.599 0.465 6. (3) What I do on my job doesn't add up to anything r e a l l y s i g n i f i c a n t . 0.495 0.394 0.295 7. (12) I am s a t i s f i e d w i t h the types of a c t i v i t i e s that I do on my job . 0.494 0.504 0.443 8. (45) I t makes me proud to t a l k to other people about what I do on my job . 0.601 0.442 0.335 82; A d m i n i s t r a t i o n Component (Hoyt Estimate =0.78) Subscale T o t a l Test T o t a l Global Rating 1. (7) There are p l e n t y of o p p o r t u n i t i e s f o r advance-ment of nursing personnel at t h i s hospital/agency. 0.236 2. (8) A d m i n i s t r a t i v e d e c i s i o n s a t t h i s hospital/agency i n t e r f e r e too much w i t h , p a t i e n t care. 0.294 3. (9) I t ' s my general impression that most of the nursing s t a f f at t h i s hospital/agency r e a l l y l i k e the way the work i s organized and done. 0.593 4. (22) There i s a great gap between the a d m i n i s t r a t i o n of t h i s hospital/agency and the d a i l y problems of the nursing s e r v i c e . 0.605 5. (39) I'm g e n e r a l l y s a t i s f i e d w i t h the way nursing work i s organized and gets done at t h i s hospital/agency. 0.600 6. (46) The nur s i n g a d m i n i s t r a t o r s g e n e r a l l y c onsult w i t h the s t a f f on d a i l y problems and procedures. 0.530 7. (47) I have a l l the v o i c e i n p l a n -ning p o l i c i e s and procedures f o r my work s e t t i n g that I want. 0.507 8. (49) There i s ample opportunity f o r n u r s i n g s t a f f to p a r t i c i -pate i n the a d m i n i s t r a t i v e decision-making process. 0.577 0.354 0.390 0.544 0.557 0.586 0.533 0.430 0.239 0.292 0.414 0.278 0.414 0.207 0.275. 0.465 0.204 83 Doctor-Nurse Relationship Component (Hoyt Estimate =0.82) 1. (15) The physicians on my unit are generally a v a i l a b l e when I need them f o r consult-a t i o n . Subscale Total 0.470 Test Total 0.279 Global Rating 0.066 2. (24) There i s not enough sharing of information between doctors and nurses on my un i t . 0.537 3. (27) The physicians on my unit recognize my s p e c i a l know-ledge and s k i l l s . 0.667 4. (29) Physicians at t h i s h o s p i t a l / agency generally understand and appreciate what the nursing s t a f f does. 0.694 5. (31) The physicians have unreason-able expectations of the nursing s t a f f i n my work s i t u a t i o n 0.411 6. (48) Physicians i n general don't cooperate with the nursing s t a f f i n my work s i t u a t i o n . 0.668 7. (50) I enjoy working with the doctors i n my work s i t u a t i o n . 0.701 8. (53) The physicians I work with expect nurses to play the "hand-maiden" r o l e . 0.364 0.412 0.438 0.415 0.303 0.404 0.406 0.453 0.175 0.157 0.122 0.082 -0.-003 0.110 0.229 84' Autonomy Component (Hoyt Estimate = 0.68) Subscale T o t a l Test T o t a l G l o b a l Rating 1. (4) I am sometimes required to make d e c i s i o n s on my job that are not part of my r e s p o n s i -b i l i t y . 0.120 0.108 0.029 2. (12) On my s e r v i c e , my supervisors make a l l the d e c i s i o n s , and I have l i t t l e d i r e c t c o n t r o l over my own work. 0.408 0.305 0.137 3. (14) I sometimes f e e l that I don't know who to answer to when I am at work. 0.408 0.353 0.228 4. (18) I am encouraged to accept r e s p o n s i b i l i t y f o r making p a t i e n t - c a r e d e c i s i o n s . 0.538 0.464 0.174 5. (20) I f e e l that I am supervised more c l o s e l y than I need to be. 0.237 0.352 0.093 6. (34) My work s i t u a t i o n allows me the independence I f e e l I need to care f o r my p a t i e n t s . 0.313 0.517 0.303 7. (44) I f e e l that I have enough a u t h o r i t y to ca r r y out the p a t i e n t - c a r e d e c i s i o n s I make. 0.468 0.420 0.242 8. (55) I have the freedom i n my work to make important d e c i s i o n s as I see f i t , and can count on my supervisors to back me up. 0.545 0.514 0.272 •"85 -Task Requirements (Hoyt Estimate = 0.70) Subscale T o t a l Test T o t a l G l o b a l Rating 1. (2) The amount of time I must spend on t r i v i a l a d m i n i s t r a t i o n d u t i e s i s q u i t e reasonable. 0.235 2. (17) There i s too much "paper work" required of the nurses i n t h i s h o s p i t a l / agencies. 0.264 3. (21) I have p l e n t y of time and opportunity to discus s p a t i e n t care problems w i t h other n u r s i n g s e r v i c e personnel. 0.441 4. (28) I could d e l i v e r much b e t t e r care i f I had more time w i t h each p a t i e n t . 0.511 5. (33) I don't spend as much time as I'd l i k e to t a k i n g care of p a t i e n t s d i r e c t l y . 0.582 6. (35) My work r o u t i n e i s f l e x i b l e enough to al l o w me to spend as much time as I need to w i t h each p a t i e n t . 0.548 7. (37) There i s enough support s t a f f to allow me to delegate r o u t i n e t a s k s . 0.225 8. (51) I th i n k I could do a b e t t e r job i f I didn't have so much to do a l l the time. 0.391 0.360 0.337 0.506 0.379 0.454 0.483 0.330 0.244 0.239 0.180 0.224 0.141 0.173 0.247 0.159 0.047 36 I n t e r a c t i o n Component (Hoyt Estimate = 0.75) Subscale T o t a l Test T o t a l G l o b a l Rating 1. (1) The nur s i n g personnel on my s e r v i c e don't h e s i t a t e to p i t c h i n and help one another out when things get i n a rush. 0.520 2. (3) The people I work w i t h are f r i e n d l y and supportive. 0.670 3. (10) There i s a good d e a l of teamwork and cooperation between various l e v e l s of nursing personnel on my s e r v i c e . 0.468 4. (23) The nursing personnel on my s e r v i c e are not as f r i e n d -l y and outgoing as I would l i k e them to be. 0.584 5. (41) The nursing personnel on my s e r v i c e don't o f t e n act l i k e "one b i g happy f a m i l y . " 0.519 6. (43) There i s a l o t of "rank consciousness" on my u n i t ; n ursing personnel seldom mingle w i t h others of lower ranks. 0.196 7. (52) Nursing personnel at t h i s hospital/agency do a l o t of b i c k e r i n g and b a c k b i t i n g . 0.495 8. (56) New employees are not q u i c k l y made to f e e l " a t home" i n my work s e t t i n g . 0.278 0.378 0.419 0.513 0.383 0.356 0.216 0.483 0.209 0.274 0.231 0.361 0.170 0.180 0.076 0.227 0.175. 

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