Psychometric evaluation of instruments measuring the work environment of healthcare professionals in hospitals: a systematic literature review.

PURPOSE: Research shows that the professional healthcare working environment influences the quality of care, safety climate, productivity, and motivation, happiness, and health of staff. The purpose of this systematic literature review was to assess instruments that provide valid, reliable and succinct measures of health care professionals' work environment (WE) in hospitals. DATA SOURCES: Embase, Medline Ovid, Web of Science, Cochrane CENTRAL, CINAHL EBSCOhost and Google Scholar were systematically searched from inception through December 2018. STUDY SELECTION: Pre-defined eligibility criteria (written in English, original work-environment instrument for healthcare professionals and not a translation, describing psychometric properties as construct validity and reliability) were used to detect studies describing instruments developed to measure the working environment. DATA EXTRACTION: After screening 6397 titles and abstracts, we included 37 papers. Two reviewers independently assessed the 37 instruments on content and psychometric quality following the COSMIN guideline. RESULTS OF DATA SYNTHESIS: Our paper analysis revealed a diversity of items measured. The items were mapped into 48 elements on aspects of the healthcare professional's WE. Quality assessment also revealed a wide range of methodological flaws in all studies. CONCLUSIONS: We found a large variety of instruments that measure the professional healthcare environment. Analysis uncovered content diversity and diverse methodological flaws in available instruments. Two succinct, interprofessional instruments scored best on psychometrical quality and are promising for the measurement of the working environment in hospitals. However, further psychometric validation and an evaluation of their content is recommended.

Factors influencing nurse participation in continuing professional development activities: Survey results from the Netherlands.

BACKGROUND: Professionals are individually responsible for planning and carrying out continuing professional development (CPD) activities, ensuring their relevance to current practice and career development. The key factors that encourage nurses to undertake CPD activities are not yet clear. Several studies have investigated motives of nurses to participate in CPD programmes ("Motives"), the importance they attach to CPD ("Importance"), the conditions they consider necessary for participation ("Conditions"), and their actual participation in CPD activities ("Pursued"). The relationships among these variables, however, have neither been investigated nor reported to date. OBJECTIVES: The aim of this study is to investigate the nature of the relationships among those factors that influence nurse participation in CPD in the Netherlands. DESIGN: An exploratory cross-sectional study was carried out using quantitative data collected with the previously validated Questionnaire Professional Development of Nurses (Q-PDN). SETTINGS AND PARTICIPANTS: A convenience sample of 5500 registered nurses working at one Dutch university hospital and several general hospitals was addressed. METHODS: A descriptive study using a survey was undertaken. The questionnaire was completed and returned by 1226 nurses. Correlation analyses were conducted to determine which factors were related to nurses undertaking CPD activities. Structural equation modelling was deployed to determine the relationships among the variables. RESULTS: "Conditions" was found to be moderately related to "Motives", which itself was strongly related to "Importance", which itself was very strongly related to "CPD activities pursued". If nurses considered a CPD activity important they were highly likely to pursue it; however, the importance attached to specific CPD activities was influenced by the presence of particular motives, which depended in part on the way CPD conditions were perceived. CONCLUSIONS: The key factor influencing CPD participation of nurses is how important they deem particular CPD activities; the latter is a function of their CPD motives and of their perceptions that the right conditions for participation are in place. Implications are discussed.

The development and empirical validation of the Q-PDN: a questionnaire measuring continuing professional development of nurses.

BACKGROUND: Although separate studies among nurses have been conducted into their continuing professional development (CPD) motives, importance attached to CPD, conditions deemed needed for CPD, and actual CPD activities undertaken, these variables have not yet been investigated at the same time, on the same sample. OBJECTIVES: The aim of this study is to report on the development and initial psychometric testing of the Q-PDN, a questionnaire measuring several aspects of CPD among nurses. METHOD: Based on a survey administered to 1329 nurses in hospitals in the Netherlands, a multi-dimensional instrument for CPD was validated. The constructs 'CPD motives', 'CPD importance', 'CPD conditions', and 'CPD activities undertaken' were established through factor analyses. RESULTS: Reliability analyses showed satisfactory to good Cronbach's alpha scores on all factors, ranging from .70 to .89. CONCLUSION: Using this instrument can stimulate and support CPD of nurses, which has been shown to contribute to increasing the quality of care. Human resource development (HRD) professionals, educators in healthcare, and managers can use this questionnaire to gain insight in the extent to which nurses undertake CPD activities, in the importance they attribute to CPD activities, in the conditions they deem necessary to participate in CPD, and in the motives that they have to engage in CPD.