Background
1. Standardized assessments of health status
2. CAT reduces the burden on patients and diagnosticians
3. Item-by-item questionnaire analyses
4. Study Objectives
Methods
1. Study participants and research instrument
2. Instrument selection
(1) Questionnaire
(2) Rasch analysis
(3) Unidimensionality
3. Web-CAT assessment
4. Generation of person responses across items
Results
1. Descriptive Statistics
Year | 2008(n = 297) | 2009(n = 291) | Prob.a
| ||
---|---|---|---|---|---|
Sample | N | (%) | N | (%) | |
Gender
| |||||
Female
| 236 | 79.46% | 228 | 78.35% | 0.819 |
Male
| 61 | 20.54% | 63 | 22.65% | |
Job title
| |||||
Administrator
| 45 | 15.15% | 51 | 15.84% | 0.597 |
Nurse
| 137 | 46.13% | 144 | 44.72% | |
Physician
| 37 | 12.46% | 47 | 14.60% | |
Technician
| 78 | 26.26% | 87 | 27.02% | |
Average age (yrs)
| |||||
18~25
| 31 | 10.44% | 29 | 9.96% | 0.299 |
26~35
| 155 | 52.19% | 150 | 51.50% | |
36~45
| 85 | 28.62% | 80 | 27.40% | |
46~55
| 20 | 6.73% | 29 | 9.96% | |
≧ 56
| 6 | 2.02% | 2 | 0.68% | |
Work tenure
| |||||
< 1 yr
| 14 | 4.71% | 15 | 5.15% | 0.283 |
1-3
| 64 | 21.55% | 56 | 19.20% | |
4-7
| 61 | 20.54% | 81 | 27.80% | |
8-14
| 104 | 35.02% | 86 | 29.50% | |
≧ 15
| 54 | 18.18% | 52 | 17.80% | |
Tenure: Mean(SD) | 8.84(6.51) | 8.38(6.43) | |||
Age: Mean(SD) | 34.22(7.73) | 34.23(7.83) |
2. Unidimensional validity and the identification of concerns
1-4 scale hospital-based employee satisfaction questionnaire | Item | MNSQ | |||
---|---|---|---|---|---|
No. | with possible responses of worse, bad, good and excellent ... | Difficulty | SE | Infit | Outfit |
1 | Working environment and necessary equipment are | misfit | |||
2 | Feelings regarding the office and staff lounge are | misfit | |||
3 | Parking lots and vehicular traffic indications are | misfit | |||
4 | Meals provided to employees by hospital are | misfit | |||
5 | Hospital's disaster prevention ability is | misfit | |||
6 | Overall feeling of the current work environment is | misfit | |||
7 | Hospital benefits and salary provided to employees are | misfit | |||
8 | Salary and wage levels compared with other hospitals are | 0.47 | 0.17 | 1.12 | 1.14 |
9 | The performance appraisal system is open, fair and reasonable | misfit | |||
10 | My objective is closely consistent with hospital goals | 0.5 | 0.17 | 1.15 | 1.09 |
11 | The hospital message delivery design works well for workers | 2.73 | 0.13 | 1.12 | 0.97 |
12 | The Plan-Do-Check-Action and review measures are | -0.96 | 0.18 | 1.03 | 1.03 |
13 | The hospital work environment compared to others is | 0.02 | 0.18 | 0.68 | 0.44 |
14 | Colleagues can cooperate with each other to achieve goals | 1.18 | 0.16 | 0.93 | 0.95 |
15 | Interpersonal relationships with colleagues are harmonious | 1.75 | 0.14 | 0.9 | 1 |
16 | My boss can give clear instructions to designate tasks | 1.03 | 0.16 | 0.93 | 0.91 |
17 | My boss often makes appropriate decisions | -0.46 | 0.18 | 1.08 | 1.13 |
18 | My boss fully shoulders and assumes accountability | -0.11 | 0.18 | 1.11 | 1.22 |
19 | Communication and interaction with my boss is | -0.37 | 0.18 | 0.71 | 0.56 |
20 | Overall, my boss performance can be scored as | -0.87 | 0.18 | 0.95 | 0.91 |
21 | Opportunities to exchange and share experiences with colleagues are | misfit | |||
22 | Opportunities to cooperate and communicate with other departments are | misfit | |||
23 | I often work together with colleagues to achieve objectives | -1.03 | 0.17 | 1.11 | 1.16 |
24 | Harmonious relations with members of other departments are | -0.46 | 0.18 | 0.86 | 0.83 |
25 | Opportunities to interact with members of other departments are | -0.49 | 0.18 | 1.05 | 0.97 |
26 | I can fully extend my professional competence and talent | -0.65 | 0.18 | 0.82 | 0.78 |
27 | Many learning and growth opportunities are available for me | -0.59 | 0.18 | 0.97 | 0.96 |
28 | My job is challenging | -0.24 | 0.18 | 0.85 | 0.84 |
29 | My job provides a sense of identity and accomplishment | 0.17 | 0.18 | 1.25 | 1.4 |
30 | My hospital provides necessary on-the-job training courses | 0.23 | 0.17 | 1.09 | 1.05 |
31 | Workload and working hours are well allocated | -0.14 | 0.18 | 0.99 | 1.01 |
32 | I can engage in my work, career planning and future vision | -0.52 | 0.18 | 0.95 | 1 |
33 | I am always able to maintain a happy mood at work | -0.68 | 0.18 | 1.08 | 1.04 |
34 | My job burdens do not interfere with my family life | -0.49 | 0.18 | 0.94 | 0.86 |
35 | I can afford my living expenses with income from my job | misfit | |||
36 | This satisfaction survey can be expected to improve the workplace | misfit | |||
37 | I would recommend the hospital if my relatives needed treatment | misfit |
3. Web-CAT performance
Step | Item difficulty | Prob. | Your response | Expected score | Estimated ability | Standard error | Outfit MNSQ |
---|---|---|---|---|---|---|---|
1 | 0.50 | 0.17 | 0 | 0.80 | 0.50 | - | - |
2 | 1.75 | 0.06 | 0 | 0.32 | 0.50 | - | - |
3 | -0.46 | 0.35 | 1 | 1.57 | 0.50 | - | - |
4 | 2.73 | 0.02 | 2* | 0.26 | 0.50 | 0.73 | 2.12 |
5 | -1.03 | 0.49 | 0* | 1.84 | -5.48 | 0.65 | 1.71 |
6 | 1.18 | 0.09 | 1 | 0.44 | -1.55 | 0.62 | 2.88 |
7 | 1.03 | 0.11 | 1 | 0.49 | -0.33 | 0.57 | 2.25 |
8 | -0.96 | 0.47 | 2 | 1.82 | 0.35 | 0.54 | 2.73 |
9 | -0.87 | 0.45 | 2 | 1.79 | 0.41 | 0.51 | 2.33 |
10 | -0.68 | 0.40 | 2 | 1.70 | -1.08 | 0.48 | 1.82 |
4. Item difference between years
Demographic | Difference | 95% CI | Test t
| |||
---|---|---|---|---|---|---|
Variable | Mean | SE | Upper | Lower |
t-value | Sig. (2-tailed) |
Year | 0.82 | 0.04 | 0.74 | 0.91 | 19.72 | <.0001 |
Gender | ||||||
Male | 0.76 | 0.10 | 0.00 | 0.76 | 7.74 | <.0001 |
Female | 0.84 | 0.05 | 0.75 | 0.93 | 18.33 | <.0001 |
Job title | ||||||
Administrator | 0.85 | 0.09 | 0.67 | 1.03 | 9.40 | <.0001 |
Nurse | 0.82 | 0.06 | 0.70 | 0.94 | 13.51 | <.0001 |
Physician | 0.96 | 0.09 | 0.79 | 1.13 | 11.18 | <.0001 |
Technician | 0.72 | 0.12 | 0.48 | 0.96 | 6.02 | <.0001 |
Average age (yrs) | ||||||
18~25 | 0.90 | 0.13 | 0.63 | 1.16 | 6.73 | <.0001 |
26~35 | 0.81 | 0.05 | 0.70 | 0.91 | 14.83 | <.0001 |
36~45 | 0.78 | 0.08 | 0.61 | 0.94 | 9.29 | <.0001 |
46~55 | 0.93 | 0.15 | 0.63 | 1.23 | 6.27 | <.0001 |
≧ 56 | 1.50 | 0.50 | -0.65 | 3.65 | 3.00 | 0.095 |
Work tenure | ||||||
< 1 yr | 0.93 | 0.18 | 0.57 | 1.30 | 5.24 | <.0001 |
1-3 | 0.80 | 0.10 | 0.61 | 0.99 | 8.44 | <.0001 |
4-7 | 0.70 | 0.08 | 0.55 | 0.85 | 9.26 | <.0001 |
8-14 | 0.86 | 0.08 | 0.70 | 1.02 | 10.44 | <.0001 |
≧ 15 | 0.94 | 0.09 | 0.77 | 1.12 | 10.65 | <.0001 |