Abstract

BackgroundMany quality-of-life studies have been conducted in healthcare settings, but few have used Microsoft Excel to incorporate Cronbach’s α with dimension coefficient (DC) for describing a scale’s characteristics. To present a computer module that can report a scale’s validity, we manipulated datasets to verify a DC that can be used as a factor retention criterion for demonstrating its usefulness in a patient safety culture survey (PSC).MethodsMicrosoft Excel Visual Basic for Applications was used to design a computer module for simulating 2000 datasets fitting the Rasch rating scale model. The datasets consisted of (i) five dual correlation coefficients (correl. = 0.3, 0.5, 0.7, 0.9, and 1.0) on two latent traits (i.e., true scores) following a normal distribution and responses to their respective 1/3 and 2/3 items in length; (ii) 20 scenarios of item lengths from 5 to 100; and (iii) 20 sample sizes from 50 to 1000. Each item containing 5-point polytomous responses was uniformly distributed in difficulty across a ± 2 logit range. Three methods (i.e., dimension interrelation ≥0.7, Horn’s parallel analysis (PA) 95% confidence interval, and individual random eigenvalues) were used for determining one factor to retain. DC refers to the binary classification (1 as one factor and 0 as many factors) used for examining accuracy with the indicators sensitivity, specificity, and area under receiver operating characteristic curve (AUC). The scale’s reliability and DC were simultaneously calculated for each simulative dataset. PSC real data were demonstrated with DC to interpret reports of the unit-based construct validity using the author-made MS Excel module.ResultsThe DC method presented accurate sensitivity (=0.96), specificity (=0.92) with a DC criterion (≥0.70), and AUC (=0.98) that were higher than those of the two PA methods. PA combined with DC yielded good sensitivity (=0.96), specificity (=1.0) with a DC criterion (≥0.70), and AUC (=0.99).ConclusionsAdvances in computer technology may enable healthcare users familiar with MS Excel to apply DC as a factor retention criterion for determining a scale’s unidimensionality and evaluating a scale’s quality.

Highlights

  • Many quality-of-life studies have been conducted in healthcare settings, but few have used Microsoft Excel to incorporate Cronbach’s α with dimension coefficient (DC) for describing a scale’s characteristics

  • In healthcare, the degree of patient harm was first publicized in the 1990s [1]

  • The criterion at 0.70, which represented an acceptable quality of scale, was improbable

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Summary

Introduction

Many quality-of-life studies have been conducted in healthcare settings, but few have used Microsoft Excel to incorporate Cronbach’s α with dimension coefficient (DC) for describing a scale’s characteristics. To present a computer module that can report a scale’s validity, we manipulated datasets to verify a DC that can be used as a factor retention criterion for demonstrating its usefulness in a patient safety culture survey (PSC). After the book To err is human: building a safer health system [2] was released, 474 papers were published on Medline using the keyword of patient safety culture (PSC) to search as of June 3, 2017. Many studies [6,7,8] have used the Safety Attitudes Questionnaire [9] as a tool to verify PSC reliability and validity [6, 10]. The comparison in practice is commonly made between departments in a hospital. Few studies examine the reliability and validity of PSC on a department-unit base. The first research question is how to examine unit-based construct validity

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