Abstract
BackgroundThis study explored the psychometric properties and dimensionality of the Stress of Conscience Questionnaire (SCQ) in a sample of health professionals from a tertiary-level Australian hospital. The SCQ, a measure of stress of conscience, is a recently developed nine-item instrument for assessing frequently encountered stressful situations in health care, and the degree to which they trouble the conscience of health professionals. This is relevant because stress of conscience has been associated with negative experiences such as job strain and/or burnout. The validity of SCQ has not been explored beyond Scandinavian contexts.MethodsA cross-sectional study of 253 health professionals was undertaken in 2015. The analysis involved estimates of reliability, variability and dimensionality. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to explore dimensionality and theoretical model fit respectively.ResultsCronbach’s alpha of 0.84 showed internal consistency reliability. All individual items of the SCQ (N = 9) met the cut-off criteria for item-total correlations (> 0.3) indicating acceptable homogeneity. Adequate variability was confirmed for most of the items, with some items indicating floor or ceiling effects. EFA retained a single latent factor with adequate factor loadings for a unidimensional structure. When the two‐factor model was compared to the one‐factor model, the latter achieved better goodness of fit supporting a one-factor model for the SCQ.ConclusionThe SCQ, as a unidimensional measure of stress of conscience, achieved adequate reliability and variability in this study. Due to unidimensionality of the tool, summation of a total score can be a meaningful way forward to summarise and communicate results from future studies, enabling international comparisons. However, further exploration of the questionnaire in other cultures and clinical settings is recommended to explore the stability of the latent one-factor structure.
Highlights
This study explored the psychometric properties and dimensionality of the Stress of Conscience Questionnaire (SCQ) in a sample of health professionals from a tertiary-level Australian hospital
Glasberg et al [3] found that health professionals, reflecting on these stressful situations, often described punitive feelings of guilt, embarrassment and/or shame accompanying an experience of a troubled conscience
The SCQ is composed of nine two-part items (Part A and Part B) measuring commonly occurring stressful situations present in their clinical setting and the extent these situations are perceived as leading to a troubled conscience [22]
Summary
This study explored the psychometric properties and dimensionality of the Stress of Conscience Questionnaire (SCQ) in a sample of health professionals from a tertiary-level Australian hospital. The SCQ, a measure of stress of conscience, is a recently developed nine-item instrument for assessing frequently encountered stressful situations in health care, and the degree to which they trouble the conscience of health professionals. Jokwiro et al BMC Psychol (2020) 8:109 settings include perceived demanding workload, lack of support from leadership/management and staff conflict [3, 4] In such situations, health professionals perceived a gap between the reality of practice and their ideal practice, between structural demands and their own aspirations to provide the quality care they feel the person in need of care deserves [3,4,5,6]. Glasberg et al [3] coined the term ‘stress of conscience’, to highlight and explore this existential dimension of workplace stress for health professionals
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