The structure of the legitimacy of health care institutions. The Polish adaptation of the Legitimacy Questionnaire and its psychometric properties

Abstract

Aim: The aim of the empirical research was (a) to identify the structure of institutional legitimacy in the health service and (b) to develop a Polish version of the Legitimacy Questionnaire (LQ) and determine its psychometric properties, especially validity and reliability. Method: To achieve the aim, based on data from two independent measurements, the author performed factor analyses: exploratory (nEFA = 210, 134 women and 76 men, MAGE = 42.37) and confirmatory (nCFA = 298, 184 women and 114 men, MAGE = 37.02). Factor analyses were used to assess validity. Multidimensional reliability estimation was also performed, using several coefficients: classic (Cronbach’s α, Jöreskog’s CR) and non-classic ones (Aranowska’s γ, ϱ2 intraclass correlation coefficient). Results: The adopted data analysis strategy yielded a three-factor structure of institutional legitimacy. The results of analyses provided strong evidence of acceptable goodness of measurement using the Polish version of the LQ. Reliability, just like construct validity, were confirmed, their levels were acceptable. Conclusions: The results indicate that the adapted LQ is a psychometrically valuable measure operationalizing three dimensions of legitimacy: normative alignment, duty to obey, and institutional trust.