Application of item response theory to achieve cross-cultural comparability of occupational stress measurement

Measuring digital transformation stress at the workplace-Development and validation of the digital transformation stress scale

Despite the unquestionable advantages of digital transformation (DT) in organizations, the very process of DT could have an impact on the level of stress of the employees. The negative effects of the digital transformation process can be observed during the implementation of information and communication technologies (ICT) solutions. They are further enhanced by the effects of COVID-19 pandemic, as digital transformation has accelerated to allow for remote work. Herein we distinguish between general stress at the workplace and the very specific type of stress, namely digital transformation stress (DTS). We assumed that this type of stress appears when rapid implementation of ICT solutions is introduced with time pressure and incertitude of further results. To quantify this phenomenon, we developed a new self-report scale-the Digital Transformation Stress Scale (DTSS), measuring employees' stress stemming from the process of digital transformation in organizations. The psychometric validity of the scale was evaluated in two studies: Study1 conducted at the beginning of COVID-19 pandemic in 2020 (N = 229) and Study 2 in 2021 (N = 558), after a year of mostly remote work. The results confirmed good reliability with Cronbach's Alpha α = .91 in Study 1 and α = .90 in Study 2 and assumed unidimensional factorial validity of the scale in both studies. All items of the scale had good difficulty and discrimination values evaluated in Item Response Theory, i.e., IRT approach. The scale showed predicted convergent validity as the indicator of the digital transformation stress moderately correlated with general stress at work. Moreover, the assumption that even employees with high ICT skills could be affected by DTS was confirmed. Additionally, the results indicated that digital transformation stress was significantly higher among employees who reported both issues: ongoing digital solutions projects at the workplace and high impact of COVID-19 pandemic on their work. The scale could be used in future work on measuring and counteracting digital transformation stress at the workplace.

Variations in Salivary Stress Biomarkers and Their Relationship with Anxiety, Self-Efficacy and Sleeping Quality in Emergency Health Care Professionals

Hospital healthcare workers of emergency departments (EDs) face a variety of occupational stressors on a daily basis. We have recently published that emergency professionals display increased salivary levels of α-amylase and dehydroepiandrosterone during the working day. The pattern of these markers may suggest a counteracting mechanism of dehydroepiandrosterone against the stress reflected by amylase increases. In order to verify this hypothesis, we have analysed different psychological aspects in the same group of healthcare professionals through different tests related to behaviours resulting from stress. These include the state-trait anxiety inventory, the self-efficacy test and the sleeping quality questionnaire. The tests were provided at the beginning of the working day and collected at the end. STAI scores (trait and state) were indicative of no anxiety. Self-efficacy scores were considered optimal, as well as those from the sleeping quality questionnaire. This is supported by the modest correlation between STAI scores and salivary levels of α-amylase and dehydroepiandrosterone. In conclusion, the emergency professionals of the studied hospitals seem to have adequate work management. Altogether it means that the stress generated during work performance is controlled, allowing a correct adaptation to the demanding situations undergone in emergency departments.

An Item Response Theory to Analyze the Psychological Impacts of Rail-Transport Delay

Questionnaire instruments have been used extensively by researchers in the literature review for evaluation of various aspects of public transportation. Important implications have been derived from those instruments to improve various aspects of the transport. However, it is important that instruments, which are designed to measure various stimuli, meet criteria of reliability to reflect a real impact of the stressors. Particularly, given the diverse range of commuter characteristics considered in this study, it is necessary to ensure that instruments are reliable and accurate. This can be achieved by finding the relationship between the item’s properties and the underlying unobserved trait, being measured. The item response theory (IRT) refers to measurement of an instrument’s reliability by examining the relationship between the unobserved trait and various observed items. In this study, to determine if our instrument suffers from any potentially associated problems, the IRT analysis was conducted. The analysis was employed based on the graded response model (GRM) due to the ordinal nature of the data. Various aspects of the instruments, such as discriminability and informativity of the items were tested. For instance, it was found while the classical test theory (CTT) confirm the reliability of the instrument, IRT highlight some concerns regarding the instrument. Also, the person fit assessment measure, for instance, highlights some concern regarding respondents answering some of the questions due to lack of interest, choosing answers randomly. Not many studies have examined instruments’ reliability in determining the psychological impacts of public transportation on commuters in the way that was performed here.

International survey for assessing COVID-19's impact on fear and health: study protocol

INTRODUCTION

COVID-19, caused by the SARS-CoV-2, has been one of the most highly contagious and rapidly spreading virus outbreak. The pandemic not only has catastrophic impacts on physical health and economy around the world, but also the psychological well-being of individuals, communities and society. The psychological and social impacts of the COVID-19 pandemic internationally have not been well described. There is a lack of international study assessing health-related impacts of the COVID-19 pandemic, especially on the degree to which individuals are fearful of the pandemic. Therefore, this study aims to (1) assess the health-related impact of the COVID-19 pandemic in community-dwelling individuals around the world; (2) determine the extent various communities are fearful of COVID-19 and (3) identify perceived needs of the population to prepare for potential future pandemics.

METHODS AND ANALYSIS

This global study involves 30 countries. For each country, we target at least 500 subjects aged 18 years or above. The questionnaires will be available online and in local languages. The questionnaires include assessment of the health impacts of COVID-19, perceived importance of future preparation for the pandemic, fear, lifestyles, sociodemographics, COVID-19-related knowledge, e-health literacy, out-of-control scale and the Patient Health Questionnaire-4. Descriptive statistics will be used to describe participants' characteristics, perceptions on the health-related impacts of COVID-19, fear, anxiety and depression, lifestyles, COVID-19 knowledge, e-health literacy and other measures. Univariable and multivariable regression models will be used to assess the associations of covariates on the outcomes.

ETHICS AND DISSEMINATION

The study has been reviewed and approved by the local ethics committees in participating countries, where local ethics approval is needed. The results will be actively disseminated. This study aims to map an international perspective and comparison for future preparation in a pandemic.

Differential Item Functioning by HIV Status and Sexual Orientation of the Center for Epidemiological Studies-Depression Scale: An Item Response Theory Analysis

The Center for Epidemiological Studies-Depression Scale (CES-D) is the most widely used instrument to assess depressive symptoms in people living with HIV. However, its differential item functioning (DIF) by HIV status and sexual orientation has yet to be explored. This study examined DIF and measurement invariance of the CES-D using an item response theory (IRT) framework, and a more traditional factor analytic approach. Data from 841 HIV-infected and HIV-uninfected individuals, from Miami, Florida, were analyzed. Uniform DIF by HIV status was detected in Items 4, 12, and 16 from the Positive Affect factor. Nonuniform DIF was detected in Items 13 and 17. Uniform DIF by sexual orientation was detected in Items 2, 15, and 19, two of them from the Interpersonal factor. Nonuniform DIF was detected in Item 2. Using a factor analytic approach, the CES-D was invariant at the configural and metric levels by HIV and sexual orientation. These findings indicate that overall, however, using IRT, the magnitudes of DIF were negligible, the CED-D was somewhat invariant using factor analytic methods; the CES-D may be reliably used to compare by HIV status or sexual orientation.

Nurse practitioner primary care organizational climate questionnaire: Item response theory and differential item functioning

AIMS AND OBJECTIVES

To validate Nurse Practitioner Primary Care Organizational Climate Questionnaire (NP-PCOCQ) items using item response theory (IRT) models and conduct differential item functioning (DIF) analysis to test the item functioning among nurse practitioners (NPs) practicing in different U.S. states with variable regulations governing NP practice.

BACKGROUND

Nurse Practitioner Primary Care Organizational Climate Questionnaire is the only NP-specific tool measuring NP work environment and is being used in different U.S. states with variable NP scope of practice regulations and internationally to produce evidence about NP work environments within their organisations.

DESIGN

Cross-sectional survey design was used to collect data from 278 primary care NPs in New York (NY) and 314 NPs in Massachusetts (MA).

METHODS

NPs completed the 29-item NP-PCOCQ. Data collection involved an online survey in NY and a mail survey in MA in 2012. We used Samejima's graded response model for IRT and ordinal logistic regression for DIF analysis. A STROBE checklist was completed.

RESULTS

IRT models yielded discrimination parameters ranging from 0.98-4.65 in NY and 1.25-6.94 in MA. Item difficulty parameters were within -3 to +3 range, suggesting a fair range of item difficulties exist in the scale. Only five of the 29 items on NP-PCOCQ exhibited DIF, suggesting some other state-related factor besides the measured construct influenced item responses; thus, the items were removed.

CONCLUSION

Our findings indicate that a shortened, 24-item NP-PCOCQ is capable of measuring organisational climate of NPs practicing in different U.S. states. NP-PCOCQ can be used in future research to measure NP work environment.

RELEVANCE TO CLINICAL PRACTICE

The tool can also be used by practice administrators to assess NP work environment and identify deficiencies to address them. This evidence about NP work environment can be used by practice administrators to promote favourable work environments for NPs to deliver high-quality care.

The Factorial Structure and Psychometric Properties of the Persian Effort-Reward Imbalance Questionnaire

Background

With global changes in the current state of work and employment, the role of health-adverse psychosocial work environments has received increasing attention in developed as well as in rapidly developing countries. Thus, there is a need to apply valid measurement tools for monitoring and preventive purposes. This study aims to examine the factorial structure and psychometric properties of the Persian version of the effort-reward imbalance (ERI) questionnaire, assessing one of the internationally leading concepts of stressful work.

Methods

This descriptive cross-sectional study of a random sample of 202 white collar employees in an industrial company in Iran analyzes the ERI scales by exploratory and confirmatory factor analysis. Moreover, aspects of construct and criterion validity are tested. To this end, correlations of ERI scales with subscales of organizational injustice, a complementary work stress model, and also the correlations of ERI scales with a questionnaire assessing psychosomatic symptoms are performed.

Results

Internal consistency of the three ERI scales was satisfactory (Cronbach α effort: 0.76, reward: 0.79, overcommitment: 0.75). Fit indices of confirmatory factor analysis pointed to an adequate representation of the theoretical construct (e.g., adjusted goodness of fit index (AGFI): 0.73, goodness of fit index (GFI): 0.78). Negative correlations with subscales of organizational injustice supported the notion of construct validity of the ERI scales, and positive correlations of ERI scales with psychosomatic symptoms indicated preliminary criterion validity.

Conclusion

The Persian version of the ERI questionnaire has acceptable psychometric properties and can be used as a valid instrument in research on this topic.

Effects of perceived job insecurity on depression, suicide ideation, and decline in self-rated health in Korea: a population-based panel study

PURPOSE

To investigate the effects of job security on new development of depressive episode, suicide ideation, and decline in self-rated health.

METHODS

Data from the Korea Welfare Panel Study from 2012 to 2015 were analysed. A total of 2912 waged workers self-assessed their depressive episode, suicide ideation, and health annually by answering the questionnaire. Participants were divided into three groups according to the level of job security: high, intermediate and low. To evaluate the influence of job security, we performed survival analysis after stratification by gender with adjustment for covariates. The result was further stratified by whether the respondent was the head of household.

RESULTS

After adjusting for covariates, men in low job security group showed significantly higher hazard ratios (HRs) for depression (HR 1.27, 95% CI 1.01-1.60), suicide ideation (HR 3.25, 95% CI 1.72-6.16), and decline in self-rated health (HR 1.73, 95% CI 1.16-2.59). Women showed significantly higher HR of depression in the intermediate (HR 1.37, 95% CI 1.01-1.87) and low (HR 1.50, 95% CI 1.12-1.99) job security group. Male head of household with low job security showed significantly higher HR of depression, suicide ideation, and decline in self-rated health. Non-head-of-household women with intermediate and low job security showed higher risk of depression than those with high job security.

CONCLUSIONS

We found that perceived job insecurity is associated with the new development of depressive episode, suicide ideation, and decline in self-rated health.

Validity of the effort/reward imbalance questionnaire in health professionals from six Latin-American countries

BACKGROUND

This study tests the validity and the invariance of ERI questionnaire (ERIQ) data from health professionals in six different Latin-American countries.

METHODS

One thousand two hundred ninety-two (1292) participants who worked in hospitals in Argentina, Chile, Colombia, Mexico, Peru and Venezuela completed the ERI and GHQ questionnaires. Partial correlations were carried out as well as reliability statistics and confirmatory factor analyses to examine factor structure and invariance of ERIQ in each subsample.

RESULTS

Overall confirmatory factor analyses confirmed the theoretical structure of the ERIQ. The effort and overcommitment scales were invariant (equivalent) across the six countries, but the reward scale was only partially invariant. Several associations between ERIQ and mental health remain significant after controlling for sociodemographic variables.

CONCLUSIONS

Although the validity of the ERIQ' scales were generally satisfactory in most Latin-American samples, future research should examine in depth the equivalence of reward scale across Latin-American cultures.

A GPU-Based Gibbs Sampler for a Unidimensional IRT Model

Item response theory (IRT) is a popular approach used for addressing large-scale statistical problems in psychometrics as well as in other fields. The fully Bayesian approach for estimating IRT models is usually memory and computationally expensive due to the large number of iterations. This limits the use of the procedure in many applications. In an effort to overcome such restraint, previous studies focused on utilizing the message passing interface (MPI) in a distributed memory-based Linux cluster to achieve certain speedups. However, given the high data dependencies in a single Markov chain for IRT models, the communication overhead rapidly grows as the number of cluster nodes increases. This makes it difficult to further improve the performance under such a parallel framework. This study aims to tackle the problem using massive core-based graphic processing units (GPU), which is practical, cost-effective, and convenient in actual applications. The performance comparisons among serial CPU, MPI, and compute unified device architecture (CUDA) programs demonstrate that the CUDA GPU approach has many advantages over the CPU-based approach and therefore is preferred.

Psychosocial work environment and intention to leave the nursing profession: a cross-national prospective study of eight countries

Many countries throughout the world are facing a serious nursing shortage, and retention of nurses also is a challenge. The aim of this study was to compare the predictive contribution of a broad spectrum of psychosocial work factors, including job strain, effort-reward imbalance, and alternative employment opportunity, to the probability of intention to leave the nursing profession. A total of 7,990 registered female nurses working in hospitals in eight countries (Germany, Italy, France, The Netherlands, Belgium, Poland, Slovakia, and China) were included in the one-year prospective study. A standardized questionnaire on job strain, effort-reward imbalance, employment opportunity, and intention to leave the nursing profession was used in the survey. Multilevel logistic regression modeling was used to analyze the data. Results showed that an imbalance between high effort and low reward (in particular, poor promotion prospects) and good employment opportunity at baseline were independently associated with a new intention to leave the nursing profession at follow-up. However, job strain appeared to have relatively less explanatory power. Findings suggest that interventions to improve the psychosocial work environment, especially the reciprocity experienced between effort and reward, may be effective in improving retention of nurses and tackling the international nursing shortage.

Psychometric properties and differential explanation of a short measure of effort-reward imbalance at work: a study of industrial workers in Germany

BACKGROUND

We test the psychometric properties of a short version of the Effort-Reward Imbalance (ERI) questionnaire in addition to testing an interaction term of this model's main components on health functioning.

METHODS

A self-administered survey was conducted in a sample of 2,738 industrial workers (77% men with mean age 41.6 years) from a large manufacturing company in Southern Germany. The internal consistency reliability, structural validity, and criterion validity were analyzed.

RESULTS

Satisfactory internal consistencies of the three scales: "Effort", "reward", and "overcommitment", were obtained (Cronbach's alpha coefficients 0.77, 0.82, and 0.83, respectively). Confirmatory factor analysis showed a good model fit of the data with the theoretical structure (AGFI = 0.94, RMSEA = 0.060). Evidence of criterion validity was demonstrated. Importantly, a significant synergistic interaction effect of ERI and overcommitment on poor mental health functioning was observed (odds ratio 6.74 (95% CI 5.32-8.52); synergy index 1.78 (95% CI 1.25-2.55)).

CONCLUSIONS

This short version of the ERI questionnaire is a reliable and valid tool for epidemiological research on occupational health.

Depressive symptoms and psychosocial stress at work among older employees in three continents

Background

To assess whether an association of psychosocial stress at work with depressive symptoms among older employees is evident in a set of comparable empirical studies from Europe, North America and Asia.

Methods

Cross-sectional and longitudinal multivariate regression analyses of data from 4 cohort studies with elder workers (2004 and 2006) testing associations of psychosocial stress at work (‘effort-reward imbalance’; ‘low control’) with depressive symptoms.

Results

Cross-sectional analyses from 17 countries with 14.236 participants reveal elevated odds ratios of depressive symptoms among people experiencing high work stress compared to those with low or no work stress. Adjusted odds ratios vary from 1.64 (95% CI 1.02-2.63) in Japan to 1.97 (95% CI 1.75-2.23) in Europe and 2.28 (95% CI 1.59-3.28) in the USA. Odds ratios from additional longitudinal analyses (in 13 countries) controlling for baseline depression are smaller, but remain in part significant.

Conclusion

Findings indicate that psychosocial stress at work might be a relevant risk factor for depressive symptoms among older employees across countries and continents. This observation may call for global policy efforts to improve quality of work in view of a rapidly aging workforce, in particular in times of economic globalization.

[Modern testing theory and its application in the field of health measurement]

This paper briefly introduces item response theory (IRT) as a typical representation of modern testing theory (MTT), and systematically reviews the processes and contents of the application of IRT in the area of health measurement, including, for example, item bank development, scale revision and computerized adaptive testing. The author presents the potential benefits and the notable problems during health measuring by IRT. Then, the author asserts the need for thorough assessment of feasibility when using the IRT in patient-reported outcome research. Further research based on IRT and computerized adaptive testing in health measurement will be carried out in the field of medical care including traditional Chinese medicine and integrative medicine.

Occupational stress and hypertension

Occupational stress, or job strain, resulting from a lack of balance between job demands and job control, is considered one of the frequent factors in the etiology of hypertension in modern society. Stress, with its multifactorial causes, is complex and difficult to analyze at the physiological and psychosocial levels. The possible relation between job strain and blood pressure levels has been extensively studied, but the literature is replete with conflicting results regarding the relationship between the two. Further analysis of this relationship, including the many facets of job strain, may lead to operative proposals at the individual and public health levels designed to reduce the effects on health and well-being. In this article, we review the literature on the subject, discussing the various methodologies, confounding variables, and suggested approaches for a healthier work environment.

Differential item functioning in quality of life measure between children with and without special health-care needs

OBJECTIVES

Limited studies consider the effect of differential item functioning (DIF) on health-related quality of life (HRQOL) comparisons between ill and health children. The objective is to assess DIF and compare HRQOL between children with special health-care needs (CSHCN) and children without needs.

METHODS

Data were collected from 1195 families of children enrolled in Florida's public insurance programs. HRQOL was measured using physical, emotional, social, and school functioning of the Pediatric Quality of Life Inventory (PedsQL). We identified CSHCN using the CSHCN Screener and assessed DIF related to CSHCN using a multiple group-multiple indicators-multiple causes method (MG-MIMIC). We assessed the impact of DIF by examining expected item/test scores and item/test information function. We tested the discrepancy between underlying HRQOL scores of both groups before and after DIF calibration (allowing parameters of DIF items to be different and DIF-free items to be the same across both groups).

RESULTS

Two (25%) and three items (60%) of physical and school functioning, respectively, were identified with nonuniform DIF, and two items (40%) of social functioning were identified with uniform DIF. Expected item/test scores and item/test information function suggest that the impact of DIF is minimal. Before DIF calibration, HRQOL in CSHCN was more impaired than in children without needs (effect sizes -1.04, -0.74, -0.96, and -0.98 for physical, emotional, social, and school functioning, respectively). After DIF calibration, the discrepancy was increased slightly.

CONCLUSIONS

Although 30% of items on the PedsQL were identified with DIF related to CSHCN status, the impact of DIF is minimal.