대한간호학회지 (Journal of Korean Academy of Nursing)

한국간호과학회 (Korean Society of Nursing Science)
권호 표지
DOI QR코드

DOI QR Code

병원 간호사의 침묵 행위 측정도구 개발

Development of the Hospital Nurses' Silence Behavior Scale

  • 투고 : 2023.10.25
  • 심사 : 2024.05.01
  • 발행 : 2024.05.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: This study aimed to develop a scale to measure hospital nurses' silence behavior and examine its validity and reliability. Methods: A total of 52 preliminary items on hospital nurses' silence behavior were selected using a content validity test by seven experts on 53 candidate items derived from a literature review and in-depth interviews with 14 nurses. A total of 405 hospital nurses participated in a psychometric testing. Data analysis comprised item analysis, exploratory and confirmatory factor analyses, and convergent and discriminant validity tests. Pearson's correlation coefficient was used for assessing concurrent validity, and Cronbach's alpha was used for the reliability test. Results: The final scale consisted of nine factors with 31 items, exhibiting acceptable model fit indices, convergent validity, and discriminant validity. The score of the entire scale was positively correlated with the 'Organizational Silence Scale (OSS)-the issues on which nurses remain silent' (r = .60, p < .001) and 'OSS-the reasons why nurses remain silent' (r = .68, p < .001). Cronbach's α of the scale was .92, and α of each subscale ranged from .71 to .90. Conclusion: The Hospital Nurses' Silence Behavior Scale is a useful tool for assessing multifaceted silence behavior among nurses. It can provide basic data for developing better communication strategies among nurses and other hospital staff.

키워드

과제정보

This study was supported by the Sigma Theta Tau International Honor Society of Nursing Lambda Alpha at-Large Chapter fund in 2019.

참고문헌

  1. Yurdakul M, Besen MA, Erdogan S. The organisational silence of midwives and nurses: Reasons and results. Journal of Nursing Management. 2016;24(5):686-694.  https://doi.org/10.1111/jonm.12374
  2. Abd El-Fattah Mohamed Aly N, El-Shanawany SM, Ghanem M. Workplace silence behavior and its consequences on nurses: A new Egyptian validation scale of nursing motives. Clinical Ethics. 2022;17(1):71-82.  https://doi.org/10.1177/1477750921994284
  3. Yi K, You M. Nurses' organizational silence in hospitals: A grounded theoretical approach. Korean Journal of Occupational Health Nursing. 2022;31(2):66-76.  https://doi.org/10.5807/kjohn.2022.31.2.66
  4. Kang K, Kim JH. Factors related to the organizational silence of Korean nurses: A systematic review and meta-analysis. The Journal of Korean Academic Society of Nursing Education. 2023;29(3):302-318.  https://doi.org/10.5977/jkasne.2023.29.3.302
  5. Choi MO, Park DG. The development and validation of the silence motivation scale. Korean Journal of Culture and Social Issues. 2017;23(2):239-270.  https://doi.org/10.20406/kjcs.2017.05.23.2.239
  6. Go D, Kang J. Conceptualization and development of measurement tools for the silence phenomenon in Korean administrative culture: Focus on adaptive silence. Korean Public Administration Review. 2017;51(4):29-55. https://doi.org/10.18333/KPAR.51.4.29
  7. Brinsfield CT. Employee silence: Investigation of dimensionality, development of measures, and examination of related factors [dissertation]. Columbus (OH): The Ohio State University; 2009. p. 1-381.
  8. Brinsfield CT. Employee silence motives: Investigation of dimensionality and development of measures. Journal of Organizational Behavior. 2013;34(5):671-697.  https://doi.org/10.1002/job.1829
  9. Knoll M, van Dick R. Do I hear the whistle…? A first attempt to measure four forms of employee silence and their correlates. Journal of Business Ethics. 2013;113(2):349-362.  https://doi.org/10.1007/s10551-012-1308-4
  10. Pinder CC, Harlos KP. Employee silence: Quiescence and acquiescence as responses to perceived injustice. Research in Personnel and Human Resources Management. 2001;20:331-369. https://doi.org/10.1016/S0742-7301(01)20007-3
  11. Van Dyne L, Ang S, Botero IC. Conceptualizing employee silence and employee voice as multidimensional constructs. Journal of Management Studies. 2003;40(6):1359-1392.  https://doi.org/10.1111/1467-6486.00384
  12. Polat S, Kutlu L, Ay F, Erkan HA, Dogrusoz LA. The relationship between work-family conflict, organizational silence and social support in nurses at a university hospita]. Journal of Psychiatric Nursing. 2018;9(3):195-204.  https://doi.org/10.14744/phd.2018.38278
  13. Han S. Effect of nursing organizational culture, organizational silence, and organizational commitment on the intention of retention among nurses: Applying the PROCESS Macro model 6. Korean Journal of Occupational Health Nursing. 2022;31(1):31-41.  https://doi.org/10.5807/kjohn.2022.31.1.31 
  14. Woo CH, Lee MJ. The effect of hospital organizational culture, organizational silence and job embeddedness on turnover intention of general hospital nurses. Journal of Digital Convergence. 2018;16(3):385-394.  https://doi.org/10.14400/JDC.2018.16.3.385
  15. Atalla ADG, Elamir H, Abou Zeid MAG. Exploring the relationship between organisational silence and organisational learning in nurses: A cross-sectional study. Journal of Nursing Management. 2022;30(3):702-715.  https://doi.org/10.1111/jonm.13539
  16. Lee MA, Kim BJ. Effects of organizational silence and organizational justice on bullying among hospital nurses at work. Journal of Korean Academy of Nursing Administration. 2023;29(1):1-11. https://doi.org/10.11111/jkana.2023.29.1.1
  17. Henriksen K, Dayton E. Organizational silence and hidden threats to patient safety. Health Services Research. 2006;41(4 Pt 2):1539-1554.  https://doi.org/10.1111/j.1475-6773.2006.00564.x
  18. Han J. A structure model of clinical nurses' silence on patient safety. Journal of Korean Academy of Fundamentals of Nursing. 2018;25(1):68-77.  https://doi.org/10.7739/jkafn.2018.25.1.68 
  19. Doo EY, Kim M. Effects of hospital nurses' internalized dominant values, organizational silence, horizontal violence, and organizational communication on patient safety. Research in Nursing & Health. 2020;43(5):499-510.  https://doi.org/10.1002/nur.22067
  20. Parlar Kilic S, Ondas Aybar D, Sevinc S. Effect of organizational silence on the job satisfaction and performance levels of nurses. Perspectives in Psychiatric Care. 2021;57(4):1888- 1896. https://doi.org/10.1111/ppc.12763
  21. Morrison EW, Milliken FJ. Organizational silence: A barrier to change and development in a pluralistic world. Academy of Management Review. 2000;25(4):706-725.  https://doi.org/10.2307/259200
  22. Tangirala S, Ramanujam R. Employee silence on critical work issues: The cross level effects of procedural justice climate. Personnel Psychology. 2008;61(1):37-68.  https://doi.org/10.1111/j.1744-6570.2008.00105.x
  23. Alparslan AM, Can A, Erdem R. Reasons for employee silence behavior: Developing and validating a scale for nurses. Hacettepe Saglik Idaresi Dergisi. 2015;18(2):183-204.
  24. Eriguc G, Ozer O, Turac IS, Songur C. Organizational silence among nurses: A study of structural equation modeling. International Journal of Business, Humanities and Technology. 2014;4(1):150-162.
  25. Yalcin B, Baykal u. Development and psychometric testing of the Organizational Silence Behavior Scale for healthcare professionals. Nursing & Health Sciences. 2019;21(4):454-460. https://doi.org/10.1111/nhs.12619
  26. Cakici A. [A research on issues, causes and perceptional results of silence at organizations]. Journal of Cukurova University Institute of Social Sciences. 2008;17(1):117-134. Turkish.
  27. Kim MR, Park JS. The effect of head nurses' authentic leadership perceived by nurses to nurses' organizational politics perception and organizational silence. Journal of East-West Nursing Research. 2020;26(1):71-79.  https://doi.org/10.14370/jewnr.2020.26.1.71
  28. Kim HJ, Jo YG, Lee JW. The effects of trust in supervisor, work intensity and organizational cynicism on organizational silence in clinical nurses. Journal of the Korea Academia-Industrial Cooperation Society. 2018;19(12):627-635.  https://doi.org/10.5762/KAIS.2018.19.12.627
  29. Cheong JO. Mediating effects of organizational silence between workplace bullying and organizational performance among nurses. Journal of Digital Convergence. 2020;18(1):169-175. https://doi.org/10.14400/JDC.2020.18.1.169 
  30. DeVellis RF. Scale development: Theory and applications. 3rd ed. Sage; 2012. p. 1-205.
  31. Schwartz-Barcott D, Kim HS. An expansion and elaboration of the hybrid model of concept development. In: Rodgers BL, Knafl KA, editors. Concept Development in Nursing: Foundations, Technqiues, and Applications. 2nd ed. Saunders; 2000. p. 129-159.
  32. Moore L, McAuliffe E. Is inadequate response to whistleblowing perpetuating a culture of silence in hospitals? Clinical Governance: An International Journal. 2010;15(3):166-178. https://doi.org/10.1108/14777271011063805
  33. Schwappach DL, Gehring K. Silence that can be dangerous: A vignette study to assess healthcare professionals' likelihood of speaking up about safety concerns. PLoS One. 2014;9(8):e104720.  https://doi.org/10.1371/journal.pone.0104720
  34. Schwappach DL, Gehring K. Trade-offs between voice and silence: A qualitative exploration of oncology staff's decisions to speak up about safety concerns. BMC Health Services Research. 2014;14:303.  https://doi.org/10.1186/1472-6963-14-303
  35. Gkorezis P, Panagiotou M, Theodorou M. Workplace ostracism and employee silence in nursing: The mediating role of organizational identification. Journal of Advanced Nursing. 2016;72(10):2381-2388. https://doi.org/10.1111/jan.12992
  36. Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qualitative Health Research. 2005;15(9):1277-1288. https://doi.org/10.1177/1049732305276687 
  37. Lynn MR. Determination and quantification of content validity. Nursing Research. 1986;35(6):382-385.  https://doi.org/10.1097/00006199-198611000-00017
  38. Labrague LJ, De los Santos JA. Association between nurse and hospital characteristics and organisational silence behaviours in nurses: A cross-sectional study. Journal of Nursing Management. 2020;28(8):2196-2204.  https://doi.org/10.1111/jonm.13101
  39. Hinkin TR. A brief tutorial on the development of measures for use in survey questionnaires. Organizational Research Methods. 1998;1(1):104-121.  https://doi.org/10.1177/109442819800100106
  40. Tak JK. Psychological testing: An understanding of development and evaluation method. 2nd ed. Hakjisa Publisher; 2007. p. 1-415.
  41. Papantoniou P. Sexual harassment and organisational silencing in nursing: A cross-sectional study in Greece. BMJ Open. 2021;11(11):e050850.  https://doi.org/10.1136/bmjopen-2021-050850
  42. Woo JP. Understanding of structural equation modeling and its concepts. Hannarae Publisher; 2012. p. 1-567.
  43. West SG, Finch JF, Curran PJ. Structural equation models with nonnormal variables: Problems and remedies. In: Hoyle RH, editor. Structural Equation Modeling: Concepts, Issues, and Applications. Sage Publications; 1995. p. 56-75.
  44. Gao S, Mokhtarian PL, Johnston RA. Nonnormality of data in structural equation models. Transportation Research Record. 2008;2082(1):116-124. https://doi.org/10.3141/2082-14
  45. Fornell C, Larcker DF. Evaluating structural equation models with unobservable variables and measurement error. Journal of Marketing Research. 1981;18(1):39-50.  https://doi.org/10.1177/002224378101800104
  46. Chung S. Development of the hospital nurses' silence behavior scale [dissertation]. Seoul: Kyung Hee University; 2021. p. 1-122.
  47. Ji H, Lee SE. The influence of speaking up climate, psychological safety, organizational learning culture, and supervisor support for patient safety on clinical nurses' silence behavior. Journal of Korean Academy of Fundamentals of Nursing. 2022;29(3):388-397.  https://doi.org/10.7739/jkafn.2022.29.3.388
  48. Taber KS. The use of Cronbach's alpha when developing and reporting research instruments in science education. Research in Science Education. 2018;48(6):1273-1296.  https://doi.org/10.1007/s11165-016-9602-2
  49. Mannion R, Davies HT. Cultures of silence and cultures of voice: The role of whistleblowing in healthcare organisations. International Journal of Health Policy and Management. 2015;4(8):503-505.  https://doi.org/10.15171/ijhpm.2015.120
  50. Li P, Stuart EA, Allison DB. Multiple imputation: A flexible tool for handling missing data. JAMA. 2015;314(18):1966- 1967. https://doi.org/10.1001/jama.2015.15281