Ma Shu-Ching, Wang Hsiu-Hung, Chien Tsair-Wei
College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.
Nursing Department, Chi-Mei Medical Center, Tainan, Taiwan.
Ann Gen Psychiatry. 2017 Jul 3;16:26. doi: 10.1186/s12991-017-0149-z. eCollection 2017.
Workplace bullying has been measured in many studies to investigate mental health issues. None uses online computerized adaptive testing (CAT) with cutting points to report bully prevalence at workplace.
To develop an online CAT to examine person being bullied and verify whether item response theory-based CAT can be applied online for nurses to measure exposure to workplace bullying.
A total of 963 nurses were recruited and responded to the 22-item Negative Acts Questionnaire-Revised (NAQ-R). All non-adaptive testing (NAT) items were calibrated with the Rasch rating scale model. Three scenarios (i.e., NAT, CAT, and the randomly selected method to NAT) were manipulated to compare their response efficiency and precision by comparing (i) item length for answering questions, person measure, (ii) correlation coefficients, (iii) paired tests, and (iv) estimated standard errors (SE) between CAT and the random to its counterpart of NAT.
The NAQ-R is a unidimensional construct that can be applied for nurses to measure exposure to workplace bullying on CAT. CAT required fewer items (=8.9) than NAT (=22, an efficient gain of 60% =1-8.9/22). Nursing measures derived from both tests (CAT and the random to NAT) were highly correlated ( = 0.93 and 0.96) and their measurement precisions were not statistically different (the percentage of significant count number less than 5%) as expected, but CAT earns smaller person measure SE than the random scenario. The prevalence rate for nurses was 1.5% (=15/963) when cutting points set at -0.7 and 0.7 logits.
The CAT-based NAQ-R reduces respondents' burden without compromising measurement precision and increases endorsement efficiency. The online CAT is recommended for assessing nurses using the criteria at -0.7 and 0.7 (or <30 and <60 in summed score) to identify bully grade as one of the three levels (high, moderate, and low). The bullied nurse can get help from a psychiatrist or a mental health expert at an earlier stage.
在许多研究中都对职场霸凌进行了测量，以调查心理健康问题。但尚无研究采用带有分界点的在线计算机自适应测试（CAT）来报告职场霸凌的发生率。
开发一种在线CAT，用于检测受霸凌者，并验证基于项目反应理论的CAT是否可在线应用于护士，以测量其遭受职场霸凌的情况。
共招募了963名护士，让他们对22项的修订版负面行为问卷（NAQ-R）做出回应。所有非自适应测试（NAT）项目均采用拉施评分量表模型进行校准。设置了三种情境（即NAT、CAT以及NAT的随机选择方法），通过比较以下方面来比较它们的反应效率和精度：（i）回答问题的项目长度、个人测量值；（ii）相关系数；（iii）配对t检验；（iv）CAT与NAT对应随机情境之间的估计标准误（SE）。
NAQ-R是一个单维结构，可用于护士在CAT上测量遭受职场霸凌的情况。CAT所需的项目数（=8.9）比NAT（=22，有效减少60% =1-8.9/22）少。两种测试（CAT和NAT的随机情境）得出的护理测量值高度相关（分别为0.93和0.96），且正如预期的那样，它们的测量精度在统计学上无差异（显著计数百分比小于5%），但CAT得出的个人测量值SE比随机情境小。当分界点设定为-0.7和0.7对数单位时，护士的发生率为1.5%（=15/963）。
基于CAT的NAQ-R减轻了受访者的负担，同时不影响测量精度，并提高了认可效率。建议使用在线CAT，按照-0.7和0.7（或总分<30和<60）的标准对护士进行评估，以将霸凌等级确定为三个级别（高、中、低）之一。受霸凌的护士可以在更早阶段获得精神科医生或心理健康专家的帮助。
