Stensland Synne Øien, Bondjers Kristina, Zwart John-Anker, Rosseland Leiv Arne, Atar Dan, Christensen Jan Olav, Matre Dagfinn, Glad Kristin Alve, Wentzel-Larsen Tore, Wøien Hilde, Dyb Grete
Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway.
Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway.
Public Health Pract (Oxf). 2025 Jan 10;9:100582. doi: 10.1016/j.puhip.2025.100582. eCollection 2025 Jun.
A lack of tools for the systematic identification of frontline health workers' changing occupational risks, characteristics, and needs, poses a major barrier to supporting vital personnel to stay in practice through health emergencies and beyond. The current study reports on the development and psychometric evaluation of the Frontline health workers' Occupational Risk and Characteristics in Emergencies index (FORCE-index).
The Covid hospital study is a large, multisite, four-wave, open cohort study of frontline health workers responding to the first four waves of the COVID-19 pandemic (2020-2022).
2496 frontline health workers responded to questionnaires assessing various aspects of their work environment. Using exploratory factor analysis, we estimated the latent structure of the FORCE-index at the first and second waves. This structure was evaluated using confirmatory factor analysis at the third and fourth waves. The internal consistency of the instrument's subscales (e.g., factors) was evaluated using omega reliability, Cronbach's alpha coefficient, and mean inter-item correlation.
A nine-factor solution provided best fit to the data. These factors mapped onto the following aspects of the work environment; competency, stress management, familiarity, workload manageability, work performance, infection safety, personal protective equipment, social safety, and social support. Internal consistency for the full FORCE-index and the nine factors was satisfactory.
The initial psychometric validation indicates that the FORCE-index is a valid measure which can be used by health authorities, services, and institutions to adequately and systematically assess central aspects of frontline health workers' work environment that are commonly challenged in health emergencies.
缺乏用于系统识别一线卫生工作者不断变化的职业风险、特征和需求的工具，这对支持关键人员在卫生紧急情况期间及之后继续从业构成了重大障碍。本研究报告了一线卫生工作者紧急情况下职业风险与特征指数（FORCE指数）的开发及心理测量学评估情况。
新冠医院研究是一项针对应对2019冠状病毒病疫情前四波（2020 - 2022年）的一线卫生工作者开展的大型、多地点、四波次开放队列研究。
2496名一线卫生工作者对评估其工作环境各个方面的问卷进行了回复。我们使用探索性因素分析在第一波和第二波时估计FORCE指数的潜在结构。在第三波和第四波时使用验证性因素分析对该结构进行评估。使用ω信度、克朗巴哈α系数和平均项目间相关性评估该工具各子量表（即因素）的内部一致性。
一个九因素解决方案与数据拟合度最佳。这些因素对应于工作环境的以下方面：能力、压力管理、熟悉程度、工作量可管理性、工作表现、感染安全、个人防护装备、社会安全和社会支持。整个FORCE指数及九个因素的内部一致性令人满意。
初步的心理测量学验证表明，FORCE指数是一种有效的测量工具，卫生当局、服务机构和单位可利用它充分且系统地评估一线卫生工作者工作环境中在卫生紧急情况期间通常会面临挑战的核心方面。
