Reliability.html

Reliability and Validity of Persian Version of Job Content Questionnaire in Health Care Workers In Iran

SM Tabatabaee Jabali1, M Ghaffari2, O Pournik3,
L Ghalichi4, AR Tehrani Yazdi5, SA Motevalian4

1Department of Nutrition, Tehran University of Medical Sciences, Tehran, Iran,
2Department of Occupational Medicine, Tehran University of Medical Sciences, Tehran, Iran,
3Department of Medical Informatics, Mashhad University of Medical Sciences, Mashhad, Iran,
4Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran,
5Shahid Beheshti University of Medical Sciences, Tehran, Iran

Correspondence to
Seyed Abbas Motevalian, MD, Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran

E-mail: amotevalian@yahoo.com

Received: May 17, 2012

Accepted: Nov 11, 2012

Abstract

Background: The effect of poor psychosocial work conditions on health status has widely been discussed in occupational literature. Job Content Questionnaire (JCQ) is a widely accepted instrument for evaluation of psychosocial work conditions.

Objective: To determine the reliability and validity of Persian version of JCQ.

Methods: The questionnaire was translated into Persian and back translated. 490 Iranian health care workers completed the questionnaire. After 4 weeks, 196 participants completed the questionnaire once again.

Results: Factor analyses revealed an acceptable level of structure validity for the questionnaire. Cronbach's α was more than 0.75 for all scales except for psychological demand (α=0.60) and job insecurity (α=0.27). reassessment of participants after 4 weeks revealed an acceptable level of reliability for all scales except depression.

Conclusion: The Persian version of JCQ is reliable and valid for assessing work conditions among Iranian health care workers, although revision is needed for job insecurity and depression scales.

Keywords: Reproducibility of results; Occupational health; Health personnel; Questionnaires; Iran

Introduction

The effect of poor psychosocial work conditions on health status has widely been discussed in occupational literature.1-3 Careful evaluation of the specification and content of a job is needed prior to doing any intervention for improving work conditions and providing high-quality occupational health services. A valid and reliable instrument is therefore needed to provide such evaluation.

Among numerous instruments developed for the assessment of psychosocial work environment, the Job Content Questionnaire (JCQ), designed based on Karasek's demand-control model, has been widely used all over the world. It has been translated into many languages (i.e., Bulgarian, Chinese, Czech, Dutch, German, Greek, French, Italian, Japanese, Korean, Malaysian, Norwegian, Polish, and Spanish, to name a few) and the reliability and validity of the translated versions have been determined.4

There is a modified translated version of the questionnaire in Persian which consists of 39 questions.5 The reliability and validity of the mentioned version is assessed in 109 nurses, but this version of the questionnaire does not contain job insecurity and job satisfaction scales. We therefore, tried to develop another version of JCQ with job insecurity and job satisfaction scales, under the supervision of JCQ center and tested the reliability and validity of this new version of the questionnaire in a group of health care workers.

Materials and Methods

Questionnaire

With permission from the JCQ center, we translated 71 questions of the English version of the questionnaire into Persian; two translators back-translated it into English independently. A total of 53 questions were selected to compose the Persian questionnaire. Seven demographic questions were included in the questionnaire. These questions were categorized into 11 subscales: decision authority (3 questions), skill dissertation (6 questions), psychological demand (5 questions), physical excretion (1 question), job insecurity (4 questions), physical trauma (8 questions), supervisor support (4 questions), coworkers support (4 questions), job satisfaction (4 questions), anxiety (6 questions), and depression (8 questions) scales.

Participants

The study was conducted in a training hospital in Tehran, Iran. All of the employees of the hospital were invited to complete the questionnaire. A total of 490 (358 female, 132 male) workers with different job titles participated in this study. After two weeks, all participants were asked to complete the questionnaire for the second time. The second questionnaires were returned within four weeks of the first one.

Statistical analysis

Structural validity was evaluated by factor analysis. The questions were checked for colinearity; Kaiser-Meyer-Olkin statistic was calculated. Principal axis factoring with varmix rotation was performed. The internal validity was assessed by calculating Cronbach's α for each scale. It was also calculated and compared in males and females. Test-retest reliability of each question was examined calculating the weighted κ statistic. Statistical analysis was performed using SPSS® ver 13 and Stata® ver 10.

Results

Characteristics of the participants are presented in Table 1. Of 490 participants, 159 (32.5%) were single, and 322 (65.8%) were married; 172 (35.1%) of the respondents were nurse, 137 (28.0%) technical officer, 137 (28.0%) support and service section worker, 34 (6.9%) doctor, and 10 (2.0%) were manager.

Table 1: Characteristics of the participants. Data are presented as mean±SD.

Parameter

Men

(n=132)

Women

(n=358)

Age (yrs)

37.5±8.6

34.8±8.4

Present work tenure (yrs)

8.1±0.7

6.9±0.7

Total work tenure (yrs)

13.1±0.8

10.8±0.4

Education (yrs)

15.1±1.8

16±1.6

The Pearson coefficient was <0.9 for all pairs of questions, thus colinearity was not considered probable. Kaiser-Meyer-Olkin statistic was 0.843; Bartlett test was significant (p<0.001), indicating the possibility of performing factor analysis. Principal axis factoring with varimax rotation was applied to 302 cases with no missing field and revealed 10 empirical factors. Seven factors perfectly corresponded to anxiety, depression, supervisor support, coworker support, job satisfaction, physical trauma, and psychological demand scales. Decision latitude scale, mainly constructed of two subscales—skill discretion and psychological demands—was represented by three separate factors. Job insecurity showed the lowest construct validity among the scales. The questions regarding “other's conflicting demands” and “losing job in the next years” could not be placed in the proper scale. Factor analysis in the gender subcategories showed very similar results. Overall, the results of the factor analysis corresponded closely with theoretical constructs of the questionnaire (Table 2).

Table 2: Factor analysis of the Persian version of JCQ using varimax rotation method

Factor

Scale

Item

1

2

3

4

5

6

7

8

9

10

11

DL

Learn new things

0.57

DL

Work not repetitive

-0.41

DL

Requires creativity

0.41

0.62

DL

Allow own decisions

0.52

DL

High skill level

DL

Freedom to make decision

0.51

DL

Variety

0.64

DL

Opinions influential

0.48

DL

Develop own abilities

0.55

PsD

Work fast

0.42

-0.42

PsD

Work hard

-0.57

PsD

Excessive work

0.49

PsD

Insufficient time

0.65

PsD

Conflicting demands

-0.47

JI

Job stability

JI

Job security

JI

Losing job

0.47

PD

Chemicals exposure

0.70

PD

Air pollution

0.54

PD

Dangerous stock

0.74

PD

Dirty or improper places

0.54

PD

Risk of disease

0.50

0.42

PD

Dangerous tools and machinery

0.67

PD

To fire, burns, or electric shocks

0.63

PD

Dangerous work methods

0.64

SS

Supervisor concerned

0.87

SS

Supervisor pays attention

0.78

SS

Supervisor helpful

0.63

SS

Supervisor good organizer

0.67

CS

Coworker competent

CS

Coworker interest in me

0.56

CS

Coworker friendly

0.72

CS

Coworker helpful

0.71

JS

Job satisfaction

0.54

JS

Advise your job to a friend

0.64

JS

Take this job again

0.89

JS

Probability of changing the job

JS

Job similar to expected

A

Tired in short period

0.47

A

Sweating hands

0.49

A

Edginess or tense

0.51

A

Poor appetite

0.47

A

Trouble going to sleep

0.70

A

Problems staying asleep

0.52

D

Life useful or useless

0.73

D

Life friendly or cold

0.65

D

Life full or empty

0.82

D

Life hopeful or hopeless

0.82

D

Life fruitful or fruitless

0.84

D

Life giving chances

0.72

D

Life boring or interesting

0.81

D

Life enjoyable or miserable

0.73

The calculated Cronbach's α was >0.75 for all scales except for psychological demand (α=0.60) and job insecurity (α=0.27), indicating insufficient internal consistency for the latter scale. The statistics were very similar for men and women, except for the anxiety scale where the coefficient was >0.7 for women and <0.7 for men (Table 3).

Table 3: Chronbach's α for scales of Persian JCQ stratified by gender

Scale

Men

Women

Decision latitude

0.78

0.76

Psychological demands

0.61

0.59

Supervisor support

0.85

0.87

Coworker support

0.77

0.81

Physical demands

0.84

0.81

Job insecurity

0.27

0.23

Job satisfaction

0.80

0.76

Anxiety

0.64

0.70

Depression

0.94

0.87

Of 490 participants, 196 completed the questionnaire once again within four weeks. The κ statistic showed significant differences between the scales: depression scale had a significantly lower κ statistic (0.26–0.28) compared to job insecurity, job satisfaction and physical trauma (p<0.004). Moreover, κ statistic for physical trauma (0.20) was significantly (p<0.035) higher than that for psychological demand scale. On average, κ statistic was substantial (0.60–0.80) for physical trauma and job satisfaction; moderate (0.40–0.60) for job insecurity scale; fair (0.20–0.40) for decision latitude, psychological demand, coworker support, supervisor support and anxiety scale; and slight (<0.20) for depression scale. More than half of the questions categorized into six scales of decision latitude, supervisor support, coworker support, physical trauma, job insecurity, and jab satisfaction had acceptable levels of reliability.

Discussion

The results of factor analysis show that the Persian version of JCQ has acceptable construct validity—similar to original questionnaire and other translated versions of the questionnaire. The inconsistency observed in “losing job in the next years” question may reflect the ambiguity of the question for the participants from public sector where there is little chance of losing job. Although the construct validity of job insecurity scale was not strong in two main studies of Karasek6 and lowest levels of Cronbach's α were reported in this scale (0.48–0.61), the statistic was even lower in our study (0.23–0.27), suggesting the need for revision in the related questions.

Other scales showed better correlation with the mentioned studies (Table 4), suggesting acceptable levels of construct validity except for job insecurity scale. The findings are similar to those reported from China,7 Korea,8 and Malaysia9 and less similar to the results from Spain,10 and Belgium11.

Table 4: Comparison of Cronbach's α of some of the previous studies and the Persian version

Main JCQ scales

Karasek, et al. (1998)

Karasek, et al. (2003)

Persian version

Men

Women

Men

Women

Men

Women

Skill discretion

0.73

0.75

0.73

0.72

0.78*

0.76*

Decision authority

0.68

0.68

0.63

0.66

Psychological demands

0.63

0.63

0.59

0.61

0.60

0.59

Supervisor support

0.84

0.84

0.85

0.86

0.85

0.87

Coworker support

0.75

0.77

0.79

0.80

0.77

0.81

Physical demands

0.86

0.79

0.86

0.84

0.84

0.81

Job insecurity

0.61

0.58

0.48

0.47

0.27

0.23

The reliability of the questionnaire varied widely, but it was acceptable except for the depression scale. Compared with the previous Persian version of JCQ,5 the new version had a higher internal consistency in decision latitude (0.76–0.78 vs 0.54); however they were similar in terms of psychological job demand, social support, and physical demand scales. The new questionnaire, however, did not have job insecurity scale.

As the former study was tested on 109 nurses with only 11 male participants, the higher sample size of the current study with 132 male participants would provide a better picture of the applicability of the questionnaire in health settings where there are variety of job titles and educational categories.

Findings of this study indicate that this Persian version of JCQ is reliable and valid for assessing health care workers in Iran, although revision is needed for job insecurity and depression scales.

Acknowledgements

The authors would like to thank Dr. F. Emami, Dr. F. Fateminazar, Dr. M. Mohaghegh, Dr. M. Emadedin, Dr. A. Hasani, and Dr. A. Pazuki for their cooperation.

Conflicts of Interest: None declared.

References

  1. Karasek R, Theorell T. Healthy work: Stress, productivity, and the reconstruction of working life, Basic books, 1994.
  2. Kawakami N, Akachi K, Shimizu H, et al. Job strain, social support in the workplace, and haemoglobin A1c in Japanese men. Occup Environ Med 2000;57:805.
  3. Requena F. Social capital, satisfaction and quality of life in the workplace. Soc Indicators Res 2003;61:331-60.
  4. JCQ Center UoM. JCQ Translations. Lowell: Job Content Questionnaire center; [updated 04/05/2008; cited 2011]. Available from www.jcqcenter.org/Translations.html (Accessed April 14, 2012).
  5. Choobineh A, Ghaem H, Ahmedinejad P. Validity and reliability of the Persian (Farsi) version of the Job Content Questionnaire: a study among hospital nurses. East Mediterr Health J 2011;17:335-41.
  6. Karasek R, Brisson C, Kawakami N, et al. The Job Content Questionnaire (JCQ): an instrument for internationally comparative assessments of psychosocial job characteristics. J Occup Health Psychol 1998;3:322.
  7. Cheng Y, Luh WM, Guo YL. Reliability and validity of the Chinese version of the Job Content Questionnaire in Taiwanese workers. Int J Behav Med 2003;10:15-30.
  8. Eum KD, Li J, Jhun HJ, et al. Psychometric properties of the Korean version of the job content questionnaire: data from health care workers. Int Arch Occup Environ Health 2007;80:497-504.
  9. Hadi AA, Naing NN, Daud A, Nordin R. Reliability and construct validity of the Malay version of the Job Content Questionnaire (JCQ) among secondary school teachers in Kota Bharu. Kelantan, Malaysia, 2006.
  10. Escribà-Agüir V, Más PR, Flores RE. [Validation of the Job Content Questionnaire in hospital nursing staff]. Gaceta Sanitaria/SESPAS 2001;15:142. [in Spanish]
  11. Santavirta N. Construct validity and reliability of the Finnish version of the demand-control questionnaire in two samples of 1028 teachers and 630 nurses. Edu Psychol 2003;23:423-36.

TAKE-HOME MESSAGE

  • Job Content Questionnaire (JCQ) is a widely accepted instrument for evaluation of psychosocial work conditions.
  • The Persian version of JCQ is reliable and valid for assessing work conditions among Iranian health care workers.

Cite this article as: Tabatabaee Jabali SM, Ghaffari M, Pournik O, et al. Reliability and validity of persian version of job content questionnaire in health care workers In Iran. Int J Occup Environ Med 2013;4:96-101.




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 eISSN: 2008-6814

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