This present study included the General Characteristics, Nurse Practice Environment Scale used of Nursing Work Index (NPES-NWI) and Burnout used of Copenhagen Burnout Inventory (CBI).
Furthermore, this study instrument questionnaire was comprised four parts. Part 1 was the informed consent form and the purpose of this study research. Part 2 was consisting of socio-demographic characteristics of subject nine items and characteristics related to working thirteen items. Part 3 and part 4 were the English version of Nurse Practice Environment (NPES from NWI) and Burnout (CBI) scale. These two scales were the English
12
version initially, NPES-NWI developed by Lake et al., (2002) for nurse practice environment and CBI developed by Kristensen et al., (2005) for burnout. These two scales were translated using the back translation. First step was translated from English version to Khmer version by researcher and professional lecturer who are teaching nursing student at university and staff nurses who are working at hospital. Second step was translated from Khmer version to English version by expert English teacher. Third step was comparing the meaning of questionnaire and pilot study with ten nurses to measure their understanding. Finally, the researcher found out two questions from NPES-NWI sub domain of “Nurse Foundation for quality of care” which ask about “a clear philosophy of nursing that pervades the patients/clients/residents care environment” was exclude from this questionnaire survey.
Because most of the clinical nurses had difficulty to understand and answer for this question.
3.3.1 General Characteristic of clinical nurses
Socio-Demographic characteristics were age, gender, marital status, education, and economic status. And Working related characteristics was survey about work in a week, night shift, currently position, year of experience, and departments.
3.3.2 Nurse Practice Environment
The nurse practice environment was measure by Practice Environment Scale of the Nursing Work Index (PES-NWI; Lake et al., 2002). The PES-NWI consist of 29 items in five subscales, manifesting core ascribe the nursing practice as professional. The below are the items subscales and the example such as: (1) staff nurse participation in facility affairs,
13
expressed by items such as “ the staff nurse have an opportunity to attendance in policy decisions”; (2) foundations for quality care, expressed by items such as “ the administration are expected in high standards of nursing care”; (3) resource adequacy, expressed by such sample item “to get the work done must have enough staff”; (4) supportive manager, expressed by such items as “a person who have a good manager and leader skill is defined as a nurse manager”; and (5) collaborative the relationships of nurse and physician, expressed by items including “a good working relationships should meet by nurses and physicians”. Clinical nurses were requested to select the term to which they agree that each item is indicated in their current jobs on a 4-point scale, design from 1 “strongly disagree”
to 4 “strongly agree”.
Lake et al., 2002 was indicated the instruction of scoring as; the more supportive practice environment show as higher scores by calculated the mean scores on each of the five subscales, and the PES-NWI (29 items) was indicated a calculated of single composite by averaging the means for all the subscales. The available scores range from 1 to 4; higher scores demonstrated the existence of a more supportive practice environment. the PES-NWI’s validity and reliability have been entrenched in assorted settings including home health agencies and hospital (Flynn et al., 2007). The each of the five subscales and total composite score’s reliability of the PES-NWI were figure for the ongoing participants.
Results demonstrated to be highly internally consistent of composite score (α = 0.80), and alphas ranging from 0.64 to 0.82 of each five subscales.
14
The Cronbach’s coefficient alpha had been used to estimate the internal consistency of five subscales by Lake’s (2002) PES-NWI. The internal consistency for nurse manager ability, leadership and support for nurses had been 0.84, for nurse participation in hospital affairs had been 0.83, that for adequacy of staffing and resource had been 0.80, that for the care quality of nursing foundations had been 0.80, and that for the relationship of collegial nurse and physicians had been 0.71. That for the composite measure was 0.82. In the author’s study, the internal consistency of each of the five work environment subscales was: 0.80 for the leadership and support ability of nurse manager; 0.75 for workplace of nurse participation; 0.73 for adequacy of staffing and resource; 0.67 for the care quality of nursing foundations; 0.81 for the relationship of collegial nurse and physicians; and 0.86 for the composite measure.
3.3.3 Burnout
The Copenhagen Burnout Inventory (CBI) developed by Kristensen et al., (2005) was used to measure the level of Burnout. The Copenhagen Burnout Inventory focuses on debilitation and is divided in to three sub-dimensions. Personal burnout content “six questions”, work-related burnout “seven questions”, and client-burnout “six questions”. For this research study was analysis by using the scale of each item from one as “always or to a very high degree, scoring 100%”, two as “often or to a high degree, scoring 75%”, three as
“sometime or somewhat, scoring 25%”, four as “Seldom or to a low degree, scoring 25%”, and five as “never or to a very low degree, scoring 0%”. Therefore, if all the scales were positively bias, indicating that most of the participants used the response categories
15
corresponding to low burnout level. Instead of this, if all the scales were negatively bias, indicating that most of the participants used the response categories corresponding to high burnout level. Furthermore, for the reliability of the burnout of 19 items were assessed by Cronbach’s alpha.
Kristensen et al., 2007 and Borritz et al., 2005 had also been estimated the internal consistency of the three subscales by using Cronbach’s coefficient alpha. The internal consistency for personal burnout had been 0.87, for work-related burnout have been 0.87, and for client-related burnout had been 0.85. In this study, the internal consistency of each of the three burnout subscales was: 0.64 for personal burnout, 0.71 for work-related burnout, and 0.75 for client-related burnout.