Reliability and Validity of the Persian Version of the Scoliosis Research Society-22r Questionnaire

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Original Article

Reliability and Validity of Persian Version of Job Content Questionnaire in Health Care Workers In IranSM Tabatabaee Jabali1, M Ghaffari2, O Pournik3, L Ghalichi4, AR Tehrani Yazdi5, SA Motevalian4

1Department of Nutri-tion, Tehran University of Medical Sciences, Tehran, Iran, 2Department of Oc-cupational Medicine, Tehran University of Medical Sciences, Tehran, Iran, 3Department of Medical Informatics, Mashhad University of Medical Sciences, Mashhad, Iran, 4Department of Epide-miology and Biostatis-tics, Tehran University of Medical Sciences, Tehran, Iran, 5Shahid Beheshti University of Medical Sciences, Tehran, Iran

Correspondence to Seyed Abbas Moteval-ian, MD, Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, IranE-mail: [email protected]: May 17, 2012Accepted: 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 ac-cepted 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 ques-tionnaire. 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 de-pression scales.

Keywords: Validity; Reliability; Occupational Health; Health care workers; Questionnaire; Iran

Cite this article as: Tabatabaee Jabali SM, Ghaffari M, Pournik O, et al. Reliability and validity of persian ver-sion of job content questionnaire in health care workers In Iran. Int J Occup Environ Med 2013;4:97-102.

Introduction

The effect of poor psychosocial work conditions on health status has widely been discussed in occupa-

tional 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 there-fore needed to provide such evaluation.

Among numerous instruments de-veloped for the assessment of psychoso-cial 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, Ger-man, Greek, French, Italian, Japanese, Korean, Malaysian, Norwegian, Polish, and Spanish, to name a few) and the reli-ability and validity of the translated ver-

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sions 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 ver-sion of JCQ with job insecurity and job satisfaction scales, under the supervi-sion of JCQ center and tested the reliabil-ity 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 ques-tions were selected to compose the Per-sian questionnaire. Seven demographic

questions were included in the question-naire. These questions were categorized into 11 subscales: decision authority (3 questions), skill dissertation (6 ques-tions), psychological demand (5 ques-tions), physical excretion (1 question), job insecurity (4 questions), physical trauma (8 questions), supervisor support (4 ques-tions), coworkers support (4 questions), job satisfaction (4 questions), anxiety (6 questions), and depression (8 questions) scales.

Participants

The study was conducted in a training hos-pital 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 re-turned 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 calcu-lating 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 respon-dents were nurse, 137 (28.0%) technical

Table 1: Characteristics of the participants. Data are pre-sented 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

TAKE-HOME MESSAGE

Reliability and Validity of Persian Version of JCQ


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

Scale Item 1 2 3 4 5 6 7 8 9 10 11DL 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 0.51DL 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 -0.47JI job stability JI job security JI losing job 0.47PD 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

DL: Decision latitude; PsD: Psychological demands; JI: Job insecurity; PD: Physical demands; SS: Supervisor support; CS: Coworker support; JS: Job satisfaction; A: Anxiety; D: Depression

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officer, 137 (28.0%) support and service section worker, 34 (6.9%) doctor, and 10 (2.0%) were manager.

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 pos-sibility of performing factor analysis. Prin-cipal 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, physi-cal trauma, and psychological demand scales. Decision latitude scale, mainly constructed of two subscales—skill dis-cretion 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. Fac-tor analysis in the gender subcategories showed very similar results. Overall, the results of the factor analysis correspond-

ed closely with theoretical constructs of the questionnaire (Table 2).

The calculated Cronbach’s α was >0.75 for all scales except for psychologi-cal demand (α=0.60) and job insecurity (α=0.27), indicating insufficient internal consistency for the latter scale. The statis-tics were very similar for men and wom-en, except for the anxiety scale where the coefficient was >0.7 for women and <0.7 for men (Table 3).

Of 490 participants, 196 completed the questionnaire once again within four weeks. The κ statistic showed signifi-cant differences between the scales: de-pression 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 statis-tic for physical trauma (0.20) was sig-nificantly (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 lati-tude, 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 lati-tude, supervisor support, coworker sup-port, 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 ver-sions of the questionnaire. The inconsis-tency 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

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 losing job. Although the construct va-lidity of job insecurity scale was not strong in two main studies of Karasek6 and low-est 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), sug-gesting 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.

The reliability of the questionnaire var-ied 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 consis-tency in decision latitude (0.76–0.78 vs 0.54); however they were similar in terms of psychological job demand, social sup-port, 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 educa-tional 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. Moha-ghegh, Dr. M. Emadedin, Dr. A. Hasani, and Dr. A. Pazuki for their cooperation.

Conflict of Interest: None declared

References

1. Karasek R, Theorell T. Healthy work: Stress, pro-ductivity, 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. Occupational and environ-mental medicine 2000;57:805.

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

Main JCQ scalesKarasek, et al. (1998) Karasek, et al. (2003) Persian version

Men Women Men Women Men Women

Skill discretion 0.73 0.75 0.73 0.720.78* 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*,†Decision latitude = Skill discretion + Decision authority

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3. Requena F. Social capital, satisfaction and quality of life in the workplace. Social Indicators Research 2003;61:331-60.

4. JCQ Center UoM. JCQ Translations. [Web Page] Lowell: Job Content Questionnaire center; [up-dated 04/05/2008; cited 2011]; Available from: http://www.jcqcenter.org/Translations.html (Ac-cessed 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 hospi-tal nurses. Eastern Mediterranean Health Journal 2011;17:335-41.

6. Karasek R, Brisson C, Kawakami N, et al. The Job Content Questionnaire (JCQ): an instrument for in-ternationally comparative assessments of psycho-social job characteristics. Journal of occupational health psychology 1998;3:322.

7. Cheng Y, Luh WM, Guo YL. Reliability and valid-ity of the Chinese version of the Job Content Questionnaire in Taiwanese workers. International

Journal of Behavioral Medicine 2003;10:15-30.

8. Eum KD, Li J, Jhun HJ, et al. Psychometric proper-ties of the Korean version of the job content questionnaire: data from health care workers. International archives of occupational and envi-ronmental 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 second-ary 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.

11. Santavirta N. Construct validity and reliability of the Finnish version of the demand-control ques-tionnaire in two samples of 1028 teachers and 630 nurses. Educational Psychology 2003;23:423-36.

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Reliability and Validity of the Persian Version of the Scoliosis Research Society-22r Questionnaire