Validation of the Nurse Managers' Work Content Questionnaire and Factors-A Structural Equation Modeling Study

Abstract

Background: The responsibilities of nurse managers are diverse and occasionally inadequately organized. Moreover, the role of nurse manager often lacks a clear job description. Few methodologies for evaluating the content of nurse managers' work exist.

Purpose: This study was designed to validate the Nurse Managers' Work Content Questionnaire (NMWCQ) instrument and to analyze the relationships between NMWCQ factors and background variables using structural equation modeling.

Methods: A multicenter descriptive and cross-sectional study design was used. The NMWCQ, which includes 87 items across 13 components, was developed based on a comprehensive literature review and pilot study. The questionnaire was sent to all of the nurse managers ( N = 756) employed at eight Finnish hospitals in 2019. Exploratory and confirmatory factor analyses were used to psychometrically test and validate the NMWCQ, whereas Cronbach's alpha values were calculated to explore the internal consistency of the instrument. Structural equation modeling was applied to detect the relationships between the constructed factor structure and the background variables.

Results: Two hundred seven nurse managers participated in this study. The final solution for the NMWCQ included 75 items across 12 factors. The NMWCQ factors were as follows: responsibility for new employees, daily management, human resource management, decision making, clinical nursing, development, planning of processes, collaboration, ensuring knowledge, evidence-based management, ensuring care quality, and financial management. The items showed factor loadings that were either positive or negative, with values ranging from .314 to .846. The Cronbach's alpha values for the factors ranged between .605 and .851. All of the covariances and relationships between background variables and factors were found to be significant ( p ≤ .05). The structural equation modeling showed acceptable index results (incremental fit index = .954, comparative fit index = .951, and root mean square error of approximation = .048).

Conclusions: The NMWCQ version assessed in this study shows a more robust structure than the previously published pilot version. Psychometric testing showed the NMWCQ as suitable for describing the diverse work requirements of nurse managers and may offer a framework for concretizing the job description of nurse managers.