Razvoj instrumenta za procjenu profesionalnih odnosa među bolničkim liječnicima [Development of an instrument for the evaluation of professional interpersonal relationships among hospital physicians]

Although, physicians’ professional interpersonal relationships single out as crucial (sub)category of medical professionalism and represents a crucial element of physicians’ everyday practice, they haven’t been systematically researched. About their potential importance, with exception of few studies, one can find out from scientific literature which aim is researching professional relationships among healthcare workers in general. Nonetheless, this scientific literature indicates that physician professional interpersonal relationships have a profound impact on health care processes and outcomes in their entirety. Questionnaire named professional interpersonal relationships among physicians (PIR) was developed as a method of evaluating the quality of professional interpersonal relationship among hospital physicians that will be reliable, valid, applicable and adequate for use in everyday practice. PIR is a self-report, five point Likert-type, internet-based questionnaire. Research was conducted through four steps involving qualitative and quantitative methods, with the aim of determining validity, reliability and usability evidence of the proposed questionnaire. Content validity and face validity of instrument were evaluated by first set of focus groups, after witch 52 items were included in next, pilot phase of research. Within the pilot phase of research (March 2016, n=84) 11 items were excluded from further analysis based on discrimination of items analysis and analysis of reliability of questionnaire subscales. Second set of focus groups confirmed findings from preliminary research phases and included additional criterion for establishing criterion validity that consisted of four self-contained items. Final testing phase, validation study (May, June and July 2016, n=445) included physicians working in hospitals in the City of Zagreb. Analysis preformed with additional established criterion excluded further 16 items from quantitative analysis. Further analysis of the final version of PIR questionnaire, which consist of 25 items, reveals sound psychometric properties. Reliability of questionnaire determined by Cronbach alpha coefficient was α=0,95. Explanatory factor analysis yielded two factor solution where the first was named „negative interpersonal relationships“ (which explained 44% variance), and second „shared and unified professional affect“ (which explained 4% variance). Construct (convergent and discriminant) validity of final questionnaire was well established thorough statistically significant correlation between PIR scores and many independent variables as physicians' age, working experience on institutional unit, working experience in medical field, medical speciality, physicians' satisfaction, physicians' subjective assessment of quality of care within institutional unit, turnover intention, workload index and physicians’ self-assessed general health. Results of the study provide robust evidence that PIR questionnaire is reliable, valid and applicable method of evaluating the quality of professional interpersonal relationship among hospital physicians’