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[The dimensions of the organisational climate as seen by general practitioners]
Ana Delgado Sánchez1, Juan Angel Bellón Saameño, María Teresa Martínez-Cañavate López-Montes
1Agencia de Calidad Sanitaria de Andalucía, Sevilla, España.
Objective:
To create and validate a tool to assess the organizational climate (OC) perceived by general practitioners (GP).
Design:
Descriptive, cross-sectional, and multi-site, study.
Setting:
Health centres (HC) in Jaén and Málaga province Spain.
Participants:
Random sample of 38 HCs and 387 GPs.
Main Measurements:
A self-administered questionnaire in March 2001, with the personal variables of sex, age, graduation date, specialty, kind of contract, time worked in primary care teams, time in current job, list size, case load, tutor of residents and academic qualification. HC variables: urban/rural, team structure, accreditation for teaching residents, service portfolio, out-patient care, and an OC scale of 40 Likert-like questions. We analysed the content validity of the scale by factorial analysis; and its reliability, by Cronbach's alpha and corrected scale-item correlation coefficients.
Results:
Reply rate was 89.8%, 71% of the GPs were male, mean age was 44, 76% had tenure, and 37% were specialists in family medicine and 28% tutors, 17% with 3rd-year residents, 9% with doctors; 50% of HCs were rural and the mean team structure had 13 GPs and 4 paediatricians. We obtained 12 factors that explained 60% of variance, and 7 factors with reliability coefficients >0.50. We made an OC-positive scale (alpha=.82) with the dimensions for team-work, cohesion and social life; and another OC-negative scale (alpha=.78) composed of team conflict, perceived team failure, excess autonomy, authoritarian management, and GP-nurse tension.
Conclusions:
We found a questionnaire with good validity and reliability, which was useful for evaluating the OC perceived by GPs.
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