Development and Psychometric Properties of the Ethics Environment Questionnaire

OBJECTIVES: The author reports on the development and the psychometric properties of the Ethics Environment Questionnaire (EEQ), an instrument by which to measure the opinions of health-care providers about ethics in their clinical practice organizations. The EEQ was developed to increase the number of valid and reliable measures pertaining to ethics in health-care delivery. METHODS: The EEQ is a 20-item self-administered questionnaire using a Likert-type 5-point format, offering ease of administration. It is applicable to a cross-section of health-care practitioners and health-care facilities. The mean administration time is 10 minutes. The EEQ represents testing on 450 respondents in acute care settings among a cross-section of acute care facilities. RESULTS: Internal consistency reliability using Cronbach's alpha coefficient is 0.93, and the test-retest reliability is 0.88. Construct, content, and criterion validity are established. The scale is unidimensional, with factor loadings exceeding the minimum preset criterion. Mean score is 3.1 out of 5.0, with scores of 3.5 and above interpreted as reflective of a positive ethics environment. CONCLUSIONS: The EEQ provides a measure of ethics in health-care organizations among multi-practitioners in clinical practice on a valid, reliable, cost effective, and easily administered instrument that requires minimum investment of personnel time.