Developing and validating the organisational health and toxicity scale: insights from a healthcare system crisis

This study introduces the Perceived Organizational Health and Toxicity (POHT) scale, a theoretically grounded and cross-culturally validated instrument designed to assess and improve workplace climate. Drawing on the Job Demands – Resources (JD-R) model, Conservation of Resources (COR) theory, and the Psychosocial Safety Climate (PSC) framework, the scale conceptualises organisationalorganisationalorganisational health and toxicity as a multidimensional continuum of employee perceptions. The POHT scale captures seven key dimensions – capability, governance, information flow, fairness, organisationalorganisationalorganisational awareness, growth, and equality – each reflecting tensions between enabling and harmful organisationalorganisationalorganisational forces. It was validated through five studies involving 2,371 clinical nurses across South Korea, China, and Japan during periods of systemic disruption, including a national doctors’ strike in South Korea. Analyses using exploratory and confirmatory factor analysis, item response theory, and cross-national comparisons confirmed the scale’s structural integrity, reliability, and contextual sensitivity. The POHT scale addresses persistent gaps in HRD scholarship by bridging positive and toxic workplace dynamics within a unified framework. Its brevity, conceptual clarity, and forced-choice format minimise response bias and enhance utility across cultural settings. HRD professionals may use the tool to monitor climate shifts, implement targeted well-being initiatives, and guide developmental interventions that promote resilience, inclusion, and sustainable organisationalorganisationalOorganisational transformation.