Luppo Kuillman

Chapter 4 90 Reporting reprehensible conduct in care (RRC) Reporting behavior was measured by presenting respondents with two vignettes (See Appendix 1). In each of the described situations, a colleague exhibited morally questionable behavior. After reading the vignettes, the respondents were asked to indicate the probability that they would report this behavior, based on a 10-centimeter visual analogue scale (VAS) with a minimum value of 0 and maximum of 100 at interval level. Higher scores on the visual analogue scale indicated greater likelihood of reporting reprehensible conduct. Factor analysis revealed that the two scales were highly correlated with the underlying construct, with factor loadings of 0.80 and 0.81, respectively, explaining 69.4% of the variance. Communalities were >.6, thus suggesting that the sample size (N=155) was good. This was corroborated by the Kaiser-Meyer-Olkin measure of sample adequacy (.70), which was also in the range of “good” (MacCallum, Widaman, Zhang, & Hong, 1999). In the current study, the scale items were operationalized for unidimensionality rather than for internal consistency. For this reason, the degree of intercorrelation between items was used as a straightforward indicator of reliability. Unlike Cronbach’s alpha, the mean inter-item correlation (MIIC) is not dependent on the number of items in the scale. According to the guidelines of Briggs and Cheek, the optimal range for the MIIC is between 0.20 and 0.50, but it should not be less than 0.15 (Briggs & Cheek, 1986). It therefore seems reasonable to take the upper value of the range (i.e., MIIC≥.25 to ≤.55). The MIIC value of 0.34 confirmed the homogeneity of the RRC scale. Within the regression-based moderation model, “reporting reprehensible conduct” was estimated according to two indicators—a) changing the waiting list for heart transplantation (Vignette 1), and b) suspected administration of morphine (Vignette 2)—as a linear combination of the subjects’ scores on both subscales (Belk, ; Korch, 2015). Residual correlations between the two indicators of planned behavior and the likelihood of reporting reprehensible conduct were allowed, as they belonged to the same measure and were assessed simultaneously. Ethics Advocacy Scale (EAS) The propensity to advocate the importance of ethics in care was measured according to three Likert-type items ranging from 1 (not applicable) to 5 (completely applicable) with the following response options: 1) “I think it’s important—when there is a good reason to do so—to raise ethical aspects of care during patient care discussions;” 2)