社会医学研究．第 34 巻 2 号．Bulletin of Social Medicine, Vol.34(2）2017

原著

Construct Validity of a Rating Scale for Workplace Harassment among Nurses
看護師の職場におけるハラスメント測定尺度の妥当性
MIKANE, Sakae1), DEI, Ryosuke2), YAMAGUCHI, Mieko1), NAKAJIMA, Kazuo3)
實金栄 1)、出井涼介 2)、山口三重子 1)、中嶋和夫 3)
1) Department of Nursing, Faculty of Health and Welfare, Okayama Prefectural University
2) Graduate School of Health and Welfare Science, Okayama Prefectural University3) Okayama Prefectural University
1) 岡山県立大学保健福祉学部看護学科
2) 岡山県立大学大学院保健福祉学研究科3) 岡山県立大学

Abstract
The aim of this study was to develop a rating scale to ascertain the circumstances of acts of harassment(hereinafter, “harassment scale”) with the objective of obtaining basic data to aid workplace harassment prevention
measures. A survey of 2,837 Japanese nurses was conducted. The survey comprised items about basic attributes(sex, age, years of experience as a nurse, years of continuous work) and six items about acts of harassment
prepared with reference to earlier studies. Surveys were recovered from 1,205 nurses, 1,149 of which were
without any missing items and were processed for analysis. In the statistical analysis, the processed surveys wererandomly divided into two groups and the data of each group were examined by factorial invariance using a onefactor model composed of six items. The results of this analysis statistically supported the factorial invarianceof this harassment scale. The discussion describes the validity of the scale development procedure and future
prospects for use of this scale.
抄録
本研究は職場ハラスメントの予防対策に資する基礎資料を得ることをねらいとして，ハラスメント加害の状況を把握する測定尺度（以下，ハラスメント加害尺度）の開発を目的に行った。調査は日本の 2837 人の看護師を対象とした．調査項目は基本属性（性，年齢，看護師経験年数，勤務継続年数）と，先行研究を参考に準備したハラスメ
ントの加害行為を問う 6 項目とした．回収された 1205 人のうち，解析項目の欠損のない 1149 人を集計対象とした．
統計解析では，集計対象を無作為に 2 群に分割し，それぞれのデータに対して 6 項目で構成される一因子モデルの因子不変性について検討した．その結果，ハラスメント加害を測定する尺度の因子不変性が統計学的に支持された。
考察では尺度開発の手順の妥当性と，今後の尺度活用の展望について述べた．
Key Word: Harassment, Perpetrator, Construct Validity
キーワード：ハラスメント、加害者、構成概念妥当性－ 11 －

社会医学研究．第 34 巻 2 号．Bulletin of Social Medicine, Vol.34(2）2017

1 Introduction

2.1 Survey subjects

In 2014, the Ministry of Health, Labour and Welfare

The authors surveyed 2,837 nurses working at(MHLW) published the “Report by the Working

one of the 25 facilities that consented to participate

Group for the Roundtable Conference Regardingfrom among the 165 medical facilities that wereWorkplace Bullying and Harassment” , which

randomly extracted by the authors from amongindicated that prevention of workplace “bullying andmedical facilities listed in the Status of Acceptance ofharassment” (hereinafter, “harassment”) is a pressing“Notification of Facility Criteria” published by eachmatter of policy. This report suggested that theRegional Bureau of Health and Welfare in Japan.

effects of harassment range widely from mental and

The survey was in the form of an anonymous self-

physical effects, such as depression1,2), post-traumatic

administered questionnaire. The questionnaires were

stress2), onset of fibromyalgia3), and job separation4),

distributed by nursing administrators (investigators)

5)

at the facilities that consented to participate.

1), to workplace effects, such as a reduction in
7)

workplace productivity or occupational accidents .

The questionnaires contained a clear explanation

Moreover, these effects may have been attributed

regarding the purpose of the study and the ethicalto extremely serious incidents. A review of previous

considerations, and subjects were requested tostudies revealed that, of the four-layer structureanswer the questionnaire and return it by mail only ifof harassment (perpetrator, victim, spectators,

they consented to participate in the study. Approval

6)

bystanders) , quite a few studies have examined

to conduct the survey was obtained from the ethicalthe relationship between impacts on victims andreview board of the authors’ institution (approval

9)

individual characteristics or workplace environment ;number: 317). The survey was conducted between

however, very few studies have examined these

November and December 2014.

8)

2.2 Survey content

10)factors in perpetrators of harassment . One reason

The survey was composed of items on basic

for this is the problem of rating scales. Rating scales
include the Leymann Inventory

subject characteristics (sex, age, years of experienceof Psychological Terrorization (LIPT-60) 12) , theas a nurse, years working at the present facility) and

Negative Act Questionnaire (NAQ)13), the Negative

items on harassment.

for harassment

11)

Act Questionnaire-Revised (NAQ-R) 14), the Work

Harassment is a superordinate concept

Harassment Scale (WHS) 15), and Work Bullying inencompassing bullying and harassment 19) and is

Nurses in Europe16) and the United States17). While

etymologically formed of the term “harass,” which

has developed a workplace bullying

means to annoy, and “-ment,” which is a suffix added

scale in Japan, this scale only measures harassment

to a noun to indicate a result, condition, action,

Munakata

18)

victims , and not acts of harassment by perpetrators.

or procedure on the previous term. Whether it isIf acts of harassment could be understood from thebullying or harassment, if an act annoys someone, it

perspective of the perpetrator, regardless of thatcan be perceived as harassment20). Terms associatedperson’s intent, that knowledge could offer significant

with harassment include “sexual harassment,”clues for the mechanisms of onset of harassment and“academic harassment,” “moral harassment,” andthe development of prevention measures.

“power harassment” (a Japanese-English term),2)

In light of the above, the aim of this study was toresulting in a mix of various expressions19). Thesedevelop a rating scale to ascertain the circumstancesindividual forms of harassment cannot always beof acts of harassment (hereinafter, “harassment

clearly classified21). In light of this, the present study

scale”) with the objective of obtaining basic data touses the term “harassment” as a generic term

aid workplace harassment prevention measures.

meaning “an act perpetrated against someone in
the same workplace that causes mental or physical2 Methods

suffering, or exacerbates the workplace environment,－ 12 －

社会医学研究．第 34 巻 2 号．Bulletin of Social Medicine, Vol.34(2）2017

that exceeds the appropriate scope of work, andthe last two responses.

that is related to workplace superiority, such as job

2.3 Statistical analysis

status or interpersonal relationships.” This definition

To obtain suggestions regarding the construct

was given in the “Report by the Working Group forvalidity of the rating scale, the conformity of the pre-the Roundtable Conference Regarding Workplaceassumed six-item, one-factor model to the data was

22)

Bullying and Harassment” . At the same time, theexamined by confirmatory factor analysis. In this14)

statistical analysis, subjects were randomly divided

and the Inventory of Violence and Psychologicalinto two groups (Group A and Group B) and theauthors took the Japanese versions

2, 23)of the NAQ-R

24)

Harassment (IVAPT-PANDO) , as well as earlier
studies12, 13, 15-17, 25)

strength of factorial invariance was investigatedas references to select scale items

using simultaneous multi-population analysis withthrough brainstorming (examination of content

equivalence constraints of threshold alone in Step 1

validity) with staff work-ing in medical health and(Model I), factor loading in addition to Step 1 in Step

welfare settings and university faculty specializing in

2 (Model II), and error variance in addition to Step 2

the field of medical health and welfare. In conjunction

in Step 3 (Model III). Comparisons of Model I and II

with satisfying the above definition of harassment,

and of Model II and III were done using a difference

attention was paid to the general rule that items

test (DIFFTEST)30). If the results of the DIFFTEST

highly likely to occur regardless of a hierarchicalwere p > 0.05, this was considered to indicate that

relationship between staff take precedence, resulting

the model was not wrong.

in the final selection of six items. The decision was

To determine the goodness-of-fit of thetherefore made in the present study not to makeaforementioned factor model to the data, comparative

this planned scale a measure that covered as much

fit index (CFI) and root mean square error of

workplace harassment as possible, but rather aapproximation (RMSEA) were used as fit indices andmeans of ascertaining the circumstances of workplaceweighted least squares means and variance adjusted

harassment. Specifically, this scale was composed of

estimation was used to estimate parameters. If

the items,“x1. Not recognizing the work or effort of

the CFI was generally 0.9 or above, the model wasthat person,” “x2. Making the person think he/she has

considered to fit the data. If the RMSEA was 0.05

no ability,” “x3. Avoiding or refusing to interact withor below, the model was considered to fit the datathat person, even while working,” “x4. Criticizing that

well, and if the RMSEA was 0.1 or above, the model

person’s working methods,” “x5. Overexaggerating

was not considered to fit the data very well31). The

or repeatedly bringing up that person’s past failures,”rating scale reliability was also examined using theand “x6. Pointing out how ineffectively that person

confidence coefficient omega 32). In analyses in theworks.” Responses to items were given on a five-present study, the software SPSS Statistics 22.0 was

point scale comprising, “I have never thought orused for descriptive statistics, M-Plus7.2 was used fordone this,” “I have thought this, but I have neverconfirmatory factor analysis and simultaneous factor

done this,” “I have thought this and attempted toanalysis, and R3.2.2 and EZRI 1.3233) were used for thedo this,” “I have done this,” and “I have done thisconfidence coefficient omega.

many times continuously.” Responses were set up in
this way in order to confirm the continuity of acts

3 Results

because harassment can be identified as a continuous

Of the 1,205 survey forms recovered (number

sequence of acts observed over a certain period of

distributed: 2,837), 1,149 without any missing items

time instead of a single act21, 26, 27), as pointed out by

were processed for analysis.

Leymann28) and Einarsen29). A score of 0 (“I have not

3.1 Distribution of processed subject

done this”) was given for the first three responses,

attributes

while a score of 1 (“I have done this”) was given for

The distribution of processed subject attributes is－ 13 －

社会医学研究．第 34 巻 2 号．Bulletin of Social Medicine, Vol.34(2）2017

presented in Table 1. The majority of subjects wereof obtaining basic data to aid workplace harassment

women, with only 178 men (15.5% ). Ages ranged fromprevention measures. Workplace bullying is an

18 to 71 years and the mean age was 42.5 years.

important factor of suicide risk routes (bullying

Nursing careers ranged from 0.1 to 57.8 years, anddepression

34)

years working at the present facility ranged from 0.4“enduring serious harassment, bullying or assault” toto 9.5 years.

problems with interpersonal relationships as “specific→→ suicide) . In 2009, the MHLW added

3.2 Examination of rating scale constructpsychologically stressful events” in the partial revisionvalidity

to their publication, “Guidelines for Determining the

The distribution of answers for harassment is presented

Role of Work in Psychological Stress-related Mental

in Table 2. Answers of “I have done this” and “I have

Disorders.” This problem was ranked III (“Strong

done this many times continuously” each accounted forpsychological stress that is rarely experienced inless than 10% of all answers to the six items. The answerslife”) in terms of severity35). This suggested that this“I have done this” and “I have done this many times

study was appropriate to address acts of harassment

continuously” were most commonly given in response toin the workplace. During scale development, the“x3. Avoiding or refusing to interact with that person, evenconstruct validity of the pre-assumed factor model

while working” (100 subjects; 8.7 % ), followed by “x1. Not

was examined by a structural equation model, which

recognizing the work or effort of that person”(79 subjects;

suggested that the selection of statistical methods

6.9% ) and “x6. Criticizing that person’s working methods”

was appropriate, based on recent trends in scale(57 subjects; 5% ).

development. This examination also suggested that

The results of the confirmatory factor analysis of
the harassment scale are presented in Figure 1. The

factorial invariance examination at each step in thetwo randomly classified groups was appropriate.

fit indices were RMSEA = 0.041 and CFI = 0.954 in

The results of the statistical analysis in thisGroup A, and RMSEA = 0.024 and CFI = 0.983 instudy revealed that the pre-assumed six-item, one-Group B, indicating that a statistically acceptablefactor model fit the data. These results support

level was met. Furthermore, the confidence coefficientthe finding that this is a strong scale in terms ofomega was 0.75 in Group A and 0.72 in Group B.

factorial invariance. In earlier studies, workplace

The results of the simultaneous factor analysis

harassment underwent so-called isolated classification,

performed while adding parameter (coefficient)such as relational aggression 36) (verbal, bodily andequivalence constraints are presented in Table 3.

physical aggression, neglect, etc.) and taking away

Adding parameter equivalence constraints lowered

opportunities 9). The six-item scale planned in thethe RMSEA and chi-square/df ratio but the CFI

present study more or less corresponds to thisremained mostly unchanged and the chi-squaretype of harassment if you exclude the bodily anddecreased. Moreover, the RMSEA was within thephysical aggression. As a general rule, harassment

range of 0.025 to 0.033 and the CFI was within theis a phenomenon formed on the premise of victim

range of 0.972 to 0.976. The results of the DIFFTEST

awareness27, 28, 37); however, there are instances where

were a chi-square of 4.220, df of 5, and p-value of 0.518

the victim is not aware they are being harassed

between Model I and Model II, and a chi-square of

because they sometimes view harassment as teaching

4.281, df of 5, and p-value of 0.383 between Model IIor guidance, and there are also instances where theand Model III.

victim does not report harassment due to fear of
being fired38). The harassment scale developed in the

4 Discussion

present study may provide useful information for

The aim of this study was to develop a rating

resolving such workplace problems.

scale to ascertain the circumstances of acts ofAt present, the impact of harassment on theharassment (“harassment scale”) with the objective

perpetrator has not been empirically clarified using－ 14 －

社会医学研究．第 34 巻 2 号．Bulletin of Social Medicine, Vol.34(2）2017

data regarding perpetrators. However, Kato 39)

to measure the harassment circumstances ofdeveloped an interpersonal stress coping scale withperpetrators in relation to workplace harassment.

delayed resolution coping, positive relationshipThis suggests that Lazarus et al 41).’s theory of coping

coping, and negative relationship coping, such as

cannot be ruled out in perpetrators, while the“ignoring” and “labeling the other party as thetheoretical variables (concepts) of stressors cannot

villain” as subordinate factors, in order to examine

be ruled out in victims. The rating scale developed

the relationship between those coping and stressin the present study therefore contributes to thereactions. Of these subordinate factors, only negative

clarification of the mechanisms of onset of workplace

relationship coping is reported to be associated withharassment in both perpetrators and victims, andstress reactions such as depression, anxiety, andcan be expected to contribute to the development of

40)

anger . This suggests that harassment including

prevention measures.

“ignoring” and “labeling the other party as the villain”

Acknowledgment

not only causes stress reactions such as depression injust the victim, but also causes negative reactions in

I would like to express my deepest appreciation

the perpetrator. The harassment scale developed in

to Mr. Hanjoe Kim of Arizona State University. Mr.

the present study can therefore be used to shed light

Hanjoe Kim gave me constructive comments on my

on the impact of harassment on perpetrators.

statistical analysis.

In the present study, we were able to develop a1This work was supported by JSPS KAKENHI

scale, with statistically supported construct validity,

Grant Number 25463336.

Table 1. Characteristics of subjects

1

GenderMale
FemaleTable 1. Characteristics
of subjects
Table 1. Characteristics
of subjects
n(%)
n(%)

178(15.5%)

Gender 971(84.5%)
Male SD (Range)
Mean㫧
Female42.5±10.9(18-71)AgeYears of experience as a nurse
18.9±11.6 (0.5-57.8)
Age 11.4±9.5 (0.1-48.8)
Years of service in current hospital

Years of experience as a nurse
Years of service in current hospital2
3

178(15.5%)971(84.5%)
Mean㫧SD (Range)
42.5±10.9(18-71)18.9±11.6 (0.5-57.8)
11.4±9.5 (0.1-48.8)

2. Distribution of answers for harassment
Table 2. Distribution of2
answers forTable
harassment

3 ItemsTable 2. Distribution of answers
1 for harassment
2

4
5
6
7
8

9
10
11
12
13
14

Answ ers

345x1. Not recognizing the w ork or effort of that person
511 (44.5)
421 (36.6)
138 (12.0) 65 (5.7)
14 (1.2)Items
x2. Making the person think he/she has no ability
818 (71.2)
237 (20.6)69(6.0) 18 (1.6)
7 (0.6)
1
2
x3. Avoiding or refusing to interact w ith that person, even(40.4)of that
422person(36.7)
163 (14.2)(7.0) 421
20 (1.7)x1. Not recognizing the w ork 464
or effort
511 80(44.5)(36.6)
w hile w orking
x2.methods
Making the person think he/she
has no ability
818 54(71.2)(20.6)
x4. Criticizing that person’s w orking
584 (50.8)420 (36.6)
88(7.7)(4.7) 237
3 (0.3)x3.bringing
Avoiding
or refusing
x5. Overexaggerating or repeatedly
up thatperson’sto interact w ith that person, even464 17(40.4)(36.7)
901 (78.4)
188 (16.4)
43(3.7)(1.5) 422
0 (0.0)past failures
w hile w orking
x6. Pointing out how ineffectively x4.
that Criticizing
person w orks
(73.1)
227 (19.8)
57(5.0)(1.7) 420
5 (0.4)that person’s w 840
orkingmethods
584 20(50.8)(36.6)
Answers: 1: I have never thought or done
2: I have thought this,I have neverdone this,I havethought this and attempted to do this,x5.this,Overexaggeratingor butrepeatedly
bringing
up 3:
that
person’s901 (78.4)
188 (16.4)
4: I have done this, 5: I have done this many
continuously
pasttimes
failures
Values are number of subjects (%).

x6. Pointing out how ineffectively that person w orks

840 (73.1)

227 (19.8)

Answ ers
3
138
69(12.0)(6.0)

163(14.2)

88

(7.7)

43

(3.7)

57

(5.0)

4 Answers: 1: I have never thought or done this, 2: I have thought this, but I have never done this, 3: I have thought this and a5
4: I have done this, 5: I have done this many times continuously
6
Values are number of subjects (%).
Table 3. Goodness of fit according to parameter (coefficient) equivalence constraints
7

df

Chi-square

Model I18

29.645Model II

23

36.746

Model III24

35.602

1.483

df

Model IV29

40.478

1.396

18

8

Chi-square/df ratio

RMSEA

CFI

1.647

0.034

0.969

Table
3. Goodness
according to parameter (coefficient) equivalence constraints
1.598
0.032of fit
0.963
Model I

0.029 0.969Chi-square/df ratio
Chi-square
0.026

29.645

0.969

1.647

Model I: No equivalence constraints.
II the equivalence
23
36.746
1.598
Model II: Factor loading of the primary Modelfactor as
constraint.
－
15－
Model III: Model II + variance of the primaryfactorastheequivalence
constraints.
Model III24
35.602
1.483
Model IV: Model III + error variance of the observed variable as the equivalence constraints.
Model
IV
29
40.478
1.396
RMSEA : root mean square error of approximation.
CFI : comparative fit index.
Model I: No equivalence constraints.

9

RMSEA

CFI

0.034

0.969

0.032

0.963

0.029

0.969

0.026

0.969

5
4:
I havedoneout
this,
5: I ineffectively
have done this
many
times
x6.
Pointing
howthat
personw continuouslyorks
840 (73.1)
227 (19.8)
57(5.0) 20 (1.7)
5 (0.46 4 Values
are number
subjects(%).or done this, 2: I have thought this, but I have never done this, 3: I have thought this and attempted to do this,Answers:
1: I haveofneverthought5
4: I have done this, 5: I have done this many times continuously
7 6 Values are number of subjects (%).
社会医学研究．第 34 巻 2 号．Bulletin of Social Medicine, Vol.34(2）20178 7 Table 3. Goodness of fit according to parameter (coefficient) equivalence constraints
3. Goodness
fit according
to parameter
equivalence
constraints
8TableTable
3. Goodnessof fit according
to parameter(coefficient)constraints
df ofChi-squareChi-square/df
ratio(coefficient)
RMSEA
CFI equivalence
Model I

18df
Model
II
Model I 2318
Model
III II 2423
Model
Model
IV III 2924
Model

29.645Chi-square
36.74629.64535.60236.746

1.647 ratio
Chi-square/df
1.598
1.647
1.483
1.598

0.034
RMSEA
0.032
0.034
0.029
0.032

0.969
CFI
0.963
0.969

0.969
0.963
40.478
1.396
0.026
0.969
35.602
1.483
0.029 0.969
Model
I: No
constraints.
Model
IVequivalence
29
40.4781.396
0.026 0.969
Model II: Factor loading of the primary factor as the equivalence constraint.
Model I: No equivalence constraints.
Model III: Model II + variance of the primary factor as the equivalence constraints.
Model II: Factor loading of the primary factor as the equivalence constraint.
Model
IV:III:
Model
IIIII++error
variance
the observed
as the equivalence
Model
Model
varianceof theofprimaryfactor asvariable
the equivalence
constraints.constraints.
RMSEA
root
meanIIIsquareerror of approximation.
Model: IV:Model+ error varianceof the observed variable as the equivalence constraints.
CFIRMSEA: comparative
fit index.
: root meansquare error of approximation.
Chi-Square
Test for Difference
CFI : comparative
fit index. Testing.
Between model
1 andmodel Testing.
2䋺Chi-Square=4.220, df=5, p-value=0.518
Chi-Square
Test forDifference9
10 9
1110
1211
1312
1413
1514
1615
16
Between model 1 and model 2䋺Chi-Square=4.220, df=5, p-value=0.518
17 Between model 2 and model 3䋺Chi-Square=4.281, df=5, p-value=0.3831㧓
17 Between model 2 and model 3䋺Chi-Square=4.281, df=5, p-value=0.3831㧓Harassment
Harassment

.679†
.679†
.866
.866
.563
.563
.734
.734
.868
.868
.764
.764

yx1
yx1
yx2
yx2
yx3
yx3
yx4
yx4
yx5
yx5
yx6
yx6

yx1

.749†

Harassment
Harassment

†
.749
.855
.855
.630
.630
.860
.860
.673
.673
.489
.489

yx1

yx2

yx2

yx3

yx3

yx4

yx4

yx5

yx5

yx6

yx6

Group
n=574
Group 2B
B n=574
df=9,=12.031,
df=9, ȤȤ2=12.031,
MSEA=0.024,
CFI=0.983
MSEA=0.024, CFI=0.983

Group
A n=575
Group
A n=575
df=9,
Ȥ2=17.720,
df=9,
Ȥ2=17.720,
RMSEA=0.041,
RMSEA=0.041,CFI=0.954
CFI=0.954

Figure 1. A Result of Confirmatory Factor Analysis

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1818 Figure
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