Samsudin, Wan Siti Auni Wan
(2023)
Cross professional team characteristics, translation and construct validation of teamwork survey questionnaire (TSQ) at Malaysian east coast public Hospital.
Masters thesis, Universiti Sains Malaysia.
Abstract
Cross professional teamwork in healthcare refers to the interaction between
individuals with different expertise and training backgrounds, working together
towards shared patient care goals. Cross professional teamwork is necessary to support
integrated service delivery. However, cross professional teamwork has not been given
sufficient attention in Malaysia’s developing country context. There is a lack of tools
to assess cross professional teamwork for Malaysian settings. This study aimed to
translate the English version teamwork survey questionnaire (TSQ) into Malay and
perform tool construct validation at a Malaysian east coast public hospital. The TSQ
assesses teamwork on domains of integration, climate and efficiency; the tool has been
previously used in Swedish and Australian settings. This study’s aim was achieved
through a cross-sectional mixed methods study in three phases. Phase 1 and Phase 2
were carried out through qualitative approaches while Phase 3 utilized a quantitative
approach. Phase 1 focused on translating the TSQ into Malay language using forwardbackward
translation together with the committee approach. Next, a qualitative
interview study was conducted in Phase 2 to explore fulfillment of cross professional
team characteristics at the hospital’s 16 inpatient wards. A total of 35 interviews were
conducted with medical, nursing and allied health professionals; the sample is
sufficient for qualitative data saturation. Recordings from interview sessions were
transcribed and thematically analyzed. The construct validity and reliability of the Malay version TSQ was determined in Phase 3. In Phase 3, 150 respondents were
recruited from wards found to have cross professional team characteristics during
Phase 2. A response rate of 98.24% was obtained in filling in the Malay version TSQ,
the percentage of recruited respondents being sufficient for statistical analysis.
Construct validity was assessed through Principal Component Analysis with Varimax
rotation and reliability was tested through the analysis of internal consistency. Findings
from Phase 1 indicate the translated Malay version TSQ to have equivalence with the
English version. Phase 2 interview findings reveal that inpatient wards generally fulfill
cross professional team criteria related to team composition, patient care objectives
and professional interactions. Phase 3 construct validation results indicate that three
constructs namely team climate, team efficiency and team integration, without any
item deletion are valid for the Malay version TSQ. The Cronbach’s alpha value is
0.917 for the translated whole TSQ scale, while the three scale constructs also have
reliable Cronbach’s alpha values in the range of 0.703-0.946. Discrepancies for
particular words used from the forward backward translation process were resolved
without affecting meaning of the original items. Health professionals in this study
acknowledge the different professions involved in patient care. However, disciplinary
diversity at the respective wards varies depending on patient care specialties and
treatment objectives. The Cronbach’s alpha values for the Malay version TSQ factors
reflect better team climate and integration values and comparably similar team
efficiency value when contrasted with the original tool. In conclusion, the results
support usage of the tool as a reliable instrument for assessing cross professional teams
in other similar Malaysian public healthcare services. Further research could test the
reliability and validity of the Malay version TSQ in other Malaysian regions.
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