Reliability And Validity Verification Of The Chinese Version Subjective Instruments Of Mental Workload And The Application In General Practitioners Of Shanghai

ObjectiveStudies have shown that settings’mental workload exceeds physicians’ capabilities will affect the work efficiency and safety, while deficiency mental workload will result in tiredness and depressed and then reduce work capacity. Therefore, the purpose of mental workload assessment is to guarantee the mental workload level of us in an appropriate level, neither too much nor too little. In this way, our work will become safer, healthier and more comfortable, and we will get a better work performance. This study mainly achieves the following two purposes:1. To verify reliability and validity of the Chinese Version Subjective Instruments of Mental Workload in General Practitioners.2. To evaluate the mental workload of General Practitioners in community health service centers (CHSC) of shanghai and discover the factors that affect the mental workload of them, then to provide a basis for policy decision-making.Methods1. The original version was translated into Mandarin Chinese according to the standardized guidelines proposed in 2000 by Beaton et al.2. A convenience sampling of 110 participators were recruited to test the reliability and validity of the Chinese Version Subjective Instruments.3. Modified version of NASA-TLX was used to evaluate the mental workload of physician practitioner in CHSC of shanghai and discover the factors that affect the mental workload of them.ResultsThe reliability and validity of the Chinese Version Subjective Instruments of Mental Workload in General Practitioners1. NASA-TLX:The Cronbach’s alpha coefficient of the Chinese version NASA-TLX was 0.619.The Guttman Split-Half reliability of NASA-TLX was 0.703. Item-total coefficients were all greater than 0.3 and reached statistical significance (except for performance). In this study, The Kaiser-Meyer-Olkin value was 0.729 and Bartlett’s test of sphericity was highly significant (p<0.001), therefore principal component analysis with varimax rotation was conducted to examine the construct validity. As a result, NASA-TLX had two factors (F) whose characteristic root is greater than 1. Mental Demand, Physical Demand, Temporal Demand and Effort had bigger factor load in the Fl (ranged from 0.635 to 0.847); Performance and Frustration had bigger factor load in the F2 (0.860 and 0.560). Two factors accumulating contribution rate is 60.540%. The four variations of NASA-TLX had high correlativity (Spearman correlation coefficient ranged from 0.791-0.986).2. SWAT:The item Cronbach’s a coefficient is 0.669. The Guttman Split-Half reliability is 0.647. Item-total coefficients were all greater than 0.3 and reached statistical significance. The Kaiser-Meyer-Olkin value was 0.634 and Bartlett’s test of sphericity was highly significant (p<0.001). Principal component analysis with varimax rotation was examining the construct validity of the Chinese version SWAT. SWAT has only one factor whose characteristic root is greater than 1 and the accumulating contribution rate is 60.662%. The item factor load ranged from 0.712 to 0.834. The five variations of NASA-TLX had high correlativity (Spearman correlation coefficient range from 0.837-0.983).3. Convergent validity:Consistency between Variations of NASA-TLX and SWAT were calculated to test convergent validity. All of the Spearman correlation coefficients are larger than 0.3(range from 0.359-0.986).4. The Modified version of NASA-TLX:We removed performance from NASA-TLX, and called the modified version Cl-NASA-TLX. Then removed performance and frustration from NASA-TLX and called it C2-NASA-TLX. The Cronbach’s alpha coefficient was 0.724 and 0.746 and the Guttman Split-Half reliability was 0.772 and 0.759 respectively. Item-total coefficients of the two modified version of NASA-TLX were greater than original version. The Kaiser-Meyer-Olkin (KMO) test statistics of modified version NASA-TLX was 0.767 and 0.738, the result of Bartlett sphericity test was χ2=138.779 and χ2=120.556, both p<0.000. Both modified versions had only one factor characteristic root greater than 1; the factor contribution rate are 50.630% and 58.652%. The communality of each entry of C1-NASA-TLX was 0.275-0.714, while C2-NASA-TLX was 0.441-0.749.The mental workload of physician practitioner in CHSC of shanghai and the factors that affect the mental workload of them1. The Cronbach’s alpha coefficient of modified NASA-TLX was 0.798. The Guttman Split-Half reliability was 0.840. The modified NASA-TLX has one factor (F) whose characteristic root was greater than 1. The factor accumulating contribution rate was 60.540% and the item factor load was 0.830,0.759,0.810 and 0.779 respectively. The Spearman correlation coefficients with SWAT ranged from 0.346 to 0.388. Item-total coefficients ranged from 0.757 to 0.832. Each item score between high group and low group were statistically significant.2. The score of mental workload of general practitioners in CHSC of shanghai range from 11.95 to 63.56 and obeys the normal distribution. The mean is 46.48, the standard deviation of 10.59. We analyzed the data of the factors that affect the score of mental workload by using T test, ANOVA, Monadic linear regression and multivariate linear regression analysis. The result showed that the score of Traditional Chinese Medicine (TCM) was greater than Western medicine. General practitioners who worked in central urban areas had more mental workload than those worked in suburban districts. Number of patients of physicians to address was positively related with mental workload, the mental workload increase with the addition of the number of encounters. Physician job satisfaction had no relevant with the mental workload.Conclusion1. The Chinese version NASA-TLX and SWAT can serve as reliable and valid instruments for assessing the medical practitioners’perception of mental workload in China. However, the modified version of NASA-TLX which removed performance and frustrate seemed more suitable in clinical setting in china.2. Work category of General practitioners, the areas and the number of encounters every day is the main factors that affect the mental workload of them. Other factors, such as age, years of working, gender, time of work, education background and professional title has no effects on mental workload of General practitioners. No relationship was found between the measures of job satisfaction and mental workload.