[The dimensions of the organisational climate as seen by general practitioners]. / Las dimensiones del clima organizacional percibidas por los médicos de familia.

OBJECTIVE: To create and validate a tool to assess the organizational climate (OC) perceived by general practitioners (GP). DESIGN: Descriptive, cross-sectional, and multi-site, study. SETTING: Health centres (HC) in Jaén and Málaga province Spain. PARTICIPANTS: Random sample of 38 HCs and 387 GPs. MAIN MEASUREMENTS: A self-administered questionnaire in March 2001, with the personal variables of sex, age, graduation date, specialty, kind of contract, time worked in primary care teams, time in current job, list size, case load, tutor of residents and academic qualification. HC variables: urban/rural, team structure, accreditation for teaching residents, service portfolio, out-patient care, and an OC scale of 40 Likert-like questions. We analysed the content validity of the scale by factorial analysis; and its reliability, by Cronbach's alpha and corrected scale-item correlation coefficients. RESULTS: Reply rate was 89.8%, 71% of the GPs were male, mean age was 44, 76% had tenure, and 37% were specialists in family medicine and 28% tutors, 17% with 3rd-year residents, 9% with doctors; 50% of HCs were rural and the mean team structure had 13 GPs and 4 paediatricians. We obtained 12 factors that explained 60% of variance, and 7 factors with reliability coefficients >0.50. We made an OC-positive scale (alpha=.82) with the dimensions for team-work, cohesion and social life; and another OC-negative scale (alpha=.78) composed of team conflict, perceived team failure, excess autonomy, authoritarian management, and GP-nurse tension. CONCLUSIONS: We found a questionnaire with good validity and reliability, which was useful for evaluating the OC perceived by GPs.

Las dimensiones del clima organizacional percibidas por los médicos de familia / The dimensions of the organisational climate as seen by general practitioners

Objetivo. Crear y validar un instrumento para medir el clima organizacional percibido por los médicos que trabajan en atención primaria. Diseño. Estudio descriptivo, transversal y multicéntrico. Emplazamiento. Equipos básicos de atención primaria (EBAP) de las provincias de Málaga y Jaén. Participantes. Muestra aleatoria de 38 EBAP y 387 médicos de familia (MF). Mediciones principales. Cuestionario autoadministrado en marzo de 2001 con variables personales: sexo, edad, año de licenciatura, especialidad, tipo de adscripción-contrato, tiempo trabajado en equipos de atención primaria y tiempo en la plaza actual, población asignada, frecuentación, tutor de residentes y grado de doctor; variables del centro: distribución urbano/rural, composición del equipo, acreditación docente para el sistema MIR, cartera de servicios y dispensación de cuidados, y escala de clima organizacional (CO) con 40 preguntas de tipo Likert. Analizamos la validez de contenido de la escala de CO mediante un análisis factorial, la fiabilidad de los factores con el alfa de Cronbach y los coeficientes de correlación ítem-escala corregidos. Resultados. Tasa de respuesta del 89,8%; el 71% de los médicos era varones, con 44 años de media; un 76%, propietario; un 37%, especialista MIR en medicina familiar; un 28%, tutor acreditado; un 17%, médico residente y un 9%, doctor. De los EBAP, 50% eran urbanos, con 13 MF y 4 pediatras de media. Obtuvimos 12 factores que explican el 60% de la varianza, y quedan 7 con coeficientes de fiabilidad > 0,50. Construimos una escala de CO positivo (alfa = 0,82) con las dimensiones trabajo en equipo, cohesión y vida social, y otra de CO negativo (alfa = 0,78) integrada por conflicto en el equipo, percepción de fracaso, exceso de autonomía, dirección autoritaria y tensión médico-enfermera. Conclusiones. Cuestionario con validez de contenido y buena fiabilidad, útil para evaluar el CO percibido por los MF en atención primaria

Objective. To create and validate a tool to assess the organizational climate (OC) perceived by general practitioners (GP). Design. Descriptive, cross-sectional, and multi-site, study. Setting. Health centres (HC) in Jaén and Málaga province Spain. Participants. Random sample of 38 HCs and 387 GPs. Main measurements. A self-administered questionnaire in March 2001, with the personal variables of sex, age, graduation date, speciality, kind of contract, time worked in primary care teams, time in current job, list size, case load, tutor of residents and academic qualification. HC variables: urban/rural, team structure, accreditation for teaching residents, service portfolio, out-patient care, and an OC scale of 40 Likert-like questions. We analysed the content validity of the scale by factorial analysis; and its reliability, by Cronbach's alpha and corrected scale-item correlation coefficients. Results. Reply rate was 89.8%, 71% of the GPs were male, mean age was 44, 76% had tenure, and 37% were specialists in family medicine and 28% tutors, 17% with 3rd-year residents, 9% with doctors; 50% of HCs were rural and the mean team structure had 13 GPs and 4 paediatricians. We obtained 12 factors that explained 60% of variance, and 7 factors with reliability coefficients >0.50. We made an OC-positive scale (*=.82) with the dimensions for team-work, cohesion and social life; and another OC-negative scale (*=.78) composed of team conflict, perceived team failure, excess autonomy, authoritarian management, and GP-nurse tension. Conclusions. We found a questionnaire with good validity and reliability, which was useful for evaluating the OC perceived by GPs