Investigating discrimination in the workplace. Translation and validation of the Everyday Discrimination Scale for nursing staff in Germany

Nazan Ulusoy; Albert Nienhaus; Patrick Brzoska

doi:10.1186/s12912-023-01367-w

Investigating discrimination in the workplace. Translation and validation of the Everyday Discrimination Scale for nursing staff in Germany

BMC Nurs. 2023 Jun 9;22(1):196. doi: 10.1186/s12912-023-01367-w.

Authors

Nazan Ulusoy¹, Albert Nienhaus^{1

2}, Patrick Brzoska³

Affiliations

¹ Institute for Health Services Research in Dermatology and Nursing (CVcare), University Medical Center Hamburg-Eppendorf (UKE), Martinistrasse 52, 20246, Hamburg, Germany.
² Department of Occupational Medicine, Hazardous Substances and Public Health, German Social Accident Insurance Institution for Health and Welfare Services, 22089, Hamburg, Germany.
³ Health Services Research, Faculty of Health, School of Medicine, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58448, Witten, Germany. patrick.brzoska@uni-wh.de.

Abstract

Background: The Everyday Discrimination Scale (EDS) is a frequently used questionnaire in the field of health and social psychology that aims to explore perceptions of discrimination, especially instances of injustice related to various diversity characteristics. No adaptation to health care staff exists. The present study translates and adapts the EDS to nursing staff in Germany and examines its reliability and factorial validity as well as its measurement equivalence between men and women and different age groups.

Methods: The study was based on an online survey conducted among health care staff of two hospitals and two inpatient care facilities in Germany. The EDS was translated using a forward-backward translation approach. Direct maximum likelihood confirmatory factor analysis (CFA) was conducted to examine the factorial validity of the adapted EDS. Differential item functioning (DIF) related to age and sex was investigated by means of multiple indicators, multiple causes (MIMIC) models.

Results: Data on 302 individuals was available, of whom 237 (78.5%) were women. The most commonly employed one-factor, 8-item baseline model of the adapted EDS showed a poor fit (RMSEA = 0.149; CFI = 0.812; TLI = 0.737; SRMR = 0.072). The model fit improved considerably after including three error covariances between items 1 and 2, items 4 and 5, and items 7 and 8 (RMSEA = 0.066; CFI = 0.969; TLI = 0.949; SRMR = 0.036). Item 4 showed DIF related to sex and age, item 6 showed DIF related to age. DIF was moderate in size and did not bias the comparison between men and women or between younger and older employees.

Conclusions: The EDS can be considered a valid instrument for the assessment of discrimination experiences among nursing staff. Given that the questionnaire, similar to other EDS adaptations, may be prone to DIF and also considering that some error covariances need to be parameterized, latent variable modelling should be used for the analysis of the questionnaire.

Keywords: DIF; Everyday discrimination scale; German; MIMIC; Nurses; Validation.