Power assessment inventory: Tool development

Clinical Methods P o w e r Assessment Inventory:Tool Development

Pauline Taglialavore J o h n s o n and Charles W. Johnson

ANY AUTHORS have written about what

M the nurse executive should do to be powerful. To date, research on the power of the nurse executive has focused primarily on the interpersonal relationships found between the leader and the subordinate (Thrane, 1980) and the perceptions of the nursing administrative role by subordinates, physicians, and hospital administrators (Tubbesing, 1979; Zagarlick, 1981). There are no empirical data to identify the power of the chief executive nurse as compared with other executives in the hospital organization. According to Dennis (1983), "nursing needs to take a close look at the empirically untouched area of lateral power" (p. 56). However, there has been a lack of instruments with which to measure the equality of power. Tools exist that measure power strategies (Landry, Porter, & Lemon, 1989), power bases (Offermann & Schrier, 1985), getting one's way when interacting with a boss, coworker, or subordinate (Kipnis, Schmidt, & Wilkinson, 1980), and how to measure power, achievement, and affiliation motives (Welcher, 1983). However, none of these tools measure the equality of power or the amount of power possessed by the chief executive nurse. According to Pfeffer (1981), power is "somewhat tricky to measure and operationalize" (p. 4), but it must be assessed and measured if we are to do research on it. Pfeffer, a business administration professor, has written a plan to assess power in the organization. The plan included assessing power by determining which social actors benefit from symbols of power. Symbols of power are usually visible within the organization and are a measure of the power distribution. Symbols of power included such things as "titles, special parking places, special eating facilities, rest

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rooms, automobiles, airplanes, office size, placement, furnishings, and other perquisites of position and power" (p. 50). Symbols are used to distinguish among vertical levels of power in organizations. Although Pfeffer's plan for a power tool is impressive, he never completed construction of the instrument. Kanter (1977), a researcher of large corporate organizations, also has written of measuring power. A proposed tool included measures of alliance, visibility, authority, discretion, and degree of routinization. Unfortunately, Kanter also failed to develop this mechanism of power assessment into an operational tool for measurement purposes. Perrow (1970) developed the only tool that appeared to be applicable for measuring power; however, this instrument was directed specifically at industry and the terminology did not lend itself to the hospital organization. Perrow studied equality among industrial groups. He looked at 4 groups within 12 industrial firms to determine which group possessed the most power. According to Perrow, top management would prefer to avoid issues of equal power and focus instead on individual or one-to-one power. The tool he used covers the following categories: degree of power possessed, technology, discretion, task structure, influence, coordination, and departmental criticism. Landry et al. (1989) developed the Principal Power Tactics Survey (PPTS) to measure the power strategies used by elementary principals as perceived by teachers in their respective schools. The PPTS measured personal and position power overall, and included the seven subscales of assertiveness, ingratiation, rationality, sanction, exchange, upward appeal, and coalition. The instrument was based on the work of Kipnis, Schmidt, and Wilkinson (1980) who looked at the influence tactics used by one individual when attempting to change the behavior of others. The overall PPST was reliable at the .84 level with subscale reliabilities ranging from .44 to .84. They concluded that their instrument was valid and reliable. The position power section of the PPTS refers to

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the legitimate position of an individual and the authority to exert influence. With revisions, the PPTS may be useful to the nurse researcher who is measuring power strategies. Because an appropriate tool to measure the amount of power one possesses in the organization could not be found, the Power Assessment Inventory was developed. POWER ASSESSMENT INVENTORY The Power Assessment Inventory is a tool that was developed by Johnson (1989) to study the equality of power between chief executive nurses and other executives with similar titles in the hospital organization. The tool is composed of a demographic data form and a questionnaire. The questionnaire measures the amount of power possessed by individuals in the organization. Three subconcepts are included in the tool: (a) symbols of power, the visible evidence of the distribution of power within an organization; (b) prestige and esteem, the importance of an individual's position and the perception of whether or not the performance fulfilled the requirements of the position; and (c) legitimacy, the activities of a position that are accepted and expected by subordinates and are considered to be authority. Objective statements for each subconcept are presented. The subconcepts were derived from Etzioni's (1975) Compliance Theory which states that for power to take place, at least two individuals must be involved in a relationship. One individual must comply with the other's directive or command because it is supported by that individual's power. According to Etzioni, compliance is universal and is the central element of organizational structure. Items included on the tool were formulated from readings in the area of power but were primarily influenced by Etzioni's (1975) writings on normative power (derived from Compliance Theory), Pfeffer's (1981) proposed tool on assessment of power, Kanter's (1977) suggestions for measurement of power, and Perrow's (1970) tool on equality of power in industry. The objective statements for the subconcepts' symbols of power, prestige and esteem, and legitimacy are listed in Table 1. VALIDITY

Seven experts in the field of power and/or nursing administration were asked to analyze and judge the objective statements of the instrument and de-

termine if they were representative of each of the specific subconcepts. These experts participated in establishing the content validity (accuracy of content) of the instrument. They consisted of two nonnurses who have written extensively on organizational power, one director of a graduate nursing administration program, two nurse administrators in acute care facilities, one corporate vice president for nursing, and one nurse who has written several books on nursing administration. Experts were asked to analyze and judge the objective statements used in the instrument and to determine representativeness of the specific subconcepts. As a result, some of the wording was changed and five statements were added. Criterion-Related Validity Concurrent validity is a type of criterion-related validity. According to Borg and Gall (1983), concurrent validity is "determined by relating the test scores of a group of subjects to a criterion measure administered at the same time or within a short interval of time" (p. 279). Concurrent validity of the Power Assessment Inventory was determined by correlating the scores of pilot subjects completing the questionnaire to the investigator-developed Power Profile Scale (a self-report score of the individual's perceived power in the organization). Pilot subjects were asked to rate their own perceived power as well as the power of other executives with similar titles. The scale ranged from 1 to 10; 1 indicating least powerful and 10 indicating most powerful. The two scores were then compared to see if the individual's perceived power was similar to the power achieved on the tool. A Pearson product-moment correlation between the ratings of the Power Profile and the test scores of the Power Assessment Inventory (r = .63, p = .001) was significant. The correlation was too low to indicate that the two instruments were measuring power in the same manner but high enough to indicate that the two instruments were measuring some of the same power dimensions. RELIABILITY Reliability was established for the Power Assessment Inventory by computing a Cronbach's coefficient alpha to determine internal consistency. Borg and Gall (1983) state that "internal consistency can be determined from a single administra-

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Table 1. Objective Statements of Power Assessment Inventory Symbols o f Power My title is the same as other executives on my organizational level (e.g., vice president). I receive the same benefits as other executives on my organizational level (e.g., company car, special parking place, private bathroom, private office, carpet on floor, and private secretary). My office is comparable to other executives on my same organizational level. M y salary is comparable to other executives on my organizational level. M y position is located on the organizational chart. My position on the organizational chart reflects the real relationship(s) I have to the chief executive officer and others with my same title. I attend cross-departmental meetings. I have access to the chief executive officer whenever I need/want it. I have access to board members/trustees. I am expected to dress comparably to other organizational executives (e.g., business attire). Prestige and Esteem attend training programs, workshops, or orientations with others at the same organizational level. work on organizational projects with others at the same organizational level. represent my organization at state and national meetings. associate with other organizational executives at business functions. am invited to attend social functions held by other organizational executives. eat lunch with other organizational executives. am sought out or used for a source Of advice by' other executives in the organization. am on a first name basis with superordinates; define my peer group as those individuals who have similar titles as myself. Legitimacy have the power to hire personnel. have the power to fire personnel. have the power to promote personnel. have the power to discipline subordinates when I deem it necessary. have the power to reward employees (e.g., raises and promotions). have the power to withhold rewards (e.g., demotion, reschedule work time, or deny promotion). make independent decisions without checking with higher authorities. determine the salary levels for subordinates. report directly to the chief executive officer (e.g., administrator, executive director, president). control the departmental budget. control the development of policies for my department. have the final say in departmental matters. My recommendations are accepted by higher authorities 75% of the time. I have a vote on all powerful organizational committees (e.g., budget and executive). There is a written job description for my activities. I am privy to confidential information before it becomes public or communicated to others at my level. I can make exceptions to organizational policies without fear of punishment. These statements are numbered on the questionnaire as follows: symbols o f p o w e r - - l , 3, 4, 6, 7, 10, 12, 13, 25, 36; prestige and esteenv--5, 9, 14, 20, 21, 22, 24, 30, 33; and legitimacy--2, 8, 11, 15, 16, 17, 18, 19, 23, 26, 27, 28, 29, 31, 32, 34, 35.

tion of a single form of the test" (p. 284). Cronbach's coefficient alpha is used when items are not scored dichotomously and also when a test has several possible answers, each of which is given a different weight. Johnson (1989) mailed the Power Assessment Inventory to 600 subjects in 12 states and the District of Columbia. Three hundred forty-five subjects returned completed questionnaires. There were 146 chief executive nurses and 199 other executives who completed the questionnaire. The co-

efficient alpha for the overall tool was 0.87; this indicates that the tool was reliable. Coefficient alphas for each subscale were determined as follows: symbols of power, 0.36; prestige and esteem, 0.67; and legitimacy, 0.86. It should be noted that the subscale reliabilities of symbols of power and prestige and esteem are not as high as the overall reliability, possibly because of the low number of items on the questionnaire. The reliability of symbols alone is low, but when included as a whole the tool is reliable.

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8 7 6

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PILE Figure 1. Weighting and scoring.

FACTOR ANALYSIS

Factor analysis is a multivariate statistical procedure that can be used in the analysis of questionnaires to develop subconcepts (factors) of the instrument's main concept. Ferguson (1981) indicated that factor analysis is applied to data where the "concern is with the description and interpretation of interdependencies within a single set of variables" (p. 488). The process of factor analysis first reduces the original set of variables to a smaller set of factors. Each factor is a consolidation of some of the original variables. The second stage of the analysis requires a "rotation" which is a graphical realignment procedure with the derived factors amenable to structural interpretation. The varimax rotation method was used as a statistical confirmation of the choice of the three subconcepts and the structure each represents. This rotational method proposed by Kaiser (1958) is one of the most widely used procedures for factor analysis. The 36 questions on the Power Assessment Inventory tool were subjected to a factor analysis with varimax rotation with two thirds of

the questions falling into the empirical categories as developed by experts. Twelve of the 36 questions could be reassigned statistically to another subconcept other than the empirical categories. It was decided to leave those questions with the category assigned by a majority of the experts. WEIGHTING AND SCORING

The importance of each Power Assessment Inventory item was determined by using a modified Q-Sort. The Q-Sort requires ranking items and sorting them into piles to determine the most important statement of power and the least important statement of power (Waltz, Strickland, & Lenz, 1984). Each of the 36 items were placed on a separate card. Six nursing administrators in acute care hospitals and eight doctoral students in nursing were asked to rank the statements from the strongest indicator of power (1) to the weakest indicator of power (36). Items receiving the higher ranking were determined to be the most important, and items with low ranking were least important. It was determined that the items would be sorted

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into nine piles because users o f Q-Sort have found this to be an optimal number o f piles (Waltz et al., 1984). Therefore, the 36 items were sorted into nine piles according to the rank assigned by the judges (see Figure 1). According to Waltz et al. (1984): After sorting, each item is usually assigned a weight corresponding to the pile into which it is placed, that is, if a particular item was placed in pile 4, it would be assigned a weight of 4, while one placed in pile 9 would be weighted 9 (p. 303). By using the concept o f the normal curve and assigning 68% of the items to the middle three piles and 16% to the three piles in each tail, an approximately normal distribution was achieved. To achieve this approximately normal distribution of weights, 6 items were cast into the left tail, 6 items into the right tail, and 24 items were cast into the middle portion of the curve. Specifically, this meant from lowest to highest, that 1 item had a weight of 1; 2 items had a weight o f 2; 3 items had a weight o f 3; all o f which were in the lower 16% o f the curve. In the middle 68% o f the curve, 7 items had a weight o f 4; 10 items had a weight of 5; and 7 items had a weight of 6. In the higher 16% of the curve, 3 items had a weight o f 7; 2 items had a weight of 8; and 1 item had the highest weight of 9. Each item is scored on a Likert-type scale. Participants are asked to circle the most appropriate response for each item. The degree of agreeability and respective scoring procedures are determined by an indication of either " y e s " (2) or " n o " (I) and in some instances " I don't k n o w " (0); or " n e v e r " (0), " s o m e t i m e s " (1), "frequently" (2) or " a l w a y s " (3). By using forced choice res p o n s e s , s u b j e c t s are u n a b l e to c h o o s e a "noncommittal" or "middle-of-the-road" score. The value of the response on a question is multiplied by the " n o r m a l " weight (1 through 9) to determine the score for that item. The total possible score on the Power Assessment Inventory is 485. The subscale scores are symbols of power, 102; prestige and esteem, 88; and legitimacy, 295. DISCUSSION

The Power Assessment Inventory has potential in other areas of the health care hierarchy as well as nonhealth care settings. The tool could be used

to determine the power o f nurse executives in corporate owned institutions, as well as federal and military institutions. The power considerations of the nurse-physician relationships could be researched. Upper and middle manager nurses who hold positional power within the organization could be studied using this tool, as well as other health care workers at different levels of management in the organization. In nonhealth care settings, the tool could be used to determine the equality o f power of corporate executives at any level. Although this tool is a beginning step in the measurement of equality of power, factor analysis will be used more extensively to refine or extend the subscales. Statements from the 36 items will be deleted or shifted to other percepts using the factor analysis criteria and the questionnaire redistributed to a larger sample. For more specifics regarding scoring, please contact the author at her given address. REFERENCES

Borg, W.R., & Gall, M.D. (1983). Educational research (4th ed.). New York: Longman. Dennis, K.E. (1983, Fall). Nursing's power in the organization: What research has shown. Nursing Administration Quarterly, 47-57. Etzioni, A. (1975). A comparative analysis of complex organizations (rev. ed.). New York: Free Press. Ferguson, G.A. (1981). Statistical analysis in psychology and education (5th ed.). New York: McGraw-Hill. Johnson, P.T. (1989). Normative power of chief executive nurses. Image, 21(3), 162-167. Kanter, R.M. (1977). Differential access to opportunity and power. In A. Alvarez & K.G. Lutterman (Eds.), Discrimination in organizations (pp. 52-68). San Francisco:Jossey-Bass. Kaiser, H.F. (1958). The varimax criterion for analytic rotation in factor analysis. Psychometrika, 23, 187-200. Kipnis, D., Schmidt, S.M., & Wilkinson, I. (1980). lntraorganizational influence tactics: Exploration in gettingone's way. Journal of Applied Phychology, 65, 440-452. Landry, R.G., Porter, A.W., & Lemon, D.K. (1989). The principal's power tactics survey: The measurement of administrative power strategies of elementary school principals. Educational and Psychological Measurement, Inc., 49(!), 221228. Offermann, L., & Schrier, P. (1985). Social influence strategies: The impact of sex, role, and attitudes toward power. Perspectives of Social Psychological Bulletin, 11, 286-300. Perrow, C. (1970). Departmental power and perspectives in industrial firms. In M.N. Zald (Ed.), Power in organizations (pp. 59-89). Nashville, TN: Vanderbilt University. Pfeffer, J. ( 198I). Power in organizations. Marshfield, MA: Pitman. Thrane, J.M. (1980). Leadership styles and social power as

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perceived by nurse leaders. Unpublished doctoral dissertation, Texas Woman's University, Denton. Tubbesing, B. (1979). Perceptions of the director of nursing role in hospitals. Unpublished doctoral dissertation, University of California, San Diego. Waltz, C.F., Strickland, O.L., & Lenz, E.R. (1984). Measurement in nursing research. Philadelphia: Davis. Welcher, P.G. (1983). A behavior-oriented approach to measuring the power motive. Unpublished master's thesis, Medical College of Georgia, Augusta. Zagarlick, M.A. (1981). Hospital administrators' perceptions of the performance, behavior, and problems of registered nurses. Unpublished master's thesis, Texas Woman's University, Denton.

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From the School of Nursing, Baylor University, Dallas, TX; and Department of Mathematics, Louisiana State University at Shreveport, Shreveport, LA. Pauline Taglialavore Johnson, PhD, RN: Associate Professor, School of Nursing, Baylor University, Dallas, TX; Charles W. Johnson, PhD: Associate Professor, Department of Mathematics, Louisiana State University at Shreveport, Shreveport, LA. Address reprint requests to Pauline Tag/ialavore Johnson, PhD, RN, Associate Professor, School of Nursing, Baylor University, 3700 Worth St, Dallas, TX 75246. Copyright © 1991 by W.B. Saunders Company 0897-189719110403-000455.00/0