In the present study, we sought to examine the psychometric properties of a Chinese translation of the WMSHW. The current results provide supportive evidence regarding the cross-cultural reliability and validity of the inventory, so that WMSHW opens a new field of research in relation to work motivation of Chinese health workers by introducing a scale that measures motivation composition. Measuring and evaluating the work motivation of health workers could not only help improve their performance for patients in China, but also enable further internationally comparative studies.
The translated and cross-culturally adapted WMSHW demonstrated a good structural validity and internal consistency among Chinese sample. We used the well-established translation and back-translation guidelines to assure equivalence in varied aspects between source and target versions. During the translation of the English WMSHW into Chinese, a minor cultural discrepancy was encountered and one item of the WMSHW was modified accordingly: ‘supervisor’ was replaced with ‘leader’ as this word is closer to Chinese culture. Compared with previous studies that measure work motivation, this is the first study to confirm the structure of WMSHW with population working at health institutions in China without sacrificing any item.
The result of CFA showed that the modified five-factor model had better fit than the other models and selected as the best-fitting model, which was consistent with the original scales. In line with previous study testing the latent structure of work motivation based on SDT in seven languages[15], fit indices in the Chinses version demonstrated slightly lower than the original English version. Culture may have played a role in shaping the understanding of work motivation. Although values of RMSEA are barely within the scope of adequate model fit, our option was not to modify the model considering that the current results suggest that the five-factor model may be a theoretically adequate model for the data based on SDT. Therefore, the current results showed that a Chinese translation of the WMSHW demonstrates five-dimensional factor structure representing IM, IDEN, INTRO, EXT-S, EXT-E as hypothesized. Specifically, IDEN dimension combines integrated regulation and identified regulation which have proven difficult to separate in previous research [15, 22].
In line with previous studies (Maxime A Tremblay, 2009; Christina Moran et al., 2012), the correlation between both factors was identified as moderate, indicating that they are related but measure different composition of work motivation. Furthermore, strong internal consistency of the Chinese WMSHW was demonstrated, as evidenced by all Cronbach’s alpha coefficients over 0.8. In the Chinese WMSHW, the Cronbach’s alpha for the total scale (0.94) were much higher than in the English (0.89) versions, and Cronbach’s alpha for the five subscales was also higher than in the English version (0.92) [16].
The present study has several limitations that should be noted. First, this study adopted a convenience sampling method for province collection. Hence, bias in these measures may occur. The use of larger sample from various geographical locations is suggested to avoid misspecification of the model and bias in the existing scale. Secondly, the Chinese WMSHW has been tested only among health workers working at primary health care facilities, so further psychometric testing in secondary-level and third-level hospitals and other health settings would contribute to reject or confirm the generalizability of the instrument. Lastly, although our study translated and adapted the English-language scale into the Chinese language using standard procedures, the cultural differences between Western countries and China limit our ability to measure work motivation in Chinese culture contexts. Thus, further development that take culture differences into account is warranted.