STRAIGHTFORWARD INCIVILITY SCALE: ADAPTATION AND

VALIDATION OF WORKPLACE INCIVILITY MEASUREMENT FOR

PORTUGUESE SAMPLES

Tito Laneiro1, Luisa Ribeiro2, Martina Nitzsche3, Tânia Ferraro4, Genta Kulari5, Michael Leiter6

PSIQUE • EISSN 21834806 • VOLUME XIX • ISSUE FASCÍCULO 2

1ST JULY JULHO  31ST DECEMBER DEZEMBRO 2023 • PP. 86105

DOI: https://doi.org/10.26619/2183-4806.XIX.2.5

Submited on 05/01/2023 Submetido a 05/01/2023

Acceptted on 27/06/2023 Aceite a 27/06/2023

Abstract

The concept of workplace incivility is an underestimated subject in Portugal but a popular

one in the international literature. Workplace incivility does not intent to harm others, but it

harms workplace norms and put peaceful workplace environment into danger. Thus, the main

purpose of this study was to present the adaptation and validation of the Straightforward

Incivility Scale (SIS; Leiter & Day, 2013) for Portuguese healthcare professionals’ samples. SIS has

25 items that cover five different sources of Workplace Incivility (WI): supervisors, colleagues,

subordinates, customers or the participant her/himself. A Portuguese version of the scale was

administered to a total of 737 healthcare professionals from two major public hospital units from

the metropolitan area in Lisbon, Portugal (78% women, 83% nurses, 56% with ages from 25 to

34). To assess the factor structure, we submitted these samples to exploratory and confirmatory

factor analyses. The results provided psychometric support for the new Portuguese measurement

(SIS). Furthermore, it showed good reliability and convergent validity indices with burnout.

Considering the mainstream of studies in the healthcare sector, this study adds to the incivility

literature as a novel area of research. Furthermore, the study provides a validated version of

Straightforward Incivility Scale allowing simultaneous registration of five different workplace

incivility sources, while also providing a measurement with good psychometric properties. It is

our hope that the workplace incivility can be the focus of future studies measuring its outcomes

1 Centro de Investigação em Psicologia, Universidade Autónoma de Lisboa, tlaneiro@autonoma.pt

2 Centro de Investigação em Psicologia, Universidade Autónoma de Lisboa, mribeiro@autonoma.pt

3 Centro de Investigação em Psicologia, Universidade Autónoma de Lisboa, martina.nitzsche@hotmail.com

4 Centro de Investigação em Psicologia, Universidade Autónoma de Lisboa, taniaferraro@upt.pt

5 Centro de Investigação em Psicologia, Universidade Autónoma de Lisboa, gkulari@autonoma.pt

6 Deakin University, michael.leiter@deakin.edu.au

Corresponding author: Luisa Ribeiro, Centro de Investigação em Psicologia, Universidade Autónoma de Lisboa, mribeiro@

autonoma.pt

PSIQUE • e-ISSN 2183-4806 • Volume XIX • Issue Fascículo 2 • 1st july julho-31st december dezembro 2023 • pp. 86-105

Tito Laneiro, Luisa Ribeiro, Martina Nitzsche, Tânia Ferraro, Genta Kulari, Michael Leiter

among healthcare employees as well as to hospital managers and human resources raising

awareness within the context of healthcare sector.

Keywords: Workplace Incivility, Straightforward Incivility Scale, measurement validation, factor struc-

ture, psychometrics, burnout, health care professionals.

1. Introduction

Workplace incivility (WI) has increased in frequency and severity in the healthcare

environment in the last decade (Cortina et al., 2001; Pearson & Porath, 2009; Tricahyadinata et

al., 2020). There are numerous circumstantial reports of uncivil behaviour in healthcare settings,

although few empirical studies exist in the literature (Laschinger et al., 2009). WI is a subtle form

of workplace violence defined as “low-intensity deviant behaviour with ambiguous intent to

harm the target, in violation of workplace norms for mutual respect” (Andersson & Pearson, 1999,

p. 475). Uncivil behaviours include rude and discourteous comments and actions and generally

displaying a lack of concern for others. Pearson and Porath (2005) found that employees who

experienced uncivil behaviours at work intentionally reduced their work efforts and the quality

of their work. Furthermore, Cortina et al. (2001) linked workplace incivility to job dissatisfaction

and burnout. In particular, in healthcare sector, the prevalence of burnout is the highest when

compared with other professions (Greenglass, Burke, & Fiksenbaum, 2001). Similarly, more

recent research supported the previous findings, linking uncivil behaviours to burnout among

healthcare professionals (Laschinger et al., 2008; Read & Laschinger, 2013; Laschinger, 2012).

However, there is a dearth of research in incivility in healthcare sector in Portugal, which may be

due to the lack of validated versions of well-established measures. Furthermore, the majority of

the international research are focused, with few exceptions, on nurses, providing no perspective

on a broad occupational group of healthcare setting.

The present study, underpins the theory of Andersson and Pearson (1999) regarding the

concept of Workplace Incivility. The authors referred to various counterproductive behaviours in

the workplace such as lack of respect, courtesy or politeness toward co-workers. However, little

is known about the intention of such manifestations, consequently researchers have provided

different interpretations based on their sample and context (Andersson & Pearson, 1999; Cortina

et al., 2001; Pearson et al., 2000). Similarly, Leiter (2013) proposed two dynamics that contribute

to the emotional response of a negative social behaviour. One reason lies behind the intention the

instigator has to exclude the recipient from his or her social group. The other argument highlights

the relation of incivility to risk, as instigators of incivility become targets of hierarchy’s own

incivility, thus affecting their decision-making, and potentially putting their careers in jeopardy

(Irum et al., 2020; Itzkovich, 2016; Jiménez, 2018). Based on a recent systematic review, incivility

is still a novel area of research, especially in healthcare sector encompassing the perspective of

a broader occupational professions (Vazconcelos, 2020).

The original Straightforward Incivility Scale (Leiter & Day, 2013) was designed to measure

five sources of uncivil behaviours, encompassing supervisors, co-workers, subordinates,

clients, and the respondent itself. The 25-item scale provides evidence on the frequency uncivil

behaviours manifested in the last month. Meanwhile, studies involving healthcare professionals

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Straightforward Incivility Scale: adaptation and validation of Workplace Incivility measurement for Portuguese samples

have reduced the scale of SIS into 15 items. The work of Portoghese et al. (2015) accounted for

incivility among supervisors, co-workers, and respondents, while Fida et al. (2018) counted only

supervisors, co-workers, and physicians in their study involving Canadian nurses.

However, despite the broad and diverse body of work on incivility, to date it is difficult

for scholars and practitioners alike to integrate and understand the variety of findings on this

negative workplace behaviour (Schilpzand et al., 2016). Moreover, without a clear understanding

of the extant work, practitioners may not be able to incorporate the accumulated knowledge

in their organizational practices (Vazconcelos, 2020). However, based on the original theory,

considering that uncivil behaviour can lead to a spiral of violence, the present study is the first

one to include all five potential sources of incivility as originally anticipated by Leiter and Day

(2013). The scale offers an integrated measurement when applied either in a short term or in a

longitudinal study, which allows the monitoring of variations in uncivil behaviour over time, as

well as considering various sources (including the respondent).

Thus, the goal of this study was to standardize a European Portuguese measure of incivility.

To do so, we aimed to examine the validity and reliability of a Portuguese version of SIS in a

representative healthcare employees population by testing the internal consistency, the

convergent and discriminant validity, and the factorial structure of the scale. To date this is

the first study to integrate the perspective of various occupational groups in healthcare sector

measuring incivility. Considering the mainstream of studies in healthcare sector, this research

adds to the general literature of incivility. Furthermore, there is a dearth of literature studying

incivility in Portugal, thus the present study can provide a new instrument for future research to

measure the outcomes of incivility, in particular among healthcare providers.

The proposed instrument will allow organizations to assess incivility levels suffered by their

staff, informing them about the actual organizational culture. Incivility is a variable related to

poor performance and errors, which in a healthcare setting are particularly dangerous. At the

same time, it is internally controllable and, therefore, can be easily changed than other variables,

which depend on market demands, national policies and budget restrictions. It will distinguish

between different origins of incivility, allowing a targeted intervention. It will further deepen

understanding between incivility (and its different origins) and other variables pertinent to

personal and organizational health and performance.

2. Relevant literature

If anyone has doubts about whether workplace incivility deserves to be concerned, the

research suggests that workplace incivility may act as a precursor to other forms of workplace

violence (Andersson & Pearson, 1999). Incivility has been recognized as being “one of the most

pervasive forms of antisocial behavior in the workplace” (Cortina, 2008, p.56). Furthermore,

the main factor making workplace incivility very crucial in today’s work life is the so-called

“incivility spiral” (Andersson & Pearson, 1999). Uncivil acts of one employee may create a

snowball effect and can influence the whole organization because the targets of incivility can

easily transform into instigators.

Among several attempts to characterize workplace incivility, Blau and Andersson (2005)

described it as a type of social interaction, while others even as an interpersonal mistreatment

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Tito Laneiro, Luisa Ribeiro, Martina Nitzsche, Tânia Ferraro, Genta Kulari, Michael Leiter

(Cortina & Magley, 2003) that jeopardizes relationships not only from a personal but also

organizational and management level as well (Cortina & Magley, 2003; Estes & Wang, 2008;

Lewis & Malecha, 2011; Pearson et al., 2000; Torkelson et al., 2016). McNamara (2012) described

incivility among healthcare professionals in particular as related to status or position of power.

She observed that it is commonplace between co-workers displaying an asymmetry of power in

this context.

This position is further solidified in studies with recently graduated nurses that found them

more vulnerable to workplace incivility as a result of their limited experience and their new

status in the work setting (Laschinger, 2014; Laschinger et al., 2013; Read & Laschinger, 2013;

Smith et al., 2010; Wing et al., 2015). Hence it is of high interest to understand the consequences

of workplace incivility in nurses’ professional and personal life such as increased work stress,

absenteeism, frustration and decreasing satisfaction, which can lead to burnout (Tastan &

Davoudi, 2015; Welbourn et al., 2020; Wing et al. 2015).

In continuity, Laschinger (2014) found that different types of workplace mistreatment,

bullying and incivility in particular, have unfavourable consequences for nurses’ perceptions

of care quality and patient safety risks. Among healthcare professionals, nurses are most prone

to be the victim of uncivil behaviours (Ten Hoeve et al., 2019), especially in cases of physical

and verbal violence by patients or their companions (Speroni et al., 2014). A majority of studies

made use of the first Workplace Incivility Scale developed by Cortina et al. (2001), evidencing

the hostility between supervisor and co-workers (Portoghese et al., 2015). However, the scale

has a uni-dimensional structure that does not differentiate the uncivil behaviours coming from

different elements of the organization.

Leiter (2013) later developed a new measure of workplace incivility, the Straightforward

Incivility Scale (SIS), allows researchers to differentiate the uncivil behaviours, as identified by

the original theory. The scale is a self-reported measure aiming to evidence the nature of incivility

in the workplace, which has been vastly adapted in different languages and cultures (Matthews

et al. 2016; Portoghese et al. 2015; Smidt et al., 2016; Tsuno et al., 2017). The current study provides

support for adaptation and validation of the workplace incivility measure, Straightforward

Incivility Scale (Leiter & Day, 2013) for Portuguese samples as well. The final discussion points out

the main advantages of using the validated instrument and the contributions to the monitoring of

civility-promoting actions. The implications for practice and new directions for future research

are also discussed.

2.1. The outcomes of incivility

Being the target of workplace incivility evokes negative emotions like anger, fear, and

sadness (Porath & Pearson, 2005). Supporting such arguments, there are several studies showing

that uncivil work-place experiences are associated with negative work outcomes, like reduced

job satisfaction, increased job withdrawal, negative mood, and cognitive distraction (Lim et al.,

2008; Miler et al., 2012). Additionally, experiencing incivility is associated with lower energy

levels, higher levels of negative effect, lower task performance, etc. (Giumetti & Harfield, 2013).

Moreover, a number of studies have found that dissatisfaction with the job predicts various job

withdrawal behaviours, including turnover and retirement (Vasconcelos, 2020). Furthermore,

workplace incivility significantly reduces the quality of supervisor and co-worker relationship,

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Straightforward Incivility Scale: adaptation and validation of Workplace Incivility measurement for Portuguese samples

which negatively impacts job satisfaction, producing long-term effects on mental and physical

health conditions (Carter & Loh, 2017; Lim et al., 2008). As a consequence, organizations suffer

the costs of workplace incivility through job turnover, as well as decreased productivity and

work performance (Pearson & Porath, 2005; Wang & Chen, 2020).

One of the most important things of incivility is the fact that even witnessing incivility has

negative impact on employees. Witnesses of incivility perform less well on complex and creative

tasks. They are also less likely to be helpful, exhibit citizenship behaviours and more likely to

engage in dysfunctional ideation (Pearson & Porath, 2005). Thus, researchers working on work-

pace incivility mostly use Leiter & Day (2013) SIS. This 5-dimensional scale allows researchers

to differentiate the uncivil behaviours coming from different elements of the organization such

as supervisor and co-worker which may have different behavioural forms. Considering the vast

repercussion of incivility in organizations, we believe that would be fundamental for future

studies to measure the manifestation of uncivil behaviours, among healthcare employees in

Portugal. The literature can be of high interest to organizational managers and human resources

to embrace a new strategy that can keep uncivil behaviours at bay.

3. Method

3.1. Translation

The first step, consistent with previous literature (Behling & Law, 2000; Brislin, 1970; Werner

& Campbell, 1970), included translating the Straightforward Incivility Scale by Leiter and Day

(2013). A group of three bilingual research experts in the field were selected to translate the

scale from English to Portuguese. Three versions of translations were obtained and compared

to keep the original meaning of the scale and adapt to the Portuguese context. Differences were

resolved by experts’ discussion, reaching unanimity regarding the best proposal. After reaching

a final version, three other bilingual research experts in the field were invited to provide the

back-translation from Portuguese to English. After concluding this phase, a seventh English

native speaker was introduced to a phase of pre-test. Further, the scale was administered

among 30 nurses in order to evaluate the items’ comprehension for the final version and assess

its psychometric properties. The scale suffered minor changes after obtaining these results,

taking into account suggestions provided by the nurses. The final Portuguese version of the

Straightforward Incivility Scale kept 25 items, same as the original scale (Leiter & Day, 2013). The

instructions, format of items and response options were maintained (Appendix A).

3.2. Study design and data collection

A cross-sectional quantitative study design was conducted for the study. A convenience

sample with a total of 737 healthcare employees participated in the study, where 310 participants

came from Hospital A and 427 from Hospital B. Following ethical approval from the Ethical

Commission for the Psychology Research Center at the Universidade Autónoma de Lisboa, a

request letter to approach health employees was sent to the administration office of two hospitals

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Tito Laneiro, Luisa Ribeiro, Martina Nitzsche, Tânia Ferraro, Genta Kulari, Michael Leiter

in the great metropolitan area of Lisbon. For anonymity reasons we will refer to these units as

Hospital A and Hospital B. Sampaio (2021) found that registered healthcare employees in Portugal

suffered from higher rates of burnout and turnover rates, when considering that shortage of staff

and overload is more resistant in major hospitals.

After receiving the confirmation from the hospital administrations, all employees received

an introductory e-mail, explaining the study. Subsequently, three authors of the study introduced

themselves to hospital employees, visiting all teams and inviting them to participate. In Hospital

A, data was gathered during December 2015, and in Hospital B from March to April 2016. Although

some time has passed since data collection, and the conditions at Hospitals might have changed,

we retained the data for instrument validation purposes. This first Portuguese validation will

benefit from further studies to verify these results. However, the present study does not use the

sample to measure current incivility levels, nor to explore recent relationships between variables.

Regardless of current levels, the structure of the concept should remain the same across time.

The surveys were self-administered using printed copies of the questionnaire in an enclosed

envelope at their workplace after obtaining formal consent, introduced by the research team.

In Hospital A questionnaires were gathered in a ballot box until recovery by the research team.

In Hospital B questionnaires were offered during team meetings, and immediately gathered by

research team members. Inclusion criteria were adult (+18 years) healthcare employees registered

at the Hospital A and B at the moment of the data collection. Exclusion criteria included intern

health employees, and employees who had ties with either the research project or research team.

3.3. Respondents profile

The study population from the SIS validation consisted from a total of 737 participants from

healthcare employees registered in two major public hospitals in Lisbon, which in both samples,

the majority were women (respectively 76.4% and 78.4%) in the 25-34 age group (52.3%, 59.4%)

with a college degree (66.9%, 85.1%). The majority of healthcare professionals were nurses (59%,

96.5%) with 6-10 years of working experience in the units (34.4%, 32.8%). Table 1 introduces

further sample composition in terms of professional groups.

TABLE1

Sociodemographic Information (N = 737)

Sociodemographic information Study 1

n = 310

Study 2

n = 427

Gender n (%) n (%)

Men 72 (23.6) 90 (21.6)

Women 233 (76.4) 327 (78.4)

Missing values 5 10

Age (years)

≤ 24 16 (8.2) 31 (14.3)

25 – 34 102 (52.3) 129 (59.4)

35 – 44 36 (18.5) 33 (15.2)

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Straightforward Incivility Scale: adaptation and validation of Workplace Incivility measurement for Portuguese samples

45 – 54 29 (14.9) 20 (9.2)

55 – 64 12 (6.2) 4 (1.8)

Missing values 115 210

Civil status

Single 134 (43.9) 200 (47.8)

Married / non-marital partnership 151 (49.5) 199 (47.6)

Divorced / Separated / Widowed 20 (6.6) 19 (4.6)

Missing values 5 9

Number of children 1.1 (1.2) ; Min: 0 – Max: 7 0.7 (0.9); Min: 0 – Max: 3

Missing values 124

Professional Category Nurses: 177 (59.0) Nurses: 412 (96.5)

Physicians: 17 (5.7) -

Assistents:84 (28.0) -

Technician: 22 (7.3)

Missing values 10 15

Educational Level

PhD - 1 (0.2)

Master degree 23 (8.0) 40 (9.6)

College degree 192 (66.9) 353 (85.1)

Bachelor or equivalent 3 (1.0) 13 (3.1)

General nursing course 3 (1.0) 8 (1.9)

12th Grade / Vocational course 66 (23.0) -

Compulsory education - -

Missing values 23 12

Tenure

< 6 months 10 (3.8) 2 (0.5)

≥ 6 months < 2 years 20 (7.6) 36 (8.9)

2 – 5 years 65 (24.8) 84 (20.8)

6 – 10 years 90 (34.4) 132 (32.8)

11 – 15 years 32 (12.2) 69 (17.1)

16 – 20 years 14 (5.3) 41 (10.2)

21 – 30 years 21 (8.0) 32 (7.9)

> 30 years 10 (3.8) 7 (1.7)

Missing values 48 24

3.4. Instruments

3.4.1. Straightforward Incivility Scale (SIS)

To measure workplace incivility, the Straightforward Incivility Scale (SIS) was administered

(Leiter & Day, 2013). The scale has a total of 25 items on a seven-point Likert scale ranging from

0 (never) to 6 (more than once per day). The scale measures the frequency uncivil behaviour is

manifested in the workplace referring to the last month among the five sources of incivility.

Each source is comprised of the same five items (such as quantifying how often a supervisor

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Tito Laneiro, Luisa Ribeiro, Martina Nitzsche, Tânia Ferraro, Genta Kulari, Michael Leiter

“Spoke rudely to you”). The overall alpha Cronbach of incivility in sample 1 (EFA) was .96, while

in sample 2 (CFA) .94. Table 3 displays the Cronbach alpha for each of the workplace incivility

dimensions.

3.4.2. Maslach Burnout Inventory – General Survey

Since strong correlation have been found between incivility and burnout, it is relevant to

test for convergent validity, the Maslach Burnout Inventory (MBI-GS; Maslach & Jackson, 1981).

Burnout is defined as “a prolonged response to chronic emotional and interpersonal stressors on

the job” [Maslach et al., (2001), p.397]. The MBI-GS consists of 16 items in a seven-point Likert scale

ranging from 0 (never) to 6 (every day), distributed along three dimensions: emotional exhaustion

(five items), cynicism (five items) and professional efficacy (six items). The concept of burnout

comprises higher scores on exhaustion (e.g., “O meu trabalho deixa-me exausto/a”) and cynicism

(e.g. “Eu duvido do significado do meu trabalho”) and lower scores on efficacy (e.g. “Na minha

opinião eu sou bom naquilo que faço”). The inventory does not provide a score for burnout, but a

medium score of each of the dimensions. In the present study the validated MBI-GS Portuguese

version (available from Mindgarden.com) was used. The overall burnout Cronbach alpha of the

study was .81. Alpha coefficients for the MBI dimensions are emotional exhaustion .90; cynicism

.83; and professional efficacy .76.

3.5. Data analysis

Meyers et al. [(2006), pp.467-468] recommend performing factorial analysis of an inventory

of 25 items with no fewer than 250 participants. Tabachnick and Fidell (2007) highlighted that

“as a general rule of thumb, it is comforting to have at least 300 cases for factor analysis” (p.

613). We presented the Exploratory Factor Analysis (EFA) with n = 310 (sample 1) and data were

collected from healthcare professionals from Hospital A. We performed a Confirmatory Factor

Analysis (CFA), with n = 427 health care professionals from several specialized areas in Hospital

B (sample2).

3.5.1. Exploratory Factor Analysis (EFA)

To evaluate the factorial structure of the Portuguese translation of the Straightforward

Incivility Scale, EFA was applied, following the procedure of Hair et al. (2006) and Tabachnick

and Fidell (2007). For this procedure, we worked with 310 healthcare professionals (sample 1).

To determine the suitability of data for factor analysis, the Kaiser–Meyer–Olkin (KMO) test was

used. Homoscedasticity of our samples was verified through the Bartlett’s test. The parallel

analysis method was used, following the procedure described by O’Connor (2000). To confirm

the number of components to extract, the scree plot technique (Cattell & Vogelmann, 1977),

based on eigenvalues, known to be one of the most accurate (Zwick & Velicer, 1986) was used.

Communalities were analysed and the factors were obliquely rotated using Promax (Tabachnick

& Fidell, 2007). Promax has been shown to perform either as satisfactory a Varimax, or “much

better” (e.g. at high correlation factors; Finch, 2006). We accepted factor loadings equal to or

greater than .40 as sufficient (Hair et al., 2006). The correspondence between the subscale scores

was assessed applying zero-order correlation (Pearson).

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Straightforward Incivility Scale: adaptation and validation of Workplace Incivility measurement for Portuguese samples

3.5.2. Confirmatory Factor Analysis (CFA)

CFA of the 25 items was performed with our second sample preponderantly composed of

nurses from a different hospital from the EFA sample. Based on previous research (Leiter et al.,

2015; Leiter and Day, 2013; Mathews and Ritter, 2016), the theoretical framework, the previous

EFA, and comparisons with other validation processes in other languages (Portoghese, et al.,

2015; Smidt et al., 2016; Tsuno et al., 2017), we expected to find five factors. Confirmatory factor

analyses were performed with IBM SPSS AMOS 24.0 (Arbuckle, 2014).

To analyse the goodness-of-fit indices of the model, we began to assess the chi square value

of sample and its significance. However, it is expected that chi-square will almost always be

statistically significant for models with N ≥ 300, because of the sensitivity of the chi-square test

to large sample sizes (Kline, 2011).

Additionally, the model was evaluated using several fit indices: the Comparative Fit Index

(CFI), the Goodness of Fit Index (GFI), the Bender-Bonnet Normed Fit Index (NFI), and the Root

Mean Square Error of Approximation (RMSEA). In general, values close to .95 for the CFI and

NFI indicate an excellent fit (Hu & Bentler, 1999; Kline, 2011; Marôco, 2014; Meyers et al., 2006),

whereas values of .90 or greater reflect a reasonable fit (Hair et al., 2006; Lomax, 2010; Mueller

& Hancock, 2010). However, especially considering the susceptibility of indices to large sample

sizes (Meyers et al., 2006), it is pointed out that for N ≥ 250 and a number of observed variables

between 12 < m < 30, CFI values of .90 or above indicate an excellent fit (Hair et al., 2006). Less

affected by sample size, GFI’ results closer to .90 indicates the best fit (Meyers et al., 2006). The

RMSEA for most acceptable models has values below .10 (Kline, 2011). Therefore, with our large

sample size, that is not surprising (Meyers et al. 2006), and we needed to employ alternative fit

measures to evaluate the proposed model. To consider the level of parsimony in the model, we

took into account the PCFI (Parsimony Comparative Fit Index), PGFI (Parsimony Goodness of Fit

Index), PNFI (Parsimony Normed Fit Index) and AIC (Akaike Information Criterion). As is well

known, there are no absolute rules or standards to determine a bad and good fit model (Hair

et al., 2006; McNeish et al., 2017). Adequacy of fit has to be judged considering the statistical

standards, psychometric reflections and internal coherence with the theoretical framework and

practical implications.

4. Results

Our results are presented in three main parts. Firstly, we examine the exploratory factor

analysis. Secondly, we present the confirmatory factor analysis using structural equation

modelling (SEM). Finally, in search of additional effects, we analyse zero-order correlations

among SIS and Burnout to assess the convergent validity.

4.1. Exploratory Factor Analysis

We performed the KMO = .93 and Bartlett = χ2 (300) = 9391.07, p < .001 tests, which indicated

appropriate values. The parallel analysis method (O’Connor, 2000) applied confirmed the five

factors. The scree plot technique based on eigenvalues indicating 5 components. The eigenvalue

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Tito Laneiro, Luisa Ribeiro, Martina Nitzsche, Tânia Ferraro, Genta Kulari, Michael Leiter

for the first factor not retained was .82 (Henson & Roberts, 2006). All factors together explain 81%

of total variance.

Results confirm the 5-fatorial structure of the instrument, no item saturated outside the

expected dimension. The interpretation assigned to each of the five factors was as follows.

Factor 1 refers to incivility of supervisor behaviour, such as ignoring, excluding, speaking

rudely, behaving rudely (through gestures, facial expressions or others) and/or behaving without

respect for the participant. Factor 2 concerns the incivility behaviour of colleagues and/or other

health care professionals from the same team. Factor 3 concerns the incivility behaviour of

subordinates. Factor 4 is related to incivility behaviour of clients, customers or users, and Factor

5 includes items related to incivility on the part of the respondent. Considering that workplace

incivility can trigger a spiral of violence, the information from different elements of teams

working in the organizations and their perception of uncivil behaviour, including that of clients,

contributes to forming a more comprehensive and integrative perspective of the reality of WI in

the organizations studied.

4.2. Confirmatory Factor Analysis

As already mentioned, we examined items correlating above .40 with the respective factors

in the exploratory factor analysis (after rotation), whose content we considered not redundant

with that of other selected items and coherent with the general meaning of the factor (Hair et al.,

2006). All 5 items for each factor were keeping. The structural model tested included a general,

second-order factor influencing the five factors previously encountered in the exploratory

analysis and explaining their intercorrelations (see Figure 1). In the initial analysis with this

model, Figure 1 shows the factor structure with standardized estimates of SIS for the adjusted

model in our sample 2 (n = 427).

We found that ten items showed raised modification indices and, additionally, still emphasized

the interaction between items 1 and 2 of the subscales relate to supervisors, colleagues,

subordinates, clients and participants themselves. Theoretical plausibility was applied to judge

whether the proposed changes should be adopted. If we resort to a qualitative analysis of these

items: item 1 refers to being ignored and item 2 refers to being excluded.

We can suppose that these two behaviours are closely related, seeming similar in some people’s

understanding, probably being related to the source of these values. We decided to add paths

between residuals (allowing for covariance) and these items. Still observing the modification

indices and taking into account the meaning of some items, we added the other covariances until

reaching the best fit. In all cases, there seemed to be a rationale behind these changes – either

the items reflected behaviours which tend to co-occur (e.g. rude gestures and rude words), or

in the case of different dimensions, the might reflect the same reality from different sources

(inconsiderate behaviours across the organization, from supervisors, colleagues, subordinates,

clients and self). We did not delete any paths. The quality of the final structural model tested

showed good adjustment, as presented in Table 2.

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Straightforward Incivility Scale: adaptation and validation of Workplace Incivility measurement for Portuguese samples

FIGURE1

Final Structural Model Tested

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Tito Laneiro, Luisa Ribeiro, Martina Nitzsche, Tânia Ferraro, Genta Kulari, Michael Leiter

TABLE2

Goodness of Fit Indices of Structural Models Tested

Sample 2 (n = 427) χ2df χ2/df CFI GFI NFI TLI RMSEA PCFI PGFI PNFI AIC

Model1 (without adjustments) 2193.48** 270 8.12 .83 .68 .81 .81 .129 [.124, .134] .75 .56 .73 2303.48

Model 2 (with adjustments) 977.44** 256 3.82 .94 .83 .92 .93 .081 [.076, .087] .80 .66 .78 1115.44

χ2 (chi-square); df (degrees of freedom); CFI (Comparative Fit Index); GFI (Goodness of Fit Index); NFI (The Bender-Bonnet Normed Fit

Index); PCFI (Parsimony Comparative Fit Index); PGFI (Parsimony Goodness of Fit Index); PNFI (Parsimony Normed Fit Index); AIC (Akaike

Information Criterion); RMSEA (Root Mean Square Error of Approximation).

** p ≤ .001

To analyse the goodness-of-fit indices of the model, we began to verify that the chi square

value of sample is statistically significant (p ≤ .000) which indicates the expected lack of fit (for

models with N ≥ 300; Kline, 2011). Therefore, with our large sample size (Meyers et al., 2006), we

needed to take into account the level of parsimony in the model (considering PCFI, PGFI, PNFI

and AIC).

These indices indicate that we have a good adjustment considering parsimony (Marôco,

2014; Mulaik et al., 1989). Goodness of fit indices before (Model 1) and after model amendments

suggested by the results (Model 2) can be seen in Table 2. The SIS showed an acceptable

representation through five latent factors representing five different relationships/ sources of

workplace incivility (supervisors, colleagues, subordinates, clients, customers, users and the

participant him/herself as instigator). Although GFI’s value (.83) is in fact below the threshold

defined in the literature as representing a good, or at least a reasonable fit (which other indices

show), this index is recognized as having a more severe downward bias then others. The general

rule of thumb, of a value higher than .90, might not equally work for all indexes (Fan et al, 1999).

The next step was to calculate Cronbach alphas for each of the five factors, checking the

contribution of items and deleting those that lowered the alpha value for the factor (see Table 3).

We concluded this stage with 25 items and 5 factors as previously observed in the EFA.

4.3. Test of convergent validity

Convergent validity (Urbina, 2014) was evaluated through Pearson’s correlation between

WI and burnout. The choice of the burnout concept to test convergent validity was due both

to its potential conceptual proximity to WI and to the existence of previous empirical studies

already mentioning the relationship between these concepts (Fida et al., 2018; Laschinger et

al., 2009; Leiter et al., 2015; Leiter et al., 2011). In particular, considering Portuguese samples of

health care professionals, Marôco et al. (2016) referred to the interactions between burnout and

the perception of poor conditions of work. Among the antecedents of organizational sources

of burnout, Vala et al. (2016) related the perception of fewer organizational resources, more

demands on relationships with co-workers, more demands on relationships with patients and

more demands of working hours as the main predictors of higher levels of burnout. Table 3 shows

the Means and Standard Deviations for the scores of Straightforward Incivility Scale (SIS), as

well as the intercorrelations of these factors with Burnout (n = 427).

We found a high level of correlation between overall constructs, with Overall Incivility

relating strongly and positively to Overall Burnout. Turning to more specific SIS factors, we also

expected all the correlations between these factors, Overall Burnout and the Burnout dimensions

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Straightforward Incivility Scale: adaptation and validation of Workplace Incivility measurement for Portuguese samples

(exhaustion, cynicism and professional inefficacy) to be strongly related. But they showed only

moderate to high correlations. Despite Burnout-Professional Inefficacy also showing significant

correlations with all Incivility factors, it was the factor showing the lowest levels of correlation.

TABLE3

Descriptive Statistics and Correlations Between Factors of the Straightforward Incivility Scale (SIS) and

Burnout Using Pearson’s Correlation Coefficient in the Portuguese Sample

(n= 427)

Measure Overall

Burnout

(MBI)

Exhaustion

(MBI)

Cynicism

(MBI)

Professional

Inecacy (MBI) M SD a

Overall Incivility (SIS) .52** .42** .45** .19** 17.03 19.42 .94

1. Factor 1_Supervisor (SIS) .48** .41** .43** .15** 4.29 6.25 .93

2. Factor 2_Colleagues (SIS) .37** .29** .33** .12** 2.89 4.93 .94

3. Factor 3_Subordinates (SIS) .34** .22** .28** .17** 2.48 4.53 .94

4. Factor 4_Client_Consumers_Users (SIS) .33** .32** .25** .12** 5.03 6.28 .91

5. Factor 5_Participant him/herself (SIS) .39** .28** .39** .16** 2.34 3.92 .89

M 33.86 16.20 10.02 7.81

SD 14.59 7.40 7.30 5.10

** Correlation is significant at the 0.01 level (1 tailed).

* Correlation is significant at the 0.05 level (1 tailed)

5. Discussion

Exploratory factor analysis allowed us to identify five factors covering different key players

as potential sources of working incivility. Confirmatory factor analysis presented good model

adjustment. Cronbach’s alpha (internal reliability coefficients) proved to be adequate for the five

factors found. Correlations with burnout showed convergent validity of SIS subscales. The SIS

measurement has only 25 items, it is simple to administer and score, and can give an integrative

vision of WI perceptions in various organizational settings. Given our original goal of validating

SIS, we concluded that we achieved the final measure.

Considering the convergent validity test, the participants correlate the perception of burnout

(overall and dimensions) with WI. Interestingly, the healthcare professionals in our sample

associate the perception of workplace inefficacy (or less professional achievement) with incivility

in a moderate way.

Leiter (2013) argued that the SIS was created as a short psychometric instrument to evaluate

the frequency of uncivil interactions in the workplace in the last month. Arvey and Cavanaugh

(1995) stressed the risk of report periods longer than 12 months potentially leading to serious bias

in self-reports related to memory distortions. SIS also differs from the preceding measurements

by offering a labelled 7-point Likert scale as response options.

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Tito Laneiro, Luisa Ribeiro, Martina Nitzsche, Tânia Ferraro, Genta Kulari, Michael Leiter

Despite reports of rising incivility levels in the healthcare environment (Cortina et al., 2001;

Pearson & Porath, 2009; Tricahyadinata et al., 2020), in Portugal the scientific literature dedicated

to this issue is still scarce. Given that incivility may affect service quality (e.g. Giumetti & Harfield,

2013; Pearson & Porath, 2005; Wang & Chen, 2020) as well as the health of the incivility recipient

(Carter & Loh, 2017; Lim et al., 2008; Laschinger et al., 2008; Read & Laschinger, 2013; Laschinger,

2012; Porath & Pearson, 2005), measuring its levels to inform the need for intervention is a critical

issue.

The proposed instrument identifies several sources of incivility, allowing for a targeted

intervention, according to the reality of the respondent. Different health services will have

different demands, depending on whether they deal with patients only, patients and their

families, different professional classes and patient criticality.

Not only does incivility influence patient care quality and healthcare professionals’ health,

but incivility, if not correctly addressed, might also work up to violence and bullying (Andersson

& Pearson, 1999). Measuring incivility prior to more severe workplace problems allows the

timely development of preventive (or corrective) measures. These measures, arising from team

and organization dynamics’ needs, will have the advantage of not depending on national health

policies, which have some stability, and can be tailored to teams’ and services’ specificities.

The availability of SIS for the general healthcare community and respective researchers is an

important asset in building better conditions for healthcare professionals, as well as assuring the

best possible patient care.

Our validation study is a first contribution towards this goal. Further studies will be

necessary to assess the viability of modifications for optimum statistical results and to further

our understanding of the SIS suitability for other professions in Portugal. SIS can also advance

scientific knowledge on the results of incivility interventions (as a pre and post measure), as

well as on the relationship between this and other relevant concepts for Portuguese participants,

namely Psychological health measures, productivity results and organizational culture variables.

6. Conclusion

The original SIS version only focused on organizational sources of WI (supervisors, colleagues,

subordinates and the participant him/herself or instigated incivility) but subsequently another

source was added: customers. SIS considers customers an outside extra-organizational source of

incivility. Future research will be able to verify if there are different types of WI spirals triggered

by sources inside or outside the organization.

As a self-reported instrument, SIS has the known limitations of this kind of measurement, and

these apply to our study. Regarding the samples, further research should strengthen the validity

assessment by recruiting samples with other professional or occupational groups and by adding

further variables to test convergent and discriminant validity. The evaluation of interactions of

Workplace Incivility with other variables will enrich the nomological network of the concept

(Cronbach & Meehl, 1955).

Information about the perceived frequency of incivility in the workplace (in the last month)

allows it to be used as a one-off measurement or in longitudinal studies to allow monitoring

WI oscillations over time, for example, as a way of monitoring the results of interventions that

100

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Straightforward Incivility Scale: adaptation and validation of Workplace Incivility measurement for Portuguese samples

promote civility (Osatuke et al., 2009). The broader spectrum of responses afforded by the 7-point

Likert scale allows the recording of a greater amplitude of incivility oscillations. So, SIS can be

an important and practical tool to complement programs to promote civility in the workplace.

Future research could bring information about WI in different professional groups. It is also

possible to expand the research on WI by considering sectors and types of business, comparing

them according to the frequency of this type of behaviour in these contexts. The SIS can bring

important developments for theoretical understanding of WI and practical interventions to

prevent it and promote civility in the workplace.

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PSIQUE • e-ISSN 2183-4806 • Volume XIX • Issue Fascículo 2 • 1st july julho-31st december dezembro 2023 • pp. 86-105

Tito Laneiro, Luisa Ribeiro, Martina Nitzsche, Tânia Ferraro, Genta Kulari, Michael Leiter

Appendix A

Escala de Incivilidade no Trabalho

[Portuguese version]

Straightforward Incivility Scale (SIS; Leiter & Day, 2013)

Indique em que medida concorda ou discorda com cada uma das seguintes afirmações. Colo-

que um ‘X’ na resposta mais adequada, utilizando a seguinte escala de avaliação.

0 1 2 3 4 5 6

Nunca Algumas vezes por

mês ou menos

Uma vez por

semana ou menos

Algumas vezes

por semana

A maior parte

dos dias

Diariamente Mais do que

uma vez por dia

No último mês com que frequência os seus supervisores se comportaram das seguintes

formas?

0 1 2 3 4 5 6

1. Ignoraram-no(a)

2. Excluíram-no(a)

3. Falaram-lhe rudemente

4. Comportaram-se rudemente consigo (e.g., gestos, expressões faciais, etc.)

5. Comportaram-se sem consideração por si

No último mês com que frequência os seus colegas/outros prossionais da equipa de saúde se

comportaram das seguintes formas?

6. Ignoraram-no(a)

7. Excluíram-no(a)

8. Falaram-lhe rudemente

9. Comportaram-se rudemente consigo (e.g., gestos, expressões faciais, etc.)

10. Comportaram-se sem consideração por si

No último mês com que frequência os seus subordinados (a quem delega tarefas) se comportaram das

seguintes formas?

11. Ignoraram-no(a)

12. Excluíram-no(a)

13. Falaram-lhe rudemente

14. Comportaram-se rudemente consigo (e.g., gestos, expressões faciais, etc.)

15. Comportaram-se sem consideração por si

No último mês com que frequência os seus utentes/clientes se comportaram das seguintes formas?

16. Ignoraram-no(a)

17. Excluíram-no(a)

18. Falaram-lhe rudemente

19. Comportaram-se rudemente consigo (e.g., gestos, expressões faciais, etc.)

20. Comportaram-se sem consideração por si

No último mês quantas vezes você já se comportou das seguintes formas em relação a outras pessoas

no trabalho?

21. Ignoraram-no(a)

22. Excluíram-no(a)

23. Falaram-lhe rudemente

24. Comportaram-se rudemente consigo (e.g., gestos, expressões faciais, etc.)

25. Comportaram-se sem consideração por si