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The main objective during the developmental phase was to develop a measuring instrument to assess the communication climate of professional nurses in public hospitals. Concepts obtained in the Gibb’s Defensive Communication Climate Paradigm were identified, substantiated and expanded on (Brink et al 2012:56-57; Polit & Beck 2010:16-17) by conducting a literature review involving national and international literature that included books, articles and research studies (Brink et al 2012:74; Burns & Grove 2009:93-94; Polit & Beck 2010:171) and utilising the Delphi technique(apanel ofexperts). The developmental phase involved

 the refinement and adaptation of all the concepts (Chinn & Kramer 2011:165) contained in the Gibb’s Defensive Communication Climate Paradigm (1961), the Communication Climate Focus and the six conceptual continuums, namely Evaluation-Description,Control-ProblemOrientation,Strategy-Spontaneity,Neutrality- Empathy, Superiority-Equality, and Certainty-Provisionalism continuums

 incorporating the concepts into statements (Chinn & Kramer 2008:246-248; 2011:180) in a questionnaire format, a Semantic Differential Scale (SDS)

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The researcher developed the SDS, (during the first Delphi round) by following three basic stages:

 In the first stage the statements for the analysed concepts had to be set. This was done by extrapolating the concepts from a qualitative literature review on the Gibb’s DefensiveCommunicationClimateParadigm(1961)and presenting these statements to the Delphi panel of experts for their perusal and comments.

 In the second stage an analysis and elimination of statements with the same meaning within the scales was done by an expert in linguistics and semantics.

 In the third stage, items were obtained for the selected statements. Once again the linguistic and semantic expert and the Delphi panel experts were requested to provide their inputs. This was done by developing a draft instrument and asking the experts to identify items and respective opposite items, for the two opposing poles. They were requested (in written format) to keep the items as simple as possible, use familiar words that were easily comprehensible and to avoid ambiguous, unknown and difficult items. From their inputs, the researcher included only the two items that obtained an agreement among the experts of more than 80 percent.

In this present study, respondents may be requested, for instance, to indicate the operational manager’s Control-Problem orientation to problem-solving on a scale similar to that depicted in figure 5.1:

The operational manager in charge of my ward/unit is …… open to problem-solving.

Never 1 2 3 4 5 6 7 Always

FIGURE 5.1: AN EXAMPLE OF A SEMANTIC DIFFERENTIAL SCALE ITEM

Analysing the preceding example (Figure 5.1), the item on the left of the block (namely Never) represents a defensive communication orientation, compared with a supportive communication orientation represented by the item on the right of the block (namely Always). In reality the dimensions of the “X” might be in the second block, indicating that it is situated two blocks from the left and six blocks from the right on the scale. This indicates that, from a communication behaviour point of view, the respondent rated the operational managers as having a defensive communication behaviour orientation in this communication dimension.

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The instrument (questionnaire) consisted of 70 statement items, as depicted in Table 5.2; constructed by using Semantic Differential Scale Items. The items are structured around the Gibb’s Defensive Communication Climate Paradigm (1961). Table 5.1 indicates examples of the conceptual continuums.

TABLE 5.1: EXAMPLES OF ITEMS CONTAINED IN GIBB’S CONCEPTUAL CONTINUUMS

Conceptual

Continuums Code Question

Statement Defensive (Negative) Item Supportive (Positive) Item Evaluative-Descriptive continuum C14 Q4.

I …… label situations as good or bad in my

ward/unit, during conversations. Always Never Control-Problem

Orientation continuum C28 Q18.

The operational manager in charge of my

ward/unit … adopts an authoritarian attitude. Always Never Strategy-Spontaneity

continuum C35 Q25.

I …….. distort what is being said in

conversations with others in my ward/unit. Always Never Neutrality-Empathy

continuum C50 Q40.

The operational manager in charge of my

ward/unit … respects the feelings of others. Always Never Superiority-Equality

continuum C65 Q55.

I ……… respect the positions of others in my

ward/unit during conversations. Always Never Certainty-Provisionalism

continuum C77 Q67.

The operational manager in charge of my

ward/unit …….. takes sides on issues. Always Never

5.2.1 Composition of the instrument

Eachof the70statementitemscontained in the questionnaire has a defensive (negative) andasupportive(positive)pole.Thustherearean equal number of items measuring both aspects of the communication climate. Items numbered from C11to15(Q1-5),C21to 26 (Q11-16),C33to38 (Q23-28), C45 to 49 (Q35-39), C55 to 60 (Q45-50), C67 to 72 (Q57- 62)andC79(Q69)measuretheprofessionalnurses’owncommunicationbehaviour, while items numbered from C16 to 20 (Q6-10), C27 to 32 (Q17-22), C39 to 44 (Q29-34), C50 to 54 (Q40-44), C61 to 66 (Q51-56), C73 to 78 (Q63-68) and C80 (Q70) indicate the professional nurse’s perception of operational manager communication behaviour.

TABLE 5.2:TOTALNUMBEROFITEMSANDCORRESPONDINGQUESTIONNUMBERSFORGIBB’S

CONCEPTUALCONTINUUMS(DISTRIBUTEDINTHEDRAFTEDQUESTIONNAIRE)

PROFESSIONAL NURSE DATA OPERATIONAL MANAGER DATA CONCEPTUAL CONTINUUMS Items Total Question Numbers Items Total Question Numbers

Evaluation-Description continuum 5 1-5

5 6-10

Control-Problem Orientation continuum 6 11-16

5 17-22 Strategy-Spontaneity continuum 6 23-28 5 29-34 Neutrality-Empathy continuum 5 35-39 5 40-44 Superiority-Equality continuum 6 45-50 5 51-56 Certainty-Provisionalism continuum 6 57-62 5 63-68 General 1 69 1 70 Total 35 35

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Table 5.2 indicates the total number of items and the corresponding item numbers for the Gibb’s conceptual continuums, with regard to the professional nurse and operational manager items. In addition, a specific number of items have been developed for each of the six Gibb’s conceptual continuums.

5.2.2 Biographical data

The only biographical information that was collected from the respondents during the pre-testing of the instrument (SDS) was the name of the public hospital and the nursing ward/unit.

5.2.3 Face validity of the measuring instrument

To confirm the face validity of the measuring instrument, the researcher presented the