Dissertation Nursing
The Healthcare Leadership Competency Questionnaire (HLCQ): development and psychometric evaluation
By Lea Godino, Chiara Melotti, Flavia Zito and 4 others.
Abstract
Background
Leadership is an important competency in healthcare, but few instruments assess leadership competencies across healthcare professions. AIM: To develop and evaluate the psychometric properties of the Healthcare Leadership Competency Questionnaire (HLCQ).
Methods
This methodological study comprised questionnaire development and psychometric validation. Items were developed through literature review, multidisciplinary expert review, and cognitive interviews. The validation sample was randomly divided into exploratory (60%) and confirmatory (40%) samples. Exploratory factor analysis (EFA) informed item reduction, followed by confirmatory factor analysis (CFA). Reliability and convergent and discriminant validity were assessed.
Results
A total of 1,171 healthcare professionals were included in the psychometric evaluation, with 705 assigned to the EFA sample and 466 to the CFA sample. EFA of the initial 47-item questionnaire supported a four-factor solution accounting for 38.9% of the total variance. Iterative item reduction resulted in a final 35-item questionnaire. CFA provided overall support for the four-factor structure, although fit indices were mixed (CFI = 0.896; TLI = 0.888; RMSEA = 0.070; SRMR = 0.075). Cronbach's α ranged from 0.601 to 0.896 and composite reliability from 0.671 to 0.906 across the four factors. HTMT values ranged from 0.374 to 0.811, supporting discriminant validity.