Soc Psychiatry Psychiatr Epidemiol (2004) 39 : 576–580
1007/s00127-004-0791-z
ORIGINAL PAPER
J. I. Røssberg · Ø. Eiring · S. Friis
Work environment and job satisfaction
A psychometric evaluation of the Working Environment Scale-10
Accepted: 18 February 2004
■ Abstract Background The working environment in
mental health wards has been shown to have profound ef-
fects on the health and work stability of mental health
workers. Despite an apparent need for regular measure-
ment of work environment,development of short and re-
liable instruments for such measurements has been
largely neglected. The aim of the present study was to
evaluate the psychometric properties of the Working En-
vironment Scale-10 (WES-10). Methods During the pe-
riod 1990 through 2000, a total of 640 staff members on
42 wards for psychotic patients completed the WES-10.
To establish the number of subscales, a factor analysis
was carried out.The internal consistency of the subscales
was calculated as Cronbach’s alpha.We also collected data
concerning satisfaction with the ward, its patients and
staff, and for how long the respondents had worked and
expected to continue to work at the ward. Results We
identified four subscales named: Self Realization, Work-
load, Conflict and Nervousness. The psychometric prop-
erties of the subscales proved to be acceptable. All the
subscales were significantly correlated with at least one
satisfaction item, and/or the time the staff expected to
continue at the ward. Most notably, the Self Realization
subscale was strongly correlated to general satisfaction
with the ward, and to the time the staff expected to work
on the ward in the future,while Conflict was strongly neg-
atively correlated with liking for staff. Conclusion The
WES-10 appears to measure four clinically meaningful
subscales. It seems well suited for use in further research
and for evaluation of clinical milieus.
■ Key words work environment – psychometrics – staff
members – satisfaction – questionnaires
J. I. Røssberg, MD (
) · Ø. Eiring, MD · S. Friis, MD, PhD
Dept. of Psychiatry
Ullevaal University Hospital
0407 Oslo, Norway
SPPE 791
Tel.: +47-22/118370
Fax: +47-22/117848
E-Mail: j.i.rxssberg@psykiatri.uio.no
DOI 10.
Introduction
An extensive literature has been generated about the mi-
lieu in which health professionals work and the impact
it has on both mental and physical health [1–5]. The po-
tentially stressful nature of mental health work has been
amply demonstrated. Several studies have reported a
high level of burnout and poor mental health among
psychiatric staff members [6–11]. A poor work environ-
ment has proved to be associated with reduced job sat-
isfaction, absenteeism, somatic complaints, burnout and
depression [12–17]. It has been reported how a poor
work environment might influence the work perfor-
mance negatively [18], and promote negative and cyni-
cal attitudes towards patients and colleagues [19]. A
poor work environment is probably one of the main rea-
sons for the high staff turnover rate [1, 20, 21] and poor
inpatient satisfaction and outcome [22, 23].
Against this background, there is an obvious need for
regular studies of the work environment on psychiatric
wards. As pointed out by Burnard et al. [24], the working
environment should be regularly measured, as one way
to measure service quality. Measures of the working en-
vironment and job satisfaction may also be useful
benchmarks for evaluating future changes and develop-
ments in the psychiatric wards, and to monitor and im-
prove the clinical working environment.
To regularly study the working environment, we need
an instrument that is clinically meaningful, easy to use
and with acceptable psychometric properties. To be clin-
ically meaningful, the instrument has to measure the
central dimensions. Reviewing the literature, it seems
that previous studies have identified three core dimen-
sions named: Workload (Work pressure, Task require-
ments) [2, 21, 24–26], Personal growth (Professional
growth, Support, Achievement value and growth) [14,
21, 26] and Conflict [2, 25, 27]. Some studies come up
with additional dimensions like safety, role clarity,
salary, work hazards, home-work conflict, professional
status and organizational issues [7, 14, 21, 24, 25].

Many of the original instruments seem to have been
so large and complex that they have been difficult to use.
Consequently, many studies of the working environ-
ment tend to have small and unrepresentative samples
of psychiatric staff members [8]. Admittedly, several
working environment scales have been used in short
forms to facilitate ease of use or they have been changed
to become more suitable for mental health workers [28],
but, as indicated in a recent review, analysis of the psy-
chometric properties of different instruments seems
mostly to be lacking [6].
To overcome many of the previous difficulties, we
have developed a short and user-friendly ten-item
working environment scale. We collected data from a
large number of psychiatric staff members on 42 differ-
ent psychiatric wards. The main aims of this study were
to evaluate the psychometric properties of the Working
Environment Scale-10 (WES-10) on a ward level. We de-
cided to examine whether the WES-10 measures clini-
cally meaningful subscales worth using in future re-
search and in a clinical context.Another objective was to
examine how these subscales were related to general job
satisfaction and the staff member’s intention to leave
their job. More specifically, we wanted to answer the fol-
lowing questions:
1. Does the factor structure of the WES-10 point to spe-
cific subscales?
2. What are the internal consistencies’, mean scores,
standard deviations, and intercorrelations of the sub-
scales?
3. What is the relationship between the WES-10 sub-
scales and the staff members’ general satisfaction
with the psychiatric ward, liking for patients and
staff?
4. What is the relationship between the WES-10 sub-
scale scores and how long the staff members have
worked at the psychiatric wards and how long they
intend to work at the wards?
Subjects and methods
During the period 1990 through 2000, a total of 640 staff members on
42 wards for psychotic patients completed the WES-10. The WES-10
is a self-report questionnaire and comprises the ten items displayed
in Appendix 1. Three items (items 1, 2 and 3) were taken from the Per-
sonal Development Scale developed by Moos [29]. The other seven
items were developed by a clinical research group at Ullevaal Univer-
sity Hospital (1981) with the intention to evaluate the restructuring of
an acute ward [30]. The items comprising the WES-10 were rated on
a five-point scale ranging from 1, not at all or never, to 5, very often or
to a large extent.
This study included wards where more than two-thirds of the pa-
tients were diagnosed in the psychotic spectrum of mental diseases.
Most of the wards were short-term (n = 36), but some intermediate
and long-term wards (n = 6) were also included.
Three questions were applied to capture general satisfaction with
the milieu. The questions were rated on a five-point scale ranging
from 1, not at all, to 5, very much, and were: (1) “How satisfied are you
with this ward?”, (2) “How much do you like the patients on this
ward?” and (3) “How much do you like the staff on this ward?”. The
mean and SD concerning these three questions were respectively: 4.03
(0.33), 4.20 (0.20) and 4.43 (0.21).
577
■ Statistics
To establish the number of subscales of the WES-10, we carried out a
factor analysis (PCA) with varimax rotation. For each factor, we made
a corresponding subscale. Items were included into the subscales if
they had a loading on the corresponding factor ≥ 0.50 and if the dif-
ference between this loading and the highest loading on non-corre-
sponding factors was ≥ 0.05.
The internal consistency of the subscales was calculated as Cron-
bach’s alpha. We calculated the Corrected Item Total subscale Corre-
lation (CITC) for the subscale, which comprised four items. Pearson
correlations were used to assess the relationships between the sub-
scales and between the subscales and the other variables.
Results
A total of 105 individual therapists and 529 nursing staff
members completed the WES-10. A total of six staff
members did not report whether they were individual
therapists or nursing staff. All staff members were in-
cluded in the study except for night staff. The limitation
was due to difficulties in obtaining an acceptable num-
ber of completed questionnaires from the latter group of
employees.
All staff members were asked for how long they had
worked at the psychiatric ward and how long they ex-
pected to work on the ward. A total of 15 % of the staff
members had been employed less than 6 months, 22 %
between 6 months and 18 months and 20 % between 18
months and 3 years. Of the staff members, 43 % had been
employed more than 3 years. A total of 15 % were plan-
ning to quit their jobs during the following 6 months.An
additional 15 % were planning to quit before 1 year had
passed. The largest group, 47 %, thought they would con-
tinue to work at the same psychiatric ward somewhere
between 1 and 3 years. A total of 23 % were planning to
continue for more than 3 years. For each ward, we calcu-
lated the percentage of staff members who had been
working: (a) for less than 18 months, and (b) for more
than 3 years. We also calculated the percentage that in-
tended to continue: (a) for less than 1 year, and (b) for
more than 3 years.
The factor analysis revealed four factors with an
Eigenvalue > 1. These four factors accounted for 79 % of
the variance. The factor loadings of the items are listed
in Table 1. The four subscales were named: Self Realiza-
tion, Workload, Conflict and Nervousness.
The Self Realization subscale explained 37 % of the
variance and comprised four items (items 1, 2, 5 and 6).
This subscale measures to what extent the staff members
feel supported, whether they achieve more confidence
and whether they experience being able to use their
knowledge working on the ward. The Workload subscale
explained 19 % of the variance and comprised two items
(items 9 and 10). This subscale measures the number of
tasks imposed on the staff members and also to what ex-
tent they feel they should have been on several places at
the same time. The last two subscales, Conflict and Ner-
vousness, each comprised two items and explained re-
spectively 13 % and 12 % of the variance. The Conflict
578

Table 1 The factor loadings for each item. Only factor loadings ≥ 0.30 are included Table 3 The intercorrelations between the four subscales and general satisfaction
with the psychiatric wards, patients and staff members
Items from the I II III IV
WES-10 How satisfied How much do you How much do you
are you with like the patients like the staff on
1 0.82 this ward? on this ward? this ward
2 0.86
Self Realization 0.56** 0.49** 0.40**
3 0.94
Conflict –0.41** –0.16 –0.61**
4 –0.45 0.32 0.63
Workload –0.20 –0.15 0.17
5 0.63 –0.43
Nervousness –0.30 –0.27 –0.15
6 0.91
7 0.83 ** Correlation is significant at the 0.01 level (2-tailed)
8 0.85 * Correlation is significant at the 0.05 level (2-tailed)
9 0.91
10 0.91 Table 4 The correlations between the four subscales and how long the staff mem-
bers have been employed and how long they expect to work at the psychiatric ward

% worked % worked % intend % intend

subscale measures to what extent the staff members’ ex- < 18 months > 3 years to continue to continue
perience conflicts and loyalty problems among them < 1 year > 3 years
(items 7 and 8). The Nervousness subscale measures to
Self Realization –0.16 0.07 –0.38* 0.32*
what extent the staff members are worried about going
Conflict –0.05 0.15 0.25 –0.26
to work and to what extent they feel nervous or tense on
Workload –0.37* 0.26 0.28 –0.29
the ward (items 3 and 4). All the items were included in
the subscales. Nervousness 0.17 –0.05 0.38* –0.25
The psychometric properties of the subscales proved * Correlation is significant at the 0.05 level (2-tailed)
to be satisfactory. Cronbach’s alpha for the four sub-
scales were: Self Realization: 0.85, Workload: 0.84, Con-
flict: 0.69 and Nervousness: 0.66. The four items in the (Self Realization and Nervousness) were significantly
Self Realization subscale had a mean CITC of 0.52. The related to the time the staff expected to work on the ward
intercorrelations between the two items comprising the in the future. The relationship was most pronounced for
last three subscales were respectively: Workload: 0.72, Self Realization, which was moderately negatively corre-
Conflict: 0.53 and Nervousness: 0.49. lated with the percentage who intended to continue less
The mean scores and standard deviations for the four than 1 year, and positively with the percentage who in-
subscales were respectively: Self Realization: 3.73 (0.23), tended to continue for more than 3 years.
Workload: 3.41 (0.36), Conflict: 2.06 (0.28) and Nervous-
ness: 1.98 (0.21).
As seen from Table 2, the subscales were only moder- Discussion
ately intercorrelated (range: 0.13–0.37, median: 0.30).
As seen from Table 3, the Self Realization subscale The main finding of this study is that the WES-10 fea-
was most strongly correlated with general satisfaction tures acceptable psychometric properties on a ward
and liking for the patients. The Conflict subscale was level.Although not directly compared to other scales,the
most strongly correlated (negatively) with liking for the results of this study clearly indicate that the core aspects
other staff members. of the working environment can be captured with an
Table 4 shows that only the Workload subscale was easy-to-use instrument that only comprises ten items.
significantly correlated with the time staff members had The instrument seems well suited for use in research and
worked at the ward. This subscale showed a moderate evaluation as it reliably measures four clinically mean-
negative correlation with the percentage that had ingful subscales.
worked less than 18 months at the ward. Two subscales The validity is demonstrated by the fact that Conflict
was strongly negatively correlated with liking for staff,
while Self Realization was fairly strongly positively cor-
Table 2 The intercorrelations between the four subscales related with liking for patients. Furthermore, three of
the four WES subscales were significantly related to gen-
Self Realization Conflict Workload Nervousness eral satisfaction with the ward. It also makes sense that
Self Realization X –0.37* –0.13 –0.35* Nervousness was significantly related to a high percent-
Conflict X 0.20 0.34* age who intended to continue at the unit for less than 1
Workload X 0.25
year.
Nervous X
It seems that the WES-10 is able to capture the core
dimensions of the working environment. The Workload
* Correlation is significant at the 0.05 level (2-tailed) and Conflict subscales frequently appear in other stud-
 579

ies and the importance of measuring these two dimen-

Appendix 1
sions of the work environment is widely described [2, 25,
27]. The Self Realization subscale measures the same as- ■ The Working Environment Scale 10 (WES-10) [Friis, 1981]
pect of the work environment as the Professional
growth, Personal growth, Support and Achievement Please mark the answer you think best describes what you feel.
value and growth dimensions of other studies [21, 26, 1. Does what you do on the ward give you a chance to see how good your abili-
31]. The Nervousness subscale, measuring how nervous ties really are?
or tense the staff members feel at the psychiatric ward,     
Not at all To a small To some To a large To a very
seems to appear less frequently in other studies. It obvi- extent extent extent large extent
ously measures an important dimension and is probably
strongly correlated with several issues of safety and in- 2. Does what you do on the ward help you to have more confidence in yourself?
security, which, in some studies, have proved to be im-     
portant factors of the work environment [28]. Not at all To a small To some To a large To a very
extent extent extent large extent
By only including ten items in the WES-10, some of
the previously reported dimensions (e. g. salary, man- 3. To what extent do you feel nervous or tense on this ward?
agement issues, safety issues, and home-work conflicts)     
are not captured by this instrument. It could be argued Not at all To a small To some To a large To a very
extent extent extent large extent
that a suitable instrument should include more items,
thus making the measurement of more aspects of the 4. How often does it happen that you are worried about going to work?
working environment possible. However, the main aim     
of this study was not to develop an instrument that was Very often Often Occasionally Rarely Never
able to capture all possible aspects of the work environ- 5. To what extent do you feel that you get the support you need, when you are
ment, but to examine and evaluate a short and easy-to- faced with difficult treatment problems?
use instrument that captures the core dimensions. The     
short format, evaluated in this study, leaves an opportu- Very often Often Occasionally Rarely Never
nity to use other instruments that capture other aspects 6. To what extent do you find that you can use yourself, your knowledge and ex-
of inpatient treatment without overloading the staff perience in the work here on this ward?
members.     
Three of the four subscales captured in this study Not at all To a small To some To a large To a very
comprised only two items. By aggregating the data on extent extent extent large extent
ward level, it was still possible to achieve acceptable re- 7. To what extent do you find that the patient treatment is complicated by con-
liability. To achieve reliable results on an individual level flicts among the staff members?
would probably have needed a much more extensive in-     
strument comprising more items. However, as also sup- Not at all To a small To some To a large To a very
extent extent extent large extent
ported by the findings of Melchior et al. [32], a consen-
sual perception of the working environment provides 8. To what extent do you find that it can be difficult to reconcile loyalty towards
enough information to capture in what way most of the your team with loyalty towards your own profession?
psychiatric staff members perceive the work environ-     
ment. This can be achieved by using a short, easy-to-use Not at all To a small To some To a large To a very
extent extent extent large extent
instrument.In this cross-sectional study,we did not con-
duct any analyses on the test/retest reliability of the 9. What do you think about the number of tasks imposed on you?
WES-10. This important subject needs to be examined     
in other studies with the WES-10. This study clearly in- Far too few Too few Sufficient Too many Far too many
dicates that the working environment is strongly related 10. How often does it happen that you have a feeling that you should have been
to staff satisfaction. To what extent the work environ- on several places at the same time?
ment, as perceived by staff, is related to inpatient satis-     
faction and outcome is still unclear [23, 33, 34]. To our Very often Often Occasionally Rarely Never
knowledge only two studies [35, 36] have examined the
relationship between the psychosocial ward climate and
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