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Factorial Structure of the ProQOL—Systematic Meta-analysis and Integration of 27 International Factor Analysis Studies

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Abstract

This study offered a systematic meta-analysis of 27 international factor analysis studies (combined n = 12,697) that scrutinized the psychometric structure of the Professional Quality of Life (ProQOL) measure. The aim of this instrument study was to explore the factorial structure of the ProQOL in varied settings, cultures, and languages; assess the nature of the relationship between the factors; and compare it to the original design. This meta-analysis provides the foundation for validation of a new brief measure of ProQOL using this study’s data. The inclusion criteria were as follows: published between 2008 and 2021 in a peer-reviewed journal, helping professionals, report factor analysis, use all 30 items of the ProQOL version 4 or 5. This meta-analysis found that compassion satisfaction (CS) is a reliable and valid construct. The elevated mean inter-factor correlation (r =  − .68, p < .01) between CS and Burnout (BO) indicates the factors are not independent. The culprits are five reversed-scored items that did not load on the BO factor yet cross-loaded on CS in nearly all validation studies. Likewise, Secondary Traumatic Stress (STS) Items 2, 5, and 29 frequently saw no loadings on any factors; item 11 frequently cross-loaded on the BO factor. An elevated mean correlation between BO and STS (r = .64, p < .01) evinced that their relationship within the 30-item ProQOL is also too closely related. Contrarily, between CS and STS (r =  − .34, p < .01), the relationship was moderate and revealed independence. This meta-analysis found that the Secondary Traumatic Stress and Burnout scales need revision. There were significant loading problems with the nine items above. Researchers are encouraged to explore more parsimonious and valid measures of the ProQOL in their caring context, language, and cultural setting using these intercultural findings.

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Data Availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We wish to acknowledge all of the researchers who had the courage to report on problems with the ProQOL instrument in a community effort to increase its validity. Validation and translations of the ProQOL in different languages are inter-culturally valuable but they are also time and resource-intensive—more gratitude to those researchers. We are especially thankful to the authors who responded to requests for ProQOL item-level data including Rachel Depner, Yen-Chin Chen, Evdokia Missouridou, Ryan Oliver, and Brian Hughes.

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Authors and Affiliations

  1. Mission Healthcare, Cornerstone University, 1001 East Beltline Avenue NE, Grand Rapids, MI, 49525, USA

    Jason T. Hotchkiss

  2. Hong Kong Baptist University, Kowloon Tong, Hong Kong

    Ming Yu Claudia Wong

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  1. Jason T. Hotchkiss
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  2. Ming Yu Claudia Wong
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Each author has contributed significantly. Dr. Wong focused on graphics, intercultural factors, and analysis. Dr. Hotchkiss was the lead with conception, manuscript, editing, analysis, and literature review.

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Correspondence to Jason T. Hotchkiss.

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Ethics Approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Cornerstone University on 10 July 2021.

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Informed consent was obtained from all participants included in this meta-analysis.

Conflict of Interest

The authors declare no competing interest.

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Hotchkiss, J.T., Wong, M.Y.C. Factorial Structure of the ProQOL—Systematic Meta-analysis and Integration of 27 International Factor Analysis Studies. Trends in Psychol. (2022). https://doi.org/10.1007/s43076-022-00184-5

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