CME A VAILABLE FOR THIS ARTICLE AT ACOEM.ORG Developing a Short Measure of Organizational Justice: A Multisample Health Professionals Study Marko Elovainio, PhD, Tarja Heponiemi, PhD, Hannamaria Kuusio, MSc, Timo Sinervo, PhD, Taina Hintsa, PhD, and Anna-Mari Aalto, PhD Objectives: To develop and test the validity of a short version of the orig- inal questionnaire measuring organizational justice. Methods: The study samples comprised working physicians (N = 2792) and registered nurses (n = 2137) from the Finnish Health Professionals study. Structural equation modelling was applied to test structural validity, using the justice scales. Fur- thermore, criterion validity was explored with well-being (sleeping problems) and health indicators (psychological distress/self-rated health). Results: The short version of the organizational justice questionnaire (eight items) provides satisfactory psychometric properties (internal consistency, a good model fit of the data). All scales were associated with an increased risk of sleeping problems and psychological distress, indicating satisfactory criterion valid- ity. Conclusion: This short version of the organizational justice questionnaire provides a useful tool for epidemiological studies focused on health-adverse effects of work environment. T he associations between various aspects of psychosocial work environment and organizational outcomes, behavioral outcomes and well-being are well demonstrated. 1–3 Epidemiological studies focusing on the health outcomes of psychosocial work environment have been dominated by the Job Strain Model, 4,5 stating that employ- ees working under high strain (a combination of high work demands and low job control) have a higher risk of health problems than those with no such strain. Recently, research on the psychosocial health determinants has extended the focus from job characteristics to so- cial relations, decision making and managerial procedures, that is, organizational justice at work. 6 Organizational justice is often de- fined as “the extent to which employees are treated with justice at their workplace” (for a review see ref 7). Organizational justice per- ceptions have been shown to predict employees’ work attitudes (eg, organizational commitment and job involvement) and behaviors (eg, willingness to support decisions and decision-makers) 8,9 and even severe stress-related health outcomes. 10 One of the main problems in creating and evaluating the cu- mulating evidence on the associations between organizational justice and health outcomes is the lack of feasible survey instrument for mea- suring organizational justice especially in prospective epidemiolog- ical studies. Such measure should provide appropriate psychometric properties of the exposure measure, including good structural valid- ity of the scales measuring the construct, and acceptable predictive validity of relevant outcomes. Furthermore, the construct and predic- tive validity should be replicable in independent samples. Although most of these requirements have been met in the original question- naire measuring organizational justice, such as the one presented From the National Institute for Health and Welfare (THL) (Drs Elovainio, Hep- oniemi, Sinervo, and Aalto, and Ms Kuusio) and University of Helsinki (Drs Elovainio and Hintsa), Helsinki, Finland; and International Institute for Society and Health, Department of Epidemiology and Public Health (Mr Elovainio), UCL Medical School, London, England. The authors have no financial interest related to this research. The JOEM Editorial Board and planners have no financial interest related to this research. Address correspondence to: Marko Elovainio, Finnish Institute for Health and Welfare, PO Box 30, 00271 Helsinki, Finland; E-mail: marko.elovainio@thlfi. Copyright C  2010 by American College of Occupational and Environmental Medicine DOI: 10.1097/JOM.0b013e3181f8447c Learning Objectives  Review the concept of organizational justice and its use in studying the adverse health effects of the psychosocial work environment.  Identify the authors’ reasons for developing a new measure of organizational justice.  Discuss the characteristics of the new tool, including com- parison with the original questionnaire by Colquitt. by Colquitt 11 or Moorman, 12 there is a need for shorter version of this questionnaire that could provide a most economic measure for large-scale epidemiologic investigations. 6,11,13–16 In this study, we developed and tested the validity of a short version of organizational justice questionnaire of Colquitt. 8,11 We reported its psychometric properties including its construct validity in two independent samples and analyzed its contribution to the pre- diction of two indicators of health. Both of the independent samples were representative of the occupational groups in Finland. We also examined whether three-dimensional or four-dimensional measure would offer the best fit to the data from two independent samples. Most of the survey measures are based on three dimension (re- source distribution, decision making, and treatment practices). 12,17 Recently a more detailed four-factor model has been suggested where the interactional justice dimension is divided into two: interpersonal (respect/truthfulness) and informational (justification) justice. 8 Facilitating the use of organizational justice measures in epi- demiological and occupational health studies may be important because of the role justice seems to play in private and public organizations. 8,9,18 Numerous studies suggesting that fair treatment may be a protective factor against various health outcomes, such as psychological distress, feelings of strain, disturbed cardiovascular functioning, and coronary heart disease. 6,10,15 , 18–22 Quite recently, it has also been suggested that low organizational justice is associated with stress-related physiological mechanisms behind many cardio- vascular and metabolic diseases, such as chronic inflammation and metabolic syndrome. 23,24 METHODS Study Population This report is based on the two independent samples from the ongoing Finnish Health Professionals (FHP) study, a nationally representative cohort survey, started in 2006. 25 Finnish Health Pro- fessionals is a self-completed questionnaire survey about the physical and psychosocial work environment, answered by health care pro- fessionals (different samples for physicians and registered nurses). The age range of respondents was 24 to 64 years. Slightly differ- ent questionnaires were divided into three parts: (1) the physical and psychosocial work environment (including the organizational justice scale of Colquitt 11 ), (2) health-related issues including self- rated health and psychological distress and (3) sociodemographic and economic conditions. A total of 2792 individuals (56% of the Copyright © 2010 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. 1068 JOEM  Volume 52, Number 11, November 2010