BAPSYCH Applied Statistics Dr Caoimhe Hannigan

Hierarchical Multiple Regression Worksheet

This worksheet contains extracts of information from the following paper, which was used as an in-
class example of Hierarchical Multiple Regression analysis:

You should read through the extracts provided and use this information to answer the 7 questions
presented at the end of the sheet.

Methods
Participants
All nurse advisors working for NHS-24 across Scotland (n = 465) were invited to take part in the
study. In all, 152 nurses, representing 37% of the total NHS-24 nurse workforce completed the study
(141 female, 11 male, mean age 41 years). Participating nurses worked an average of 23 hr a week
(SD = 10.5), had been qualified for an average of 20 years (SD =7.9) and employed by NHS-24 for an
average of 3 years (SD = 1.8).

Measures

Perceived stress measures

12-item General Health Questionnaire (GHQ-12; Goldberg & Williams, 1988). This was used to
measure symptoms of stress and associated distress ‘over the last few weeks’. All items have a 4-
point scoring system that ranges from a ‘better/healthier than usual’ option, through a ‘same as
usual’ option, to ‘worse than usual’ and ‘much worse than usual’ options. The exact wording of items
varies according to the content of the item. Likert scoring was used (0, 1, 2, 3) with higher scored
BAPSYCH Applied Statistics Dr Caoimhe Hannigan

being indicative of greater stress/distress. The psychometric properties of the GHQ have been
extensively evaluated, and the measure found to have good reliability and validity.
Perceived stress of shifts. Immediately after completion of each of the two participation shifts, nurses
rated how stressful they had found the shift as a whole on a 5-point scale (from ‘not at all stressful’
to ‘extremely stressful’). Higher scores indicated higher perceived stress.

Cognitive performance & information-processing measures

Work-Specific Cognitive Failures Questionnaire (WS-CFQ; 15 items; Wallace & Chen,

2005). This was used to measure nurses’ cognitive failure rate while at work, that is, the
frequency of lapses in concentration, memory, and attention. This measure has good
reliability and validity (Wallace & Chen, 2005), and was developed specifically for use in
the workplace. Minor adaptations were made to several of the items to reflect the NHS-24
working environment (e.g., ‘unintentionally press switches on machines’ altered to read
‘unintentionally press keys on computer’).

Measures to control for reporting style

As perceived stress and cognitive failures are subjective phenomena, data about them
must be self-reported. However, self-report measures have well-established limitations,
most notably the introduction of bias from participants’ reporting style. To minimize this,
measures to control for two of the most common forms of self-report bias were included.

Positive And Negative Affect Schedule (PANAS; 20 items; Watson, Clark & Tellegen,
1988). This was used to measure general affect, so that the effect of negative mood on
reporting can be controlled for. Participants rate the extent to which they have
experienced each of 10 negative emotions (afraid, distressed, upset, guilty, scared, hostile,
irritable, ashamed, nervous, and jittery) over the last few weeks on a 5-point scale from
‘very slightly or not at all’ to ‘very much’. The PANAS has good reliability and validity
(Crawford & Henry, 2004).

Social Desirability Scale (SDS; 16 items; Stober, 2001). This was used to control for
social desirability bias. Participants are asked whether a range of socially desirable but
infrequent and socially undesirable but frequent behaviours are things that they do (‘true’
or ‘false’). Higher scores indicate greater social desirability bias. This measure has
adequate reliability and validity (Stober, 2001).

Results

Does stress predict the number of cognitive failures reported by nurses?

The average number of cognitive failures nurses reported making over two shifts was
significantly associated with both general stress level (GHQ score; r(147) = .37, p < .001)
and the average stress rating of the two shifts (r(132) = .33, p < .001). Hierarchical
multiple regression was used to predict average number of cognitive failures nurses
reported over two working shifts from stress while controlling for other factors.
Demographic variables (age and gender) were entered in step 1 (R2 = .02, F(2,130) = 1.30,
p = 0.28), variables to control for reporting style (negative affect and social desirability) in
step 2 (R2change = .10, Fchange(2,128) = 7.20, p < 0.01), and finally measures of stress
(GHQ and an average of the two shift stressfulness ratings) in step 3 (R2change = .14,
BAPSYCH Applied Statistics Dr Caoimhe Hannigan

Fchange(2,126) = 11.90, p < 0.01). The final model accounted for 26% of the variance in
cognitive failure rate (R2 = .26, F(6, 132) = 7.33, p < 0.001). On examination of the
regression coefficients (Table 2), it is clear that after controlling for age, gender, negative
affect, and social desirability, stress (both general distress and shift specific stress)
significantly predicts the number of cognitive failures reported by nurses during work. In
each case, higher ratings of stress are associated with more cognitive failures.
BAPSYCH Applied Statistics Dr Caoimhe Hannigan

Questions

1. What is the criterion variable for this study? How was it measured?

2. What are the predictor variables in the study, and how were they measured?

3. Based on the results presented in Table 2, what is the STRONGEST predictor of the criterion
variable? Explain your answer with reference to the results.
BAPSYCH Applied Statistics Dr Caoimhe Hannigan

4. Based on the final model tested in this study and presented in Table 3, did the authors have
a sufficient sample size for their analyses? Support your answer with reference to two
different formulas for calculating sample size requirements for regression based analyses.

5. Describe the order that the variables were entered in the model. Name the variables that
were included in each step/block of the hierarchical multiple regression model.
BAPSYCH Applied Statistics Dr Caoimhe Hannigan

6. What was the percentage of variance uniquely explained by step/block 3 of the mode, after
controlling for step 1 and step 2? Explain your answer with reference to the results.

7. Was the percentage of variance in cognitive failures scores explained by the model
statistically significant? Explain with reference to the relevant information in the text.

8. What does the symbol β stand for? Explain what this means using one of the β values
presented in the paper as an example.