Validation of Psychometric Properties of the Nursing Work Index—Revised Scale in Portugal

Abstract

The use of instruments designed to assess the nursing practice environment is crucial to improve the quality of nursing care, to anticipate problems and difficulties that may arise in organizations, and allow nurse managers to implement changes and improvements in key areas. In this study, we aimed to evaluate the psychometric properties of the Nursing Work Index—Revised Portuguese version (NWI-R-PT) scale. A quantitative, observational, descriptive, and cross-sectional study was conducted. Methods: The sample consisted of 767 nurses from 4 public Portuguese hospitals. Exploratory and confirmatory factor analysis techniques were used to test the distinct structural models. The scale’s accuracy was evaluated through internal consistency, using Cronbach’s alpha. Results: NWI-R-PT internal consistency was 0.91. The NWI-R-PT model with six factors, namely “Management Support,” “Professional Development,” “Fundamentals of Nursing,” “Nurse–Physician Relationship,” “Endowments,” and “Organization of Nursing Care,” was supported by exploratory and confirmatory factor analysis. The NWI-R-PT scale presents adequate goodness-of-fit indices concerning the final factorial model and the convergent validity. Conclusions: The NWI-R-PT scale has a competent and reliable structure. The scale’s validity is confirmed; therefore, it may be employed in all contexts in clinical practice, research, and nursing management. The NWI-R-PT is a useful and valid instrument to assess the nursing environment in hospitals, primary care, long-term care, and nursing homes. The scale has significance in improving the quality of nursing care and patient safety, the professional development of nurses, and organizational results.

Translation and Validation of the Indicators of Quality Nursing Work Environments in the Portuguese Cultural Context

“…The stages of translation, retroversion, and analysis were essential to produce and maintain the objectivity of the process of translation and cultural adaptation of the IQN-WE. The IQN-WE-PT scale has undergone some changes concerning the original, most likely because it is a different cultural reality, with distinct health care use and health policies [24] due to the existence of a National Health Service. Confirmatory factor analysis determined the validity of the construct.…”

The Relationship between Nursing Practice Environment and Pressure Ulcer Care Quality in Portugal’s Long-Term Care Units

“…Our research question is to understand how the LTC unit’s environment in Alentejo influences the healing rates of PUs. We looked at the associations between components of the Nursing Work Index-Revised Scale (NWI-R-PT) [ 44 ] and wound healing rates obtained from PUs identified in the 2018 prevalence study [ 21 ]. We focused on the institutionalised population in The National Network of Long-Term Care (RNCCI) [ 45 ].…”

“…Since then, the instrument has been widely used to measure the nursing practice environment and study its relationship with patient outcomes and job satisfaction [ 30 , 33 , 34 , 36 , 49 , 50 ]. In the present study, the validated Portuguese version of the NWI-R-PT was used [ 44 ].…”

Analyzing and Validating a Structure for Measuring the Nurse Practice Environment

“…Organizational characteristics are included as an expansion of the original NWI because they are associated with nurse job satisfaction [ 9 ], reduced intention to leave [ 11 ], and subsequent job enjoyment and patient outcomes [ 12 , 19 ]. The NWI-R can be modified to a country-specific context, such as by Anunciada et al, 2022, who identify the NWI-R as a reliable and valid instrument for characterizing the nursing practice environment in Portugal [ 20 ].…”