Structural Validity and Reliability of an Adapted Practice Environment Scale-Nursing Work Index for Primary Health Care Nurses

Abstract

The Practice Environment Scale of the Nursing Work Index (PES-NWI) is widely used to assess nursing practice environments; however, existing versions available for primary health care still need to capture the unique aspects of this healthcare setting fully. This study aimed to develop and validate an adapted PES-NWI version tailored for primary health care. A cross-sectional study and a test-retest design were conducted among primary health care nurses. Structural validity was assessed using confirmatory factor analysis, while internal consistency and test-retest reliability were evaluated through Cronbach's alpha and Intraclass Correlation Coefficients (ICCs), respectively. A total of 528 nurses participated, achieving a response rate of 78% with minimal missing data (0-0.6%). The confirmatory factor analysis showed a good model fit, with subscale Cronbach's alpha values between 0.70 and 0.95. Test-retest reliability was strong, with ICCs above 0.70. The adapted PES-NWI demonstrated adequate structural validity, internal consistency, and reliability, supporting its use in primary health care. This adapted measurement tool can support nursing workforce policies by improving the assessment of work environments in primary health care settings. Patient or Public Contribution: No direct patient or public involvement. Primary health care nurses contributed to the content validity assessment of the adapted PES-NWI.