Abstract
Studies related to the work environment in primary health care are scarce in the literature. The present study aimed to validate the psychometric properties of the Practice Environment Scale of Nursing Work Index (PES-NWI) in primary health care (PHC) and to evaluate its construct validity through exploratory and confirmatory factor analyses in a sample of Portuguese nurses. A quantitative, cross-sectional, and validation study design was implemented. Methods: The sample consisted of 1059 nurses from the PHC units of all 55 health center groups (HCGs) in mainland Portugal, 15 health centers in the Autonomous Region of Madeira, and 6 health centers in the Autonomous Region of the Azores. The study tested different structural models using exploratory and confirmatory factor analysis techniques. The reliability of the scale was tested by determining Cronbach’s alpha coefficient. Results: The internal consistency of the PES-NWI was 0.91. Exploratory and confirmatory factor analyses were performed on the PES-NWI model in PHC with five factors: NPOA, NFQC, NMALSN, SRA, and CNPR. The results show that the scale presents acceptable fit quality indexes in the final factorial solution and adequate convergent validity. Conclusion: The PES-NWI in PHC has an adequate, robust, and reliable five-factor structure. The scale is valid and can be used in clinical practice, nursing management, and PHC research.
Highlights
Knowledge and scientific evidence about nursing practice environments (NPEs) in the context of primary health care (PHC) are scarce [1,2,3,4] compared with those in other contexts, such as hospitals
NPEs are a key factor in ensuring quality nursing care with positive results for clients, teams, and organizations
This study used data from RN4CAST@pt 2018 related to PHC in Portugal and is the first study with a large sample of nurses originating from all health center groups (HCGs) and health centers from the autonomous regions of Madeira and the Azores
Summary
Knowledge and scientific evidence about nursing practice environments (NPEs) in the context of primary health care (PHC) are scarce [1,2,3,4] compared with those in other contexts, such as hospitals. NPEs are vital for the success of health systems [6] They relate to the quality of nursing care, job satisfaction, patient safety, the effectiveness of client care, and the efficiency of organizations [1,5,7,8]. Promoting the quality of care offered by nurses, and contributing to the improvement of clinical practice contexts, is a vital factor of NPEs. The quality of nursing care is an essential element in the profession; it refers to, among other aspects, the direct relationship between the client and the nurse. The quality of nursing care is an essential element in the profession; it refers to, among other aspects, the direct relationship between the client and the nurse It depends on several factors, the NPEs themselves [1,9]. NPEs are a key factor in ensuring quality nursing care with positive results for clients, teams, and organizations
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