A Chinese-Version Nursing Practice Environment Scale: Preliminary Scale Development

Wednesday, 24 July 2013: 11:10 AM

Yao-Mei Chen, PhD, RN
Department of Nursing/ College of Nursing, Kaohsiung Municipal HsiaoKang Hospital (KMHK)/ Kaohsiung Medical University, Kaohsiung, Taiwan
Hsiu-Chu Chiang, RN, MS
Department of Nursing, Kaohsiung Medical University Hospital (KMUH), Kaohsiung, Taiwan

Learning Objective 1: The learner will be able to understand the process of scale development from different languages.

Learning Objective 2: The learner will be able to learn the possible construct domains of nursing practice environment in a Chinese healthcare system.


Nurse shortage becomes a great challenge among Taiwan’s healthcare systems due to heavy workload, caused by complicate patient needs and cost containment from the national health insurance policies. Creating a positive work environment is thus one of the 10 strategic plans proclaimed by the Department of Health in Taiwan in 2012. The current instruments for measuring work environment maily based on the framework of magnetism; yet, lack of a native measurement limits the movement of facilitating positive work environment. The purposes of this study was to develop the Chinese version Nursing Practice Environment Scale (NPES).


The study is a cross-sectional survey design. Using stratified sampling strategy, 500 registered nurses from a medical center in Southern Taiwan were invited and 488 participated in the survey, with a response rate of 97.6%. Survey questions adopted the content domains from the Essentials of Magnetism (EOM) and Index of Work Satisfaction (IWS). The scale development proceeded in several stages: (1) tanslation and back translation, (2) validation of both translated versions by content expert, (3) field surveys and data cleaning, (4) factor analyses for possible constructs.


The content experts validated both tanslation and backtanslation versions as 72% most likely or completely same. Only 7% questions were rated unlikely and were modified to ensure the meaning of the items. Factor analysis extracted ten factors from the variance matrix, including nurse manager support, cultural values, autonomy, RN-MD relationship, time for practice, professionalism , sufficient rewards, adequate staffing, support for competence, shared governance.


The development of Chinese-version nursing practice environment scale in this study is a preliminary attempt. Further exploration should be focused on the construct domains of the scale, the applicablity and the validity of the measurement.