Nurses' Perception of Care Practice Environment in Portugal

Monday, 22 July 2013

Telma Sofia Santos Vidinha, RN1
Fernando Amaral, RN, MsC2
Maria Lucília Silva Cardoso, MsC1
(1)Health Systems and Organizations, Health Sciences Research Unit: Nursing, Coimbra, Portugal

Learning Objective 1: To acknowledge the nurses´ perception of care practice environment in four portuguese hospitals.

Learning Objective 2: To recognise factors within the nursing practice environment that may affect nurse outcomes.

Purpose: To acknowledge the nurses’ perception about care practice environment in the portuguese context.


This study was undertaken under the scope Results of the nursing care: Quality and Effectiveness project (FCT-PTPC/CS-SOC/113519/2009).

This was a correlational cross-sectional study. Data were analysed using SPSS 19.0. We used the Practice Environment Scale, portuguese version (Amaral, Ferreira & Lake, 2012). It was composed of 31 items, grouped into 5 factors. Nurses had to mark their level of agreement whit each item on a scale of four points, from 1 (Strongly agree) to 4 (Strongly disagree). Lake (2002) proposes a neutral midpoint of 2.5 to analyze the mean scores of the factors. Purposive convenience sample was composed of all staff nurses from the 26 medicine and surgery wards of the 4 portuguese hospitals. Data were collected between July and August of 2012.


365 nurses responded to the questionnaire, registering a response rate of 66.19%. Nurses' ages vary between 24 and 59 years (mean = 35.15) and the time of exercise of the profession is on average 11.19 years. The mean composite of the averages of the factors was 2.55 on the 4 hospitals and when compared the means of the four hospitals by the teste ANOVA, there were no significant differences (p = .104). However, there was a mean below the neutral point in the dimensions Participation (mean = 2.22) and Resources (mean = 2.28). The factor which has a mean with the highest value was Quality of Care (mean = 2.95).


Regardless the hospital to which they belong, nurses have a positive perception about the practice care environment and give greater value to the quality of care they provide. However, they recognise that the environment is unfavorable to their participation in hospital decisions and to the creation of opportunities for their professional development.