Development and Validation of the Indonesian Version of Quality Nursing Work Environment (QNWE-I) Instrument

Abstract

Background: Nursing shortages are a significant problem experienced by medical institutions worldwide as well as Indonesia. Understanding nurses’ work environment is a proper strategy for enhancing the retention and overcoming shortages of nurses. The Quality Nursing Work Environment (QNWE) is a well-known tool that has been commonly used to evaluate the working atmosphere of nurses. However, the availability and validated version of the instrument for hospital nurses in Indonesia is not confirmed. Purpose: This study aims to confirm the psychometric evaluation of the Indonesian version of QNWE instruments in hospital settings. Methods: A cross-sectional study design and psychometric analyses were administered. The 65-item, eight-domain questionnaire was translated, adapted, and face-validated using content validity index (CVI) analysis. The construct validity and internal consistency of the translated version were tested using confirmatory factor analysis (CFA) and Cronbach's Alpha to 334 hospital nurses. The intraclass correlation coefficient (ICC) was employed to determine test-retest and interrater reliability analysis to 33 nurses and 10 ratters in the pilot testing. Results: The CVI of the QNWE-I scale ranged from 0.86 to 1.00. The CFA determined an adequate model fit of the instrument. As to overall reliability, test-retest reliability of 0.90, ICC analysis of 0.82, and Cronbach's alpha of 0.96; was confirmed. Conclusions: The psychometric evaluation of the QNWE-I showed excellent acceptability, validity, and reliability. Therefore, the QNWE-I can serve as a comprehensive instrument for assessing the quality of nurses' work environments in Indonesia.