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Objective: This study aims to validate the Portuguese version of the Practice Environment Scale of the Nursing Work Index (PES-NWI) and assess construct validity through exploratory and confirmatory factor analyses. Materials and Methods: This cross-sectional study validates the psychometric properties of the PES-NWI in Portugal. Exploratory factorial analysis is used to analyze the psychometric properties of the PES-NWI in a sample of 5,075 Portuguese nurses; the data sample covers all geographic regions in the country. Confirmatory factor analysis is performed to confirm the model’s data adequacy. Results: Factorial analysis explained 54.6 % of the variance and a five-dimension structure. The five factors identified were Nurse Participation in Hospital Affairs, Nurse Manager Ability, Leadership and Support of Nurses, Nursing Foundations for Quality of Care, Staffing and Resource Adequacy, and Nurse-Physician Relations. The confirmatory analysis showed that the five-factor model fit well with the data in the Portuguese context. Conclusion: In a Portuguese health context, the PES-NWI is a valid scale to access the nursing environment and improve working conditions.

The nature of the turnover process calls for the study of more complex relationships among variables beyond simple bivariate or multiple associations between predictors and turnover intentions. The present article aims to examine the predictive value of job demands and resources in the explanation of nurses' intention to leave the organization and to test the mediating roles of professional burnout and engagement in these relationships, within a Portuguese nursing population. The research models were tested within the scope of the Registered Nurse Forecasting project. Data included the self-report questionnaires of 2,235 Portuguese nurses from 31 hospitals, collected through stratified random sampling procedures. The statistical analyses of the structural models showed that nurses' participation in hospital affairs, a job resource at the work organization level, was the only significant predictor of nurses´ intention to leave the organization (β = -.45, p < .001). Analyses of the mediation models revealed that the emotional exhaustion symptoms of burnout (β = -.11, p < .001) and job engagement feelings (β = -.15, p < .001) were both significant mediators between nurses' decisional involvement and their intentions to leave the organization. Results suggest that including nurses in decision-making processes regarding their professional practice policy and environment, and improving nurses' professional well-being are two crucial strategies to reduce nurses' turnover intentions.

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.

OBJECTIVE The aims of this study were to summarize the current state of knowledge regarding the relationship between nursing work environment (NWE) and patient outcomes and to identify gaps in the literature. BACKGROUND There was an increased awareness of the impact of NWE on patient outcomes, in particular, related to safety and quality of care. METHOD Scoping review was conducted. Studies published between 2002 and the 1st quarter of 2018 were included to provide an overview of the research on the associations between NWE and patient outcomes. RESULTS Of 2238 titles and abstracts identified, 35 studies were included, and publication ranged from 2005 to 2018. All studies included were observational, 4 had a longitudinal design, and the remaining studies were cross-sectional. Evidence indicates that better NWE decreases the risk of patient adverse events and increases the quality of care. CONCLUSIONS The associations between different dimensions of NWE and patient outcomes should be explored.