Practice Environment Scale-Nursing Work Index for use in primary health care: a qualitative content validity study

Identifier:  imarina:9514649

Handle: https://hdl.handle.net/20.500.11797/imarina9514649

Authors:  Zabaleta-del-Olmo, Edurne; Rene-Rene, Anna; Sauch-Valmana, Gloria; Rios-Jimenez, Ana; Marchal-Torralbo, Ana; Rey-Renones, Cristina; Brunet-Reverte, Nuria; Barnes-Valles, Isabel; Zamora-Sanchez, Juan-Jose; Artigas-Lage, Montserrat; Urpi-Fernandez, Ana-Maria; Planas-Campmany, Carme; Diaz-Herrera, Miguel-Angel; Calvet-Tort, Gemma; Gimeno-Pi, Iraida

Abstract:
Objective: To assess the content validity of an adapted version of the Practice Environment Scale-Nursing Work Index (PES-NWI) for use in Primary Health Care (PHC). Methodology: A qualitative study was conducted using cognitive interviews. Eight PHC nurses with diverse professional profiles completed the adapted version of the PES-NWI and participated in interviews aimed at exploring their interpretation of the items. The analysis was guided by the Question Appraisal System 99 (QAS-99), supplemented with field notes and transcript verification. Identified issues were categorised into four domains: clarity, required knowledge, assumptions, and response format. These findings informed subsequent revisions to the scale. Results: Twenty-six of the 34 items (76.5%) were identified as problematic by at least one participant, resulting in a total of 56 coded issues. The majority (87.5%) pertained to clarity, primarily due to ambiguous or imprecise wording. All participants considered the items to be relevant and did not perceive any content omissions. Revisions were undertaken to enhance item clarity and contextual appropriateness. The final version was endorsed by the participants, the research team, and the original scale's author. Conclusions: The high proportion of items with clarity-related issues underscores the utility of cognitive interviews in detecting interpretive difficulties and refining item wording. Participants judged the adapted scale to be relevant and comprehensive, supporting its content validity and contextual suitability for PHC settings. This study offers a replicable methodology for assessing content validity from the perspective of the target population.