In Taiwan, the ability to measure the changing of health care reform and the improvement in nursing practice environment is hindered by the lack of a valid, reliable, and culture-sensitive instrument for measuring nursing practice environment. The purposes of this two-phase study were to translate and psychometrically validate the Chinese versions of the PPE Scale (CPPE).
Phase I focused on translating and adapting the 38-item PPE into CPPE and evaluating the semantic and content equivalency. Semantic equivalence of the CPPE was secured using Translation Validity Indices as judged by American and bilingual experts. The content equivalence of the CPPE was supported by the satisfactory Content validity Indices. To increase the cultural sensitivity and comprehensiveness of the CPPE, 27 items were added at the suggestion of Taiwanese experts following content validation. A 66-item CPPE including 38 PPE items, 1 adapted item and 27 new items was produced for psychometric evaluation.
Phase II focused on establishing the psychometric properties of the CPPE. A cross-sectional survey was conducted to test the 66-item CPPE on 977 Taiwanese nurses working in acute care settings. PCA with Varimax rotation on the 38 PPE items produced an eight-component solution for the 36-item CPPE after deleting two items. Cronbach's alpha was .90 for the total 36-item CPPE and .68 - .87 for the eight subscales. PCA with Varimax rotation on 66 items of the CPPE produced an eleven-component solution for the 58-item CPPE after deleting 8 items. Cronbach's alpha was .95 for the total 58-item CPPE and .71 - .87 for the eleven subscales. Both the 36-item CPPE and the 58-item CPPE demonstrated satisfactory test-retest reliability and concurrent validity. The psychometric structures of the 36-item CPPE and the 58-item CPPE were different from the original PPE.
Both the 36-item CPPE and the 58-item CPPE were reliable and valid, but the 58-item CPPE is culturally sensitive to the Taiwanese nurses. The 58-item CPPE is useful for measuring Taiwanese nursing practice environment.
