護理工作環境指標包含在病人照顧上的自主、臨床實務控制、醫護關係、組織支持及繼續教育。若具有適當信、效度之護理工作環境量表，可了解護理人員工作環境狀態。Aiken 和 Patrician針對原始NWI量表65題中，最後精簡為15題的修訂版護理工作指標（Revised nursing work index, NWI-R）量表，測量護理人員目前的工作環境狀態，不僅信、效度佳、題數少，包含工作環境的自主、臨床實務控制、醫護關係、組織支持的構面，但卻缺少繼續教育的評估。
本研究目的為測試護理工作環境量表中文版（Nursing Work Environment Index Chinese Version, NWEI-C）應用於台灣護理人員之信度與效度。採橫斷式研究設計，使用次級資料庫分析。以主成份分析（PCA）萃取共同因素方法，因素轉軸採斜交轉軸法（Promax）進行探索性因素分析，萃取出四個構面為組織支持、人力與資源、醫護合作、繼續教育，共19題合計解釋58.5％的變異量。
中文量表之模式測試與原理論架構不適配（χ2 =1981.4、χ2/df = 13.57、p < .05、GFI = .88、AGFI = .84、RMSEA = .08）。資料以探索性因素分析所建立之新模式，再以驗證性因素分析進行模式驗證（χ2 = 858.27、χ2/df = 5.99、 p < .05、GFI = .90、AGFI = .88、RMSEA = .07），本研究所提出之新模式與觀察值資料適配。另以護理人員平均工作滿意度為本量表效標效度，相關係數為.64 (p < .001)。各次量表之信度Cronbach's Alpha介於.71至.82，顯示護理工作環境量表中文版（NWEI-C）應用於台灣護理人員具有合適之信度與效度。

Nursing work environment indicators consist of nurse-physician relationships, control over the practice setting, autonomy, organizational support and continue education. However, different factorial structures of the Nursing Work Environment Index Chinese Version (NWEI-C) have been presented in various cultures. The purpose of this study was to investigate the reliability and validity of NWEI-C among nurses in Taiwan.
This was a cross-sectional study. The data was obtained from NURSE-outcomes study. Total of 1,782 questionnaires were completed and response rate was 97% (1782/1846). Item analysis was used to examine an appropriate measurement items in the present study. All subjects were randomly assigned to two sub-groups for exploratory and confirmatory factor analysis. The first half of the sample was adopted to explore the factorial structure using exploratory factor analysis and the other half was used to confirm the modified structure among Taiwan nurses. Finally, patient satisfaction was considered as a current validity index using McCloskey/Mueller satisfaction scale (MMSS) to test the correlation.
A four-factor with 19 items of NWEI-C model was set up at the first half sample and the explained accounting for 58.5％ of the variance. In the second half sample, confirmatory factor analysis was showed an acceptable result in the overall fit (GFI = .90, AGFI = .88, RMSEA = .07). The correlation was .64 (p < .001) between NWEI-C and MMSS. The Cronbach's Alpha were .90 for the NWEI-C and .71 - .82 for the subscales.

中華民國護理師護士公會全國聯合會（2010年11月04日）．台閩地區護理人員統計表．2010年12月16日http://www.nurse.org.tw/userfiles/file/DataSearch/台閩地區護理人員統計表.99年10月.xls
李玉秀、何美瑤、孫凡軻等編著（2007）．護理研究概要．台北市：華杏。
李茂能（2006）．結構方程模式軟體AMOS之簡介及其在測驗編制上之應用．臺北市：心理。
吳明隆、涂金堂（2009）．SPSS與統計應用分析．臺北市：五南。
談靜慧、金繼春（2004）･自主之概念分析･護理雜誌，51（3），65-70。
趙婉青、袁千邑、王美華、謝碧晴（2008）･護理工作環境之現況調查—以台北縣區域教學醫院護理人員為例･亞東學報，55，105-116。
榮泰生（2009）．AMOS與研究方法．台北市：五南。
Aiken, L. H., & Patrician, P. A. (2000a). Measuring organizational traits of hospitals: the Revised Nursing Work Index. Nursing Research, 49(3), 146-153.
Aiken, L. H., Havens, D. S., & Sloane, D. M. (2000b). The Magnet Nursing Services Recognition Program. American Journal of Nursing, 100(3), 26-35.
Aiken, L. H., Clarke, S. P., Sloane, D. M., Lake, E. T., Cheney, T., Aiken, L. H., et al. (2008). Effects of hospital care environment on patient mortality and nurse outcomes. Journal of Nursing Administration, 38(5), 223-229.
Aiken, L. H., Clarke, S. P., Sloane, D. M., Sochalski, J., Silber, J. H., Aiken, L. H., et al. (2002). Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. Journal of the American Medical Association, 288(16), 1987-1993.
Aiken, L. H., Clarke, S. P., Sloane, D. M., Sochalski, J. A., Busse, R., Clarke, H., et al. (2001). Nurses' reports on hospital care in five countries. Health Affairs, 20(3), 43-53.
Bagozzi, R. P., & Yi, Y. (1988). On the Evaluation for Structural Equation Model. Journal of the Academy of Marketing Science, 16(1), 74-94.
Bollen, K. A. (1989). Over Fit in Covariance Structure Models:Two types of sample size effects. Phychological Bulletin, 107(2), 256-259.
Bonneterre, V., Liaudy, S., Chatellier, G., Lang, T., & de Gaumaris, R. (2008). Reliability, validity, and health issues arising from questionnaires used to measure psychosocial and organizational work factors (POWFs) among hospital nurses: a critical review. Journal of Nursing Measurement, 16(3), 207-230.
Casanova, J., Hendricks, B., Day, K., Theis, L., Dorpat, D., & Wiesman, S. (2007). Nurse physician work relations and role expectation. Journal of Nursing Adminstration, 37(2), 68-70.
Chang, W. Y., Ma, J. C., Chiu, H, T., Lin, K. C., & Lee P. H. (2009). Job satisfaction and Perceptions of qua1ity of patent care, collaboration and teamwork in acute care Hospitals. Joumal of Advanced Nursing, 65(9), 1946-1955.
Chin, W. W., & Todd, P. A. (1995). Om the Use, Usefulness, and Eae of Structural Equation Modeling in MIS Reearch: A Not of Caution. MIS Quarterly, 19(2), 237-246
Chang, W. Y., Ma, J. C., Chiu, H. T., Lin, K. C., & Lee, P. H. (2009). Job satisfaction and perceptions of Quality of patient care collaboration and teamwork in acute care hospitals. Joumal of Advanced Nuring, 65(9), 1946-1955.
Chang, Y. (2008). The Impact of Chinese Cultural Values on Taiwan Nursing Leadership Styles: Comparing the Self-Assessments of Staff Nurses and Head Nurses. Journal of Nursing Research, 16( 2), 109-120.
Chiang, H. Y., ＆ Lin, S. Y. (2008). Psychometric testing of the Chinese version of nursing practice environment scale. Journal of Clinical Nursing, 18, 919-929.
Chiou, J. S. (2001). Horizontal and Vertical Individualism and Collectivism Among College Students in the United States, Taiwan, and Argentina. The Journal of Social Psychology, 141, 667-678.
Choi, J., Bakken, S., Larson, E., Du, Y., & Stone, P. W. (2004). Perceived nursing work environment of critical care nurses. Nursing Research, 53(6), 370-378.
Cummings, G. G., Hayduk, L., & Estabrooks, C. A. (2006). Is the Nursing Work Index measuring up? Moving beyond estimating reliability to testing validity. Nursing Research, 55(2), 82-93.
Estabrooks, C. A., Tourangeau, A. E., Humphrey, C. K., Hesketh, K. L., Giovannetti, P., Thomson, D., Wong, J., Acorn, S., Clarke, H., & Shamian, J. (2002). Measuring the hospital practice environment：A Canadian context. Research in Nursing & Health, 25(4), 256-268.
Havens D.S. & Aiken L.H. (1999). Shaping systems to promote desired outcomes. Journal of Nursing Administration, 29, 14–20.
Halcomb, E. J., Davidon, P. M., Caldwell, B., Salamonson, Y., ＆ Rolley, J. X. (2006). Validation of the Profeional Practice Environment Scale in Australin General Practice. Journal of Nuring Scholarhip, 42(2), 207-213.
Kramer, M., & Hafner, L. P. (1989). Shared values：Impact on staff nurse job satisfaction and perceived productivity. Nursing Research, 38, 172-177.
Kramer, M., & Schmalenberg, C. (2004). Development and Evaluation of Essentials of Magnetism Tool. Journal of Nursing Administration, 34(7-8), 365-378.
Kramer, M., Maguire, P., & Schmalenberg, C. (2004). Excellence Through Evidence The What, When, and Where of Clinical Autonomy, Journal of Nursing Administration,36(10), 479-491.
Kreitzer, M.J., Wright, D., Hamlin, C., Towey, S., Marko, M., ＆Disch, J. (1997). Creating a healthy work environment in the midst of organizational change and transition. Journal of Nursing Administration, 27(6), 5–41.
Lake, E. T. (2002). Development of the practice environment scale of the Nursing Work Index. Research in Nursing & Health, 25(3), 176-188.
Levett-Jones, T. L. (2005). Continuing education for nurses: A necessity or a nicety? . The Journal of Continuing Education in Nursing, 36(5), 229-233.
Li, Y.-F., Lake, E. T., Sales, A. E., Sharp, N. D., Greiner, G. T., Lowy, E., et al. (2007). Measuring nurses' practice environments with the revised nursing work index: evidence from registered nurses in the Veterans Health Administration. Research in Nursing & Health, 30(1), 31-44.
Lin, L., & Liang, B. A. (2007) . Addressing the Nursing Work Environment to Promote Patient Safety. Nursing Forum, 42(1), 20-30.
Liou, S.-R., & Cheng, C.-Y. (2009). Using the Practice Environment Scale of the Nursing Work Index on Asian Nurses. Nursing Research , 58(3), 218-225.
McCusker, J., Dendukuri, N., Cardinal, L., Laplante, J., & Bambonye, L. (2004). Nursing work environment and quality of care: differences between units at the same hospital. International Journal of Health Care Quality Assurance Incorporating Leadership in Health Services, 17(6), 313-322.
Pett, M. A., Lackey, N. R., & Sullivan, J. J. (2003). Making Sense of Factor Analysis: The Use of Factor Analysis for Instrument Development in Health Care Research.. Thousand Oaks, California: Sage.
Polit, D. F., & Beck, C.T. (2006). Essentials of nursing research :methods, appraisal, and utilization. (6nd ed.), Philadelphia :Lippincott Williams & Wilkins.
Schmalenberg, C., ＆ Kramer, M. (2008). Essentials of a Productive Nurse Work Environment. Nursing Research, 57(1), 2-13.
Shirey, M.R., (2006). Authentic leaders creating healthy work environments for nursing practice. American Journal Crit Care, 15, 256–267.
Slater, P., & McCormack, B. (2007). An exploration of the factor structure of the nursing work index. Worldviews on Evidence-Based Nursing, 4(1), 30-39.
Sochalski J., Aiken L.H., Rafferty A.M., Shamian J., Mu¨ ller-Mundt G., Hunt J., Giovannetti P. & Clarke H. (1998). Building multi- national research. Reflections Third Quarter, 45, 20–23.
Straickland, O.L., (2003). Use Factor Analysis for Validity Assessment: Practical Considerations. Journal of Nursing Measurement, 11 (3), 203-205.
Terwee, C.B., Bot, S.D.M., Boer, M.R., Windt, D.A.W.M., Knol, D.L., Dekker, J., Bouter, L.M., ＆ Vet, H. C.W. (2007). Quality criteria were proposed for measurement properties of health status questionnaires. Journal of Clinical Epidemiology, 60, 34-42.
Thompson, B. (2005). Exploratory and confirmatory factor analysis: Understanding concepts and applications. Washington, DC: American Psychological Association.
Vahey, D. C., Aiken, L. H., Sloane, D. M., Clarke, S. P., & Vargas, D. (2004). Nurse burnout and patient satisfaction. Medical Care, 42(2), 57-66.
Van Bogaert, P., Clarke, S., Vermeyen, K., Meulemans, H., & Van de Heyning, P. (2009). Practice environments and their associations with nurse-reported outcomes in Belgian hospitals: development and preliminary validation of a Dutch adaptation of the Revised Nursing Work Index. International Journal of Nursing Studies, 46(1), 54-64.
Wagner, C. M. (2004). Is your nursing staff ready for magnet hospital status? An application of the revised Nursing Work Index. Journal of Nursing Administration, 34(10), 463-468.
Waltz, C. F., Strickland, O. L., & Lenz, E. R. (2005). Measurement in nursing and health research (3rd ed.). New York: Springer.
Zangaro, G. A., & Soeken, K. L. (2007). A meta-analysis of studies of nurses' job satisfaction. Research in Nursing & Health, 30(4), 445-458.
Zelauskas, B., ＆ Howes, D. G. (1992). The effects of implementing a professional practice model. Journal of Nursing Administration, 22(7-8), 18-23.