Developing a Revised Short Form of the Practice Environment Scale for Home Healthcare: A Nationwide Cross-Sectional Study for Healthcare Professionals

Introduction With staffing shortages, retaining healthcare professionals working in home healthcare is one of the key strategies. Easier tools are needed to capture the work environment characteristics associated with their retention. This study aims to develop a shortened version of the Practice Environment Scale for Home Healthcare, capable of measuring the attractiveness to healthcare professionals. Methods A mail survey with anonymous self-administered questionnaires was distributed to healthcare professionals working at 153 (rate of intention to participate: 7.7%) home-visit nursing agencies in Japan (July-October 2023). The questions included 37 items from the original version of the Practice Environment Scale for Home Healthcare, which comprises seven factors, including job satisfaction, quality of care, and intention to remain. Confirmatory factor analysis was conducted on 21 items from 380 (rate of valid responses: 31.4%) mail surveys. The relationships between the subscale and composite scores of the 21 items for the home healthcare practice environment scale and participants' job satisfaction, quality of care, and intention to remain at the agencies were assessed. Results A seven-dimensional model with 21 items was supported by a confirmatory factor analysis. The Cronbach's alpha of the seven subscales and the composite was 0.80-0.91. The scores on the Practice Environment Scale for Home Healthcare were positively associated with participants' job satisfaction, quality of care, and intention to remain. Conclusion A shortened Practice Environment Scale for Home Healthcare, comprising 21 items, is a valid and reliable measurement that effectively assesses attractive practice environments for healthcare professionals. Improving the characteristics of the work environment, as indicated in the shortened scale, will aid managers and policymakers in securing healthcare professionals in home healthcare settings.