Aiken and Patrician [8] developed the revised NWI (NWI-R)
based on the NWI. Through proof-of-concept study emphasising
the correlation of items and their potential to reflect the
traits of a healthy working environment, the new scale ultimately
contained 57 items after relatively less correlated
items in the original scale were excluded. Aiken and colleagues
[9] used the NWI-R for the first time in 1994 in a
controlled study of 39 magnet hospitals and 195 non-magnet
hospitals, and found lower patient mortality and signifi-
cantly higher NWI-R scores in magnet hospitals than in nonmagnet
hospitals. Based on this scale, follow-up studies
attempted to develop subscales to evaluate related content in
the nursing work environment [10e12]. The total Cronbach's a
coefficient of the NWI-R is 0.96; the coefficient for each subscale
ranges from 0.75 to 0.79.