New 18-Item Scale Measures the Workplace Supports That Keep Nurses Well

Nursing has long been described as a profession of compassion under pressure, but the science of measuring exactly what sustains nurses through that pressure has lagged behind the need. A research team led by Claudia Steinke, Chiedozie James Alumona, Helen Kelley, Suha Damag and Oluwagbohunmi Adetunji Awosoga at the University of Lethbridge, working with colleagues in Nigeria, has now built and rigorously tested a new instrument designed to capture the workplace supports that buffer nurses against stress and protect their well-being. The study, published in BMC Nursing, introduces the Workplace Supports Resource for Nurses’ Well-being scale, abbreviated as the SRNW scale, and reports a detailed psychometric evaluation suggesting the tool is both reliable and valid.

The starting point for the work is the well-established Job Demands-Resources model, a framework in occupational health psychology that treats every workplace as a balance between demands, such as heavy workloads, time pressure and emotional strain, and resources, such as social support, autonomy and feedback, that help employees cope. Demands on nurses have intensified dramatically in recent years, particularly since the COVID-19 pandemic exposed chronic understaffing and burnout across health systems worldwide. Supports, the researchers argue, are not merely pleasant extras; they actively buffer against occupational stress, promote resilience, strengthen role commitment and enhance work-related satisfaction. Yet before this study, there was no validated instrument grounded specifically in nurses’ own accounts of the supports they experience at work.

To build one, the team used an exploratory sequential mixed-methods design, a strategy in which qualitative work comes first and directly shapes the quantitative instrument that follows. A systematic review of the existing literature informed the initial conceptualisation of the scale, generating a pool of candidate items. The researchers then conducted individual interviews with nurses, asking them to describe in their own words the supports that matter to them on the job. This grounded approach matters because scales built purely from theory or from management perspectives can miss the lived realities of frontline staff. The interview findings refined the item pool, and the resulting items then underwent face validation, checking that respondents understood the questions as intended, and content validation, checking with experts that the items adequately covered the construct of workplace support.

With a validated item pool in hand, the team moved to the quantitative phase. They administered a cross-sectional survey to nurses working in Southern Alberta, Canada, distributed through contact supervisors and managers at eleven government hospitals and healthcare centres, with operational support from Alberta Health Services. The survey package included the new SRNW scale alongside two established subdomains of the Work-Related Quality of Life instrument: General Well-Being and Job and Career Satisfaction. These comparison measures served as benchmarks, allowing the researchers to test whether their new scale actually correlated with well-being and satisfaction in the ways theory predicts. In total, 269 nurses completed the survey, providing a dataset substantial enough for the battery of statistical analyses that followed.

The first round of development and evaluation produced a 21-item scale, but the psychometric testing refined it further. Using exploratory factor analysis, a technique that uncovers latent structure by identifying clusters of items that covary together, and preliminary confirmatory factor analysis, which tests whether a hypothesised structure fits the observed data, the team arrived at a final 18-item instrument organised into three subdomains: co-worker supports, immediate supervisor supports and organisational supports. This three-tier structure is conceptually elegant because it maps onto the distinct levels of the workplace hierarchy. A nurse may enjoy strong camaraderie with peers on the unit while receiving little backing from a supervisor, or vice versa, and the scale can now capture those differences rather than collapsing support into a single undifferentiated score.

The statistical evidence for the refined scale is strong. Convergent validity within each factor was assessed using average variance extracted, a measure of how much of the variance in a set of items is explained by the underlying construct. Values above 0.5 are conventionally considered adequate, and the SRNW subdomains delivered 0.54 for co-worker supports, 0.69 for immediate supervisor supports and 0.64 for organisational supports. Discriminant validity, tested with the Fornell-Larcker criterion, confirmed that the three subdomains are related but statistically distinct constructs rather than redundant measures of the same thing. In practical terms, this means researchers and hospital administrators can use the subdomains separately to diagnose precisely where support is flourishing and where it is failing.

Reliability, the consistency of measurement, was evaluated with two complementary coefficients. Cronbach’s alpha, the classic index of internal consistency, reached 0.93 for the overall SRNW scale, with subdomain values ranging from 0.85 to 0.94. McDonald’s omega, a more modern coefficient that is less dependent on the assumption that all items contribute equally to the latent construct, told a nearly identical story: 0.92 for the full scale and 0.85 to 0.94 across the subdomains. Values in this range indicate that the items within each subdomain hang together tightly and that the instrument would yield stable results if administered repeatedly to comparable samples. For a newly developed scale, such consistency across two different estimation methods is a reassuring sign of robustness.

Perhaps most importantly for the scale’s usefulness, the team tested whether scores on the SRNW actually moved in step with well-being outcomes. Pearson correlations between the SRNW and the General Well-Being subdomain ranged from 0.34 to 0.48 across the overall scale and its subdomains, while correlations with Job and Career Satisfaction ranged from 0.42 to 0.70, and all were statistically significant. These are meaningful associations: nurses who reported stronger co-worker, supervisor and organisational supports also reported better general well-being and greater satisfaction with their jobs and careers. The correlations are strong enough to demonstrate the scale’s predictive relevance but not so strong as to suggest it is simply measuring well-being itself, which is exactly the pattern a good support measure should show.

The authors are careful to frame their findings as preliminary evidence rather than a finished verdict. The sample was drawn from a single region of Canada, and psychometric properties can shift when instruments are used in different settings, cultures and nursing specialties. Further validation in larger and more diverse populations will be needed before the SRNW scale can be considered a fully generalisable tool. The study also received ethics approval from the University of Alberta Research Ethics Board and was funded by the Prentice Institute for Global Population and Economy and the National Emergency Nurses Association, underscoring the institutional commitment to addressing nurse well-being as a research priority rather than a rhetorical one.

Even so, the implications are considerable. Health systems around the world are grappling with nursing shortages, burnout epidemics and record attrition, and interventions often fail because they target demands, such as workload, without measuring the resource side of the equation. A short, reliable, 18-item scale that can pinpoint whether the weak link is peer support, supervisory backing or organisational commitment gives researchers a diagnostic instrument and gives hospital leaders a baseline against which to evaluate workplace initiatives. By grounding the measure in nurses’ own voices and subjecting it to a full battery of modern psychometric tests, the Lethbridge team has produced a tool with the potential to support research and organisational programmes aimed at improving workplace conditions and, ultimately, keeping the people who care for everyone else well enough to keep caring.

Subject of Research: Development and psychometric validation of a workplace supports scale for nurses' well-being

Article Title: Workplace supports resource for nurses’ well-being: development and psychometric evaluation

Article References: Steinke, C., Alumona, C. J., Kelley, H., Damag, S., & Awosoga, O. A. (2026). Workplace supports resource for nurses’ well-being: development and psychometric evaluation. BMC Nursing. https://doi.org/10.1186/s12912-026-05409-x

Image Credits: AI Generated

DOI: 10.1186/s12912-026-05409-x

Keywords: nurses, workplace support, well-being, psychometric validation, scale development, mixed-methods design, job demands-resources model, nursing research, employee health, burnout, quality of life, occupational stress