Validation of the Arabic Version of the Quality of Healthy Work Environment Instrument Among Nurses

A healthy work environment is fundamental to enabling nursing professionals to deliver high-quality patient care, sustain personal well-being, and support the long-term viability of healthcare organizations. Despite its importance, the lack of culturally and linguistically validated instruments hinders accurate assessment of work environments within Arabic-speaking nursing populations. This study aimed to translate and validate the Arabic version of the Quality of Healthy Work Environment (Ar-QHWE) instrument for use among registered nurses. A methodological cross-sectional design was employed. The QHWE instrument underwent forward and backward translation in accordance with WHO guidelines to ensure linguistic and conceptual equivalence. A total of 200 registered nurses from a tertiary care hospital were recruited. Construct validity was examined through confirmatory factor analyses (CFA), while internal consistency was assessed using Cronbach's alpha coefficients. Convergent validity was examined using average variance extracted and Pearson correlation between Ar-QHWE and job satisfaction (JS), perceived quality of care (PQC), and intention to leave (ITL). The Ar-QHWE demonstrated robust psychometric properties. CFA confirmed satisfactory model fit indices (CFI = 0.94, TLI = 0.93, RMSEA = 0.04). Cronbach's alpha coefficients for all subscales ranged from 0.74 to 0.85, indicating high internal consistency. Test-retest reliability, as assessed by ICCs, was also excellent across subscales and for the overall scale. The convergent and discriminant validities were also good, with strong correlations between Ar-QHWE and JS, PQC, and ITL. No major floor or ceiling effects were observed, indicating appropriate score distribution. The Ar-QHWE is a psychometrically sound instrument for evaluating perceptions of a healthy work environment among Arabic-speaking nurses. Its use is recommended for research, policy development, and organizational initiatives aimed at improving workplace quality across Arabic-speaking healthcare systems.