Cross-Cultural Adaptation and Preliminary Psychometric Evaluation of the Romanian Version of the Revised MISSCARE Survey: A Single-Centre Pilot Study.

BACKGROUND/

OBJECTIVES

Missed nursing care is a patient-safety concern shaped by organizational resources, workload, and care prioritization. No Romanian version of the Revised MISSCARE Survey has previously undergone published cross-cultural and psychometric evaluation. This study translated and culturally adapted the instrument and examined its preliminary measurement properties and item-level findings in a Romanian hospital.

METHODS

A methodological, cross-sectional, single-centre pilot study invited all 487 nurses employed at a large university-affiliated hospital in western Romania. Translation and back-translation, expert review, and pretesting preceded electronic administration. Part A activities and Part B reasons were summarized descriptively. The Part B structure was investigated using polychoric correlations, parallel analysis, minimum-residual extraction, and promax rotation. McDonald's omega and ordinal alpha assessed internal consistency. A unique-response-pattern sensitivity analysis evaluated stability.

RESULTS

Overall, 266 nurses participated (response proportion, 54.6%). Ambulation or mobilization was the most frequently missed activity, reported as missed at least occasionally by 55.3% of respondents, followed by bathing and skin care (36.8%), turning every two hours (36.5%), and mouth care (35.3%). The leading moderate or significant reasons were inadequate assistive or clerical personnel (84.6%), unexpected patient volume or acuity (83.5%), and inadequate staffing (82.7%). Parallel analysis supported two correlated Part B factors: organizational resources, coordination, and support; and staffing and workload pressure (r = 0.658). Omega was 0.968 and 0.943, respectively. The two-factor solution and item rankings remained stable in sensitivity analyses.

CONCLUSIONS

The Romanian Revised MISSCARE Survey produced interpretable item-level findings and preliminary evidence of a two-factor structure for Part B, with high internal consistency within each factor.