Translation and psychometric properties of the Japanese version of the revised MISSCARE Survey.
The Japanese version of the MISSCARE Survey shows good validity and reliability for assessing missed nursing care, but its application may be limited by cultural and contextual factors.
Where it sits
this study against the rest of the eloralintide corpusSummary and findings
This study developed a Japanese version of the revised MISSCARE Survey and evaluated its psychometric properties among 1136 registered nurses in acute care hospitals. The survey assessed missed nursing care and reasons for missed care, demonstrating acceptable validity and reliability. No therapeutic claims are made.
Abstract
<h4>Objective</h4>To develop a Japanese version of the revised MISSCARE Survey and evaluate its psychometric properties among nurses in acute care hospitals.<h4>Design</h4>Cross-cultural adaptation and validation of a psychometric instrument.<h4>Methods</h4>Between October and November 2025, a cross-sectional survey was conducted among 1136 registered nurses working at two acute care hospitals in Tokyo. The construct validity of Part A (missed nursing care) and Part B (reasons for missed care) was examined using exploratory factor analysis, followed by confirmatory factor analysis. Reliability was assessed using McDonald's omega and test-retest intraclass correlation coefficients.<h4>Results</h4>Of the 1136 eligible nurses, 455 responded to the web-based survey, and 375 nurses with complete data were included in the analysis. Forty-five participants completed the retest 3 weeks after the initial survey. Confirmatory factor analysis indicated a three-factor structure for Part A, comprising (1) fundamental care; (2) clinical monitoring and management; and (3) responsive care (Satorra-Bentler scaled χ²(204) = 515.38, <i>p</i> < .001; root mean square error of approximation [RMSEA] = 0.069, comparative fit index [CFI] = 0.918, Tucker-Lewis Index [TLI] = 0.906, Standardized Root Mean Square Residual [SRMR] = 0.052), and a three-factor structure for Part B, comprising (1) communication; (2) material and operational resources; and (3) labour resources (Satorra-Bentler scaled χ²(202) = 542.80, <i>p <</i> .001; RMSEA = 0.081, CFI = 0.906, TLI = 0.893, SRMR = 0.058), with several items reallocated to better reflect the Japanese context. Internal consistency was high for both parts of the survey, with McDonald's omega values exceeded 0.80 for all factors. The test-retest intraclass correlation coefficients for the total scores of Parts A and B were 0.82 (95% confidence interval [CI], 0.67-0.91) and 0.68 (95% CI, 0.45-0.82), respectively.<h4>Conclusions</h4>The Japanese version of the revised MISSCARE Survey demonstrated acceptable validity and reliability. This instrument enabled the systematic assessment of missed nursing care in Japanese acute care settings, supported the evaluation of nurse staffing and work environment interventions, and facilitated international comparisons to inform evidence-based nursing policies and practices.
Background
This paper addresses the need for a validated tool to assess missed nursing care in Japan, an area previously explored in other cultural contexts. The MISSCARE Survey has been used internationally, but its adaptation for Japanese nurses is necessary to ensure cultural relevance and accuracy. This study is important as it contributes to the understanding of nursing care quality and the factors influencing missed care in acute settings.
Methods
The study employed a cross-sectional survey design, targeting 1136 registered nurses from two acute care hospitals in Tokyo. The survey was conducted between October and November 2025, and the psychometric properties were evaluated using exploratory and confirmatory factor analyses. Reliability was assessed through McDonald's omega and test-retest intraclass correlation coefficients.
Results
The primary endpoint indicated that the confirmatory factor analysis for Part A yielded a Satorra-Bentler scaled χ²(204) = 515.38, p < .001, with RMSEA = 0.069, CFI = 0.918, TLI = 0.906, and SRMR = 0.052. For Part B, the analysis showed Satorra-Bentler scaled χ²(202) = 542.80, p < .001, RMSEA = 0.081, CFI = 0.906, TLI = 0.893, and SRMR = 0.058. Internal consistency was high, with McDonald's omega values exceeding 0.80 for all factors.
Interpretation
The findings suggest that the Japanese version of the MISSCARE Survey is a valid and reliable tool for assessing missed nursing care, consistent with previous studies in other languages. However, the effect sizes, while statistically significant, may not translate to clinically meaningful changes in practice without further context. Limitations include the study's reliance on self-reported data and the lack of a broader sample, which may affect the generalizability of the results.
Key findings
- Satorra-Bentler scaled χ²(204) = 515.38, p < .001, RMSEA = 0.069, CFI = 0.918, TLI = 0.906, SRMR = 0.052 for Part A.
- Satorra-Bentler scaled χ²(202) = 542.80, p < .001, RMSEA = 0.081, CFI = 0.906, TLI = 0.893, SRMR = 0.058 for Part B.
- McDonald's omega values exceeded 0.80 for all factors in both parts of the survey.
- Test-retest intraclass correlation coefficient for total scores of Part A was 0.82 (95% CI, 0.67-0.91).
- Test-retest intraclass correlation coefficient for total scores of Part B was 0.68 (95% CI, 0.45-0.82).
Limitations
- Single-site study may limit generalizability.
- Response rate not reported.
- Self-reported data may introduce bias.
- Short follow-up period for retest.
- Adaptation may not capture all cultural nuances.