To Örebro University

BACKGROUND: Missing nursing care in the perioperative context affects quality of care and patient safety. More validated language versions of the MISSCARE Survey OR enable local, national, and international comparisons. The aim was to translate and culturally adapt the American MISSCARE Survey OR to the Swedish perioperative context and assess the instrument's psychometric properties.

METHODS: A cross-sectional validation study with translation and cultural adaptation was conducted in eight steps according to the International Society for Pharmacoeconomics and Outcomes Research guidelines. To assess the psychometric properties, data were collected via a web survey distributed at a Swedish national conference for operating room nurses. The data collection was concluded in November 2023. Acceptability, construct validity and internal consistency were analyzed.

RESULTS: Cultural adaptation resulted in the omission of two items from the section measuring missed elements of care. A total of 107 (out of 261 invited operating room nurses) respondents were included in the psychometric testing, leading to a response rate of 41%. Acceptability was high, and 95.3% of the respondents answered all the items. The factor analysis on missed elements of care was inconclusive and was therefore regarded as a list of nursing actions. With respect to reasons for missed nursing care, the factor analysis resulted in a three-factor solution, which explained a cumulative variance of 62.6%. The alpha coefficients for internal consistency for the three factors ranged from 0.760 to 0.947.

CONCLUSIONS: The Swedish MISSCARE Survey OR is a valid instrument with sufficient psychometric properties and provides a reliable measure of missed nursing care and its reasons. Usage could be valuable for nursing managers and directors, who are responsible for care processes and strategic care planning.