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Aims: To develop and validate a comprehensive tool based on those established in the field capable of reflecting the broader concept of Unfinished Nursing Care. Background: Different tools have been established in the field of Missed Care, Rationing Care and Tasks Left Undone. However, despite them sharing similar items and all referring to the common concept of Unfinished Nursing Care, no attempts to collapse them in a single tool capable of reflecting current nursing practice, and its increased complexity, have been attempted to date. Methods: A development and validation study was performed in 2017. After developing the instrument starting from the MISSCARE Survey and critically reviewing the other tools available in the field, the Unfinished Nursing Care Survey (UNCS) was subjected to validation. A total of 1977 nurses from 13 acute Italian hospitals were recruited. Acceptability, construct validity (Mokken Scaling, Explorative and Confirmative Factor Analysis), internal consistency, hypothesis testing and criterion validity were assessed according to the COnsensus‐based Standards for the selection of health Measurement INstruments guideline. Results: 1,400 (70.8%) nurses participated. The UNCS is composed of part A (=elements of unfinished care) and part B (=reasons for unfinished care) with 21 and 18 items, respectively. The UNCS has showed high acceptability (>90%). Part A has reported a strong scalability (H =.52), thus suggesting a hierarchical structure among the items. The six factors in part B explained a total variance of 64.3% (internal consistency =.806) as confirmed by the Confirmative Factor Analysis. Conclusions: The comprehensive nature of the UNCS can contribute to the establishment of a common reference measure of the phenomenon worldwide although its psychometric properties require future investigation in different cultural contexts, languages and clinical settings. Implications for Nursing Management: Measuring Unfinished Nursing Care provides information on the processes implicated in the development of adverse events before these become visible; moreover, it can increase awareness on nurses' performance and inform appropriate interventions to improve it. [ABSTRACT FROM AUTHOR]

Aim To develop and psychometrically test the Italian-language Nurse Caring Behaviours Scale, a short measure of nurse caring behaviour as perceived by inpatients. Background Patient perceptions of nurses' caring behaviours are a predictor of care quality. Caring behaviours are culture-specific, but no measure of patient perceptions has previously been developed in Italy. Moreover, existing tools show unclear psychometric properties, are burdensome for respondents, or are not widely applicable. Design Instrument development and psychometric testing. Method Item generation included identifying and adapting items from existing measures of caring behaviours as perceived by patients. A pool of 28 items was evaluated for face validity. Content validity indexes were calculated for the resulting 15-item scale; acceptability and clarity were pilot tested with 50 patients. To assess construct validity, a sample of 2,001 consecutive adult patients admitted to a hospital in 2014 completed the scale and was split into two groups. Reliability was evaluated using nonlinear structural equation modelling coefficients. Measurement invariance was tested across subsamples. Results Item 15 loaded poorly in the exploratory factor analysis ( n = 983) and was excluded from the final solution, positing a single latent variable with 14 indicators. This model fitted the data moderately. The confirmatory factor analysis ( n = 1018) returned similar results. Internal consistency was excellent in both subsamples. Full scalar invariance was reached, and no significant latent mean differences were detected across subsamples. Conclusion The new instrument shows reasonable psychometric properties and is a promising short and widely applicable measure of inpatient perceptions of nurse caring behaviours. [ABSTRACT FROM AUTHOR]