<b>Validation of the MISSCARE-BRASIL survey - A tool to assess missed nursing care</b>

Siqueira, Lillian Dias Castilho; Caliri, Maria Helena Larcher; Haas, Vanderlei José; Kalisch, Beatrice; Dantas, Rosana Aparecida Spadoti

doi:10.1590/1518-8345.2354.2975

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Revista Latino-Americana de Enfermagem

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Original Article • Rev. Latino-Am. Enfermagem 25 • 2017 • https://doi.org/10.1590/1518-8345.2354.2975 copy

Validation of the MISSCARE-BRASIL survey - A tool to assess missed nursing care ¹ 1 Paper extracted from Doctoral Dissertation “Validation of the MISSCARE-BRASIL - Instrument to evaluate missed nursing care”, presented to Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to analyze the metric validity and reliability properties of the MISSCARE-BRASIL survey.

Method:

methodological research conducted by assessing construct validity and reliability via confirmatory factor analysis, known-groups validation, convergent construct validation, analysis of internal consistency and test-retest reliability. The sample consisted of 330 nursing professionals, of whom 86 participated in the retest phase.

Results:

of the 330 participants, 39.7% were aides, 33% technicians, 20.9% nurses, and 6.4% nurses with administrative roles. Confirmatory factorial analysis demonstrated that the Brazilian Portuguese version of the instrument is adequately adjusted to the dimensional structure the scale authors originally proposed. The correlation between “satisfaction with position/role” and “satisfaction with teamwork” and the survey’s missed care variables was moderate (Spearman’s coefficient =0.35; p<0.001). The results of the Student’s t-test indicated known-group validity. Professionals from closed units reported lower levels of missed care in comparison with the other units. The reliability showed a strong correlation, with the exception of “institutional management/leadership style” (intraclass correlation coefficient (ICC)=0.15; p=0.04). The internal consistency was adequate (Cronbach’s alpha was greater than 0.70).

Conclusion:

the MISSCARE-BRASIL was valid and reliable in the group studied. The application of the MISSCARE-BRASIL can contribute to identifying solutions for missed nursing care.

Descriptors:
Validation Studies; Nursing Care; Nursing Methodology Research; Patient Safety; Nursing; Factor Analysis, Statistical

Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo Av. Bandeirantes, 3900, 14040-902 Ribeirão Preto SP Brazil, Tel.: +55 (16) 3315-3451 / 3315-4407 - Ribeirão Preto - SP - Brazil
E-mail: rlae@eerp.usp.br

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[1] Corresponding Author: Lillian Dias Castilho Siqueira Universidade Federal da Grande Dourados Hospital Universitário Rua Ivo Alves da Rocha, 558 Bairro: Altos do Indaiá CEP: 79823-501, Dourados, MS, Brasil E-mail: ldcsiqueira@usp.br

			Unstandardized regression coefficients	Standard-error	Critical ratio	Factor loading	p*
Item B11	←	Communication	1				0,670
Item B5	←	Communication	0,865	0,091	9,473	0,574	<0,001
Item B16	←	Communication	1,034	0,097	10,708	0,658	<0,001
Item B15	←	Communication	1,08	0,099	10,896	0,671	<0,001
Item B13	←	Communication	1,06	0,076	13,94	0,712	<0,001
Item B8	←	Communication	0,833	0,093	8,958	0,541	<0,001
Item B14	←	Communication	0,994	0,092	10,794	0,665	<0,001
Item B7	←	Communication	0,858	0,093	9,204	0,557	<0,001
Item B12	←	Communication	0,985	0,09	10,996	0,678	<0,001
Item B24	←	Communication	0,976	0,095	10,289	0,629	<0,001
Item B10	←	Material resources	1				0,733
Item B6	←	Material resources	0,881	0,082	10,773	0,645	<0,001
Item B9	←	Material resources	1,092	0,069	15,854	0,783	<0,001
Item B23	←	Material resources	0,945	0,094	10,047	0,605	<0,001
Item B1	←	Labor resources	1				0,611
Item B4	←	Labor resources	1,076	0,081	13,23	0,663	<0,001
Item B3	←	Labor resources	0,816	0,101	8,087	0,529	<0,001
Item B2	←	Labor resources	0,736	0,101	7,282	0,467	<0,001
Item B17	←	Labor resources	1,139	0,112	10,155	0,713	<0,001
Item B19	←	Labor resources	0,966	0,11	8,755	0,584	<0,001
Item B27	←	Labor resources	1,091	0,117	9,359	0,638	<0,001
Item B28	←	Labor resources	1,051	0,118	8,937	0,603	<0,001
Item B18	←	Ethical dimension	1				0,817
Item B20	←	Ethical dimension	0,971	0,065	15,043	0,781	<0,001
Item B25	←	Ethical dimension	1,047	0,066	15,829	0,818	<0,001
Item B21	←	Management	1				0,763
Item B22	←	Management	0,986	0,075	13,158	0,78	<0,001
Item B26	←	Management	0,787	0,086	9,118	0,553	<0,001

Variables			Mean missed care score				Number of missed care elements per participant
Variables		n (%)	Mean	SD*	p ^†	d ^‡	Mean	SD*	p ^†	d ^‡
Satisfaction with position/role
	Satisfied	205 (62,1)	1,70	0,40	<0,001	0,79	3,6	3,47	<0,001	0,82
	Dissatisfied	125 (37,8)	2,05	0,51			7,0	5,32
Satisfaction with profession
	Satisfied	250 (75,8)	1,77	0,44	<0,001	0,57	4,34	4,22	0,001	0,50
	Dissatisfied	80 (24,2)	2,03	0,52			6,57	5,21
Satisfaction with teamwork
	Satisfied	179 (54,2)	1,72	0,45	<0,001	0,54	3,86	4,10	<0,001	0,50
	Dissatisfied	149 (45,2)	1,97	0,47			6,08	4,83
Plans to leave position/role
	Yes	60 (18,1)	2,1	0,60	0,007	0,67	7,12	6,26	<0,001	0,65
	No	267 (80,9)	1,79	0,43			4,31	3,88
Sector
	Closed units ^§	68 (20,6)	1,66	0,44	0,001	0,47	3,44	3,52	0,001	0,41
	Others	262 (79,4)	1,88	0,47			5,26	4,74