Translation and Adaptation of the MISSCARE Survey for Use in Arabic Countries
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Abstract
Objective: Since the MISSCARE Survey is the most used instrument in international research, this study aimed to translate and adapt the MISSCARE Survey to literary Arabic.
Methods: The translation and adaptation were performed according to Beaton et al. (2000) in 5 steps: translation, synthesis, back-translation, expert committee, and testing of the pre-final version of MISSCARE. This last step was conducted with a purposive sample of nurses working in a hospital in Qatar to evaluate the clarity, comprehensibility, and relevance of the translated instrument.
Results: Thirty nurses participated in our study from different Arabic countries, including Tunisia (53.3%), Egypt (23.3%) and Jordan (23.3%). The instrument was considered clear, comprehensible, relevant, and culturally appropriate. All items achieved acceptable I-CVI values (≥ 0.78), indicating good content validity. No major modifications were required.
Discussion and Conclusion: Findings show the relevance of each item of the Arabic version of MISSCARE to examine missed nursing care and its reasons. However, to permit its use in Arabic countries, additional studies are required to further test the validity and the reliability of our instrument.
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References
Alfuqaha, O. A., Alhalaiqa, F. N., Ayed, A., & Alqurneh, M. K. (2022). Arabic version of the Missed Nursing Care Survey: Validity and reliability. International journal of nursing practice, 28(5), e13074. https://doi.org/10.1111/ijn.13074
Ausserhofer, D., Zander, B., Busse, R., Schubert, M., De Geest, S., Rafferty, A. M., Ball, J., Scott, A., Kinnunen, J., Heinen, M., Sjetne, I. S., Moreno-Casbas, T., Kózka, M., Lindqvist, R., Diomidous, M., Bruyneel, L., Sermeus, W., Aiken, L. H., Schwendimann, R., & RN4CAST consortium (2014). Prevalence, patterns and predictors of nursing care left undone in European hospitals: results from the multicountry cross-sectional RN4CAST study. BMJ quality & safety, 23(2), 126–135. https://doi.org/10.1136/bmjqs-2013-002318
Ball, J. E., Murrells, T., Rafferty, A. M., Morrow, E., & Griffiths, P. (2014). 'Care left undone' during nursing shifts: associations with workload and perceived quality of care. BMJ quality & safety, 23(2), 116–125. https://doi.org/10.1136/bmjqs-2012-001767
Ball, J. E., Bruyneel, L., Aiken, L. H., Sermeus, W., Sloane, D. M., Rafferty, A. M., Lindqvist, R., Tishelman, C., Griffiths, P., & RN4Cast Consortium (2018). Post-operative mortality, missed care and nurse staffing in nine countries: A cross-sectional study. International journal of nursing studies, 78, 10–15. https://doi.org/10.1016/j.ijnurstu.2017.08.004
Beaton, D. E., Bombardier, C., Guillemin, F., & Ferraz, M. B. (2000). Guidelines for the process of cross-cultural adaptation of self-report measures. Spine, 25(24), 3186–3191. https://doi.org/10.1097/00007632-200012150-00014
Bragadóttir, H., Kalisch, B. J., Smáradóttir, S. B., & Jónsdóttir, H. H. (2015). Translation and psychometric testing of the Icelandic version of the MISSCARE Survey. Scandinavian journal of caring sciences, 29(3), 563–572. https://doi.org/10.1111/scs.12150
Elo, S., & Kyngäs, H. (2008). The qualitative content analysis process. Journal of Advanced Nursing, 62(1), 107–115. https://doi.org/10.1111/j.1365-2648.2007.04569.x
Ghali, H., Cheikh, A. B., Bhiri, S., Fredj, S. B., Layouni, S., Khefacha, S., Dhidah, L., Rejeb, M. B., & Latiri, H. S. (2020). Évènements indésirables dans un hôpital universitaire tunisien : incidence et facteurs de risque. Santé publique (Vandoeuvre-les-Nancy, France), 32(2), 189–198. https://doi.org/10.3917/spub.202.0189
Hammad, M., Guirguis, W., & Mosallam, R. (2021). Missed nursing care, non-nursing tasks, staffing adequacy, and job satisfaction among nurses in a teaching hospital in Egypt. The Journal of the Egyptian Public Health Association, 96(1), 22. https://doi.org/10.1186/s42506-021-00083-0
Hosseini, Z., Raisi, L., Maghari, A., & Karimollahi, M. (2022). Translation and psychometric properties of the MISSCARE survey-Persian version. BMC nursing, 21(1), 3. https://doi.org/10.1186/s12912-021-00787-w
IBM Corp. (2024). IBM SPSS Statistics for Windows (Version 30) [Computer software]. IBM Corp.
Kalisch, B. J., Landstrom, G. L., & Hinshaw, A. S. (2009). Missed nursing care: a concept analysis. Journal of advanced nursing, 65(7), 1509–1517. https://doi.org/10.1111/j.1365-2648.2009.05027.x
Kalisch B. J. (2006). Missed nursing care: a qualitative study. Journal of nursing care quality, 21(4), 306–315. https://doi.org/10.1097/00001786-200610000-00006
Kalisch, B. J., & Williams, R. A. (2009). Development and psychometric testing of a tool to measure missed nursing care. The Journal of nursing administration, 39(5), 211–219. https://doi.org/10.1097/NNA.0b013e3181a23cf5
Kalisch, B. J., Tschannen, D., Lee, H., & Friese, C. R. (2011). Hospital variation in missed nursing care. American journal of medical quality : the official journal of the American College of Medical Quality, 26(4), 291–299. https://doi.org/10.1177/1062860610395929
Kalisch, B. J., Xie, B., & Dabney, B. W. (2014). Patient-reported missed nursing care correlated with adverse events. American journal of medical quality : the official journal of the American College of Medical Quality, 29(5), 415–422. https://doi.org/10.1177/1062860613501715
Khalaila R. (2013). Translation of questionnaires into Arabic in cross-cultural research: techniques and equivalence issues. Journal of transcultural nursing : official journal of the Transcultural Nursing Society, 24(4), 363–370. https://doi.org/10.1177/1043659613493440
Nymark, C., Göransson, K. E., Saboonchi, F., Falk, A. C., & von Vogelsang, A. C. (2020). Translation, culture adaption and psychometric testing of the MISSCARE Survey-Swedish version. Journal of clinical nursing, 29(23-24), 4645–4652. https://doi.org/10.1111/jocn.15505
Palese, A., Navone, E., Danielis, M., Vryonides, S., Sermeus, W., & Papastavrou, E. (2021). Measurement tools used to assess unfinished nursing care: A systematic review of psychometric properties. Journal of advanced nursing, 77(2), 565–582. https://doi.org/10.1111/jan.14603
Schubert, M., Glass, T. R., Clarke, S. P., Schaffert-Witvliet, B., & De Geest, S. (2007). Validation of the Basel Extent of Rationing of Nursing Care instrument. Nursing research, 56(6), 416–424. https://doi.org/10.1097/01.NNR.0000299853.52429.62
Schubert, M., Clarke, S. P., Aiken, L. H., & de Geest, S. (2012). Associations between rationing of nursing care and inpatient mortality in Swiss hospitals. International journal for quality in health care : journal of the International Society for Quality in Health Care, 24(3), 230–238. https://doi.org/10.1093/intqhc/mzs009
Siqueira, L. D. C., Caliri, M. H. L., Haas, V. J., Kalisch, B., & Dantas, R. A. S. (2017). Validation of the MISSCARE-BRASIL survey - A tool to assess missed nursing care. Revista latino-americana de enfermagem, 25, e2975. https://doi.org/10.1590/1518-8345.2354.2975
Sist, L., Contini, C., Bandini, A., Bandini, S., Massa, L., Zanin, R., Maricchio, R., Gianesini, G., Bassi, E., Tartaglini, D., Palese, A., & Ferraresi, A. (2017). MISSCARE Survey - Versione Italiana: risultati dello studio di validazione di uno strumento per la rilevazione delle cure infermieristiche mancate [MISSCARE Survey - Italian Version: findings from an Italian validation study]. Igiene e sanita pubblica, 73(1), 29–45.
Slawomirski L., & Klazinga N. (2022, 12 August). The economics of patient safety: From analysis to action (Health Working Papers no 145). Organisation for Economic Co-operation and Development. https://www.oecd.org/content/dam/oecd/en/publications/reports/2022/08/the-economics-of-patient-safety_dda2a072/761f2da8-en.pdf
Willis, E., Harvey, C., Thompson, S., Pearson, M., & Meyer, A. (2018). Work Intensification and Quality Assurance: Missed Nursing Care. Journal of nursing care quality, 33(2), E10–E16. https://doi.org/10.1097/NCQ.0000000000000277
World Health Organization. (2023, 11 September). Patient safety. https://www.who.int/news-room/fact-sheets/detail/patient-safety