Abstract
Development of simple, valid and reliable instruments to determine nursing care rationing is a subject of ongoing research. One such instrument, which is gaining popularity worldwide and has significant research applicability, is the Basel Extent of Rationing of Nursing Care (BERNCA) and its revised version, the BERNCA-R. The aim of this study was to translate and adapt the BERNCA-R into a Polish-language version and to assess its reliability and validity in evaluating the level of implicit rationing of nursing care in Poland. Standard methodological requirements were followed during translation and cultural adaptation of the English version of the BERNCA-R questionnaire into Polish. The cross-sectional validation study was conducted between May and September 2017, which included 175 nurses undergoing specialisation and qualification courses at the European Postgraduate Education Centre in Wrocław, Poland. Cronbach’s alpha and inter-item correlations were used to analyse the internal consistency of the Polish BERNCA-R questionnaire. The mean total BERNCA-R score was 1.9 points (SD = 0.74) on a scale of 0–4. Cronbach’s alpha for the unidimensional scale was 0.96. The mean inter-item correlation was 0.4 (range 0.1–0.84), which indicates high internal consistency. A single-factor solution demonstrated stable loadings above 0.5 for almost all items of the Polish BERNCA-R questionnaire. The study using the Polish BERNCA-R questionnaire demonstrated that the instrument is valid and reliable for use in investigating care rationing in groups of Polish nurses.
Highlights
The phenomenon of implicit rationing of nursing careImplicit rationing of nursing care occurs when the available resources are not sufficient to provide the necessary care to all patients
Cross-cultural adaptation of the original English version of the Basel Extent of Rationing of Nursing Care (BERNCA)-R for Poland was performed in accordance with the Brislin method of using standard back-translation. This method is strongly recommended for cross-cultural research [21]
The purpose of this study was to prepare a Polish adaptation of the BERNCA-R questionnaire and to validate the instrument with a group of Polish nurses
Summary
The phenomenon of implicit rationing of nursing careImplicit rationing of nursing care occurs when the available resources are not sufficient to provide the necessary care to all patients. The individual nurse makes the decision as to decide how scarce resources are distributed among the patients and who will or will not receive an element of necessary nursing care [1,2,3,4,5] It has been shown in the most recent systematic review that missed care is a promising indicator of nurse staffing adequacy, it should be noted that so far there is still little evidence that adding support workers to the team reduced missed care [6]. The restriction can be seen as an end product of clinical judgment and decision-making processes when resources are not sufficient to provide all necessary nursing care to all patients In this case, the responsible nurse has no other option than to ration certain aspects of necessary care [1]
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