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External influencing factors on missed nursing care in hospital settings : testing aspects of the missed nursing care model using structural equation modelling


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Cartaxo, Ana ; Eberl, Inge ; Mayer, Hanna:
External influencing factors on missed nursing care in hospital settings : testing aspects of the missed nursing care model using structural equation modelling.
Veranstaltung: 19th European Doctoral Conference in Nursing Science, 09.09.- 10.09.2022, Bern, Schweiz.
(Veranstaltungsbeitrag: Kongress/Konferenz/Symposium/Tagung, Vortrag)


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necessary nursing intervention is not performed according to patient’s needs. The MNC Model explains this problem and describes four types of external influencing factors that can lead
to MNC: (1) demand for patient care, (2) available labor and (3) material resources, (4) relationship and communication problems. MNC and its external influencing factors can be surveyed using the revised MISSCARE Survey. Available versions of this survey, including an Austrian version, have proven reliable and valid for measuring this phenomenon from nurses’ perspective. Problem statement: Previous psychometric studies on the MISSCARE Survey are mainly exploratory and show a lack of theoretical grounding. As a result, disparities regarding the construct validity of MNC and its external influencing factors has been observed in the literature. Furthermore, studies using latent constructs, i. e., those which can test the theoretical theses as explained by Kalisch, Landstrom and Hinshaw (2009) in
the MNC Model are lacking. Aims: To test the structural validity of the MISSCARE Survey using the latent constructs (1) MNC, (2) demand for patient care, (3) labor resources, (4) material resources (5), and work environment, and to examine the statistical relationships
between them; uncovering the specific impact of the single external influencing factors on MNC. Methods: Cross-sectional study using the revised MISSCARE-Austria, which was completed by nurses in general units of Austrian hospitals between May and July 2021. Latent
constructs were defined based on the MNC Model and tested using a confirmatory factor analysis; relationships between them were explored using structural equation modeling.
Results: Structural validity was confirmed. Measurement models for all latent variables are adequate but show high errors of variance for single items. The structural model is adequate
but shows high covariances between external influencing factors. “Labor resources” have a statistically significant impact on MNC. Conclusion: In our study, MNC is mostly influenced by a lack of appropriate labor resources. Further studies exploring mediation effects and using non-linear statistical approaches may contribute to a better understanding of the influence of external factors on MNC. Relevance for research and practice: Theoretical theses regarding MNC and its influencing factors were tested, advancing the discussion on this topic. Identifying the impact of different reasons on MNC can further guide practice development when preventing MNC in acute care settings.


Die MISSCARE-Austria-Studie

Weitere Angaben

Publikationsform:Veranstaltungsbeitrag (unveröffentlicht): Kongress/Konferenz/Symposium/Tagung, Vortrag
Sprache des Eintrags:Englisch
Institutionen der Universität:Fakultät für Soziale Arbeit (FH) > Professur für Pflegewissenschaft
DOI / URN / ID:10.13140/RG.2.2.18185.11362
Open Access: Freie Zugänglichkeit des Volltexts?:Nein
Titel an der KU entstanden:Nein
Eingestellt am: 12. Dez 2022 14:26
Letzte Änderung: 12. Dez 2022 14:26
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