Translation and psychometric properties of the Japanese version of the revised MISSCARE Survey

To develop a Japanese version of the revised MISSCARE Survey and evaluate its psychometric properties among nurses in acute care hospitals.

Cross-cultural adaptation and validation of a psychometric instrument.

Between October and November 2025, a cross-sectional survey was conducted among 1136 registered nurses working at two acute care hospitals in Tokyo. The construct validity of Part A (missed nursing care) and Part B (reasons for missed care) was examined using exploratory factor analysis, followed by confirmatory factor analysis. Reliability was assessed using McDonald's omega and test-retest intraclass correlation coefficients.

Of the 1136 eligible nurses, 455 responded to the web-based survey, and 375 nurses with complete data were included in the analysis. Forty-five participants completed the retest 3 weeks after the initial survey. Confirmatory factor analysis indicated a three-factor structure for Part A, comprising (1) fundamental care; (2) clinical monitoring and management; and (3) responsive care (Satorra-Bentler scaled χ²(204) = 515.38, p < .001; root mean square error of approximation [RMSEA] = 0.069, comparative fit index [CFI] = 0.918, Tucker-Lewis Index [TLI] = 0.906, Standardized Root Mean Square Residual [SRMR] = 0.052), and a three-factor structure for Part B, comprising (1) communication; (2) material and operational resources; and (3) labour resources (Satorra-Bentler scaled χ²(202) = 542.80, p < .001; RMSEA = 0.081, CFI = 0.906, TLI = 0.893, SRMR = 0.058), with several items reallocated to better reflect the Japanese context. Internal consistency was high for both parts of the survey, with McDonald's omega values exceeded 0.80 for all factors. The test-retest intraclass correlation coefficients for the total scores of Parts A and B were 0.82 (95% confidence interval [CI], 0.67-0.91) and 0.68 (95% CI, 0.45-0.82), respectively.

The Japanese version of the revised MISSCARE Survey demonstrated acceptable validity and reliability. This instrument enabled the systematic assessment of missed nursing care in Japanese acute care settings, supported the evaluation of nurse staffing and work environment interventions, and facilitated international comparisons to inform evidence-based nursing policies and practices.