AIMS: To evaluate the psychometric properties of the Perceived Implicit Rationing of Nursing Care (PIRNCA) instrument and to report the prevalence of rationed care at university and faculty hospitals. DESIGN: A cross-sectional study. METHODS: The study was carried out at two university and five faculty hospitals in the Slovak Republic. Participants were 895 Registered Nurses recruited by the purposive sampling method between December 2017-July 2018. Data were collected using the PIRNCA instrument. Construct validity and reliability of the instrument were tested. RESULTS: The prevalence of rationed care at university and faculty hospitals was identified as being 42.1%. Furthermore, 87.6% of nurses reported rationing one or more nursing care activities. Using both statistical methods when evaluating the PIRNCA resulted in the confirmation that the tool is valid and reliable. CONCLUSION: Rationed care is a common phenomenon at university and faculty hospitals. The PIRNCA is a suitable instrument to measure the phenomenon in adult acute care units because of its high reliability and validity. We recommend using the instrument in different contexts, not only for specific conditions that were presented for this study. IMPACT: Rationed care at university and faculty hospitals has never been reported. Psychometric properties of the instrument that measures nurses´ perception of rationed care have never been evaluated by using different approaches. The most frequently rationed nursing care activities are those that nurses are competent to initiate on the basis of their knowledge and skills - the independent ones. The PIRNCA is a valid and reliable instrument. Hospital management can use the instrument to explore the prevalence of rationed care, followed by the application of prevention strategies. Our findings represent the base for further exploration of rationed care using the PIRNCA.

目的: 评价感知式内隐护理配给(PIRNCA)工具的心理测量特性,并汇报大学和学院附属医院的配给护理情况。 设计: 横断面研究。 方法: 在斯洛伐克共和国的两所大学和五所学院附属医院进行此项研究。受试者为895名注册护士(于2017年12月至2018年7月采用目的抽样法招募)。采用感知式内隐护理配给工具来收集数据。检验了该工具的结构效度和信度。 结果: 大学和学院附属医院的配给式护理普及率被确定为42.1%。此外,87.6%的护士汇报了一次或多次配给式护理活动。在评估感知式内隐护理配给时,采用这两种统计方法,可以确认工具是有效的、可靠的。 结论: 在大学和学院附属医院,配给式护理是一种普遍现象。由于具有较高的信度和效度,感知式内隐护理配给工具可用于测量成人急症监护室中这类现象。我们建议在不同的环境中使用该工具,而不仅仅是针对本研究中提出的特定条件。 影响: 从未报道过大学和学院附属医院的配给式护理现象。从未使用不同方法评价心理测量特性工具(该工具用于计量护士对配给式护理的感知情况)。最常见的配给式护理活动是护士有能力根据他们的知识和技能发起的活动(独立活动)。感知式内隐护理配给是一种有效且可靠的工具。医院管理人员可以利用这一工具来探讨配给式护理的普及情况,然后施行预防策略。研究成果为采用感知式内隐护理配给工具进一步探索配给式护理奠定了基础。.

Department of Mathematics and Statistics University of Turku Turku Finland

Department of Nursing Faculty of Health Sciences Palacký University Olomouc Czech Republic

Department of Nursing Jessenius Faculty of Medicine in Martin Comenius University in Bratislava Martin Slovak Republic

Department of Nursing Science University of Turku Turku Finland

Welfare Division Turku University Hospital Turku Finland

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