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Anteayer Journal of Advanced Nursing

Missed Nursing Care From the Perspectives of Patients: A Cross‐Sectional Study in Denmark

ABSTRACT

Aim

To identify the prevalence and types of missed nursing care in a Danish hospital context from patients' perspectives and to examine associations between missed nursing care, patient demographics, and patient-reported adverse events.

Design

Cross-sectional study.

Methods

A total of 284 medical and surgical patients from 21 wards at a Danish university hospital completed the Danish version of the MISSCARE Survey–Patient. Descriptive statistics and analyses of associations between missed nursing care and patient demographics and adverse events were conducted.

Results

Patients reported an overall prevalence of missed nursing care of 15%, with most omissions occurring in the physical care domain (22%), followed by psychosocial care (13%) and timeliness (6%). The most frequently missed activities included oral care, clarity about which nurse was responsible for their care, repositioning in bed, and help with eating. Medication errors were significantly associated with higher missed nursing care scores across all domains, while associations with other adverse events and demographics were inconsistent.

Conclusion

Patients generally perceived a low prevalence of missed nursing care, although notable variations were observed across care domains and specific activities. Incorporating patient perspectives alongside nurse perspectives offers a more complete understanding of missed nursing care.

Implication

Continuous assessment of missed nursing care from patients' perspectives could serve as a valuable complement to nurse-reported assessments, helping to identify specific areas for improvement. Targeted interventions addressing activities with higher patient-reported missed nursing care may enhance both care quality and patient outcomes.

Reporting Method

STROBE guidelines were followed.

Patient Contribution

Patients were not involved in the study's design, conduct, or reporting.

Impact

This study highlights missed nursing care from patients' perspectives, revealing key care gaps. The findings can inform hospital administrators, nursing leaders, nursing educators, and policymakers in developing strategies to improve care quality and patient satisfaction.

The Lived Experience of the Trusting Nurse–Patient Relationship Among Patients Admitted to Internal Medicine Wards

ABSTRACT

Aim

To explore the lived experience of the trusting nurse–patient relationship among patients admitted to internal medicine wards.

Design

A qualitative study guided by van Manen's hermeneutic phenomenological approach.

Methods

Semi-structured interviews were conducted with fourteen hospitalised patients in a Danish University hospital in 2024. Data were analysed through thematic reflection.

Results

The analysis revealed one overarching theme—the journey towards trust: bridging the need to feel safe with the pathways to wellbeing—supported by five subthemes. Trust developed through a dynamic and interpersonal process shaped by the patient's vulnerability, the nurse's actions and their mutual understanding. When trust was present, care was experienced as coherent, meaningful and safe; when absent, it felt disconnected and inadequate.

Conclusion

Trust within the nurse–patient relationship is experienced as a dynamic process shaped by the nurse's presence, authenticity and responsiveness. Rather than a static state, trust unfolds gradually, influencing how patients feel safe, understood and cared for. Relational competence should be recognised as a clinical skill, requiring the same support as technical competencies. Education, leadership and policies must protect interpersonal care. Further research should examine nurses' experiences and interventions that sustain trust.

Implications for the Profession

The findings emphasise the need to recognise relational care as a professional and clinical competence. Supportive environments, relational training and organisational awareness are essential to enable nurses to prioritise trust-based relationships.

Impact

This study addresses the challenge of sustaining relational care in time-constrained hospital settings. It offers insight into patients' experiences of trust and highlights key relational behaviours. The findings are relevant for nurses, educators and healthcare leaders aiming to strengthen relational competence and improve patient care quality.

Reporting Method

The study adheres to the COREQ reporting guidelines.

Patient or Public Contribution

This study did not include patient or public involvement in its design, conduct, or reporting.

Cross‐Cultural Adaptation and Validation of the MISSCARE Survey–Patient—Danish Version

ABSTRACT

Aim

To translate, cross-culturally adapt, validate and psychometrically test the MISSCARE Survey–Patient for assessing patients' perspectives on missed nursing care (MNC) in a Danish hospital setting.

Design

A two-phase cross-cultural adaptation and psychometric validation study.

Methods

The study was conducted in two phases. First, the MISSCARE Survey–Patient was cross-culturally adapted to ensure its relevance in a Danish hospital context. This phase involved translation and back-translation, expert committee reviews and cognitive interviews with 18 inpatients to establish content validity. Second, a convenience sample of 284 patients from surgical and medical departments completed the adapted survey. Psychometric properties were evaluated using structural equation modelling to test a second-order formative model.

Results

The cross-cultural adaptation phase led to minor and substantial revisions, including the addition of six new items to enhance content validity. These items addressed aspects of nursing care relevant to patients in the contemporary hospital setting that were not captured by the original survey. Structural equation modelling confirmed the second-order formative model and demonstrated robust psychometric properties.

Conclusion

The MISSCARE Survey–Patient was successfully adapted and validated for use in Danish hospitals, ensuring strong content validity and psychometric robustness.

Implication

The Danish version of the survey provides a valuable tool for assessing MNC from patients' perspectives in hospital settings. Its use can help identify specific areas where nursing care falls short, guiding targeted initiatives to enhance care quality and patient safety. By integrating patients' experiences into quality improvement initiatives, the survey supports the development of more person-centred care practices.

Reporting Method

The study adhered to the COnsensus-based Standards for the selection of health Measurement INstruments reporting guideline for studies on measurement properties of patient-reported outcome measures.

Patient Contribution

Patients were not involved in the study's design, conduct, or reporting.

Impact

The Danish version of the survey facilitates data collection on patients' perspectives of MNC in contemporary hospital settings, providing valuable insights into care quality. By offering a validated tool to assess MNC from patients' perspectives, the survey helps hospitals identify care gaps, prioritise improvement efforts and enhance person-centred care.

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