Juxtaposing Nurses' and Patients' Perspectives of Missed Nursing Care: A Descriptive Mixed Method Design

Abstract

Aims: To compare nurses' and patients' reports of missed nursing care, explore patients' perspectives and utilise these insights to elucidate discrepancies or congruence between perceptions. Design: A descriptive mixed-methods design combining quantitative (questionnaires) and qualitative (semi-structured interviews) methods. Methods: In the quantitative phase, 143 nurses and 643 patients completed the MISSCARE and MISSCARE-Patient surveys. Correlations between their total missed care scores were examined. In the qualitative phase, 68 patients participated in semi-structured interviews analysed using thematic analysis. Results: The correlation between nurses' and patients' perceptions of missed nursing care was nonsignificant. Qualitative findings revealed three themes: (1) patients' need to preserve individuality; (2) most patients attributed missed care to systemic factors, while some attributed it to nurses' attitudes and (3) emotional responses varied from empathetic understanding, inadvertently enabling more missed care, to frustration and assertiveness to ensure receiving necessary care. Conclusions: This study reveals a significant discrepancy between nurses' and patients' perceptions of missed care. Patient perspectives offer insights into this misalignment, highlighting differences in care priorities and role understanding. Implications for the Profession and/or Patient Care: Enhancing nurse–patient communication and patient empowerment are crucial. Healthcare institutions should integrate patient feedback into quality initiatives, create supportive work environments and foster a patient-centred care culture. Effectively marketing nurses' expertise and implementing strategies to manage patient assertiveness are essential. Impact: This study addresses the discrepancy in perceptions of missed nursing care between nurses and patients. It reveals how patients' care priorities and attributions influence their experience of missed care. Findings will impact healthcare policymakers, nursing educators and hospital administrators, informing strategies to improve care quality, patient satisfaction and nurse work environments across healthcare settings. Reporting Method: The study has adhered to STROBE guidelines for the quantitative component and SRQR guidelines for the qualitative component. Patient or Public Contribution: No patient or public contribution.