Research Article: Validation of Polish version of the Basel Extent of Rationing of Nursing Care revised questionnaire

Date Published: March 20, 2019

Publisher: Public Library of Science

Author(s): Izabella Uchmanowicz, Marcia Kirwan, Olga Riklikiene, Renata Wolfshaut–Wolak, Joanna Gotlib, Maria Schubert, Mojtaba Vaismoradi.


Development of simple, valid and reliable instruments to determine nursing care rationing is a subject of ongoing research. One such instrument, which is gaining popularity worldwide and has significant research applicability, is the Basel Extent of Rationing of Nursing Care (BERNCA) and its revised version, the BERNCA-R. The aim of this study was to translate and adapt the BERNCA-R into a Polish-language version and to assess its reliability and validity in evaluating the level of implicit rationing of nursing care in Poland. Standard methodological requirements were followed during translation and cultural adaptation of the English version of the BERNCA-R questionnaire into Polish. The cross-sectional validation study was conducted between May and September 2017, which included 175 nurses undergoing specialisation and qualification courses at the European Postgraduate Education Centre in Wrocław, Poland. Cronbach’s alpha and inter-item correlations were used to analyse the internal consistency of the Polish BERNCA-R questionnaire. The mean total BERNCA-R score was 1.9 points (SD = 0.74) on a scale of 0–4. Cronbach’s alpha for the unidimensional scale was 0.96. The mean inter-item correlation was 0.4 (range 0.1–0.84), which indicates high internal consistency. A single-factor solution demonstrated stable loadings above 0.5 for almost all items of the Polish BERNCA-R questionnaire. The study using the Polish BERNCA-R questionnaire demonstrated that the instrument is valid and reliable for use in investigating care rationing in groups of Polish nurses.

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The study included 175 nurses and detailed characteristics of the participants are shown in Table 1.

The purpose of this study was to prepare a Polish adaptation of the BERNCA-R questionnaire and to validate the instrument with a group of Polish nurses. The original BERNCA was developed based on the previously described conceptual framework of implicit rationing of nursing care, as well as on preliminary evidence, the clinical expertise of members of the research team and the Swiss Red Cross (Schweizerisches Rotes Kreuz; SRK) framework for nursing education (SRK, 1992). The original BERNCA version was validated within the RICH nursing study [4].

The study using the BERNCA questionnaire demonstrated that the questionnaire may be used for investigating care rationing in groups of Polish nurses. Based on results of the Polish validation, considering cultural and regional differences, we can conclude that it is a reliable and valid tool that is recommended for use in Poland.




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