Dante Angelo, Marcotullio Alessia, Checchi Adriana, Caponnetto Valeria, Masotta Vittorio, Paoli Ilaria, Petrucci Cristina, Lancia Loreto
Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy.
Ann Ig. 2025 Jul-Aug;37(4):425-434. doi: 10.7416/ai.2024.2668. Epub 2024 Dec 10.
The term 'Missed Nursing Care' (MNC) refers to any aspect of nursing care that is not delivered, partially delivered, or delayed. MNC has significant negative consequences, including adverse patient outcomes, safety risks, and decreased job satisfaction. While extensively studied in hospitals, MNC in community healthcare settings, remains under-researched, especially in Italy. This study aims to explore the phenomenon of MNC in Italian home care settings by documenting and analyzing the lived experiences of freelance nurses, focusing on the characteristics, influencing factors, and consequences of MNC as perceived by these healthcare professionals.
This is a descriptive phenomenological study.
Using snowball sampling, 12 Italian freelance nurses were recruited and interviewed from November 2022 to February 2023. Data collection was based on in-depth interviews, that have been transcribed and analyzed using Giorgi's phenomenological framework. The study report adhered to the COREQ-32 checklist for qualitative research.
Thematic analysis revealed four main themes: dimensions of MNC, organizational challenges, consequences of MNC, and family-nurse collaboration. Freelance nurses frequently addressed unmet fundamental and complex nursing needs, highlighting significant clinical, psychological, and economic impacts on patients and families. Organizational issues, such as rigid public service schedules and inadequate staffing, were identified as primary contributors to MNC. Families played a crucial role in managing care and collaborating with freelance nurses to ensure continuity.
This study provides novel insights into MNC in Italian home care settings, emphasizing the critical role of freelance nurses in filling care gaps. The findings suggest the need for systemic changes to improve flexibility, staffing, and integration of public and private nursing services. Further research, particularly quantitative studies, is essential to validate these findings and explore broader implications for patient care and health outcomes.
“漏护”（MNC）一词指的是未提供、部分提供或延迟提供的任何护理方面。漏护会产生重大负面后果，包括不良的患者结局、安全风险以及工作满意度下降。虽然在医院中对漏护进行了广泛研究，但社区医疗环境中的漏护仍研究不足，尤其是在意大利。本研究旨在通过记录和分析自由职业护士的实际经历，探讨意大利家庭护理环境中的漏护现象，重点关注这些医疗专业人员所感知的漏护的特征、影响因素和后果。
这是一项描述性现象学研究。
采用滚雪球抽样法，于2022年11月至2023年2月招募并访谈了12名意大利自由职业护士。数据收集基于深入访谈，访谈内容已转录并使用 Giorgi 的现象学框架进行分析。研究报告遵循了定性研究的 COREQ - 32 清单。
主题分析揭示了四个主要主题：漏护的维度、组织挑战、漏护的后果以及家庭与护士的合作。自由职业护士经常提到未满足的基本和复杂护理需求，强调对患者和家庭产生的重大临床、心理和经济影响。组织问题，如僵化的公共服务时间表和人员配备不足，被确定为漏护的主要促成因素。家庭在管理护理以及与自由职业护士合作以确保护理连续性方面发挥了关键作用。
本研究为意大利家庭护理环境中的漏护提供了新的见解，强调了自由职业护士在填补护理缺口方面的关键作用。研究结果表明需要进行系统性变革，以提高灵活性、人员配备以及公共和私人护理服务的整合。进一步的研究，尤其是定量研究，对于验证这些发现并探索对患者护理和健康结局的更广泛影响至关重要。
