ABSTRACT
AIM: This study aimed to identify the factors influencing nurses' migration patterns in Turkey. BACKGROUND: The flow of nurse migration from developing countries to developed countries is steadily increasing. As a result, countries that are sources of migration tend to develop domestic inequities with respect to the population's ability to access health services. In particular, fragile economic conditions and the pandemic triggered the migration of nurses from Turkey, a developing country. METHODS: This study employed a mixed-method explanatory sequential design and was conducted in Turkey between April and November 2022. The decision to migrate was the focus of both the quantitative aspect, involving 237 participants, and the qualitative aspect, with 20 participants. Quantitative data were gathered through a questionnaire, and qualitative data were obtained using open-ended questions during in-depth individual interviews. We followed the Strengthening the Reporting of Observational Studies in Epidemiology checklist in the quantitative phase and the Consolidated Criteria for Reporting Qualitative Research checklist in the qualitative phase. Descriptive statistics and thematic analyses were used to analyze the data. RESULTS: In the quantitative stage of the study, nurses' reasons for deciding to migrate were identified as economic conditions, working conditions, society's outlook on the profession, political factors, and professional growth opportunities. In the qualitative stage, four major themes influencing nurse migration patterns emerged: devaluation and poor collegiality in nursing; inadequate management support; negative work environment; and health, social, and economic policies. CONCLUSION: The results of the study showed that the three factors most influential in the decision to migrate were economic issues, a negative work environment, and political climate. IMPLICATIONS FOR NURSING AND HEALTH POLICY: In developing countries, there is an urgent need for nurse administrators and health workforce decision-makers to create healthy working conditions and manage resources efficiently, focusing on improving nurses' economic situations while developing appropriate nationwide and international strategies.
ABSTRACT
Background: Studies have shown that nurses do not complete one or more necessary nursing care elements in their last shift due to lack of time. The Basel Extent of Rationing Nursing Care (BERNCA) instrument is one of the most used scales to measure the rationing of nursing care. Aim: This study is aimed to culturally adapt the revised BERNCA (BERNCA-R) instrument to the Turkish language and to test its validity and reliability. Methods: A cross-sectional and methodological study was used. The instrument was adapted in three stages: translation and adaptation, content validity testing and validity and reliability. Data were obtained from 350 nurses working in two public acute care hospitals in Turkey, between September 2019 and January 2020. The descriptive statistics, content validity index, exploratory and confirmatory factor analyses, Cronbach's α, Guttman split-half and inter-item reliability analyses were performed for the analysis of the data. Results: The Turkish version of the BERNCA-R instrument with a 27-item and three-subscales (monitoring, daily care and needs and psychosocial care) structure was found to have acceptable and good fit indices. Conclusion: The Turkish version of the BERNCA-R instrument is valid and reliable tool to measure rationing of nursing care.
