Home›Geriatrics & Aging› Chinese BERNCA-NH shows acceptable preliminary psychometrics in 251 nursing assistants
Chinese BERNCA-NH shows acceptable preliminary psychometrics in 251 nursing assistantsResearchers adapted a nursing care survey for use in Chinese long-term care homes
Frontiers in MedicinePublished April 17, 2026Study authors: Mengjiao Xu, Hongwei Qi, Yinfei Duan, Qiuyun Mao, Franziska Zúñiga, Yuting SongDOI ↗Editorial oversight: Dr. Sofia Müller, MD · Lifespan & Whole-Person Care
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Key Takeaway
Consider the Chinese BERNCA-NH as a preliminary, not fully validated, measure of unfinished care in Chinese LTC homes.
Investigators translated and culturally adapted the Basel Extent of Rationing of Nursing Care for Nursing Homes (BERNCA-NH) into Chinese and evaluated its preliminary psychometric properties among nursing assistants in Chinese long-term care (LTC) facilities. This was a cross-sectional survey, not a systematic review or randomized trial.
Adaptation followed a standard multi-step process: forward translation, back-translation, synthesis, cognitive interviews, and expert review after obtaining permission from the original developers. A cross-sectional survey was then administered to 251 nursing assistants recruited by convenience sampling from LTC facilities in China. Analyses included descriptive statistics, item analysis, exploratory factor analysis, and internal consistency testing.
During adaptation, the team identified three main challenges: syntactic and idiomatic differences between English and Chinese, mismatch between some original care scenarios and the local LTC context, and multiple possible Chinese interpretations of certain English expressions. These required iterative resolution through cognitive interviewing and expert review.
Psychometric results were modest but supportive. The Chinese version showed good overall internal consistency (Cronbach's alpha = 0.815). Sampling adequacy for factor analysis was acceptable (KMO = 0.746), and Bartlett's test of sphericity was significant (chi-squared = 1579.889, df = 210, p < 0.001), indicating the correlation matrix was suitable for factor extraction.
The authors conclude the Chinese BERNCA-NH has acceptable preliminary psychometric properties and may serve as a preliminary tool for assessing unfinished (rationed) care among nursing assistants in Chinese LTC homes, while emphasizing that further validation is needed. They note the instrument may help identify priority areas for care improvement and support quality assessment and management in LTC settings. Convenience sampling and the single-country context are relevant limitations for generalizability.
Researchers conducted a cross-sectional survey involving 251 nursing assistants working in long-term care facilities in China. The study focused on translating and culturally adapting the Basel Extent of Rationing of Nursing Care for Nursing Homes (BERNCA-NH) into Chinese to assess unfinished care. The goal was to create a reliable tool for these specific settings.
The analysis showed that the Chinese version of the survey had good overall internal consistency, with a Cronbach's alpha of 0.815. Additionally, the data met acceptable standards for factor analysis, indicated by a KMO value of 0.746 and a significant Bartlett's test. These results suggest the tool works well for measuring care rationing in this population.
No safety concerns or adverse events were reported during this research process. The main reason to be careful is that this is an early-stage study using a convenience sample. Readers should understand that this tool is currently a preliminary resource and needs more validation before it can fully support quality management and improvement efforts in long-term care homes.
What this means for you:
This is a preliminary survey tool for Chinese nursing homes that needs more testing before official use.
Study Details
Study typeSystematic review
EvidenceLevel 1
PublishedApr 2026
View Original Abstract ↓
To translate and culturally adapt the Basel Extent of Rationing of Nursing Care for Nursing Homes (BERNCA-NH) into Chinese and to examine its preliminary psychometric properties among nursing assistants working in Chinese long-term care (LTC) homes for older adults.
After obtaining permission from the original developers, the BERNCA-NH was translated and culturally adapted through forward translation, back-translation, synthesis, cognitive interviews, and expert review. A cross-sectional survey was conducted among 251 nursing assistants recruited by convenience sampling from long-term care facilities in China. Descriptive statistics, item analysis, exploratory factor analysis, and internal consistency testing were performed.
We identified three main challenges during the translation and cultural adaptation of the BERNCA-NH for use in Chinese LTC homes: syntactic and idiomatic differences between English and Chinese, mismatch between some original care scenarios and the local LTC context, and multiple possible Chinese interpretations of certain English expressions. The Chinese version of the BERNCA-NH showed good overall internal consistency (Cronbach’s α = 0.815). The KMO value was 0.746 and Bartlett’s test of sphericity was significant (χ2 = 1579.889, df = 210, p
The Chinese version of the BERNCA-NH showed acceptable preliminary psychometric properties and may serve as a preliminary tool for assessing unfinished care among nursing assistants in Chinese LTC homes, although further validation is needed. It may help identify priority areas for care improvement and provide support for quality assessment, management, and improvement in LTC homes.
