Turkish Adaptation, Psychometric Validity and Measurement Invariance of the Reasons for Implicit Rationing of the Nursing Care Scale

Aim: This study aimed to adapt the Reasons for Implicit Rationing of Nursing Care Scale into Turkish and evaluate its validity, reliability and measurement invariance among nurses in Türkiye. Background: Implicit rationing of nursing care may compromise care quality and patient safety and is influenced by organizational, resource-related and communication factors. A culturally valid instrument is needed to identify the factors contributing to implicit rationing of nursing care within the Turkish healthcare context. Design: A methodological, cross-sectional psychometric validation study. Method: Data were collected between July and December 2025 from nurses working in a public hospital in Türkiye. The source population comprised 900 nurses and 411 nurses were included in the final sample using convenience sampling. Data were collected using the Personal Information Form and the Reasons for Implicit Rationing of Nursing Care Scale. Construct validity was examined using exploratory and confirmatory factor analyses on randomly divided samples. Convergent and discriminant validity and gender-based measurement invariance were assessed. Reliability was evaluated using Cronbach's alpha, McDonald's omega and the intraclass correlation coefficient. Results: The Kaiser–Meyer–Olkin value was 0.936, indicating that the data were suitable for factor analysis. Exploratory factor analysis revealed a two-factor structure consistent with the original scale, explaining 74.30% of the total variance. Confirmatory factor analysis demonstrated acceptable model fit. Convergent validity was supported, whereas the heterotrait–monotrait ratio value indicated borderline discriminant validity. Measurement invariance across genders was largely supported at the configural, metric and scalar levels. The scale demonstrated high internal consistency and temporal stability, with a Cronbach's alpha value of 0.941, a McDonald's omega value of 0.932 and an intraclass correlation coefficient value of 0.873. Conclusion: The Turkish version of the Reasons for Implicit Rationing of Nursing Care Scale is a valid, reliable and gender-invariant instrument. It can be confidently used in Turkish clinical settings to assess factors contributing to implicit rationing of nursing care.