{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T06:03:58Z","timestamp":1784873038002,"version":"3.55.0"},"reference-count":31,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:00:00Z","timestamp":1784764800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100009687","name":"Uniwersytet Medyczny im. Piast\u00f3w Slaskich we Wroclawiu","doi-asserted-by":"publisher","award":["SUBZ.L010.26.045"],"award-info":[{"award-number":["SUBZ.L010.26.045"]}],"id":[{"id":"10.13039\/501100009687","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Nursing"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To identify demographic, organisational and psychological predictors of nursing care rationing among nurses working in Polish healthcare settings and to examine its associations with burnout, coping strategies and depressive symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A cross\u2010sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study was conducted between February and September 2025 among 434 nurses employed in various healthcare settings in Poland. Data were collected using the Basel Extent of Rationing of Nursing Care\u2013Revised (BERNCA\u2010R), the Maslach Burnout Inventory (MBI), the Mini\u2010COPE and the Beck Depression Inventory (BDI). Descriptive statistics and univariate and multivariable linear regression analyses were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Reporting Method<\/jats:title>\n                    <jats:p>This study adhered to the STROBE guidelines for cross\u2010sectional studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The mean BERNCA\u2010R score indicated moderate levels of care rationing. In the multivariable model, higher care rationing was associated with shift work, higher patient loads, employment in professional unions and higher income levels. Living in medium\u2010sized cities was associated with lower rationing levels. Additionally, the coping strategy \u2018turning to religion\u2019 showed a small but significant positive association with care rationing. The most frequently rationed activities included patient conversations, emotional support, patient education, proper documentation and shift handovers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Nursing care rationing is influenced by organisational and workforce\u2010related factors. Workload and shift organisation emerged as key modifiable determinants. Addressing these may reduce care rationing and improve care quality and safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for the Profession and\/or Patient Care<\/jats:title>\n                    <jats:p>Rationing is strongly influenced by modifiable organisational factors, including staffing and shift organisation. High patient loads and shift work increase the risk of missed care, particularly in communication, documentation and patient support. Optimising staffing and work organisation may enhance patient safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>This study highlights organisational drivers of missed care in a Central European context and provides evidence to inform staffing strategies and healthcare policy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>None.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jocn.70467","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T05:55:09Z","timestamp":1784872509000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Predictors of Nursing Care Rationing in Polish Healthcare Settings: A Cross\u2010Sectional Study Using\n                    <scp>BERNCA<\/scp>\n                    \u2010R"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4292-161X","authenticated-orcid":false,"given":"Stanis\u0142aw","family":"Manulik","sequence":"first","affiliation":[{"name":"Department of Nursing, Faculty of Nursing and Midwifery Wroclaw Medical University  Wroclaw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4245-5420","authenticated-orcid":false,"given":"Micha\u0142","family":"Czapla","sequence":"additional","affiliation":[{"name":"Division of Scientific Research and Innovation in Emergency Medical Service, Department of Emergency Medical Service, Faculty of Nursing and Midwifery Wroclaw Medical University  Wroclaw Poland"},{"name":"Group of Research in Healthcare (GRUPAC), Faculty of Health Science University of La Rioja  Logro\u00f1o Spain"},{"name":"Nursing Care and Education Research Group (GRIECE), Faculty of Nursing and Podology 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