{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T06:59:33Z","timestamp":1785308373444,"version":"3.55.0"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Lean management has been increasingly applied in nursing services to improve workflow efficiency and reduce waste in care processes. This study aimed to translate, culturally adapt, and evaluate the psychometric properties of the Lean Management Scale for Nursing Services in Hospitals (LMS-N) among Chinese clinical nurses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 2,127 clinical nurses were recruited from four tertiary hospitals in Liaoning Province, China, using convenience sampling. Following Brislin\u2019s translation guidelines, the LMS-N was translated and culturally adapted into Chinese. Psychometric evaluation included item analysis, internal consistency and test\u2013retest reliability, exploratory and confirmatory factor analyses, parallel analysis, convergent and discriminant validity, and measurement invariance testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Parallel analysis and exploratory factor analysis supported a five-factor structure, explaining 62.609% of the total variance. Confirmatory factor analysis demonstrated acceptable model fit (CMIN\/DF\u202f=\u202f2.130, SRMR\u202f=\u202f0.046, RMSEA\u202f=\u202f0.032, GFI\u202f=\u202f0.967, AGFI\u202f=\u202f0.958, NFI\u202f=\u202f0.971, IFI\u202f=\u202f0.985, RFI\u202f=\u202f0.967, CFI\u202f=\u202f0.985). Reliability indices indicated satisfactory internal consistency (Cronbach\u2019s\n                      <jats:italic>\u03b1<\/jats:italic>\n                      =\u202f0.933; McDonald\u2019s\n                      <jats:italic>\u03c9<\/jats:italic>\n                      =\u202f0.931) and test\u2013retest reliability (0.880). Measurement invariance across gender, department, and educational attainment was supported.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The Chinese version of the LMS-N demonstrated acceptable reliability and validity among clinical nurses from tertiary hospitals in one province of China. The scale may be useful for assessing lean management implementation in nursing practice, although further validation in more diverse settings is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1895347","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T06:02:45Z","timestamp":1785304965000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Cross-cultural validation of the Chinese version of the lean management scale for nursing services in hospitals"],"prefix":"10.3389","volume":"14","author":[{"given":"Xue","family":"Du","sequence":"first","affiliation":[{"name":"Department of Hematology, First Affiliated Hospital of Jinzhou Medical University","place":["Jinzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liyun","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Nursing, First Affiliated Hospital of Jinzhou Medical University","place":["Jinzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Jinzhou Women's and Children's Hospital","place":["Jinzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e41535","DOI":"10.1097\/MD.0000000000041535","article-title":"Sustainable development goals (SDGs) and resilient healthcare systems: addressing medicine and public health challenges in conflict zones","volume":"104","author":"Ugwu","year":"2025","journal-title":"Medicine"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1186\/s12912-022-00822-4","article-title":"Keeping nurses in nursing: a qualitative study of German nurses\u2019 perceptions of push and pull factors to leave or stay in 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