# Exploring the Relationship Between Caring and Missed Nursing Care: A Scoping Review

## TL;DR

This review explores how caring behaviors in nursing relate to missed nursing care, finding that higher caring is linked to fewer missed care instances.

## Contribution

The study provides a synthesis of limited empirical evidence linking caring and missed nursing care, highlighting gaps in theoretical consistency and experimental research.

## Key findings

- Five studies showed caring behaviors and ability are negatively associated with missed nursing care.
- Most studies used Watson’s Theory of Human Caring or similar frameworks.
- The evidence base is limited and lacks experimental approaches.

## Abstract

Background/Objectives: Missed nursing care is a recognized indicator of nursing quality and safety, while caring is a foundational concept in nursing practice. Few studies have empirically examined their relationship. This scoping review aimed to map and synthesize existing evidence on the conceptualisation, measurement approaches, and empirical relationships between caring and missed nursing care. Methods: The review was conducted using JBI methodology, reported according to PRISMA-ScR guidelines, and was registered in the Open Science Framework. Literature was searched in PubMed, CINAHL Ultimate (EBSCOhost), MEDLINE (EBSCOhost), and Web of Science, with additional grey literature searches in ProQuest Dissertations & Theses and Google Scholar. The review included studies examining caring in relation to missed nursing care across any healthcare setting. All study designs were considered. Data were extracted using an extraction tool, developed based on JBI guidelines, and piloted. Data were analyzed descriptively, tabulated, and summarized narratively. Results: Five quantitative cross-sectional studies met the inclusion criteria, conducted between 2012 and 2024 in the Philippines and Slovenia. Caring was assessed using the Caring Behaviors Inventory, Caring Ability Inventory, or CARE-Q, while missed nursing care was measured using the MISSCARE Survey or the Missed Nursing Care Scale. Most studies used Watson’s Theory of Human Caring, Duffy’s Quality Caring Model, or the Missed Nursing Care Model as theoretical frameworks. Across studies, caring behaviours and caring ability were negatively associated with missed nursing care. Conclusions: Caring can function as a moral and relational ideal and as a measurable and actionable factor related to patient outcomes. However, the evidence base remains limited, with inconsistent theoretical foundations and a lack of experimental studies. Future research should adopt theory-based, experimental approaches with diverse samples to explore causal mechanisms and evaluate strategies that strengthen caring competence and caring organizational cultures.