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Life sciences · Journal article
International Journal of Nursing Studies Advances · July 20, 2026
Encouraging direction, but not yet definitive.
This is a preliminary validation of the Dutch translation of the TOGETHER questionnaire, a 17-item tool measuring family perception of involvement in nursing care. Exploratory factor analysis identified three factors (Collaboration, Involvement, Communication) with good internal consistency, but the study is limited to a single Dutch hospital and lacks comparison with the original instrument or external validity testing.
Cross-sectional validation study with exploratory factor analysis. Family members of adult patients admitted to participating nursing wards at a Dutch university hospital. Intervention: Translation and cross-cultural adaptation of the TOGETHER questionnaire into Dutch. n = 286. 19 nursing wards of a Dutch university hospital.
286 family members completed the questionnaire from 19 nursing wards Six of 23 items were removed due to low correlations or cross-loadings, yielding 17-item final structure Three factors identified (Collaboration, Involvement, Communication) explaining over half of the variance
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This validation supports the use of the Dutch TOGETHER questionnaire to assess family perceptions of involvement in nursing care. Hospital wards may use it to identify strengths and areas for improvement in family-centered care delivery, though results are limited to the Dutch context and single institution.
Preliminary validation of a translated measurement tool shows good internal consistency and explains >50% of variance, but lacks comparison group, test-retest reliability, and external validation needed to confirm clinical utility.
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Quoted from the source exactly as published.
This validation supports the use of the Dutch TOGETHER questionnaire to assess family perceptions of involvement in nursing care. Hospital wards may use it to identify strengths and areas for improvement in family-centered care delivery, though results are limited to the Dutch context and single institution.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Background. Family-centered care improves knowledge, satisfaction and well-being for patients and families. However, it is still insufficiently implemented in adult hospital care even though family want more involvement. Understanding their experiences is essential to improve the collaboration between family and nurses.Aim. To explore the translation, cross-cultural adaptation, structural validity, and reliability of the TOGETHER questionnaire within the Dutch context. The TOGETHER questionnaire is a tool designed to assess how family members of patients perceive their involvement in the care provided by nurses.Design. Cross-sectional data collection of the TOGETHER questionnaire.Setting. 19 nursing wards of a Dutch university hospital.Participants. A total of 286 family members of patients that were admitted to a participating hospital ward were included.Method. The 23-item questionnaire was translated and assessed by five family members and two healthcare professionals prior to distribution. Family members of adult patients admitted to a university hospital ward were asked to complete the questionnaire. Structural validity was assessed using exploratory factor analysis, and reliability was evaluated with Cronbach's alpha.Results. In total 286 family members completed the questionnaire. Six items were removed because of low correlations or cross-loadings on multiple factors. The resulting structure of the questionnaire consisted of 17 items, loading onto one of three factors (Collaboration, Involvement and Communication), together explaining over half of the variance. All the factors demonstrated good internal consistency.Conclusion. The exploration of the Dutch adaptation of the TOGETHER questionnaire suggests strong psychometric properties. The questionnaire can be used to evaluate the experiences and perceptions of family members regarding their involvement in care by nurses, enabling hospital wards to identify strengths and areas for improvement in the delivery of family-centered care.Registration. not registered.Patient or public contribution. Family members of patients admitted to the nursing ward and healthcare professionals evaluated the clarity and relevance of the translated questionnaire.
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