{
  "abstract": "Objectives Medication errors are a major patient safety concern, and double-checking is a commonly used method to mitigate risks during administration. Despite its questionable efficacy, Japanese hospitals are reluctant to transition to single-checking, particularly due to nurses’ resistance. This study developed and psychometrically evaluated a questionnaire assessing nurses’ negative emotional responses to single-checking medications to enable targeted interventions aimed at easing their resistance.Design Cross-sectional survey, with multisource questionnaire development and psychometric validation.Setting Three Japanese university hospitals. Surveys were distributed in September–October 2023.Participants Full-time registered nurses working in inpatient wards, not in management positions, with more than 1 year of experience. Of 1861 questionnaires distributed, 1224 (66%) were analysed.Outcome measures Psychometric evaluation included exploratory factor analysis (EFA), internal consistency reliability (Cronbach’s α), convergent validity against the Japanese version of the State–Trait Anxiety Inventory (STAI) and known-groups validity across levels of nursing experience and duration of single-checking practice.Results EFA (maximum-likelihood extraction, Promax rotation) supported a final four-factor, 18-item solution (Kaiser-Meyer-Olkin=0.947, 64.6% variance explained). Factors were as follows: lack of self-confidence (α=0.92), fear of error due to situational factors (α=0.84), fear of being held responsible (α=0.91) and fear of being perceived as inadequate (α=0.80). Items were scored 1–5, with higher scores indicating stronger negative emotional responses; factor means ranged from 2.23 to 3.23. Correlations with the STAI were low-to-moderate (r=0.23–0.45), supporting convergent validity while indicating the questionnaire is not simply a proxy for state and trait anxiety. Known-groups validity was supported: early-career nurses scored 11.1 points higher than experienced nurses (d=0.85, p<0.001), with similar patterns for recent versus veteran single-checkers (d=0.67, p<0.001)—all exceeding the prespecified minimal important difference.Conclusions The questionnaire demonstrates promising preliminary reliability and validity for assessing nurses’ negative emotional responses towards single-checking medications. Its factor structure could allow targeted interventions to address resistance during the transition to single-checking.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Patient Safety, Graduate School of Medicine, Kyoto University, Kyoto, Japan",
    "Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University, Kyoto, Japan",
    "Japanese Red Cross Osaka Hospital, Osaka, Japan"
  ],
  "article_type": "research article",
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  "author_total": 7,
  "authors": [
    {
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        0
      ],
      "name": "Altanshagai Ganbileg",
      "orcid": "0009-0007-9821-6924"
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    {
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        0
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      "name": "Megumi Iida",
      "orcid": "0009-0008-4817-4057"
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    {
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        1
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      "name": "Yu Hidaka",
      "orcid": "0000-0003-3637-4429"
    },
    {
      "affs": [
        2
      ],
      "name": "Takashi Yamamoto",
      "orcid": "0000-0003-0484-7287"
    },
    {
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        0
      ],
      "name": "Mariko Morishita",
      "orcid": "0000-0002-7648-4553"
    },
    {
      "affs": [
        0
      ],
      "name": "Sawako Hiroi",
      "orcid": "0000-0003-4142-7599"
    },
    {
      "affs": [
        0
      ],
      "name": "Yumi Matsumura",
      "orcid": "0000-0002-4974-7098"
    }
  ],
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  "doi": "10.1136/bmjopen-2026-120532",
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      "openalex",
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  "pmcid": "PMC13711514",
  "pmid": "42919583",
  "published": "2026-10-23",
  "publisher": "BMJ",
  "ris": "https://research.draconitic.com/paper/cxx1smwmyk3ht.ris",
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  "title": "Development and validation of a questionnaire assessing nurses’ negative emotional responses to single-checking medications: a cross-sectional survey in Japanese university hospitals",
  "title_text": "Development and validation of a questionnaire assessing nurses’ negative emotional responses to single-checking medications: a cross-sectional survey in Japanese university hospitals",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:22:16Z",
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