Comment on: "Associating Multimorbidity Patterns With Healthcare Utilization and Unmet Healthcare Needs Among Older Koreans Living Alone".

Nurse Unit Managers (NUMs) are responsible for coordinating unit‐level clinical operations, managing nursing staff and resources, and ensuring the delivery of safe and effective patient care within increasingly complex healthcare systems []. Leadership and management competencies of nurse managers are widely recognized as essential determinants of effective nursing management and have been associated with improved practice environments, reduced missed nursing care, and better patient outcomes []. Despite the acknowledged importance of managerial and leadership competencies, the conceptualization and measurement of nurse manager competence remain inconsistent. International literature has identified multiple competency domains relevant to NUMs; however, definitions vary considerably, and existing assessment approaches lack standardization. A recent scoping review of head nurse competency instruments similarly highlighted inconsistencies in terminology, competency descriptions, and measurement approaches, indicating that clearer and more standardized competency definitions are still needed for practice‐based assessment []. To date, no universally accepted instrument comprehensively captures NUM competencies across diverse healthcare settings [, ]. Moreover, instruments developed to assess nurse manager competencies differ substantially in structure, content, and psychometric quality. A recent systematic review identified more than ten competency‐related tools, with varying emphasis on managerial, clinical, or specialized competencies, many of which lacked rigorous evaluation of measurement properties or evidence of cross‐context applicability []. Recent psychometric validation studies have also supported the multidimensional nature of nurse manager competencies, while suggesting that further validation across healthcare systems and institutional contexts remains necessary [, ]. In China, although competency frameworks and validated instruments have been developed for specific nursing roles—such as research nurses and clinical nurse specialists—comprehensive and psychometrically robust tools specifically designed for NUMs remain scarce [].