Validation study of the Amharic version Safety Attitudes Questionnaire (SAQ) in public hospitals of Addis Ababa, Ethiopia: a cross-sectional study

BACKGROUND

In Ethiopia, there is a growing concern about improving patients' safety in healthcare facilities. However, the lack of a valid and reliable instrument sensitive to the Ethiopian culture for measuring health professional practice environment leads to difficulty in constructing evaluations of safety climate and further linking organizational research to outcomes research. This research study examined the psychometric properties of the Safety Attitude Questionnaire (SAQ) in the Amharic language within an Ethiopian healthcare context.

METHOD

A hospital-based cross-sectional study design was conducted. The SAQ was meticulously translated into Amharic using forward and backward translation methods. Content validity was evaluated with input from seven patient safety and healthcare quality experts. Face validity was established through feedback from healthcare professionals. Then, the Amharic SAQ (SAQ-A) was distributed to 648 participants working in 11 public hospitals, and a total of 611 valid questionnaires were completed and returned (95.2% response rate). Cronbach's alpha, McDonald's omega, composite reliability, correlation analysis, and average variance estimation were calculated, and confirmatory factor analysis was performed. Descriptive analyses were performed to describe socio-demographic characteristics. A P-value of ≤0.05 was considered statistically significant. Tables, figures, charts, and texts are used for data presentation.

RESULT

The overall internal consistency (Cronbach's alpha) for the 31-item SAQ-A was 0.903, indicating excellent reliability. Confirmatory factor analyses demonstrated a good model fit for each dimension and the entire construct (χ2=1086.675, df=412, p<0.001, comparative fit index (CFI)=0.923, Tucker Lewis index (TLI)=0.913, and root mean square error of approximation (RMSEA)=0.052). The positive response rate of healthcare workers in hospitals was 32.1%. The positive response rates of the six dimensions were teamwork climate (59.7%), safety climate (41.9%), job satisfaction (57.1%), working conditions (37.5%), perception of management (37.6%), and stress recognition (46.2%).

CONCLUSION

The Amharic translation of the SAQ showed good psychometric properties, making it a valuable tool for assessing safety attitudes among Amharic-speaking Ethiopian healthcare practitioners.

Review: application of the Safety Attitudes Questionnaire (SAQ) in primary care - a systematic synthesis on validity, descriptive and comparative results, and variance across organisational units

Patient safety research has focused mostly on the hospital and acute care setting whereas assessments of patient safety climate in primary health care settings are warranted. Valid questionnaires as e.g., the Safety Attitudes Questionnaire (SAQ) may capture staff perceptions of patient safety climate but until now, an overview of the use of SAQ in primary care has not been systematically presented. Thus, the aim of this systematic review is to present an overview of SAQ used in primary care.Methods The electronic databases: PubMed, Embase, Cinahl, PsycInfo and Web of Science were used to find studies that used any version of SAQ in primary care. Studies were excluded if only abstract or poster was available, as the information in abstract and posters was deemed insufficient. Commentaries and nonempirical studies (e.g., study protocols) were excluded. Only English manuscripts were included.Results A total of 43 studies were included and 40 of them fell into four categories: 1) validation analysis, 2) descriptive analysis, 3) variance assessment and 4) intervention evaluation and were included in further analyses. Some studies fell into more than one of the four categories. Seventeen studies aimed to validate different versions of SAQ in a variety of settings and providers. Twenty-five studies from fourteen different countries reported descriptive findings of different versions of SAQ in a variety of settings. Most studies were conducted in primary health care centres, out-of-hours clinics, nursing homes and general practice focusing on greatly varying populations. One study was conducted in home care. Three studies investigated variance of SAQ scores. Only five studies used SAQ to assess the effects of interventions/events. These studies evaluated the effect of electronic medical record implementation, a comprehensive Unit-based Safety Program or COVID-19.Conclusion The synthesis demonstrated that SAQ is valid for use in primary care, but it is important to adapt and validate the questionnaire to the specific setting and participants under investigation. Moreover, differences in SAQ factor scores were related to a variety of descriptive factors, that should be considered in future studies More studies, especially variance and intervention studies, are warranted in primary care.Trial registration This systematic review was not registered in any register.

Determining the psychometric properties of safety attitudes questionnaire in NICUs

INTRODUCTION

This study aimed to translate and assess the psychometric properties of the Persian version of the "Safety Attitude Questionnaire" in the NICUs.

METHODS

In this psychometric study, the "Safety Attitude Questionnaire" was translated into Persian. Then this version was used for psychometric evaluation. For this purpose, the qualitative face, content validity and construct validity were performed by confirmatory factor analysis. Internal consistency and stability reliability were calculated. Data were analyzed using SPSS and AMOS software.

RESULTS

Face validity was also performed with a slight change in four items. The factor structure of the tool was determined by confirmatory factor analysis. Fit indices were appropriate. Internal consistency reliability in the whole questionnaire was 0.65 and the stability reliability was calculated to be 0.64.

DISCUSSION AND CONCLUSION

"Safety Attitude Questionnaire" has appropriate psychometric properties and can be used in NICUs.

Evaluation of safety attitudes of hospitals and the effects of demographic factors on safety attitudes: a psychometric validation of the safety attitudes and safety climate questionnaire

BACKGROUND

The objectives of this study are to test the psychometric properties of the safety attitudes and safety climate questionnaire Chinese simplified version (SAQ-CS), to test the safety attitudes of health professionals in tertiary hospitals in the Liaoning province and to explore the effects of demographic factors on safety attitudes.

METHODS

The SAQ-CS was used to conduct a cross-sectional survey in nine tertiary hospitals in Liaoning province.

RESULTS

Cronbach's alpha of each subscale of SAQ-CS were > 0.7, the values of GFI, TLI, and CFI were > 0.8, and RMSEA values ranged from 0.048-0.199. The mean of the safety attitudes of 2157 health professionals was 4.00, indicating a good safety attitude, with a positive response rate (% of items that scored ≥4) of 51.1%. The stress recognition subscale had the lowest score, with a mean of 2.73 and a positive response rate of 17.8%. A multiple linear regression equation revealed that demographic factors like gender, age, and training participation significantly affected the scores (β_gender > 0.06, β_age < - 0.08, β_training < - 0.07, p < 0.05).

CONCLUSIONS

The psychometric properties of SAQ-CS are good and stable. Health professionals rate teamwork climate, safety climate, perception of management, and work conditions in Liaoning province are perceived as good; however, the stress of the health professionals is poor. To improve safety attitudes, it is necessary to not only reduce the stress of health professionals, but also to pay more attention to men, older health professionals, and health professionals who have not participated in safety training.

The Perceptions of Physicians and Nurses Regarding the Establishment of Patient Safety in a Regional Teaching Hospital in Taiwan

BACKGROUND

Physicians and nurses are core staff who are the first points of contact in care provision to patients. We aimed to examine physicians' and nurses' perceptions of patient safety in a case hospital by administering the Chinese Safety Attitude Questionnaire (CSAQ), developed from the Taiwan Joint Commission on Hospital Accreditation, in order to provide the patients with a safe environment and excellent medical service.

METHODS

An intra-organizational online survey was conducted. Confirmatory factor analysis (CFA) was first performed on the assessment of the measures for patient safety culture and seven dimensions with 33 items were identified. Pearson correlation analysis was subsequently used to examine the strength and direction of the relationships between seven dimensions of patient safety culture.

RESULTS

A total of 800 questionnaires were issued and 405 valid questionnaires were collected, the effective response rate being 50.6%. The findings highlighted that safety climate (SC) was positively and significantly related to teamwork climate (TC) and perception of management (PM), whereas stress recognition (SR) was negatively related to burnout (BUR).

CONCLUSION

Patient safety culture in healthcare organizations has been considered a critical issue for improving the quality of healthcare. This study further focused on the contribution of a better patient safety culture for healthcare organizations in Taiwan.

[Analysis and modelling of safety culture in a Mexican hospital by Markov chains]

INTRODUCTION

The objective of this study was to analyse and model the safety culture with Markov chains, as well as predicting and/or prioritizing over time the evolutionary behaviour of the safety culture of the health's staff in one Mexican hospital.

METHOD

The Markov chain theory has been employed in the analysis, and the input data has been obtained from a previous study based on the Safety Attitude Questionnaire (CAS-MX-II), by considering the following 6 dimensions: safety climate, teamwork, job satisfaction, recognition of stress, perception of management, and work environment.

RESULTS

The results highlighted the predictions and/or prioritisation of the approximate time for the possible integration into the evolutionary behaviour of the safety culture as regards the "slightly agree" (Likert scale) for: safety climate (in 12 years; 24.13%); teamwork (8 years; 34.61%); job satisfaction (11 years; 52.41%); recognition of the level of stress (8 years; 19.35%); and perception of the direction (22 years; 27.87%). The work environment dimension was unable to determine the behaviour of staff information, i.e. no information cultural roots were obtained.

CONCLUSION

In general, it has been shown that there are weaknesses in the safety culture of the hospital, which is an opportunity to suggest changes to the mandatory policies in order to strengthen it.