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Published in: BMC Health Services Research 1/2013

Open Access 01-12-2013 | Research article

Swedish translation and psychometric testing of the safety attitudes questionnaire (operating room version)

Authors: Camilla Göras, Fan Yang Wallentin, Ulrica Nilsson, Anna Ehrenberg

Published in: BMC Health Services Research | Issue 1/2013

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Abstract

Background

Tens of millions of patients worldwide suffer from avoidable disabling injuries and death every year. Measuring the safety climate in health care is an important step in improving patient safety. The most commonly used instrument to measure safety climate is the Safety Attitudes Questionnaire (SAQ). The aim of the present study was to establish the validity and reliability of the translated version of the SAQ.

Methods

The SAQ was translated and adapted to the Swedish context. The survey was then carried out with 374 respondents in the operating room (OR) setting. Data was received from three hospitals, a total of 237 responses. Cronbach’s alpha and confirmatory factor analysis (CFA) was used to evaluate the reliability and validity of the instrument.

Results

The Cronbach’s alpha values for each of the factors of the SAQ ranged between 0.59 and 0.83. The CFA and its goodness-of-fit indices (SRMR 0.055, RMSEA 0.043, CFI 0.98) showed good model fit. Intercorrelations between the factors safety climate, teamwork climate, job satisfaction, perceptions of management, and working conditions showed moderate to high correlation with each other. The factor stress recognition had no significant correlation with teamwork climate, perception of management, or job satisfaction.

Conclusions

Therefore, the Swedish translation and psychometric testing of the SAQ (OR version) has good construct validity. However, the reliability analysis suggested that some of the items need further refinement to establish sound internal consistency. As suggested by previous research, the SAQ is potentially a useful tool for evaluating safety climate. However, further psychometric testing is required with larger samples to establish the psychometric properties of the instrument for use in Sweden.
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Literature
2.
go back to reference Kohn LT, Corrigan JM, Donaldson MS: To Err is human: building a safer health system. 1999, Washington DC: National Academy Press Kohn LT, Corrigan JM, Donaldson MS: To Err is human: building a safer health system. 1999, Washington DC: National Academy Press
5.
go back to reference Wachter R: Understanding patient safety. 2008, McGraw-Hill Wachter R: Understanding patient safety. 2008, McGraw-Hill
6.
go back to reference Reason J: Managing the risks of organizational accidents. 1997, Surrey: Ashgate Reason J: Managing the risks of organizational accidents. 1997, Surrey: Ashgate
9.
go back to reference Guldenmund FW: The nature of safety culture: a review of theory and research. Saf Sci. 2000, 34: 215-257. 10.1016/S0925-7535(00)00014-X.CrossRef Guldenmund FW: The nature of safety culture: a review of theory and research. Saf Sci. 2000, 34: 215-257. 10.1016/S0925-7535(00)00014-X.CrossRef
10.
11.
go back to reference Mearns KJ, Flin R: Assessing the state of organizational safety – culture or climate?. Current Psychology: Developmental – Learning – Personality – Social. 1999, 18 (1): 5-17. 10.1007/s12144-999-1013-3.CrossRef Mearns KJ, Flin R: Assessing the state of organizational safety – culture or climate?. Current Psychology: Developmental – Learning – Personality – Social. 1999, 18 (1): 5-17. 10.1007/s12144-999-1013-3.CrossRef
12.
go back to reference Nieva V, Sorra J: Safety culture assessment: a tool for improving patient safety in health care organizations. Quality of Safety Health Care. 2003, 12: 17-23.CrossRef Nieva V, Sorra J: Safety culture assessment: a tool for improving patient safety in health care organizations. Quality of Safety Health Care. 2003, 12: 17-23.CrossRef
13.
go back to reference Robb G, Seddon M: Measuring the safety culture in a hospital setting: a concept whose time has come?. Journal of the New Zealand Medical Association. 2010, 123 (1313): 66-76. Robb G, Seddon M: Measuring the safety culture in a hospital setting: a concept whose time has come?. Journal of the New Zealand Medical Association. 2010, 123 (1313): 66-76.
14.
go back to reference Colla JB, Bracken AC, Kinney LM, Weeks WB: Measuring patient safety climate: a review of surveys. Quality and Safety in Healthcare. 2005, 14: 364-366. 10.1136/qshc.2005.014217.CrossRef Colla JB, Bracken AC, Kinney LM, Weeks WB: Measuring patient safety climate: a review of surveys. Quality and Safety in Healthcare. 2005, 14: 364-366. 10.1136/qshc.2005.014217.CrossRef
15.
go back to reference Pronovost PJ, Goeschel CA, Marsteller JA, Sexton JB, Pham JC, Berenholz S: Framework for patient safety research and improvement. Circulation. 2009, 119: 330-337. 10.1161/CIRCULATIONAHA.107.729848.CrossRefPubMed Pronovost PJ, Goeschel CA, Marsteller JA, Sexton JB, Pham JC, Berenholz S: Framework for patient safety research and improvement. Circulation. 2009, 119: 330-337. 10.1161/CIRCULATIONAHA.107.729848.CrossRefPubMed
16.
go back to reference Vincent CA, Taylor-Adams S, Stanhope N: Framework for analyzing risk and safety in clinical medicine. Br Med J. 1998, 316: 1154-1157. 10.1136/bmj.316.7138.1154.CrossRef Vincent CA, Taylor-Adams S, Stanhope N: Framework for analyzing risk and safety in clinical medicine. Br Med J. 1998, 316: 1154-1157. 10.1136/bmj.316.7138.1154.CrossRef
17.
go back to reference Alfredsdottir H, Bjornsdottir K: Nursing and patient safety in the operating room. J Adv Nurs. 2007, 61 (1): 29-37. 10.1111/j.1365-2648.2007.04462.x.CrossRef Alfredsdottir H, Bjornsdottir K: Nursing and patient safety in the operating room. J Adv Nurs. 2007, 61 (1): 29-37. 10.1111/j.1365-2648.2007.04462.x.CrossRef
18.
go back to reference Kingdon B, Halvorsen F: Perioperative nurses’ perceptions of stress in the workplace. AORN J. 2006, 84 (4): 607-614. 10.1016/S0001-2092(06)63939-2.CrossRefPubMed Kingdon B, Halvorsen F: Perioperative nurses’ perceptions of stress in the workplace. AORN J. 2006, 84 (4): 607-614. 10.1016/S0001-2092(06)63939-2.CrossRefPubMed
19.
go back to reference Chard R: How perioperative nurses define, attribute causes of, and react to intraoperative nursing errors. AORN J. 2010, 91 (1): 132-145. 10.1016/j.aorn.2009.06.028.CrossRefPubMed Chard R: How perioperative nurses define, attribute causes of, and react to intraoperative nursing errors. AORN J. 2010, 91 (1): 132-145. 10.1016/j.aorn.2009.06.028.CrossRefPubMed
20.
go back to reference Chen CK, Lin C, Wang SH, Hou TH: A study of job stress, stress coping strategies, and job satisfaction for nurses working in middle – level hospital operating rooms. J Nurs Res. 2009, 17 (3): 199-210. 10.1097/JNR.0b013e3181b2557b.CrossRefPubMed Chen CK, Lin C, Wang SH, Hou TH: A study of job stress, stress coping strategies, and job satisfaction for nurses working in middle – level hospital operating rooms. J Nurs Res. 2009, 17 (3): 199-210. 10.1097/JNR.0b013e3181b2557b.CrossRefPubMed
22.
go back to reference Deilkås ET, Hofoss D: Psychometric properties of the Norwegian version of the safety attitudes questionnaire (SAQ), generic version (Short Form 2006). BMC Heal Serv Res. 2008, 8: 1-10. 10.1186/1472-6963-8-1.CrossRef Deilkås ET, Hofoss D: Psychometric properties of the Norwegian version of the safety attitudes questionnaire (SAQ), generic version (Short Form 2006). BMC Heal Serv Res. 2008, 8: 1-10. 10.1186/1472-6963-8-1.CrossRef
23.
go back to reference Norden-Hägg A, Sexton JB, Kälvemark-Sporrong S, Ring L, Kettis-Lindblad Å: Assessing safety culture in pharmacies: The psychometric validation of the safety attitudes questionnaire (SAQ) in a national sample of community pharmacies in Sweden. BMC Clin Pharmacol. 2010, 10 (8): 2-12. Norden-Hägg A, Sexton JB, Kälvemark-Sporrong S, Ring L, Kettis-Lindblad Å: Assessing safety culture in pharmacies: The psychometric validation of the safety attitudes questionnaire (SAQ) in a national sample of community pharmacies in Sweden. BMC Clin Pharmacol. 2010, 10 (8): 2-12.
24.
go back to reference Kaya S, Barsbay S, Karabulut E: The Turkish version of the safety attitudes questionnaire: psychometric properties and baseline data. Quality and Safety in Healthcare. 2010, 19 (6): 572-577. 10.1136/qshc.2008.032003. Kaya S, Barsbay S, Karabulut E: The Turkish version of the safety attitudes questionnaire: psychometric properties and baseline data. Quality and Safety in Healthcare. 2010, 19 (6): 572-577. 10.1136/qshc.2008.032003.
25.
go back to reference Sexton JB, Helmreich RL, Neilands TB, Rowan K, Wella K, Boyden J, Roberts PR, Thomas EJ: The safety attitudes questionnaire: psychometric properties, benchmarking data, and emerging research. BMC Heal Serv Res. 2006, 6 (44): 1-10. Sexton JB, Helmreich RL, Neilands TB, Rowan K, Wella K, Boyden J, Roberts PR, Thomas EJ: The safety attitudes questionnaire: psychometric properties, benchmarking data, and emerging research. BMC Heal Serv Res. 2006, 6 (44): 1-10.
26.
go back to reference Sexton JB, Thomas TJ, Helmreich RL: Error, stress and teamwork in medicine and aviation: cross sectional surveys. Br Med J. 2000, 320: 745-749. 10.1136/bmj.320.7237.745.CrossRef Sexton JB, Thomas TJ, Helmreich RL: Error, stress and teamwork in medicine and aviation: cross sectional surveys. Br Med J. 2000, 320: 745-749. 10.1136/bmj.320.7237.745.CrossRef
27.
go back to reference Helmreich RL, Merritt AC, Sherman PJ, Gregorich SE, Wiener EL: The flight management attitudes questionnaire (FMAQ) NASA/ UT/FAA Technical report. 1993, Austin, TX: The University of Texas, 93-94. Helmreich RL, Merritt AC, Sherman PJ, Gregorich SE, Wiener EL: The flight management attitudes questionnaire (FMAQ) NASA/ UT/FAA Technical report. 1993, Austin, TX: The University of Texas, 93-94.
28.
go back to reference Pronovost PJ, Berenholz S, Goeschel C, Thom I, Watson S, Holzmuller C, Lyon JS, Lubomski LH, Thompson DA, Needham D, Hyzy R, Welsh R, Roth G, Bander J, Morlock L, Sexton JB: Improving patient safety in intensive care units in Michigan. J Crit Care. 2008, 23 (2): 201-221.CrossRef Pronovost PJ, Berenholz S, Goeschel C, Thom I, Watson S, Holzmuller C, Lyon JS, Lubomski LH, Thompson DA, Needham D, Hyzy R, Welsh R, Roth G, Bander J, Morlock L, Sexton JB: Improving patient safety in intensive care units in Michigan. J Crit Care. 2008, 23 (2): 201-221.CrossRef
29.
go back to reference Sexton JB, Makary MA, Tersigni AR, Pryor D, Hendrich A, Thomas EJ, Holzmuller CG, Knight AP, Wu Y, Pronovost PJ: Teamwork in the operating room: frontline perspectives among hospitals and operating room personnel. Anesthesiology. 2006, 105 (5): 877-884. 10.1097/00000542-200611000-00006.CrossRefPubMed Sexton JB, Makary MA, Tersigni AR, Pryor D, Hendrich A, Thomas EJ, Holzmuller CG, Knight AP, Wu Y, Pronovost PJ: Teamwork in the operating room: frontline perspectives among hospitals and operating room personnel. Anesthesiology. 2006, 105 (5): 877-884. 10.1097/00000542-200611000-00006.CrossRefPubMed
30.
go back to reference Modak I, Sexton JB, Lux TR, Helmreich RL, Thomas EJ: Measuring safety culture in the ambulatory setting: the safety attitudes questionnaire- ambulatory version. J Gen Intern Med. 2007, 22: 1-5.CrossRefPubMedPubMedCentral Modak I, Sexton JB, Lux TR, Helmreich RL, Thomas EJ: Measuring safety culture in the ambulatory setting: the safety attitudes questionnaire- ambulatory version. J Gen Intern Med. 2007, 22: 1-5.CrossRefPubMedPubMedCentral
31.
go back to reference Wild D, Grove A, Martin M, Eremenco S, McElroy S, Verjee-Lorenz A, Erikson P: Principles of good practice for the translation and cultural adaption process of patient-reported outcomes (PRO) measures: report of the ISPOR task force for translation and cultural adaption. Value Health. 2005, 8 (5): 94-104.CrossRefPubMed Wild D, Grove A, Martin M, Eremenco S, McElroy S, Verjee-Lorenz A, Erikson P: Principles of good practice for the translation and cultural adaption process of patient-reported outcomes (PRO) measures: report of the ISPOR task force for translation and cultural adaption. Value Health. 2005, 8 (5): 94-104.CrossRefPubMed
32.
go back to reference Polit DF, Beck CT: Nursing research. Generating and assessing evidence for nursing practice (8 th ed.). 2008, Lippincot Williams & Wilkins: Crawfordsville. Polit DF, Beck CT: Nursing research. Generating and assessing evidence for nursing practice (8 th ed.). 2008, Lippincot Williams & Wilkins: Crawfordsville.
33.
go back to reference Rubin DB: Multiple imputation for non response in surveys. 1987, New York: John Wiley & SonsCrossRef Rubin DB: Multiple imputation for non response in surveys. 1987, New York: John Wiley & SonsCrossRef
34.
go back to reference Brown TA: Confirmatory factor analysis for applied research. 2006, New York: The Guilford Press Brown TA: Confirmatory factor analysis for applied research. 2006, New York: The Guilford Press
35.
go back to reference Bartholomew D, Steele F, Galbraith J, Moustaki I: Analysis of multivariate social science data. 2008, Routledge: Chapman & Hall, 2 Bartholomew D, Steele F, Galbraith J, Moustaki I: Analysis of multivariate social science data. 2008, Routledge: Chapman & Hall, 2
36.
go back to reference Jöreskog K, Sörbom D: LISREL 8: User’s reference guide. 2006, Lincolnwood: Scientific Software International Jöreskog K, Sörbom D: LISREL 8: User’s reference guide. 2006, Lincolnwood: Scientific Software International
37.
go back to reference Nunnaly J, Bernstein I: Psychometric theory. 1994, New York: McGraw Hill, 3 Nunnaly J, Bernstein I: Psychometric theory. 1994, New York: McGraw Hill, 3
Metadata
Title
Swedish translation and psychometric testing of the safety attitudes questionnaire (operating room version)
Authors
Camilla Göras
Fan Yang Wallentin
Ulrica Nilsson
Anna Ehrenberg
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2013
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-13-104

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