Psychometric Properties Of The Chinese Version Of The Safety Attitudes Questionnaire

It is well known that protecting patients from harm is a universal research interest.How to measure and improve the safety culture in clinical areas becomes more and more important for promoting safe environment for patients.The Safety Attitudes Questionnaire(SAQ in brief) is the only existed instrument that measures safety culture in a way which correlates with patient performance and is widely used in various domains of medical industry in more than ten countries of the world.The aim of this paper is to translate,revise SAQ into Chinese version(C-SAQ in brief) and to evaluate its psychometric properties.The application future of C-SAQ in China is also discussed.In order to fulfill the translation and amendment of C-SAQ,both clinical and academic experts have been consulted for ensuring its semantic equivalence with original version.Based on the pilot study carried out by 213 clinical staff in third grade hospitals,30 items in SAQ were devised into 31 items in C-SAQ.Subsequently,C-SAQ was completed by 630 clinical staff in third grade hospitals both in Taiyuan of Shanxi province and in Weifang of Shandong province. Confirmatory factor analyses were performed to examine the applicability of the factor structure of the American questionnaire to the Chinese data.Explorative factor analyses were performed to examine another composition of items and factors would fit the data better.One-factor ANOVA(analysis of variance),internal consistency,test-retest correlations and construct validity were calculated.One item was removed from the original questionnaire and two items were added after reviewing literature and carring a pilot study.Similar to SAQ,six factors in C-SAQ were drawn from 31 items with the explorative factor analyses,but the composition of the factors was slightly changed.Three factors including teamwork climate,safety climate,and perception of management in SAQ turned out to be one factor,safety climate in C-SAQ.The other factors in C-SAQ including job satisfaction,working condition,and stress recognition were similar to those in SAQ.The reliability of C-SAQ were good(Cronbach'sα-is 0.882) and construction validity was acceptable.The scores of C-SAQ were positive.It was easier to detect the differences among hospitals and clinical units than caregivers.The results shows that the translated Chinese edition of The Safety Attitudes Questionnaire (C-SAQ) with 4 factors has good reliability and acceptable construction validity for measuring safety culture among hospitals and clinical units.Further studies on the relationship between SAQ-scores and patient outcome data should be carried.