THE URDU VERSION OF THE SAFETY ATTITUDE QUESTIONNAIRE (SAQ) FOR INPATIENT SETTINGS IN PAKISTAN: PSYCHOMETRIC PROPERTIES AND BASELINE DATA

Authors

  • Hammad Muhammad Khan
  • Muhammad Zeeshan Fazal
  • Mohsin Ali Shah
  • Owais Muhammad Ali
  • Suleman Khan Afridi
  • Hasnain Syed Ahmad
  • Muhammad Irfan Head, Department of Mental Health, Psychiatry & Behavioral Sciences, Peshawar Medical College, Riphah International University Islamabad - Pakistan

Abstract

Background: This study aimed to test the psychometric properties of the Urdu version of the Safety Attitudes Questionnaire for inpatient settings in Pakistan. Methods: The SAQ short form (inpatient version) was translated with the back-translation technique into Urdu. The SAQ-Urdu was administered in three teaching hospitals in Pakistan to a sample of 483 front line healthcare personnel from August 2016 through December 2017. Confirmatory factor analysis was performed to test the factor structure of the responses. Cronbach’s alphas and correlation coefficients were computed. Mean and percentage agreement scores for items were reported. Results: The response rate was 75%. Goodness-of-fit indices from the confirmatory factor analysis showed a reasonable model fit (χ2=213.27, df=125, p<0.001; CFI 0.94, RMSEA 0.044). Cronbach’s alphas of survey factors (teamwork climate, safety climate, job satisfaction, perceptions of management, and working conditions) ranged from 0.71 to 0.87. In terms of mean percentage agreement scores, substantial variability was found at the clinical unit level. Conclusion: The Urdu version of the SAQ showed satisfactory internal psychometric properties. The attitudes around patient safety considerably vary and indicate a need for improvement. Keywords: Patient safety; Healthcare; Pakistan; Safety culture

Author Biography

Muhammad Irfan, Head, Department of Mental Health, Psychiatry & Behavioral Sciences, Peshawar Medical College, Riphah International University Islamabad - Pakistan

Dr. Muhammad IrfanMBBS, MCPS (Psychiatry), FCPS (Psychiatry), MS (Mental Health Policy & Services), PhD Head, Department of Mental Health, Psychiatry & Behavioral Sciences, Peshawar Medical College, Riphah International University, Islamabad-Pakistan  President-Elect, Pakistan Association of Medical EditorsDirector, World Association of Cultural Psychiatry  General Secretary, Pakistan Association of Cognitive Therapists

References

Makary MA, Daniel M. Medical error-the third leading cause of death in the US. BMJ: British Medical Journal (Online). 2016;353.

Brennan TA, Leape LL, Laird NM, Hebert L, Localio AR, Lawthers AG, et al. Incidence of adverse events and negligence in hospitalized patients: results of the Harvard Medical Practice Study I. BMJ Quality & Safety. 2004;13(2):145-51.

Wilson RM, Runciman WB, Gibberd RW, Harrison BT, Newby L, Hamilton JD. The quality in Australian health care study. Medical journal of Australia. 1995;163(9):458-71.

Vincent C, Neale G, Woloshynowych M. Adverse events in British hospitals: preliminary retrospective record review. Bmj. 2001;322(7285):517-9.

Baker GR, Norton PG, Flintoft V, Blais R, Brown A, Cox J, et al. The Canadian Adverse Events Study: the incidence of adverse events among hospital patients in Canada. Canadian medical association journal. 2004;170(11):1678-86.

Wilson RM, Michel P, Olsen S, Gibberd RW, Vincent C, El-Assady R, et al. Patient safety in developing countries: retrospective estimation of scale and nature of harm to patients in hospital. Bmj. 2012;344:e832.

Botwinick L, Bisognano M, Haraden C. Leadership Guide to Patient Safety. Cambridge, MA: Institute for Healthcare Improvement; 2006.

The National Quality Forum. Safe practices for better healthcare - a consensus report. 2003.

The Patient Safety Group. Leadership Standard Organization Culture and System Performance. Joint Commission; 2008.

World Health Organization. World Alliance for Patient Safety. Forward Programme 2008-2009. 2008.

Seo D-C, Torabi MR, Blair EH, Ellis NT. A cross-validation of safety climate scale using confirmatory factor analytic approach. Journal of safety research. 2004;35(4):427-45.

Flin R, Burns C, Mearns K, Yule S, Robertson EM. Measuring safety climate in health care. BMJ Quality & Safety. 2006;15(2):109-15.

Colla JB, Bracken AC, Kinney LM, Weeks WB. Measuring patient safety climate: a review of surveys. BMJ Quality & Safety. 2005;14(5):364-6.

Deilkås ET, Hofoss D. Psychometric properties of the Norwegian version of the Safety Attitudes Questionnaire (SAQ), generic version (short form 2006). BMC health services research. 2008;8(1):191.

Sexton JB, Helmreich RL, Neilands TB, Rowan K, Vella K, Boyden J, et al. The Safety Attitudes Questionnaire: psychometric properties, benchmarking data, and emerging research. BMC health services research. 2006;6(1):44.

Watts BV, Percarpio K, West P, Mills PD. Use of the Safety Attitudes Questionnaire as a measure in patient safety improvement. Journal of patient safety. 2010;6(4):206-9.

Modak I, Sexton JB, Lux TR, Helmreich RL, Thomas EJ. Measuring safety culture in the ambulatory setting: the safety attitudes questionnaire—ambulatory version. Journal of general internal medicine. 2007;22(1):1-5.

Jafree SR, Zakar R, Zakar MZ, Fischer F. Assessing the patient safety culture and ward error reporting in public sector hospitals of Pakistan. Safety in Health. 2017;3(1):10.

Jha AK, Prasopa-Plaizier N, Larizgoitia I, Bates DW. Patient safety research: an overview of the global evidence. BMJ Quality & Safety. 2010;19(1):42-7.

Sexton JB, Thomas EJ, Helmreich RL. Error, stress, and teamwork in medicine and aviation: cross sectional surveys. Bmj. 2000;320(7237):745-9.

Zimmermann N, Küng K, Sereika SM, Engberg S, Sexton B, Schwendimann R. Assessing the safety attitudes questionnaire (SAQ), German language version in Swiss university hospitals-a validation study. BMC health services research. 2013;13(1):347.

Jones PS, Lee JW, Phillips LR, Zhang XE, Jaceldo KB. An adaptation of Brislin’s translation model for cross-cultural research. Nursing research. 2001;50(5):300-4.

Sperber AD. Translation and validation of study instruments for cross-cultural research. Gastroenterology. 2004;126:S124-S8.

Lee W-C, Wung H-Y, Liao H-H, Lo C-M, Chang F-L, Wang P-C, et al. Hospital safety culture in Taiwan: a nationwide survey using Chinese version safety attitude questionnaire. BMC health services research. 2010;10(1):234.

Vandenberg RJ, Lance CE. A review and synthesis of the measurement invariance literature: Suggestions, practices, and recommendations for organizational research. Organizational research methods. 2000;3(1):4-70.

Browne MW, Cudeck R. Alternative ways of assessing model fit. Sociological methods & research. 1992;21(2):230-58.

Jöreskog KG. A general approach to confirmatory maximum likelihood factor analysis. Psychometrika. 1969;34(2):183-202.

Smits M, Christiaans-Dingelhoff I, Wagner C, van der Wal G, Groenewegen PP. The psychometric properties of the hospital Survey on Patient Safety Culture'in Dutch hospitals. BMC health services research. 2008;8(1):230.

Field A. Discovering statistics using SPSS for windows, edited. Wright D London Thousand Oaks New. 2000.

Pronovost P, Needham D, Berenholtz S, Sinopoli D, Chu H, Cosgrove S, et al. An intervention to decrease catheter-related bloodstream infections in the ICU. New England Journal of Medicine. 2006;355(26):2725-32.

Pronovost PJ, Rinke ML, Emery K, Dennison C, Blackledge C, Berenholtz SM. Interventions to reduce mortality among patients treated in intensive care units. Journal of critical care. 2004;19(3):158-64.

Downloads

Published

2021-02-20

Most read articles by the same author(s)