Hutchinson A, Cooper K L, Dean J E, McIntosh A, Patterson M, Stride C B, Laurence B E, Smith C M
Section of Public Health, ScHARR, Sheffield S1 4DA, UK.
Qual Saf Health Care. 2006 Oct;15(5):347-53. doi: 10.1136/qshc.2005.016584.
To explore the factor structure, reliability, and potential usefulness of a patient safety climate questionnaire in UK health care.
Four acute hospital trusts and nine primary care trusts in England.
The questionnaire used was the 27 item Teamwork and Safety Climate Survey. Thirty three healthcare staff commented on the wording and relevance. The questionnaire was then sent to 3650 staff within the 13 NHS trusts, seeking to achieve at least 600 responses as the basis for the factor analysis. 1307 questionnaires were returned (36% response). Factor analyses and reliability analyses were carried out on 897 responses from staff involved in direct patient care, to explore how consistently the questions measured the underlying constructs of safety climate and teamwork.
Some questionnaire items related to multiple factors or did not relate strongly to any factor. Five items were discarded. Two teamwork factors were derived from the remaining 11 teamwork items and three safety climate factors were derived from the remaining 11 safety items. Internal consistency reliabilities were satisfactory to good (Cronbach's alpha > or =0.69 for all five factors).
This is one of the few studies to undertake a detailed evaluation of a patient safety climate questionnaire in UK health care and possibly the first to do so in primary as well as secondary care. The results indicate that a 22 item version of this safety climate questionnaire is useable as a research instrument in both settings, but also demonstrates a more general need for thorough validation of safety climate questionnaires before widespread usage.
探讨英国医疗保健领域患者安全氛围调查问卷的因子结构、信度及潜在效用。
英格兰的四家急症医院信托机构和九家初级保健信托机构。
所使用的问卷为包含27个条目的团队合作与安全氛围调查问卷。33名医护人员对问卷措辞及相关性发表了意见。随后，该问卷被发送至13家国民保健服务信托机构的3650名员工，力求获得至少600份回复作为因子分析的基础。共收回1307份问卷（回复率为36%）。对897名直接参与患者护理的员工的回复进行因子分析和信度分析，以探究这些问题在测量安全氛围和团队合作潜在结构方面的一致性。
部分问卷条目与多个因子相关，或与任何因子均无强烈关联。剔除了5个条目。从其余11个团队合作条目得出2个团队合作因子，从其余11个安全条目得出3个安全氛围因子。内部一致性信度令人满意至良好（所有5个因子的Cronbach's α≥0.69）。
这是少数对英国医疗保健领域患者安全氛围调查问卷进行详细评估的研究之一，可能也是首次在初级和二级保健领域均开展此类评估的研究。结果表明，该安全氛围调查问卷的22条目版本在这两种环境中均可作为研究工具使用，但也表明在广泛使用之前，对安全氛围调查问卷进行全面验证的普遍需求。
