Department of Medical Affairs and Planning, Taipei Veterans General Hospital, and Institute of Hospital and Health Care Administration, National Yang-Ming University School of Medicine, Taipei, Taiwan.
BMC Health Serv Res. 2010 Aug 10;10:234. doi: 10.1186/1472-6963-10-234.
Safety activities have been initiated at many hospitals in Taiwan, but little is known about the safety culture at these hospitals. The aims of this study were to verify a safety culture survey instrument in Chinese and to assess hospital safety culture in Taiwan.
The Taiwan Patient Safety Culture Survey was conducted in 2008, using the adapted Safety Attitude Questionnaire in Chinese (SAQ-C). Hospitals and their healthcare workers participated in the survey on a voluntary basis. The psychometric properties of the five SAQ-C dimensions were examined, including teamwork climate, safety climate, job satisfaction, perception of management, and working conditions. Additional safety measures were asked to assess healthcare workers' attitudes toward their collaboration with nurses, physicians, and pharmacists, respectively, and perceptions of hospitals' encouragement of safety reporting, safety training, and delivery delays due to communication breakdowns in clinical areas. The associations between the respondents' attitudes to each SAQ-C dimension and safety measures were analyzed by generalized estimating equations, adjusting for the clustering effects at hospital levels.
A total of 45,242 valid questionnaires were returned from 200 hospitals with a mean response rate of 69.4%. The Cronbach's alpha was 0.792 for teamwork climate, 0.816 for safety climate, 0.912 for job satisfaction, 0.874 for perception of management, and 0.785 for working conditions. Confirmatory factor analyses demonstrated a good model fit for each dimension and the entire construct. The percentage of hospital healthcare workers holding positive attitude was 48.9% for teamwork climate, 45.2% for perception of management, 42.1% for job satisfaction, 37.2% for safety climate, and 31.8% for working conditions. There were wide variations in the range of SAQ-C scores in each dimension among hospitals. Compared to those without positive attitudes, healthcare workers with positive attitudes to each SAQ dimension were more likely to perceive good collaboration with coworkers, and their hospitals were more likely to encourage safety reporting and to prioritize safety training programs (Wald chi-square test, p < 0.001 for all).
Analytical results verified the psychometric properties of the SAQ-C at Taiwanese hospitals. The safety culture at most hospitals has not fully developed and there is considerable room for improvement.
台湾许多医院已经启动了安全活动，但对这些医院的安全文化知之甚少。本研究旨在验证中文版安全文化调查问卷，并评估台湾医院的安全文化。
2008 年进行了台湾患者安全文化调查，采用中文改编的安全态度问卷（SAQ-C）。医院及其医护人员自愿参与调查。检验了五个 SAQ-C 维度的心理测量特性，包括团队合作氛围、安全氛围、工作满意度、管理认知和工作条件。还询问了其他安全措施，以评估医护人员对与护士、医生和药剂师合作的态度，以及对医院鼓励安全报告、安全培训以及因临床区域沟通中断而导致的交付延迟的看法。使用广义估计方程分析了受访者对每个 SAQ-C 维度的态度与安全措施之间的关系，调整了医院层面的聚类效应。
从 200 家医院共收到 45242 份有效问卷，平均应答率为 69.4%。团队合作氛围维度的克朗巴赫 α 系数为 0.792，安全氛围为 0.816，工作满意度为 0.912，管理认知为 0.874，工作条件为 0.785。验证性因子分析表明，每个维度和整个结构的模型拟合度良好。持有积极态度的医院医护人员百分比分别为：团队合作氛围 48.9%，管理认知 45.2%，工作满意度 42.1%，安全氛围 37.2%，工作条件 31.8%。各医院之间 SAQ-C 得分的范围差异很大。与对每个 SAQ 维度没有积极态度的医护人员相比，对每个 SAQ 维度有积极态度的医护人员更有可能与同事良好合作，并且他们的医院更有可能鼓励安全报告和优先考虑安全培训计划（Wald 卡方检验，p<0.001 均为）。
分析结果验证了台湾医院的 SAQ-C 的心理测量特性。大多数医院的安全文化尚未充分发展，还有很大的改进空间。
