Eiras Margarida, Escoval Ana, Grillo Isabel Monteiro, Silva-Fortes Carina
Int J Health Care Qual Assur. 2014;27(2):111-22. doi: 10.1108/IJHCQA-07-2012-0072.
Quantitative instruments to assess patient safety culture have been developed recently and a few review articles have been published. Measuring safety culture enables healthcare managers and staff to improve safety behaviours and outcomes for patients and staff. The study aims to determine the AHRQ Hospital Survey on Patient Safety Culture (HSPSC) Portuguese version's validity and reliability.
DESIGN/METHODOLOGY/APPROACH: A missing-value analysis and item analysis was performed to identify problematic items. Reliability analysis, inter-item correlations and inter-scale correlations were done to check internal consistency, composite scores. Inter-correlations were examined to assess construct validity. A confirmatory factor analysis was performed to investigate the observed data's fit to the dimensional structure proposed in the AHRQ HSPSC Portuguese version. To analyse differences between hospitals concerning composites scores, an ANOVA analysis and multiple comparisons were done.
Eight of 12 dimensions had Cronbach's alphas higher than 0.7. The instrument as a whole achieved a high Cronbach's alpha (0.91). Inter-correlations showed that there is no dimension with redundant items, however dimension 10 increased its internal consistency when one item is removed.
ORIGINALITY/VALUE: This study is the first to evaluate an American patient safety culture survey using Portuguese data. The survey has satisfactory reliability and construct validity.
近期已开发出用于评估患者安全文化的定量工具，且已发表了几篇综述文章。对安全文化进行测量可使医疗保健管理人员和工作人员改善患者及工作人员的安全行为和结果。本研究旨在确定美国医疗保健研究与质量局（AHRQ）患者安全文化医院调查（HSPSC）葡萄牙语版本的有效性和可靠性。
设计/方法/途径：进行缺失值分析和项目分析以识别有问题的项目。进行可靠性分析、项目间相关性和量表间相关性分析以检查内部一致性、综合得分。检查相互相关性以评估结构效度。进行验证性因素分析以研究观察数据与AHRQ HSPSC葡萄牙语版本中提出的维度结构的拟合情况。为分析不同医院在综合得分方面的差异，进行了方差分析和多重比较。
12个维度中有8个维度的克朗巴哈系数高于0.7。该工具整体的克朗巴哈系数较高（0.９1）。相互相关性表明没有维度存在冗余项目，不过维度10在去除一个项目后其内部一致性有所提高。
原创性/价值：本研究首次使用葡萄牙语数据评估美国的患者安全文化调查。该调查具有令人满意 的可靠性和结构效度。
