Atukwatse Joseph, Niyonzima Vallence, Asher Aliga Cliff, Nakandi Serwadda Jalia, Nankunda Rosemary, Nakiganda Catherine, Komugabe Peninah, Nantongo Hanifah
School of Nursing and Midwifery, Aga Khan University Uganda, Kampala, Uganda.
Department of Nursing, Mbarara University of Science and Technology, Mbarara, Uganda.
Drug Healthc Patient Saf. 2023 Jan 26;15:13-23. doi: 10.2147/DHPS.S389978. eCollection 2023.
The safety attitudes questionnaire (SAQ) short form (2006) is important for assessing patient safety culture in clinical environments. However, little is known about its validity and applicability in Uganda. This study validated the SAQ short form (2006) for use in assessing patient safety culture in critical care settings of hospitals in the Ugandan context.
Using a sequential exploratory mixed-methods research design, the face, content and construct validity for the SAQ short form (2006) was assessed in a multi-phased approach. A panel of eight (8) purposively selected experts assessed the face and content validity in rounds 1 and 2, respectively, while construct validity was assessed in round 3 using data from a cross-sectional survey of 256 frontline health workers in critical care settings of the selected hospitals. Analysis of survey data followed confirmatory factor analysis. Cronbach's alpha examined internal reliability.
Of the 36 items in the tool's original version, 33 were rated clear, with a score of 100% on face validity. The use of contextual vocabulary and formatting issues arose as concerns. The S-CVI/ was 100%, and S-CVI/ was 86.1%. Four new items added on effective communication as another dimension of patient safety culture. The survey had KMO=0.8605, the a priori-based model had a scale Cronbach's alpha=0.8881, with unsatisfactory goodness of fit (RMSEA=0.051, 90% CI: 0.044-0.057, close=0.427; chi-square=694.28, <0.001; CFI=0.884, TLI=0.871). The modified final model had a scale Cronbach's alpha =0.8967 and satisfactory goodness of fit (RMSEA=0.030, 90% CI: 0.019-0.039, close=1.000; chi-square=424.98, =0.002; CFI=0.966, TLI=0.960).
In the tool's original form, the face validity was lacking despite satisfactory scores on item clarity. Content validity was adequate, while construct validity required modifications in construct specifications. Reliability was adequate before and after specification modifications. The modified version has adequate psychometric properties for Uganda.
安全态度问卷简版（2006年）对于评估临床环境中的患者安全文化非常重要。然而，对于其在乌干达的有效性和适用性知之甚少。本研究验证了安全态度问卷简版（2006年）在乌干达医院重症监护环境中用于评估患者安全文化的有效性。
采用序贯探索性混合方法研究设计，分多阶段评估安全态度问卷简版（2006年）的表面效度、内容效度和结构效度。一个由八名经过有目的挑选的专家组成的小组分别在第1轮和第2轮评估表面效度和内容效度，而在第3轮使用来自所选医院重症监护环境中256名一线医护人员的横断面调查数据评估结构效度。调查数据分析采用验证性因子分析。Cronbach's α系数用于检验内部信度。
该工具原始版本中的36个条目中，33个被评为清晰，表面效度得分为100%。出现了对使用情境词汇和格式问题的担忧。S-CVI/ 为100%，S-CVI/ 为86.1%。增加了四个关于有效沟通的新条目，作为患者安全文化的另一个维度。该调查的KMO = 0.8605，基于先验的模型的量表Cronbach's α系数 = 0.8881，拟合优度不理想（RMSEA = 0.051，90% CI：0.044 - 0.057，近似误差均方根 = 0.427；卡方 = 694.28，p < 0.001；CFI = 0.884，TLI = 0.871）。修改后的最终模型的量表Cronbach's α系数 = 0.8967，拟合优度令人满意（RMSEA = 0.030，90% CI：0.019 - 0.039，近似误差均方根 = 1.000；卡方 = 424.98，p = 0.002；CFI = 0.966，TLI = 0.960）。
在该工具的原始形式中，尽管条目清晰度得分令人满意，但表面效度仍有欠缺。内容效度足够，而结构效度需要在结构规范方面进行修改。在规范修改前后，信度都足够。修改后的版本在乌干达具有足够的心理测量学特性。
