Grech Adrienne, Naamanka Kati, Mattsson Janet, Pakpour Amir, Kivelä Suvi, Cassar Maria, Manninen Katri, Circenis Kristaps, Melbārde-Kelmere Agita, Korsström Nina, Marqués-Sule Elena, Cortés-Amador Sara, Hernández-Guillén David, Poikkeus Tarja, Björling Gunilla
Faculty of Health Sciences, University of Malta, Valetta, Malta.
Turku University of Applied Sciences, Turku, Finland.
BMC Med Ethics. 2025 Sep 8;26(1):115. doi: 10.1186/s12910-025-01279-1.
Ethical safety supports the development of ethical competencies and sound decision-making, central to good healthcare practice. The Ethical Safety Questionnaire (ESQ) evaluates ethical safety in healthcare environments, based on three subscales; ,, The objective of this study was to determine the psychometric properties of the ESQ in acute healthcare environments.
The domain development of the ESQ was carried out in Finland in 2019. The ESQ was translated into English, Latvian and Swedish. To determine the validity of the ESQ, a cross-sectional design was used. Data was collected from nurses and physiotherapists ( = 275) in Sweden, Finland, Latvia and Malta, using purposive sampling. The validation (in all languages) consisted of an exploratory factor analysis, Rasch analysis and network analysis. This assessed the ESQ for internal consistency and construct validity. Ethical approval was granted from all participating countries in accordance with national law and the Declaration of Helsinki.
The internal consistency for the three subscales of the ESQ, ,,, was satisfactory, with Cronbach’s α coefficients (> 0.7) and McDonald’s omega coefficients (> 0.7). All corrected item-total correlations among the items of the ESQ were high, exceeding 0.6. Thus, the ESQ exhibits acceptable levels of internal consistency and construct validity.
The results suggest that the ESQ is a reliable tool for evaluating ethical safety in healthcare environments. However, the two general items in the ESQ can be omitted without loss of scale validity.
道德安全有助于培养道德能力和做出合理决策，这是优质医疗实践的核心。道德安全问卷（ESQ）基于三个分量表评估医疗环境中的道德安全。本研究的目的是确定ESQ在急性医疗环境中的心理测量特性。
ESQ的领域开发于2019年在芬兰进行。ESQ被翻译成英语、拉脱维亚语和瑞典语。为了确定ESQ的有效性，采用了横断面设计。通过立意抽样从瑞典、芬兰、拉脱维亚和马耳他的护士和物理治疗师（n = 275）中收集数据。验证（所有语言）包括探索性因素分析、拉施分析和网络分析。这评估了ESQ的内部一致性和结构效度。根据国内法律和《赫尔辛基宣言》，所有参与国家均获得了伦理批准。
ESQ三个分量表的内部一致性令人满意，克朗巴赫α系数（> 0.7）和麦克唐纳ω系数（> 0.7）。ESQ各项之间所有校正后的项目-总分相关性都很高，超过0.6。因此，ESQ表现出可接受的内部一致性和结构效度水平。
结果表明，ESQ是评估医疗环境中道德安全的可靠工具。然而，ESQ中的两个一般项目可以省略而不影响量表效度。
