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Swedish translation and psychometric testing of the safety attitudes questionnaire (operating room version)
Anesthesia and Intensive Care Unit, Falu Lasarett, Falun, Sweden; School of Health and Social Studies, Dalarna University, Falun, Sweden; School of Health and Social Studies, Dalarna University, Falun, Sweden.ORCID iD: 0000-0002-0883-4072
Uppsala University, Uppsala, Sweden. (Department of Statistics)
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.ORCID iD: 0000-0001-5403-4183
School of Health and Social Studies, Dalarna University, Falun, Sweden.ORCID iD: 0000-0002-3964-196X
2013 (English)In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 13, article id 104Article in journal (Refereed) Published
Abstract [en]

Background: Tens of millions of patients worldwide suffer from avoidable disabling injuries and death every year. Measuring the safety climate in health care is an important step in improving patient safety. The most commonly used instrument to measure safety climate is the Safety Attitudes Questionnaire (SAQ). The aim of the present study was to establish the validity and reliability of the translated version of the SAQ.

Methods: The SAQ was translated and adapted to the Swedish context. The survey was then carried out with 374 respondents in the operating room (OR) setting. Data was received from three hospitals, a total of 237 responses. Cronbach's alpha and confirmatory factor analysis (CFA) was used to evaluate the reliability and validity of the instrument.

Results: The Cronbach's alpha values for each of the factors of the SAQ ranged between 0.59 and 0.83. The CFA and its goodness-of-fit indices (SRMR 0.055, RMSEA 0.043, CFI 0.98) showed good model fit. Intercorrelations between the factors safety climate, teamwork climate, job satisfaction, perceptions of management, and working conditions showed moderate to high correlation with each other. The factor stress recognition had no significant correlation with teamwork climate, perception of management, or job satisfaction.

Conclusions: Therefore, the Swedish translation and psychometric testing of the SAQ (OR version) has good construct validity. However, the reliability analysis suggested that some of the items need further refinement to establish sound internal consistency. As suggested by previous research, the SAQ is potentially a useful tool for evaluating safety climate. However, further psychometric testing is required with larger samples to establish the psychometric properties of the instrument for use in Sweden.

Place, publisher, year, edition, pages
BioMed Central, 2013. Vol. 13, article id 104
Keywords [en]
Patient safety, Operating room, Safety climate, Psychometrics, Translation, Safety attitudes questionnaire
National Category
Nursing
Research subject
Caring sciences
Identifiers
URN: urn:nbn:se:oru:diva-28904DOI: 10.1186/1472-6963-13-104ISI: 000317113300001PubMedID: 23506044Scopus ID: 2-s2.0-84875072612OAI: oai:DiVA.org:oru-28904DiVA, id: diva2:619683
Available from: 2013-05-06 Created: 2013-05-03 Last updated: 2019-05-15Bibliographically approved
In thesis
1. Open the door to complexity: Safety climate and work processes in the operating room
Open this publication in new window or tab >>Open the door to complexity: Safety climate and work processes in the operating room
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

A complex adaptive system such as the operating room (OR), consists of different safety cultures, sub-cultures and ways of working. When measuring, a strong safety climate has been associated with lower rates of surgical complications. Teamwork is an important factor of safety climate. Discrepancies among professionals’ perceptions of teamwork climate exists. Hence it seems crucial to explore if diversity exists in the perception of factors related to safety climate and between managers and front-line staff in the OR. Complex work processes including multitasking and interruptions are other challenges with potential effect on patient safety. However, multitasking and interruptions may have positive impact on patient safety, but are not well understood in clinical work. Despite challenges a lot of things go well in the OR. Thus, the overall aim of this thesis was to evaluate an instrument for assessing safety climate, to describe and compare perceptions of safety climate, and to explore the complexity of work processes in the OR.

To evaluate the Safety Attitudes Questionnaire-operating room (SAQ-OR) version and elicit estimations of the surgical team a cross-sectional study design was used. How work was done was studied by observations using the Work Observation Method by Activity Timing and by group interviews with OR professionals.

The results show that the SAQ-OR is a relatively acceptable instrument to assess perceptions of safety climate within Swedish ORs. OR professionals´ perceptions of safety climate showed variations and some weak areas which cohered fairly well with managers' estimations. Work in the OR was found to be complex and consisting of multiple tasks where communication was most frequent. Multitasking and interruptions, mostly followed by communication, were common. This reflects interactions and adaptations common for a complex adaptive system. Managing complexity and creating safe care in the OR was described as a process of planning and preparing for the expected and preparedness to be able to adapt to the unexpected.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2019. p. 100
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 193
Keywords
Patient safety, operating room, complexity, safety climate, psychometrics, cross-sectional, observations and qualitative
National Category
Other Health Sciences
Identifiers
urn:nbn:se:oru:diva-73093 (URN)978-91-7529-285-4 (ISBN)
Public defence
2019-05-24, Föreläsningssalen Falu Lasarett, Lasarettsvägen 10, Falun, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2019-03-11 Created: 2019-03-11 Last updated: 2019-05-06Bibliographically approved

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Göras, CamillaNilsson, UlricaEhrenberg, Anna

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