Dimensions analysis of the Hospital Survey on Patient Safety Culture questionnaire in Iran: Psychometric properties

• Published in: The International journal of health planning and management 2020-11, Vol.35 (6), p.1532-1545
• Main Authors: Rahimi, Elnaz, Alizadeh, Seyed Shamseddin, Safaeian, Abdol‐Rasoul, Abbasgholizadeh, Nategh
• Format: Article
• Language: English
• Subjects: Confirmatory factor analysis; Consistency; Construct validity; Construction standards; Correlation analysis; Cronbach's alpha; Culture; dimensions analysis; Discrepancies; Exploratory factor analysis; Factor analysis; Health administration; Hospital Survey on Patient Safety Culture (HSOPSC); Hospitals; Mathematical models; Multivariate statistical analysis; Patient safety; patient safety culture; Patients; Polls & surveys; Quantitative psychology; Questionnaires; Reliability; Reliability analysis; Safety; Stability analysis; Structural equation modeling; Translation; Two dimensional models; Validation studies; Validity; Wording
• ISSN: 0749-6753; 1099-1751
• DOI: 10.1002/hpm.3044

Summary Aim The present study aimed to investigate the possible alternative factorial structure of the patient safety culture model in Iran. Methods This study was performed based on data collected by Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire from 420 staff in four hospitals. Internal consistency reliability and construct validity were evaluated by Cronbach's alpha and correlation analysis. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA) and structural equation modeling (SEM) were used to investigate the possible alternative factorial structure, examine and confirm the obtained structure, alternatively. Kaiser‐Meyer‐Olkin measure and Bartlett test were calculated to determine the factor ability of sample and fit of the factor analysis, alternatively. SPSS and AMOS version 25 were used. Results EFA identified 12 dimensions which one dimension has been also created from a new question. Distribution of items in all dimensions differed from the original HSOPSC questionnaire except two dimensions. The obtained structure was a proportional model. The calculation of Cronbach's alpha (∝ = .8) showed that, the internal consistency reliability was appropriate for all items in the questionnaire. Also, construct validity was acceptable for all factors. Conclusions The structure of the dimensions obtained in this study was not consistent with the structure of the original HSOPSC model. Highlights Provide a model for assessing patient safety culture with relative stability with respect to the native culture of the region. Good content and construct validity. Differences in the distribution of items in dimensions. Formation of new dimensions. Performing a psychometric analysis of the instrument using EFA, CFA and SEM to examine the disagreement on the validity, reliability and dimensions of patient safety culture in previous studies in Iran. Numerous discrepancies in item wording comply with the approach advocated by the translation guideline for AHRQ survey on patient safety.