The psychometric properties of the 'safety Attitudes questionnaire' in out-of-hours primary care services in the Netherlands
Journal article, Peer reviewed
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Original versionSmits, M., Keizer, E., Giesen, P., Deilkas, E. C., Hofoss, D., & Bondevik, G. T. (2017). The psychometric properties of the 'safety attitudes questionnaire' in out-of-hours primary care services in the Netherlands. PLoS One, 12(2), e0172390. doi:10.1371/journal.pone.0172390 https://doi.org/10.1371/journal.pone.0172390
Background The Safety Attitudes Questionnaire (SAQ) is one of the most widely used instruments to assess safety culture among healthcare providers. The ambulatory version of the SAQ (SAQ-AV) can be used in the primary care setting. Our study objective was to examine the underlying factors and psychometric properties of the Dutch translation of the SAQ-AV in out-of-hours primary care services. Design Cross-sectional observational study using a web-survey. Setting Sixteen out-of-hours general practitioner cooperatives and two call centers in the Netherlands. Participants Primary healthcare providers in out-of-hours services. Main outcome measures Item-descriptive statistics, factor loadings, Cronbach’s alpha scores, corrected item-total correlations, scale correlations. Results The questionnaire was answered by 853 (43.2%) healthcare professionals. In the factor analyses, 784 respondents were included; mainly general practitioners (N = 470) and triage nurses (N = 189). Items were included in the analyses based on question type and results from previous studies. Five factors were drawn with reliability scores between .49 and .86 and a good construct validity. The five factors covered 27 of the 62 questionnaire items, with three to five items per factor. Conclusions The Dutch translation of the SAQ-AV, with five factors, seems to be a reliable tool for measuring patient safety culture and guide quality improvement interventions in out-of-hours primary care services. The Dutch factor structure differed from the original SAQ-AV and other translated versions. In future studies, the questionnaire should be validated further by examining if there is a relationship between the responses on the SAQ-AV, patient experiences, and the occurrence of adverse events.