中文版病人安全態度問卷信效度分析

Validation Study of the Chinese Safety Attitude Questionnaire in Taiwan

10.6288/TJPH2008-27-03-03

李偉強(Wui-Chiang Lee)；簡淑芬(Shu-Feng Chien)；陳玉枝(Yu-Chih Chen)；黃東波(Tong-Po Huang)；李建賢(Chen-Hsen Lee)；李壽東(Shou-Dong Lee)

安全態度問卷 ； 病人安全 ； 安全文化 ； 問卷調查 ； safety attitude questionnaire ； Patient safety ； safety culture ； questionnaire survey

台灣公共衛生雜誌

27卷3期（2008 / 06 / 01）

214 - 222

繁體中文

Objectives: The Safety Attitude Questionnaire (SAQ) has been used in several countries to measure healthcare workers' attitudes toward patient safety. It has not been validated in Taiwan, however. The objective of this study was to develop and validate a Chinese version of the SAQ. Methods: The original SAQ was translated into Chinese in October 2006. There were 30 core items, measuring six domains of an organization's safety culture: Teamwork Climate, Safety Climate, Job Satisfaction, Stress Recognition, Perception of Management, and Working Conditions. A hospital-wide safety attitude survey was conducted in one medical center in Taipei in April 2007. The reliability and validity of the SAQ were examined by multilevel confirmatory factor analysis. Results: The overall response rate was 71.1%. The internal consistency of each domain was high (composite reliability: 0.77-0.93). The explanatory abilities of two-thirds (21/30) of the core items are considered important for the corresponding domains (squared multiple correlation [SMC]≥0.5). The standardized factor loadings (λ) for most core items were statistically meaningful (λ=0.75-0.85), but the two reverse items were not (λ＜0.5). The model fit was satisfactory for the six domains and for the safety culture via structural equation models. Except for Stress Recognition (λ=-0.09, SMC=0.01), all domains were highly correlated to one another (correlation coefficients: 0.67-0.93) and had good factoral loadings (λ=0.69-0.88) and SMC (0.48-0.78) to the hospital safety culture. Conclusions: The Chinese version of the SAQ is reliable and valid in measuring frontline workers' safety attitudes in this healthcare organization in Taiwan.

Objectives: The Safety Attitude Questionnaire (SAQ) has been used in several countries to measure healthcare workers' attitudes toward patient safety. It has not been validated in Taiwan, however. The objective of this study was to develop and validate a Chinese version of the SAQ. Methods: The original SAQ was translated into Chinese in October 2006. There were 30 core items, measuring six domains of an organization's safety culture: Teamwork Climate, Safety Climate, Job Satisfaction, Stress Recognition, Perception of Management, and Working Conditions. A hospital-wide safety attitude survey was conducted in one medical center in Taipei in April 2007. The reliability and validity of the SAQ were examined by multilevel confirmatory factor analysis. Results: The overall response rate was 71.1%. The internal consistency of each domain was high (composite reliability: 0.77-0.93). The explanatory abilities of two-thirds (21/30) of the core items are considered important for the corresponding domains (squared multiple correlation [SMC]≥0.5). The standardized factor loadings (λ) for most core items were statistically meaningful (λ=0.75-0.85), but the two reverse items were not (λ＜0.5). The model fit was satisfactory for the six domains and for the safety culture via structural equation models. Except for Stress Recognition (λ=-0.09, SMC=0.01), all domains were highly correlated to one another (correlation coefficients: 0.67-0.93) and had good factoral loadings (λ=0.69-0.88) and SMC (0.48-0.78) to the hospital safety culture. Conclusions: The Chinese version of the SAQ is reliable and valid in measuring frontline workers' safety attitudes in this healthcare organization in Taiwan.

1. Bagozzi RP,Yi Y(1988).On the evaluation of structural equation models.J Acad Mark Sci,16,74-94.
2. Bagozzi RY,Yi Y,Phillips LW(1991).Assessing construct validity in organizational research.Administrative Science Quarterly,36,421-458.
3. Colla JB,Bracken AC,Kinney LM,Weeks WB(2005).Measuring patient safety climate: a review of surveys.Qual Saf Health Care,14,364-366.
4. Flin R,Burns C,Mearns K,Yule S,Robertson EM(2006).Measuring safety climate in health care.Qual Saf Health Care,15,109-115.
5. Guldenmund FW(2000).The nature of safety culture: a review of theory and research.Saf Sci,34,215-257.
6. Leape LL(1994).Error in medicine.JAMA,272,1851-1857.
7. Nieva VF,Sorra J(2003).Safety culture assessment: a tool for improving patient safety in healthcare organizations.Qual Saf Health Care,12(2),17-23.
8. Pronovost P,Sexton JB(2005).Assessing safety culture: guidelines and recommendations.Qual Saf Health Care,14,231-233.
9. Pronovost PJ,Miller MR,Wachter RM(2006).Tracking progress in patient safety: an elusive target.JAMA,296,696-699.
10. Raykov T(1998).Coefficient alpha and composite reliability with interrelated nonhomogenous items.Appl Psychol Meas,22,375-385.
11. Reason J(1995).Understanding adverse events: human factors.Qual Health Care,4,80-89.
12. Reason JT,Carthey J,de Leval MR(2001).Diagnosing "vulnerable system syndrome": an essential prerequisite to effective risk management.Qual Health Care,10(2),21-25.
13. Schein EH(1992).Organizational Culture and Leadership.San Francisco:Jossey-Bass.
14. Scott T,Mannion R,Davies H,Marshall M(2003).The quantitative measurement of organizational culture in health care: a review of the available instruments.Health Serv Res,38,923-945.
15. Sexton JB(2002).A matter of life and death: social psychological and organizational factors related to patient outcomes in the intensive care unit [Dissertation].Austin, TX:University of Texas.
16. Sexton JB,Helmreich RL(2000).Analyzing cockpit communications: the links between language, performance, error, and workload.Hum Perf Extrem Environ,5,63-68.
17. Sexton JB,Helmreich RL,Neilands TB(2006).The safety attitudes questionnaire: psychometric properties, benchmarking data, and emerging research.BMC Health Serv Res,6,44-53.
18. Sexton JB,Thomas EJ,Helmreich RL(2000).Error, stress, and teamwork in medicine and aviation: cross sectional surveys.BMJ,320,745-749.
19. Thomas EJ,Sexton JB,Helmreich RL(2003).Discrepant attitudes about teamwork among critical care nurses and physicians.Crit Care Med,31,956-959.
20. Vandenberg RJ,Lance CE(2000).A review and synthesis of the measurement invariance literature: suggestions, practices, and recommendations for organizational research.Organ Res Meth,3,4-69.
21. Vincent C,Taylor-Adams S,Stanhope N(1998).Framework for analyzing risk and safety in clinical medicine.BMJ,316,1154-1157.
22. Weingart SN,Farbstein K,Davis RB,Philips RS(2004).Using a multihospital survey to examine the safety culture.Jt Comm J Qual Saf,30,125-132.
23. 施貞伶(2004)。碩士論文(碩士論文)。台北，台灣大學醫療機構管理研究所。
24. 翁豐榮(2004)。碩士論文(碩士論文)。高雄，高雄醫學大學公共衛生所。
25. 郭昱廷(2004)。碩士論文(碩士論文)。桃園，長庚大學醫務管理學研究所。
26. 潘韋翰(2004)。碩士論文(碩士論文)。台北，台北醫學大學醫務管理學研究所。

1. 陳怡甄,郭素娥,阮祺文(2017)。護理人員的病人安全文化對工作生活平衡之影響－復原力之調節效果。弘光學報，80，13-26。
2. 黃素枝,周嘉宜,吳婷婷(2021)。南部某醫學中心護理人員之安全態度調查分析。榮總護理，38(1)，37-46。
3. 賴君瑋,劉千禎,馮兆康,張炳華,李怡慶,吳信宏(2022)。探討員工滿意度與病人安全文化認知之相關性。管理實務與理論研究，16(2)，1-11。
4. 蘇佩瑾,馮兆康,彭彥群,張振傑(2023)。家長式領導對病人安全態度的影響－個人與上司適配為調節效果。管理實務與理論研究，17(2)，29-40。
5. 吳信宏(2017)。從安全態度量表談論病人安全文化。品質月刊，53(8)，26-30。
6. 蕭世槐,陳綾穗,郭彥宏,張嘉芳,張怡萱(2021)。推動國際醫院評鑑對醫師的病人安全文化態度之影響。醫務管理期刊，22(2)，151-170。
7. 謝俊逸,黃冠凱,黃志璿,李怡慶,李怡芳,吳信宏,余嘉惠(2021)。探討醫護人員之病人安全文化：以中部某地區醫院為例。品質學報，28(5)，322-348。
8. 謝秀梅,黃芷苓,呂旻芬,江季蓁(2023)。照顧服務員之病人安全態度調查：以南部某二家區域教學醫院為例。長期照護雜誌，26(2)，157-172。
9. 楊鎮嘉、李憶萱、王怡舜(2012)。領導行為、安全文化對安全績效之影響—以護理人員為例。輔仁管理評論，19(1)，47-72。
10. 張雯婷、李毅、朱正一(2016)。探討領導風格對安全績效之影響─以安全態度為中介變項。醫務管理期刊，17(3)，188-209。
11. 鍾明惠、蕭淑代、楊勤熒、林秋芬、林育萱(2018)。職場霸凌與女性護理師照護病人安全態度之相關性探討。護理雜誌，65(1)，51-60。
12. (2024)。急、重症與一般成人病房護理人員於新冠肺炎疫情中病人安全文化態度之變化。護理雜誌，71(1)，47-59。
13. (2024)。醫院員工之病人安全文化與組織公民行為之相關性探討－以中部某公立醫院為例。醫務管理期刊，25(2)，144-170。