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Abstract：
BACKGROUND: Patient safety culture concerns the values, beliefs and standards shared by an organisation\'s health staff and other personnel which influence their care provision actions and conduct. Several countries have made a priority of strengthening patient safety culture to improve the quality and safety of health care. In this direction, measuring the patient safety culture through validated instruments is a strategy applied worldwide. The purpose of this study was to adapt transculturally and validate the HSOPSC 2.0 to Brazilian Portuguese and the hospital context in Brazil.
METHODS: Of the various validated scales for measuring safety culture, the instrument most used internationally is the Hospital Survey on Patient Safety Culture (HSOPSC) developed by the United States Agency for Healthcare Research and Quality in 2004 and revised in 2019, when version 2.0 was released. Adaptation was conducted on a universalist approach and the adapted instrument was then applied to a sample of 2,702 respondents (56% response rate) comprising staff of a large general hospital in the city of São Paulo. Construct validity was investigated by Exploratory Structural Equation Modelling-within-Confirmatory Factor Analysis (ESEM-within-CFA) and reliability was measured in each dimension by means of Cronbach alpha coefficients.
RESULTS: ESEM fit indexes showed good data fit with the proposed model: χ2 = 634.425 df = 221 χ2/df ratio = 2.9 p-value < 0.0000; RMSEA = 0.045 (90% C.I. = 0.041-0.050) and probability RMSEA < = .05 = 0.963; CFI = 0.986; TLI = 0.968. However, ten items had loads lower than 0.4. Cronbach alpha values were 0.6 or more for all dimensions, except Handoffs and information exchange ([Formula: see text]= 0.50) and Staffing and work pace ([Formula: see text] = 0.41).
CONCLUSIONS: The psychometric properties of the Brazilian version were found to be satisfactory, demonstrating good internal consistency and construct validity as expressed by estimates of reliability and indexes of model fit. However, given factor loadings smaller than 0.4 observed in ten items and considering that the scale translated and adapted to Portuguese was tested on a single sample during the Covid-19 pandemic, the authors recognize the need for it to be tested on other samples in Brazil to investigate its validity.
METHODS: Of the various validated scales for measuring safety culture, the instrument most used internationally is the Hospital Survey on Patient Safety Culture (HSOPSC) developed by the United States Agency for Healthcare Research and Quality in 2004 and revised in 2019, when version 2.0 was released. Adaptation was conducted on a universalist approach and the adapted instrument was then applied to a sample of 2,702 respondents (56% response rate) comprising staff of a large general hospital in the city of São Paulo. Construct validity was investigated by Exploratory Structural Equation Modelling-within-Confirmatory Factor Analysis (ESEM-within-CFA) and reliability was measured in each dimension by means of Cronbach alpha coefficients.
RESULTS: ESEM fit indexes showed good data fit with the proposed model: χ2 = 634.425 df = 221 χ2/df ratio = 2.9 p-value < 0.0000; RMSEA = 0.045 (90% C.I. = 0.041-0.050) and probability RMSEA < = .05 = 0.963; CFI = 0.986; TLI = 0.968. However, ten items had loads lower than 0.4. Cronbach alpha values were 0.6 or more for all dimensions, except Handoffs and information exchange ([Formula: see text]= 0.50) and Staffing and work pace ([Formula: see text] = 0.41).
CONCLUSIONS: The psychometric properties of the Brazilian version were found to be satisfactory, demonstrating good internal consistency and construct validity as expressed by estimates of reliability and indexes of model fit. However, given factor loadings smaller than 0.4 observed in ten items and considering that the scale translated and adapted to Portuguese was tested on a single sample during the Covid-19 pandemic, the authors recognize the need for it to be tested on other samples in Brazil to investigate its validity.
摘要：
背景：患者安全文化涉及价值观，一个组织的卫生工作人员和其他影响其护理提供行动和行为的人员所共有的信念和标准。一些国家已将加强患者安全文化作为优先事项，以提高医疗保健的质量和安全性。在这个方向上,通过经过验证的仪器测量患者安全文化是一种全球应用的策略。这项研究的目的是适应跨文化并验证HSOPSC2.0对巴西葡萄牙语和巴西医院环境的影响。
方法：在各种经过验证的安全文化测量量表中，国际上使用最多的仪器是美国医疗保健研究和质量机构于2004年开发的医院患者安全文化调查(HSOPSC),并于2019年发布2.0版.采用普遍主义方法进行了适应，然后将适应后的工具应用于2,702名受访者（回复率为56％）的样本，其中包括圣保罗市一家大型综合医院的工作人员。通过探索性结构方程模型验证性因子分析（ESEM-in-CFA）研究了结构效度，并通过Cronbachα系数在每个维度上测量了可靠性。
结果：ESEM拟合指数显示出与建议模型的良好数据拟合：χ2=634.425df=221χ2/df比率=2.9p值<0.0000；RMSEA=0.045（90％C.I.=0.041-0.050）和概率RMSEA<=.05=0.963；CFI=0.986；TLI=0.968。然而,十个项目的负荷低于0.4。所有尺寸的Cronbachα值均为0.6或更高，除了交接和信息交换（[公式：见文本]=0.50）和人员配置和工作节奏（[公式：见文本]=0.41）。
结论：发现巴西版本的心理测量特性令人满意，表现出良好的内部一致性和结构效度，如可靠性估计和模型拟合指数所表示的。然而,考虑到在10个项目中观察到的因子负荷小于0.4，并且考虑到在Covid-19大流行期间对单个样本进行了翻译和调整的量表，作者认识到有必要在巴西的其他样本上进行测试，以调查其有效性。
方法：在各种经过验证的安全文化测量量表中，国际上使用最多的仪器是美国医疗保健研究和质量机构于2004年开发的医院患者安全文化调查(HSOPSC),并于2019年发布2.0版.采用普遍主义方法进行了适应，然后将适应后的工具应用于2,702名受访者（回复率为56％）的样本，其中包括圣保罗市一家大型综合医院的工作人员。通过探索性结构方程模型验证性因子分析（ESEM-in-CFA）研究了结构效度，并通过Cronbachα系数在每个维度上测量了可靠性。
结果：ESEM拟合指数显示出与建议模型的良好数据拟合：χ2=634.425df=221χ2/df比率=2.9p值<0.0000；RMSEA=0.045（90％C.I.=0.041-0.050）和概率RMSEA<=.05=0.963；CFI=0.986；TLI=0.968。然而,十个项目的负荷低于0.4。所有尺寸的Cronbachα值均为0.6或更高，除了交接和信息交换（[公式：见文本]=0.50）和人员配置和工作节奏（[公式：见文本]=0.41）。
结论：发现巴西版本的心理测量特性令人满意，表现出良好的内部一致性和结构效度，如可靠性估计和模型拟合指数所表示的。然而,考虑到在10个项目中观察到的因子负荷小于0.4，并且考虑到在Covid-19大流行期间对单个样本进行了翻译和调整的量表，作者认识到有必要在巴西的其他样本上进行测试，以调查其有效性。
