UNASSIGNED: This study aimed to translate the revised Hospital Survey on Patient Safety Culture (HSOPSC 2.0) to Mandarin, evaluate its psychometric properties, and apply it to a group of private hospitals in China to identify the determinants associated with patient safety culture.
UNASSIGNED: A two-phase study was conducted to translate and evaluate the HSOPSC 2.0. A cross-cultural adaptation of the HSOPSC 2.0 was performed in Mandarin and applied in a cross-sectional study in China. This study was conducted among 3,062 respondents from nine private hospitals and 11 clinics across six cities in China. The HSOPSC 2.0 was used to assess patient safety culture. Primary outcomes were measured by the overall patient safety grade and patient safety events reported.
UNASSIGNED: Confirmatory factor analysis results and internal consistency reliability were acceptable for the translated HOSPSC 2.0. The dimension with the highest positive response was \"Organizational learning - Continuous improvement\" (89%), and the lowest was \"Reporting patient safety event\" (51%). Nurses and long working time in the hospital were associated with lower assessments of overall patient safety grades. Respondents who had direct contact with patients, had long working times in the hospital, and had long working hours per week reported more patient safety events. A higher level of patient safety culture implies an increased probability of a high overall patient safety grade and the number of patient safety events reported.
UNASSIGNED: The Chinese version of HSOPSC 2.0 is a reliable instrument for measuring patient safety culture in private hospitals in China. Organizational culture is the foundation of patient safety and can promote the development of a positive safety culture in private hospitals in China.

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.