Psychometric validation of a tool that assesses safety culture in Primary Care

A quantitative cross-sectional study conducted with multidisciplinary team professionals working in Primary Health Care in a city in the Northwest region of Rio Grande do Sul State, Brazil. The tool used was “Pesquisa sobre Cultura de Segurança do Paciente para Atenção Primária à Saúde” (Survey on Patient Safety Culture in Primary Care).

Results:

Cronbach's alpha was considered satisfactory. Factorial analysis reached satisfactory loads in all its factors. The tool showed feasibility of application and potential structure assessment for which it is proposed.

Conclusion:

The Brazilian version of the questionnaire proved to be valid and reliable and could contribute to research on Patient Safety Culture in Primary Care in the country.

Keywords
Patient safety; Primary health care; Validation studies

Domains	Mean	Standard Deviation	Amplitude		Quartiles 1^st			αC
Domains	Mean	Standard Deviation	Minimum	Maximum	1^st	2^nd Median	3rd	αC
Patient Safety and Quality	4.12	0.77	1.00	5.00	3.89	4.28	4.60	0.848
Information Exchange with Other Institutions	4.11	0.75	1.40	5.00	3.80	4.20	4.80	0.853
Teamwork	4.31	0.48	2.00	5.00	4.00	4.25	4.75	0.603
Work Pressure and Pace	2.38	0.76	1.00	5.00	1.75	2.25	2.75	0.683
Staff Training	3.40	0.75	1.00	5.00	3.00	3.33	4.00	0.603
Office Process and Standardization	3.64	0.63	1.00	5.00	3.27	3.75	4.00	0.477
Communication Openness	4.07	0.66	1.75	5.00	3.50	4.00	4.54	0.676
Patient Care Tracking/Follow-up	4.32	0.58	3.00	5.00	4.00	4.50	4.75	0.660
Communication About Error	3.89	0.65	2.00	5.00	3.50	4.00	4.25	0.416
Owner/Managing partner/Leadership Support for Patient Safety	3.19	0.77	1.00	5.00	2.75	3.25	3.75	0.703
Organizational Learning	3.87	0.70	1.00	5.00	3.67	4.00	4.33	0.568
Overall Perceptions of Patient Safety and Quality	3.72	0.61	2.00	5.00	3.50	3.75	4.13	0.620
Overall Patient Safety Assessment	3.48	0.73	2.00	5.00	3.00	3.00	4.00	– – –
Overall Quality Assessment	3.45	0.66	2.00	5.00	3.00	3.40	4.00	0.829
Patient Safety Indicators (PSI)	3.64	0.84	1.00	5.00	3.77	4.25	4.75	0.941

Factorial component (latent variable)	Eigenvalues	% Explained variance
Factorial component (latent variable)	Eigenvalues	Per factor	Accumulated
1	5.232	9.386	9.386
2	4.289	7.695	17.081
3	2.963	5.316	22.397
4	2.880	5.167	27.563
5	2.577	4.624	32.188
6	2.509	4.502	36.690
7	2.386	4.281	40.971
8	2.159	3.874	44.845
9	2.001	3.589	48.434
10	1.800	3.230	51.664
11	1.782	3.197	54.861
12	1.687	3.120	57.981
13	1.427	2.912	60.893
14	1.235	2.551	63.444

ITEMS	F1	F2	F3	F4	F5	F6	F7	F8	F9	F10	F11	F12	F13	F14
A1	0.602
A2	0.518
A3	0.437
A4	0.350
A5	0.578
A6	0.463
A7	0.586
A8	0.476
A9	0.661
A10	0.575
B1							0.704
B2							0.744
B3							0.750
B4							0.630
B5
C1					0.752
C2					0.747
C5					0.555
C13					0.418
C3						0.555
C6						0.751
C11						0.781
C14						0.801
C4								0.431
C7								0.577
C10								0.366
C8				0.511
C9				0.630
C12				0.487
C15				0.655
D1			0.599
D2			0.603
D4			0.464					0.495
D10			0.369					0.333
D3										0.490
D5										0.489
D6										0.480
D9										0.452
D7												0.488
D8												0.419
D11												0.531
D12												0.369
E1									0.552
E2									0.735
E3									0.766
E4									0.591
F1													0.552
F5													0.553
F7													0.403
F2														0.674
F3														0.466
F4														0.594
F6														0.463
G1A		0.689
G1B		0.756
G1C		0.640
G1D		0.703
G1E		0.731
G2											0.686

Escola Paulista de Enfermagem, Universidade Federal de São Paulo R. Napoleão de Barros, 754, 04024-002 São Paulo - SP/Brasil, Tel./Fax: (55 11) 5576 4430 - São Paulo - SP - Brazil
E-mail: actapaulista@unifesp.br

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[1] Corresponding author Adriane Cristina Bernat Kolankiewicz E-mail: adri.saudecoletiva@gmail.com