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Adaption and validation of the Safety Attitudes Questionnaire for the Danish hospital setting

Authors Kristensen S, Sabroe S, Bartels P, Mainz J, Bang Christensen K

Received 8 October 2014

Accepted for publication 24 November 2014

Published 2 February 2015 Volume 2015:7 Pages 149—160

DOI https://doi.org/10.2147/CLEP.S75560

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 5

Editor who approved publication: Professor Henrik Toft Sørensen


Solvejg Kristensen,1–3 Svend Sabroe,4 Paul Bartels,1,5 Jan Mainz,3,5 Karl Bang Christensen6

1The Danish Clinical Registries, Aarhus, Denmark; 2Department of Health Science and Technology, Aalborg University, Aalborg, Denmark; 3Aalborg University Hospital, Psychiatry, Aalborg, Denmark; 4Department of Public Health, Aarhus University, Aarhus, Denmark; 5Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; 6Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark


Purpose: Measuring and developing a safe culture in health care is a focus point in creating highly reliable organizations being successful in avoiding patient safety incidents where these could normally be expected. Questionnaires can be used to capture a snapshot of an employee's perceptions of patient safety culture. A commonly used instrument to measure safety climate is the Safety Attitudes Questionnaire (SAQ). The purpose of this study was to adapt the SAQ for use in Danish hospitals, assess its construct validity and reliability, and present benchmark data.
Materials and methods: The SAQ was translated and adapted for the Danish setting (SAQ-DK). The SAQ-DK was distributed to 1,263 staff members from 31 in- and outpatient units (clinical areas) across five somatic and one psychiatric hospitals through meeting administration, hand delivery, and mailing. Construct validity and reliability were tested in a cross-sectional study. Goodness-of-fit indices from confirmatory factor analysis were reported along with inter-item correlations, Cronbach's alpha (α), and item and subscale scores.
Results: Participation was 73.2% (N=925) of invited health care workers. Goodness-of-fit indices from the confirmatory factor analysis showed: c2=1496.76, P<0.001, CFI 0.901, RMSEA (90%CI) 0.053 (0.050-0056), Probability RMSEA (p close)=0.057. Inter-scale correlations between the factors showed moderate-to-high correlations. The scale stress recognition had significant negative correlations with each of the other scales. Questionnaire reliability was high, (α=0.89), and scale reliability ranged from α=0.70 to α=0.86 for the six scales. Proportions of participants with a positive attitude to each of the six SAQ scales did not differ between the somatic and psychiatric health care staff. Substantial variability at the unit level in all six scale mean scores was found within the somatic and the psychiatric samples.
Conclusion: SAQ-DK showed good construct validity and internal consistency reliability. SAQ-DK is potentially a useful tool for evaluating perceptions of patient safety culture in Danish hospitals.

Keywords: patient safety culture, questionnaire, validity, reliability, Denmark

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