BACKGROUND:Patient safety (PS) is one of the essential elements of health care quality and a priority of healthcare systems in most countries. Thus the creation of validated instruments and the implementation of systems that measure patient safety are considered to be of great importance worldwide.AIM:The present paper aims to illustrate the process of linguistic validation, cross-cultural verification and adaptation of the Bulgarian version of the Hospital Survey on Patient Safety Culture (B-HSOPSC) and its test-retest reliability.METHODS:The study design is cross-sectional. The HSOPSC questionnaire consists of 42 questions, grouped in 12 different subscales that measure patient safety culture. Internal con­sistency was assessed using Cronbach’s alpha. The Wilcoxon signed-rank test and the split-half method were used; the Spear­man-Brown coefficient was calculated.RESULTS:The overall Cronbach’s alpha for B-HSOPSC is 0.918. Subscales 7 Staffing and 12 Overall perceptions of safety had the lowest coefficients. The high reliability of the instrument was confirmed by the Split-half method (0.97) and ICC-coefficient (0.95). The lowest values of Spearmen-Broun coefficients were found in items A13 and A14.CONCLUSION:The study offers an analysis of the results of the linguistic validation of the B-HSOPSC and its test-retest reliability. The psychometric characteristics of the questions revealed good validity and reliability, except two questions. In the future, the instrument will be administered to the target population in the main study so that the psychometric properties of the instrument can be verified.

AimTo validate the Bulgarian EUROPEP-questionnaire and its implementation to measure patient evaluation of general practice care in Bulgarian population.MethodsA multicenter cross-sectional study was conducted at twenty five primary care practices from South-Central Region of Bulgaria. A total of 1000 adult patients aged over 18 years and visiting the practice for more than a year were approached consecutively to take part in the study. The internal consistency and test-retest reliability of the EUROPEP questionnaire were evaluated. To confirm the construct validity of the questionniare, еxplanatory factor analysis was performed.ResultsCronbach’alpha for “clinical behaviour” is 0.95 and for “organisation of care” 0.81. Factor analysis identifed two factors, which accounted for 77.0% of the total variation in these items. On average, 58.7% of respondents rated the level of care received as excellent. The waiting time in the waiting room was the item most poorly rated (33.8%). The item “keeping patients' records and data confidential” was the most highly rated (88.8%). Patients were less satisfied with “providing quick services for urgent health problems” (78.5% excellent or good) and “getting an appropriate for them appointment” (76.2% excellent or good).ConclusionTwo scales with satisfactory psychometric properties were established in the Bulgarian version of the EUROPEP-questionnaire. The study identified areas requiring improvement in general practice, such as reduction in waiting times and obtaining patient’s convenience appointment.

Introduction A patient safety culture (PSC) is a complex phenomenon, representing an essential part of the organizational culture and refers to the shared values, conceptions and beliefs which contribute to the formation and encouragement of safe behavioural models in a health organization. With this study, the authors wanted to delineate the attitude of hospital staff in Bulgaria regarding PSC and to document to whether attitudes differ between physicians and other healthcare professionals (HCPs). Methods A national cross-sectional survey among 384 HCPs was conducted using an online version of the Bulgarian version of Hospital Survey on Patient Safety Culture (B-HSOPSC). The data was analysed with descriptive statistics, non-parametric Mann-Whitney U and x 2 tests. Results The physicians represented 37.50% (144) of the sample and other HCPs 62.50% (240). Respondents from governmental/municipal hospitals prevailed (53.6%). The dimensions “Staffing” and “Non-punitive response to error” were most problematic, as their percentage of positive response rates (PRRs) were lowest. However, “Handoffs and transitions” and “Supervisor/manager expectations and actions promoting safety“ showed the highest mean values in both physicians and other HCPs. From all participants, 76.0% have never reported an adverse event or error. Conclusion The results of the study show that all respondents demonstrate a positive attitude regarding PSC. A comparison of the mean values and that of PRRs in the dimensions did not show any group differences, according to the type of staff position, i.e. physicians or other HCPs.

Health care professionals appear able to report UEs, MEs, and NMs occurring in medical care practice. They seem more willing to report and distinguish incidents related to MEs than to UEs and NMs.

Background and aimsAssessment of Health-related Quality of Life in chronic hemodialysis patients (CHD) is a predictive indicator of the outcome of the disease, including mortality and hospitalization. Regular surveys of the quality of life (QoL) in CHD patients have been conducted worldwide, using various, internationally validated and standardized tools, including the Missoula-VITAS Quality of Life Index scale (MVQOLI). The aim of this study was to examine the reliability and validity of the Bulgarian version of the Missoula-VITAS Quality of Life Index-15 (B-MVQOLI-15) and QoL in CHD patients using this instrument.MethodsOur study was designed as multi-center cross-sectional. It incorporated 263 end-stage renal disease (ESRD) patients on CHD from across the country and applied the B-MVQOLI-15. Internal consistency and convergent validity of the index were assessed. Non-parametric methods were used to evaluate the impact of demographic factors on the different dimensions scores and on the total score. The relationship between the total QoL score, the total MVQOLI-15 score and dimensions scores were measured based on Spearman’s rho Correlation Coefficient.ResultsThe total MVQOLI-15 score in the study was 16.44, which is slightly above the middle of the index scale. The patients with higher education were less satisfied with the level of their symptom control compared to patients with lower education. However, high education patients seem to manage better with everyday life compared to those with low education. Men seem to feel more satisfied than women when fulfilling their daily activities (P=0.026). Retired patients and unemployed expressed more satisfaction, compared to the employed (P=0.021). Also, patients on dialysis for over 5 years had lower QoL scores (P=0.043).ConclusionsB-MVQOLI-15 is a reliable instrument to measure QoL in Bulgarian patients with CHD. The majority of CHD patients rate their QoL as “Fair”. Four of all five dimensions positively affect the QoL of CHD patients. The most important dimensions positively affecting the QoL of CHD patients were: interpersonal relationships and transcendent factors. Future studies are necessary to assess the adequacy of the delivered dialysis, the level of medico-social care and the needs of ESRD patients treated with CHD in order to improve their QoL.