This study aimed to reassess the psychometric properties of the Hospital Survey on Patient Safety Culture (HSOPSC) adapted to Portuguese for use in the Brazilian context. An observational, cross-sectional study was performed in a large, private, non-profit, acute care hospital, reference in patient safety, in a major Brazilian metropolis. Participants were selected from a non-probability sample of all eligible personnel in the various hospital departments invited to participate in the study. Reliability of the HSOPSC was assessed by estimating Cronbach's alpha for each dimension. confirmatory factor analysis (CFA), a matrix of correlations between the dimensions, and exploratory structural equation modelling (ESEM) were used in exploratory and confirmatory analyses of the structural validity of the construct. The overall response rate was 18.7% (n = 1,439). Four dimensions ("overall perceptions of patient safety"; "staffing"; "teamwork across units"; and "non-punitive response to error") returned problems of internal consistency. CFA returned acceptable fit with the original 12-dimension model. Correlations between the dimensions of the original 12-dimension model indicated discriminant validity problems, while residual variance was greater than 0.70 in 13 items. The ESEM of the original 12-dimension model returned good fit, with the following indices: CFI = 0.985; TLI = 0.968,). Although better than those of the first evaluation, the results obtained in this validity and reliability reassessment of the Brazilian version of the HSOPSC require further research. Patient Safety; Organizational Culture; Health Care Surveys; Reproducibility of Results Correspondence J. Laguardia
BackgroundSafety culture comprises values, beliefs, and standards regarding what is important in an organization and what safety-related attitudes and behavior are valued, supported, and expected 1 . It is a multidimensional concept, defined in the health service context as the product of individual and group values, attitudes, perceptions, competences, and behavior patterns that determine the commitment to, and the style and proficiency of, an organization's patient safety management 2 .In health care organizations, safety culture assessment is a key strategy in the world movement to improve health care quality and patient safety. There is evidence of the association between high safety culture scores and positive clinical outcomes, especially in hospitals, as a result of interventions to improve the quality of patient care 3,4,5 .Among the instruments developed to assess safety culture in hospitals, the Hospital Survey on Patient Safety Culture (HSOPSC) is one of the most widely used 1,6 . Developed in American English by the Agency for Healthcare Research and Quality (AHRQ), this instrument contains 42 items and 12 dimensions and was conceived as a questionnaire to be self-administered, to ensure respondents' anonymity. The theoretical model underpinning its development is fully documented by the AHRQ 1 . Since its introduction in 2004, the...