Reliability and validity of the Brazilian version of the HSOPSC: a reassessment study

Abstract

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...

Psychometric Evaluation of the Korean Version of Hospital Survey on Patient Safety Culture

“…32 Previous research also showed strong relationships between these 2 dimensions. 4,20,30,37 Communication openness and feedback and communication about error showed the second strongest relationship because both dimensions deal with communication, 32 and these dimensions were found to be correlated in previous research. 4,28,30 Similar to other research, 4,30,37 all HSOPSC factors were positively correlated with patient safety grade, the single-item outcome measure, which supports the convergent validity of the scale.…”

Cross-cultural adaptation and validation of the Hospital Survey on Patient Safety Culture 2.0 – Brazilian version

“…Public and private hospitals in Brazil display different degrees of development and maturity as regards care quality and patient safety. Accordingly, similarly to previous studies of transcultural adaptation of the HSOPSC version 1.0 to the Brazilian context [ 11 , 29 , 30 ], all the items contained in the original version of the instrument were retained in the final version produced in the study reported here, as in the Indonesian study [ 21 ]. This study thus differed from the Korean study [ 10 ], which excluded the item A5R “This unit relies too much on temporary, float, or PRN staff”.…”

“…The 56% response rate obtained in this study was higher than those of Brazilian studies of transcultural adaptation of the HSOPSC version 1.0. A study at two large hospitals in southeast Brazil obtained a response rate of 38.5% [ 11 ]; another, at a large hospital in a major metropolis in Brazil had a response rate of 18.7% [ 30 ]. It is essential to achieve a high response rate to assure robust psychometric analyses and, in parallel, to understand the capillarity of safety culture in the context where the instrument is applied.…”

“…For several reasons, we chose not to go this way. The theoretical basis underlying the AHRQ SOPS survey is recognised as applicable to the reality of Brazilian health services [ 29 , 30 ]. Brazil's National Patient Safety Programme highlights the importance of building a strengthened patient safety culture and encourages its measurement to monitor advances and weaknesses in this area.…”

Patient safety culture in a COVID-19 ICU compared to a clinical-surgical ICU in the Brazilian Eastern Amazon: A cross-sectional study

“…To assess the knowledge of health team professionals about the definitions of adverse events and PS in care, the questionnaire "Hospital Survey on Patient Safety Culture" (HSOPSC) was applied, in the version adapted from the instrument that was translated and validated for the Brazilian context [17,20].…”