Abstract
BackgroundOur previous analyses using the Stress Recognition subscale of the Safety Attitudes Questionnaire (SAQ) resulted in significant effect estimates with equally opposing explanations. We suspected construct validity issues and investigated such using our own data and correlation matrices of previous published studies.MethodsThe correlation matrices for each of the SAQ subscales from two previous studies by Speroff and Taylor were replicated and compared. The SAS Proc Factor procedure and the PRIORS = SMC option were used to perform Common Factor Analysis.ResultsThe correlation matrices of both studies were very similar. Teamwork, Safety Climate, Job Satisfaction, Perceptions of Management and Working Conditions were well-correlated. The correlations ranged from 0.53 to 0.76. For Stress Recognition correlations ranged from -0.15 to 0.03. Common Factor Analysis confirmed the isolation of Stress Recognition. CFA returned a strong one-factor model that explained virtually all of the communal variance. Stress Recognition loaded poorly on this factor in both instances, and the CFA indicated that 96.4-100.0% of the variance associated with Stress Recognition was unique to that subscale, and not shared with the other 5 subscales.ConclusionsWe conclude that the Stress Recognition subscale does not fit into the overall safety climate construct the SAQ intended to reflect. We recommend that this domain be omitted from overall safety climate scale score calculations, and clearly identified as an important yet distinct organizational construct. We suggest that this subscale be investigated for its true meaning, characterized as such, and findings conveyed to SAQ end users. We make no argument against Stress Recognition as an important organizational metric, rather we suggest that as a stand-alone construct its current packaging within the SAQ may be misleading for those intent on intervention development and evaluation in healthcare settings if they interpret Stress Recognition results as emblematic of safety climate.
Highlights
Our previous analyses using the Stress Recognition subscale of the Safety Attitudes Questionnaire (SAQ) resulted in significant effect estimates with opposing explanations
From a face validity perspective, the Stress Recognition items elicit an individual perspective about abilities (“I am more likely to make errors in tense or hostile situations” [emphasis added]) while the items on the other SAQ subscales elicit perspectives about their work area or broader organizational unit. (“The culture in this clinical area makes it easy to learn from the errors of others” [emphasis added])
We focused on the psychometric validation of the SAQ to determine whether Stress Recognition is related to the Perceptions of mgmt. 61.38 23.99 902 0.59 0.62 0.63 0.63 1 0.03
Summary
Our previous analyses using the Stress Recognition subscale of the Safety Attitudes Questionnaire (SAQ) resulted in significant effect estimates with opposing explanations. We suspected construct validity issues and investigated such using our own data and correlation matrices of previous published studies. Our previous work with the SAQ raised validity concerns regarding its Stress Recognition subscale [1,2]. The Safety Attitudes Questionnaire (SAQ) is one of the most highly validated hospital climate assessment instruments in use today [3]. Subscales within the SAQ include Teamwork, Safety Climate, Job Satisfaction, Perceptions of Management, Working Conditions, and Stress Recognition. The SAQ has been well-described [16,17,18]
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