The Ambulatory Version of the Safety Attitude Questionnaire: Psychometric Validation and Measurement Properties in Nigerian Clinical Setting.

Abstract

Understanding the safety culture of health care providers can help administrators improve patient safety. However, it is difficult to measure complex constructs such as safety culture without valid and reliable tools. This study determined the measurement properties of the ambulatory version of the safety attitude questionnaire (SAQ-AV) in the Nigerian clinical setting. A multiphase, iterative research involving clinical staff in primary and tertiary level of care in South-south Nigeria. The phases included face and content validity by subject experts, pretesting with clinical staff and a field validation involving 812 clinical staff. The acceptability, reliability (internal consistency), and validity (face, content, and construct) of the SAQ-AV were determined. All quantitative analysis was conducted using the SPSS Version 22 statistical package with statistical significance set at a P value of less than 0.05. A response rate of 53.7% was obtained during the field validation study. The item nonresponse rates were less than 10%, whereas extremes of the response scale were frequently endorsed. The internal consistency of the scale was good (Cronbach's α of 0.91 for entire scale and ranged from 0.62 to 0.76 among the different domains of the tool). Patient safety culture scores from primary and tertiary health care facilities assessed were significantly different. The SAQ-AV is an acceptable, reliable, and valid tool for use in assessing patient safety culture in ambulatory settings in Nigeria. There is a need to determine its dimensionality and factor structure in future research.