患者安全文化测评问卷的构建

Patient Safety Culture Assessment Scale:Design and Establishment

目的编制符合我国护理特点的患者安全文化测评问卷，并检验其信效度，确保问卷科学、可靠。方法参考国内外文献形成问卷初稿，经过反复的专家咨询及探索性因素分析筛选和修订条目，编制出适用于医院护理人员的患者安全文化测评问卷。采用分层随机法抽取上海市三级、二级医院临床护士211名进行测评，使用SPSS 13．0医学统计软件，应用主成分分析法、内在一致性信度等评价问卷信效度。结果形成适用于医院护理人员的患者安全文化测评问卷，其主要内容是医院护理人员的安全态度调查，共分为5个维度、24个条目。5个维度分别是团队氛围、对工作的满意、对压力的认知、单位安全的氛围、对管理的感受，累计贡献率为59．879％，数据经方差最大正交旋转后，根据各条目最大维度负荷值归因，5个维度的负荷值都在0．4以上，各条目的共同性在0．432～0．697之间；问卷各维度的Cronbach’s a系数为0．7234-0．8523，总体为0．8861；各维度两次测量得分的Pearson相关系数为0．701～0．833，总体为0．895；各条目与问卷总体的相关系数在0．661～0．843，且相关性均有显著统计学意义（P〈0．01）；各维度得分与问卷总体的相关系数为0．381～0．854，且相关性均有显著统计学意义（P〈0．01）。结论初步编制了适用于医院护理人员的患者安全文化测评问卷，信效度良好。

Objective To design the structure of patient safety culture assessmentscale,and measure its the reliability and validity. Methods The primary scale was developed on the basis of literature review. After expert consulting, pilot testing and exploratory factor analyzing, the scale was finished. The reliability and validity of the scale were tested in 211 nurses from Grade Ⅲ and Grade Ⅱ hospitals of Shanghai,and statistic methods such as analysis of variance were adopted to analyze the data. Results Patient safety culture assessment scale on clinical nurse was developed, and the primary was safety attitudes questionnaire,which composed of 5 factors （teamwork climate,job satisfaction,stress recognition, safety climate, and perceptions of management） and 24 items. The cumulative interpret rate of them was 59. 879%. Loading for each factor ranged from 0. 432 to 0. 697,and for each item was greater than 0. 40. Cronbach＇ a coefficient of each dimension was 0. 723±0. 8523 ,and that of the overall scale was 0. 8861. The test retest Pearson correlation coefficient of the 5 dimensions and the overall scale was 0. 701-0. 833 and 0. 895 respectively. Internal relation between scales of each dimension and the overall scale was good, and the structure was excellent（ r =0. 381-0. 854, P 〈0. 01）. The correlation coefficient was 0. 661-0. 843 （ P 〈0. 01）. Conclusion The patient safety culture assessment scale was established and proved to have good reliability and validity.