title: The hospital survey on patient safety culture in Portuguese hospitals: instrument validity and reliability.
abstract: OBJECTIVE
  Quantitative instruments to assess patient safety culture have been developed recently and a few review articles have been published. Measuring safety culture enables healthcare managers and staff to improve safety behaviours and outcomes for patients and staff. The study aims to determine the AHRQ Hospital Survey on Patient Safety Culture (HSPSC) Portuguese version's validity and reliability.
  
  
  METHODS
  A missing-value analysis and item analysis was performed to identify problematic items. Reliability analysis, inter-item correlations and inter-scale correlations were done to check internal consistency, composite scores. Inter-correlations were examined to assess construct validity. A confirmatory factor analysis was performed to investigate the observed data's fit to the dimensional structure proposed in the AHRQ HSPSC Portuguese version. To analyse differences between hospitals concerning composites scores, an ANOVA analysis and multiple comparisons were done.
  
  
  RESULTS
  Eight of 12 dimensions had Cronbach's alphas higher than 0.7. The instrument as a whole achieved a high Cronbach's alpha (0.91). Inter-correlations showed that there is no dimension with redundant items, however dimension 10 increased its internal consistency when one item is removed.
  
  
  CONCLUSIONS
  This study is the first to evaluate an American patient safety culture survey using Portuguese data. The survey has satisfactory reliability and construct validity.
authors.forename: Margarida
authors.initials: M
authors.lastname: Eiras
authors.forename: Ana
authors.initials: A
authors.lastname: Escoval
authors.forename: Isabel Monteiro
authors.initials: IM
authors.lastname: Grillo
authors.forename: Carina
authors.initials: C
authors.lastname: Silva-Fortes
mesh_terms: D003142:Communication; D003625:Data Collection; D006739:Hospital Administration / Q000379:methods*; D006801:Humans; D007857:Leadership; D015279:Organizational Culture; D061214:Patient Safety; D010564:Personnel, Hospital; D011174:Portugal; D058996:Quality Improvement / Q000458:organization & administration; D015203:Reproducibility of Results