title: Adaption and validation of the Safety Attitudes Questionnaire for the Danish hospital setting.
abstract: OBJECTIVE
  Measuring and developing a safe culture in health care is a focus point in creating highly reliable organizations being successful in avoiding patient safety incidents where these could normally be expected. Questionnaires can be used to capture a snapshot of an employee's perceptions of patient safety culture. A commonly used instrument to measure safety climate is the Safety Attitudes Questionnaire (SAQ). The purpose of this study was to adapt the SAQ for use in Danish hospitals, assess its construct validity and reliability, and present benchmark data.
  
  
  METHODS
  The SAQ was translated and adapted for the Danish setting (SAQ-DK). The SAQ-DK was distributed to 1,263 staff members from 31 in- and outpatient units (clinical areas) across five somatic and one psychiatric hospitals through meeting administration, hand delivery, and mailing. Construct validity and reliability were tested in a cross-sectional study. Goodness-of-fit indices from confirmatory factor analysis were reported along with inter-item correlations, Cronbach's alpha (α), and item and subscale scores.
  
  
  RESULTS
  Participation was 73.2% (N=925) of invited health care workers. Goodness-of-fit indices from the confirmatory factor analysis showed: c(2)=1496.76, P<0.001, CFI 0.901, RMSEA (90% CI) 0.053 (0.050-0056), Probability RMSEA (p close)=0.057. Inter-scale correlations between the factors showed moderate-to-high correlations. The scale stress recognition had significant negative correlations with each of the other scales. Questionnaire reliability was high, (α=0.89), and scale reliability ranged from α=0.70 to α=0.86 for the six scales. Proportions of participants with a positive attitude to each of the six SAQ scales did not differ between the somatic and psychiatric health care staff. Substantial variability at the unit level in all six scale mean scores was found within the somatic and the psychiatric samples.
  
  
  CONCLUSIONS
  SAQ-DK showed good construct validity and internal consistency reliability. SAQ-DK is potentially a useful tool for evaluating perceptions of patient safety culture in Danish hospitals.
authors: The Danish Clinical Registries, Aarhus, Denmark ; Department of Health Science and Technology, Aalborg University, Aalborg, Denmark ; Aalborg University Hospital, Psychiatry, Aalborg, Denmark.
authors: Solvejg
authors: S
authors: Kristensen
authors: Department of Public Health, Aarhus University, Aarhus, Denmark.
authors: Svend
authors: S
authors: Sabroe
authors: The Danish Clinical Registries, Aarhus, Denmark ; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
authors: Paul
authors: P
authors: Bartels
authors: Aalborg University Hospital, Psychiatry, Aalborg, Denmark ; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
authors: Jan
authors: J
authors: Mainz
authors: Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark.
authors: Karl Bang
authors: KB
authors: Christensen
keywords: Denmark; patient safety culture; questionnaire; reliability; validity