The psychometric properties of the ‘safety attitudes questionnaire’ in out-of-hours primary care services in the Netherlands

<div><p>Background</p><p>The Safety Attitudes Questionnaire (SAQ) is one of the most widely used instruments to assess safety culture among healthcare providers. The ambulatory version of the SAQ (SAQ-AV) can be used in the primary care setting. Our study objective was to examine the underlying factors and psychometric properties of the Dutch translation of the SAQ-AV in out-of-hours primary care services.</p><p>Design</p><p>Cross-sectional observational study using a web-survey.</p><p>Setting</p><p>Sixteen out-of-hours general practitioner cooperatives and two call centers in the Netherlands.</p><p>Participants</p><p>Primary healthcare providers in out-of-hours services.</p><p>Main outcome measures</p><p>Item-descriptive statistics, factor loadings, Cronbach’s alpha scores, corrected item-total correlations, scale correlations.</p><p>Results</p><p>The questionnaire was answered by 853 (43.2%) healthcare professionals. In the factor analyses, 784 respondents were included; mainly general practitioners (N = 470) and triage nurses (N = 189). Items were included in the analyses based on question type and results from previous studies. Five factors were drawn with reliability scores between .49 and .86 and a good construct validity. The five factors covered 27 of the 62 questionnaire items, with three to five items per factor.</p><p>Conclusions</p><p>The Dutch translation of the SAQ-AV, with five factors, seems to be a reliable tool for measuring patient safety culture and guide quality improvement interventions in out-of-hours primary care services. The Dutch factor structure differed from the original SAQ-AV and other translated versions. In future studies, the questionnaire should be validated further by examining if there is a relationship between the responses on the SAQ-AV, patient experiences, and the occurrence of adverse events.</p></div

Characteristics of the respondents.

<p>Characteristics of the respondents.</p

Flowchart of the response to the SAQ-AV.

<p>Flowchart of the response to the SAQ-AV.</p

Features of general practitioner (GP) cooperatives in the Netherlands [21].

<p>Features of general practitioner (GP) cooperatives in the Netherlands [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0172390#pone.0172390.ref021" target="_blank">21</a>].</p

Most frequent presented ICPC domains.

<p>Most frequent presented ICPC domains.</p