Background
Methods
Survey instrument
Translation and adaptation of the SAQ
Administration of the survey
Data management and analysis
Reliability analysis
Validity analysis
Benchmarking climate
Results
Reliability of the SAQ in Chinese
Dimension | Cronbach’s α | Split-half reliability Spearman-Brown coefficient |
---|---|---|
Teamwork climate | 0.785 | 0.773 |
Safety climate | 0.822 | 0.784 |
Job satisfaction | 0.899 | 0.912 |
Stress recognition | 0.881 | 0.844 |
Recognition of management | 0.879 | 0.868 |
Working condition | 0.785 | 0.738 |
Total Scale | 0.945 | 0.869 |
Validity of the SAQ in Chinese
Factor | Total scale | Teamwork climate | Safety climate | Job satisfaction | Stress recognition | Recognition of management | Working condition |
---|---|---|---|---|---|---|---|
Teamwork climate | 0.837 | 1.000 | … | … | … | … | … |
Safety climate | 0.874 | 0.777 | 1.000 | … | … | … | … |
Job satisfaction | 0.850 | 0.681 | 0.707 | 1.000 | … | … | … |
Stress recognition | 0.412 | 0.177 | 0.181 | 0.196 | 1.000 | … | … |
Recognition of management | 0.860 | 0.678 | 0.720 | 0.728 | 0.174 | 1.000 | … |
Working condition | 0.801 | 0.572 | 0.648 | 0.665 | 0.195 | 0.749 | 1.000 |
Dimension | Teamwork climate | Safety climate | Job satisfaction | Stress recognition | Recognition of management | Working condition |
---|---|---|---|---|---|---|
item | ||||||
TC 1 | 0.713 | 0.541 | 0.527 | 0.102 | 0.576 | 0.475 |
TC 2 | 0.535 | 0.334 | 0.243 | 0.176 | 0.229 | 0.188 |
TC 3 | 0.745 | 0.610 | 0.555 | 0.142 | 0.544 | 0.458 |
TC 4 | 0.719 | 0.563 | 0.455 | 0.116 | 0.484 | 0.430 |
TC 5 | 0.744 | 0.604 | 0.473 | 0.078 | 0.478 | 0.399 |
TC 6 | 0.753 | 0.640 | 0.636 | 0.113 | 0.559 | 0.474 |
SC 1 | 0.576 | 0.705 | 0.501 | 0.140 | 0.512 | 0.462 |
SC 2 | 0.644 | 0.751 | 0.542 | 0.141 | 0.546 | 0.476 |
SC 3 | 0.562 | 0.757 | 0.498 | 0.124 | 0.554 | 0.488 |
SC 4 | 0.599 | 0.742 | 0.605 | 0.107 | 0.599 | 0.539 |
SC 5 | 0.394 | 0.515 | 0.269 | 0.214 | 0.267 | 0.228 |
SC 6 | 0.488 | 0.698 | 0.482 | 0.058 | 0.498 | 0.475 |
SC 7 | 0.569 | 0.749 | 0.590 | 0.094 | 0.573 | 0.527 |
JS 1 | 0.443 | 0.466 | 0.743 | 0.184 | 0.507 | 0.487 |
JS 2 | 0.642 | 0.632 | 0.837 | 0.153 | 0.621 | 0.536 |
JS 3 | 0.604 | 0.631 | 0.881 | 0.133 | 0.648 | 0.577 |
JS 4 | 0.571 | 0.610 | 0.900 | 0.177 | 0.633 | 0.600 |
JS 5 | 0.619 | 0.646 | 0.859 | 0.182 | 0.665 | 0.604 |
SR 1 | 0.131 | 0.139 | 0.135 | 0.815 | 0.132 | 0.165 |
SR 2 | 0.115 | 0.111 | 0.154 | 0.890 | 0.132 | 0.152 |
SR 3 | 0.173 | 0.180 | 0.182 | 0.874 | 0.167 | 0.177 |
SR 4 | 0.186 | 0.190 | 0.203 | 0.855 | 0.165 | 0.174 |
RM 1 | 0.601 | 0.632 | 0.654 | 0.098 | 0.838 | 0.655 |
RM 2 | 0.448 | 0.473 | 0.430 | 0.138 | 0.712 | 0.455 |
RM 3 | 0.634 | 0.652 | 0.683 | 0.175 | 0.877 | 0.685 |
RM 4 | 0.526 | 0.571 | 0.584 | 0.144 | 0.837 | 0.606 |
RM 5 | 0.577 | 0.632 | 0.643 | 0.159 | 0.845 | 0.679 |
WC 1 | 0.362 | 0.421 | 0.475 | 0.166 | 0.509 | 0.776 |
WC 2 | 0.422 | 0.492 | 0.492 | 0.170 | 0.598 | 0.794 |
WC 3 | 0.500 | 0.553 | 0.574 | 0.122 | 0.630 | 0.800 |
WC 4 | 0.569 | 0.625 | 0.585 | 0.150 | 0.665 | 0.794 |
Statistical test | Actual fitting values | Adaptation of the criteria or the critical value | Result |
---|---|---|---|
Absolute fit indices | |||
χ2
| 1,410.544 (p = 0.000) |
p > 0.05 | unsatisfactory |
GFI | 0.948 | >0.90 | satisfactory |
AGFI | 0.936 | >0.90 | satisfactory |
RMR | 0.060 | <0.05 | unsatisfactory |
RMSEA | 0.039 | <0.05 | satisfactory |
NCP | 1,044.544 | The less the better | unsatisfactory |
ECVI | 0.957,0.597,18.410 | Default model less than Independence model and Saturated model | unsatisfactory |
Relative fit indices | |||
NFI | 0.954 | >0.90 | satisfactory |
RFI | 0.947 | >0.90 | satisfactory |
IFI | 0.967 | >0.90 | satisfactory |
TLI(NNFI) | 0.962 | >0.90 | satisfactory |
CFl | 0.963 | >0.90 | satisfactory |
Parsimonious fit indices | |||
PGFI | 0.776 | >0.05 | satisfactory |
PNFI | 0.833 | >0.05 | satisfactory |
CN | 535 | >200 | satisfactory |
NC | 3.474 | <3 | unsatisfactory |
AIC | 1,590.544; 992.000; 30,597.421 | Default model less than Independence model and Saturated model | unsatisfactory |
CAIC | 2,168.018; 4,174.524; 30,796.329 | Default model less than Independence model and Saturated model | satisfactory |
Demographic information
Characteristics | Valid frequency | Percent(%) |
---|---|---|
Hospital level | ||
Secondary-level hospitals | 652 | 39.21 |
Tertiary-level hospitals | 1011 | 60.79 |
Department category | ||
Obstetrics and gynecology department | 112 | 7.33 |
Intensive care units | 114 | 7.47 |
Operating rooms | 119 | 7.79 |
The wards of internal medicine | 406 | 26.59 |
General surgery | 340 | 22.27 |
Emergency rooms | 105 | 6.88 |
Outpatient department | 100 | 6.55 |
Medico-technical departments | 231 | 15.13 |
Gender | ||
Male | 338 | 20.62 |
Female | 1301 | 79.38 |
Age groups(years) | ||
≤ 20 | 14 | 0.85 |
21 ~ 30 | 743 | 45.06 |
31 ~ 40 | 518 | 31.41 |
41 ~ 50 | 294 | 17.83 |
≥ 51 | 80 | 4.85 |
Education degree | ||
Senior high schools and middle special schools | 81 | 4.90 |
College degree | 626 | 37.85 |
Bachelor degree | 696 | 42.08 |
Master degree | 220 | 13.30 |
Doctor degree | 31 | 1.87 |
Job discipline | ||
Physicians | 506 | 30.69 |
Nurses | 908 | 55.06 |
Pharmacists | 103 | 6.25 |
Technicians | 114 | 6.91 |
Others | 18 | 1.09 |
Technical titles | ||
None | 178 | 10.77 |
Primary title | 791 | 47.88 |
Middle title | 541 | 32.75 |
Associated advanced title | 103 | 6.23 |
Advanced title | 39 | 2.36 |
Administrative post | ||
Director of the department | 44 | 2.68 |
Nursing manager | 58 | 3.53 |
Normal staff | 1511 | 92.02 |
Others | 29 | 1.77 |
Years working in the current department | ||
< 6 months | 182 | 11.06 |
6 ~ 11 months | 68 | 4.13 |
1 ~ 2 years | 228 | 13.86 |
3 ~ 7 years | 510 | 31.00 |
8 ~ 12 years | 284 | 17.26 |
13 ~ 20 years | 215 | 13.07 |
≥ 21 years | 158 | 9.60 |
Have participated in the survey before | ||
Yes | 447 | 27.01 |
No | 1208 | 72.99 |
Benchmarking climate
Dimension | Mean (SD) | Positive response rate (%) |
---|---|---|
Teamwork climate | 74.87 (18.23) | 59.31b
|
Safety climate | 73.82 (17.51) | 54.09b
|
Job satisfaction | 72.43 (22.50) | 54.63b
|
Stress recognition | 44.53 (28.70) | 20.80b
|
Recognition of management | 69.64 (19.68) | 45.97b
|
Working condition | 68.59 (20.09) | 46.69b
|
Total scale | 69.72 (15.47) | 38.57b
|
Item | Mean (SD) | Positive response rate (%) |
---|---|---|
Items belong to six dimensions | ||
Teamwork climate | ||
1. Nurse input is well received in this clinical area. | 68.99(27.12) | 65.70 |
2. In this clinical area, it is difficult to speak up if I perceive a problem with patient care. (R) | 67.68(29.78) | 63.89 |
3. Disagreements in this clinical area are resolved appropriately (i.e., not who is right, but what is best for the patient). | 75.21(25.43) | 74.50 |
4. I have the support I need from other personnel to care for patients. | 74.49(26.79) | 75.77 |
5. It is easy for personnel here to ask questions when there is something that they do not understand. | 81.20(23.45) | 83.29a
|
6. The physicians and nurses here work together as a well-coordinated team. | 81.15(24.07) | 82.91a
|
Safety climate | ||
7. I would feel safe being treated here as a patient. | 80.24(22.87) | 82.30a
|
8. Medical errors are handled appropriately in this clinical area. | 81.32(21.86) | 84.42a
|
9. I know the proper channels to direct questions regarding patient safety in this clinical area. | 73.60(25.76) | 70.51 |
10. I receive appropriate feedback about my performance. | 66.48(28.23) | 62.89 |
11. In this clinical area, it is difficult to discuss errors. (R) | 68.69(28.15) | 66.21 |
12. I am encouraged by my colleagues to report any patient safety concerns I may have. | 69.45(25.35) | 64.42 |
13. The culture in this clinical area makes it easy to learn from the errors of others. | 76.66(22.95) | 77.74 |
Job satisfaction | ||
15. I like my job. | 68.13(26.97) | 61.02 |
16. Working here is like being part of a large family. | 77.41(24.57) | 78.82 |
17. This is a good place to work. | 72.80(27.74) | 71.06 |
18. I am proud to work in this clinical area. | 71.97(26.79) | 66.51 |
19. Morale in this clinical area is high. | 71.88(27.11) | 67.49 |
Stress recognition | ||
20. When my workload becomes excessive, my performance is impaired. (R) | 44.49(33.45) | 32.97b
|
21. I am less effective at work when fatigued. (R) | 41.97(32.74) | 30.24b
|
22. I am more likely to make errors in tense or hostile situations. (R) | 45.64(33.54) | 35.93b
|
23. Fatigue impairs my performance during emergency situations (e.g. emergency resuscitation, seizure). (R) | 46.00(33.86) | 35.66b
|
Recognition of management | ||
24. Management supports my daily efforts. | 69.16(23.79) | 57.27b
|
25. Management doesn’t knowingly compromise patient safety. | 76.43(24.6) | 72.40 |
26. Management is doing a good job. | 69.34(23.52) | 57.09b
|
27. Problem personnel are dealt with constructively by our management. | 66.63(23.83) | 54.55b
|
28. I get adequate, timely information about events that might affect my work from Management. | 65.96(23.94) | 51.36b
|
Working condition | ||
29. The levels of staffing in this clinical area are sufficient to handle the number of patients. | 56.94(32.27) | 48.40b
|
30. This hospital does a good job of training new personnel. | 72.41(24.77) | 70.52 |
31. All the necessary information for diagnostic and therapeutic decisions is routinely available to me. | 70.62(23.15) | 69.13 |
32. Trainees in my discipline are adequately supervised. | 74.40(21.55) | 76.07 |
Items not belong to six dimensions | ||
14. My suggestions about safety would be acted upon if I expressed them to management. | 61.81(28.48) | 53.13b
|
33. I experience good collaboration with nurses in this clinical area. | 82.33(19.74) | 87.05a
|
34. I experience good collaboration with staff physicians in this clinical area. | 80.46(20.6) | 84.54a
|
35. I experience good collaboration with pharmacists in this clinical area. | 75.82(22.75) | 74.08 |
36. Communication breakdowns that lead to delays in delivery of care are common.(R) | 65.22(31.67) | 60.22 |