[Cross-cultural adaptation into Spanish of the Nursing Home Survey on Patient Safety Culture questionnaire]

Assessing Resident Safety Culture in Six Nursing Homes in Belgium

OBJECTIVES

The primary aim was to measure resident safety culture in six nursing homes in northern Belgium (Flanders). In addition, differences in safety culture perceptions between professions were also examined. Finally, results of the present study were compared with the Nursing Home Comparative Database from the Agency for Healthcare Research and Quality (USA).

METHODS

A cross-sectional study was conducted by administering the Nursing Home Survey on Patient Safety Culture in six nursing homes in Belgium (Flanders). Each nursing home has 92 to 170 licensed nursing home beds. Data collection occurred between December 2016 and January 2017.

RESULTS

Highest mean scores were found for "feedback and communication about incidents" (mean [SD] = 4.20 [0.58]), "overall perceptions of resident safety" (mean [SD] = 4.07 [0.52]), and "supervisor expectations and actions promoting resident safety" (mean [SD] = 4.04 [0.70]). The lowest mean score was found for "staffing" (mean [SD] = 2.99 [0.61]). In addition, managers/supervisors scored significantly higher on all resident safety dimensions, with the exception of the dimensions "teamwork" and "supervisor expectations and actions promoting resident safety." Finally, the present study scored higher on the dimensions "teamwork," "nonpunitive response to mistakes," "handoffs," "feedback and communication about incidents," and "communication openness" than the benchmarking data from the Nursing Home Comparative Database.

CONCLUSIONS

More work is necessary to improve the safety of resident care in nursing homes, especially regarding staffing issues and turnover rates. The present research findings serve to shine a light on an often-overlooked patient population and emphasize the need to develop improvement strategies for preventing resident safety incidents in nursing homes.

Transcultural adaptation and psychometric evaluation of the mainland China version of Nursing Home Survey on Patient Safety Culture Questionnaire: a cross-sectional survey based on 50 nursing homes in China

OBJECTIVE

To provide a validated Chinese-language measurement of the Nursing Home Survey on Patient Safety Culture (NHSOPS) in mainland China. The primary goal is to carry out a transcultural adaptation of the NHSOPS Questionnaire into Chinese and evaluate its psychometric properties.

DESIGN

A psychometric evaluation study is constructed. First, the 'translation-back-translation-cultural adaptation' and the pretesting procedure were followed to introduce the NHSOPS. Second, a cross-sectional survey was used to assess the psychometric properties for the mainland China version of the NHSOPS (M-NHSOPS), and a test-retest survey was then applied.

SETTING AND PARTICIPANTS

The survey was carried out among 1397 nursing home staff from 50 nursing homes in Southwest China.

OUTCOME MEASURES

Exploratory factor analysis (EFA) was used to assess the potential structure, and confirmatory factor analysis (CFA) was then applied. Reliability was assessed by the content validity index, Cronbach's α and the test-retest value.

RESULTS

Among the 1397 respondents, 1211 were included (86.7%). EFA was used, and a nine-factor structure was explored. Five factors (Cronbach's α ＞0.6) were selected into the new structure for the M-NHSOPS. Moreover, data showed that it was suitable for CFA, and convergent validity and discriminant validity were satisfactory. On the other hand, M-NHSOPS contains five dimensions and 22 items. The overall Cronbach's α value was 0.883; the values of each dimension ranged from 0.648 to 0.913. Additionally, content validity showed significant performance. Eventually, test-retest reliability was 0.892, and each dimension was 0.713, 0.809, 0.924, 0.795 and 0.859, respectively (p<0.001).

CONCLUSIONS

M-NHSOPS has acceptable reliability and satisfactory validity among staff of nursing homes in Southwest China, and further verification among samples in other regions of mainland China is required.

Transcultural adaptation and psychometric study of the French version of the nursing home survey on patient safety culture questionnaire

BACKGROUND

The Nursing Home Survey on Patient Safety Culture (NHSOPS) questionnaire was developed by the Agency for Healthcare Research and Quality (AHRQ), particularly as an intervention to raise staff awareness about patient safety issues. The main objective of the present study was to provide a validated French-language measure of the safety culture (SC) in nursing homes. Thus the aim was i) to carry out a transcultural adaptation into French of the NHSOPS questionnaire, ii) to assess its psychometric properties in a sample of professionals working in French EHPAD facilities and iii) to develop our own tool.

METHODS

The study was carried out on volunteering professionals from 61 nursing homes (from January to March 2016). Two phases were conducted: an initial phase involving the translation and cultural adaptation of the questionnaire, and a second phase in which the psychometric properties of the questionnaire were assessed. A Structural Equation Model (SEM) with a maximum likelihood estimation method was used to evaluate the construct validity of the questionnaire. As the fit of the structure was not sufficient, an exploratory factor analysis using a principal axis factoring with an oblique rotation was then performed. Internal consistency was evaluated and we examined test-retest reliability using Intra-class Correlation Coefficients (ICC).

RESULTS

During the initial phase, all items were retained and minor adjustments were made. The participation rate by professionals was 58.4%. The exploratory analysis led to the identification of seven dimensions: Teamwork, Staffing, Compliance with procedures, Handoffs, Feedback and communication about incidents, Supervisor expectations and actions promoting resident safety, Overall perceptions of resident safety and Organizational learning. The SEM confirmed the existence of the seven latent dimensions (CFI = 0.946; TLI = 0.933; SRMR = 0.059; RMSEA = 0.061); internal consistency was acceptable. ICC per item ranged from 0.19 to 0.88.

CONCLUSIONS

The results from this study were robust on seven dimensions. This French version is the first on Patient SC to have been applied to the medical-social sector caring for dependent elderly people in France. The NHSOPS questionnaire provides the opportunity to broach this subject. A national evaluation campaign should provide the opportunity to confirm or improve this measure.

TRIAL REGISTRATION

NCT02908373 (September 21, 2016) «Retrospectively registered».

English-to-Spanish Translation of the Nijmegen Professionalism Scale

BACKGROUND AND PURPOSE

The aim of this investigation was to perform the cross-cultural and linguistic translation and adaptation of the Nijmegen Professionalism Scale for Spanish nursing. Originally designed by Tromp et al. (2010) for its use by general practitioners, the new Spanish version of this tool assesses professional commitment, allowing for the comparison, prevention, association, and longitudinal monitoring of commitment among nursing professionals.

METHODS

The linguistic translation from English to Spanish was performed using the translation-back-translation method; the process of cross-cultural adaptation to the Spanish nursing context was carried out following the recommendations given by a panel of experts comprised of 24 practicing nurses with different professional backgrounds. The data for the feasibility study were collected between December 2015 and January 2016.

RESULTS

The original English version of the instrument contains 106 items and was originally developed for assessing professional behavior of general practitioner trainees; the new version, with a significant reduction in the initial number of items, comprises 49 items and is now ready for pilot testing and validation in our context.

IMPLICATIONS FOR PRACTICE

The Nijmegen Professionalism Scale in its Spanish version will act not only as a tool for measuring professional commitment among Spanish nurses but also as a motivational resource and means for reflection which will, in turn, increase the quality of the care provided by these professionals.

Cross-cultural adaptation methods of instruments in the nursing area

OBJECTIVE

To analyze scientific publications in order to identify the cross-cultural adaptation methods of instruments that are mainly applied in nursing.

METHOD

Integrative review, in the electronic sources Medline - Pubmed, Cinahl, Lilacs, Scopus and Web of Science. 96 peer-reviewed papers, published between 2010 and 2015 were selected.

RESULTS

The articles that composed the sample were published in 59 different journals, 15.2% were Brazilian. The largest number of publications was concentrated in 2015 (31.2%), 28 countries appeared on the list which is led by Brazil (33.3%), followed by China (10.4%). It was used 26 different guidelines, however the one proposed by Beaton and their collaborators was mentioned in 47 (49.0%) articles and the Brislin's in 12 (12.5%).

CONCLUSION

This review does not allow us to define the most appropriate method, however all methods applied agreed on the use of back translation. In addition, many studies in different languages and countries showed the international acceptability of the method developed by Beaton et al.