Development and validation of an Italian version of the PMOS-30 questionnaire at hospital level

Background

An important challenge for health systems worldwide is to ensure that health professionals can carry out their mission to treat, rehabilitate and prevent diseases safely. The Patient Measure of Safety (PMOS) questionnaire is an instrument that allows the systematic collection of patients' feedback about their care to understand and assess the level of safety in hospital. The PMOS-30 questionnaire was recently developed as shorter version of the 44-item PMOS. The objectives of this study are to develop and validate an Italian version of the PMOS-30 questionnaire so that this instrument can be utilised in hospital routine for the continuous improvement of patient safety.

Methods

A cross-sectional study was carried out on patients in a hospital in Italy. A confirmatory factor analysis was conducted after the development of an Italian version of the PMOS-30 questionnaire. Maximum Likelihood (ML) estimation was used to perform CFA. The quality of the model fit was evaluated on the basis of the Comparative Fit Index (CFI), Tucker Lewis Index (TLI) and Root Mean Square Error of Approximation (RMSEA).

Results

A total of 435 patients filled in the Italian version of the PMOS-30 questionnaire. The CFI did not achieve the fit value (CFI= 0.802). But RMSEA suggests a reasonably good fit value (RMSEA=0.076). Internal consistency analysis showed that the Cronbach's alpha value was more than 0.6 in all domains except for the domain “organisation and care planning” that had a value of 0.525.

Conclusions

Patients feedback about their safety in hospital is an important source of information for the routine hospital life. Since patient safety is an intrinsic part of patient care, it deserves every possible new approach in the continuous improvement of care. The PMOS-30 questionnaire is a validated instrument for hospital settings and future research in other Italian hospitals may increase the routine use of this instrument to improve patient safety.

Key messages

The use of the Italian version of the PMOS-30 questionnaire can support the identification of vulnerable areas in the hospital through patient feedback and therefore improve patient safety. The PMOS-30 questionnaire offers the opportunity to enable Italian hospital managers to track changes in safety over time through repeated assessments in the wards and avoid future patient incidents.

Beta-alanine and the hormonal response to exercise

The effect of 30 days of beta-alanine supplementation (4.8 g per day) on resistance exercise performance and endocrine changes was examined in eight experienced resistance-trained men. An acute resistance exercise protocol consisting of 6 sets of 12 repetitions of the squat exercise at 70 % of one-repetition maximum (1-RM) with 1.5 minutes of rest between sets was performed before and after each supplemental period. Blood draws occurred at baseline (BL), immediate (IP), 15-minutes (15P) and 30-minutes (30P) postexercise for growth hormone, testosterone and cortisol concentrations. A 22 % (p < 0.05) difference in total number of repetitions performed at the end of 4 weeks of supplementation was seen between beta-alanine (BA) and placebo (PL), and Delta mean power was greater in BA (98.4 +/- 43.8 w) vs. PL (7.2 +/- 29.6 w). Growth hormone concentrations were elevated from BL at IP and 15P for both groups, while cortisol concentrations were greater than BL at all time points for both BA and PL. No group differences were noted. No change from BL was seen in testosterone concentrations for either group. Results indicate that four weeks of beta-alanine supplementation can significantly improve muscular endurance during resistance training in experienced resistance-trained athletes. However, these performance gains did not affect the acute endocrine response to the exercise stimulus.