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Evaluating the psychometric properties of the Chinese version of the Safety Attitudes Questionnaire among medical staff in Taiwan

Yung-Tai Tang (Department of International Business, Providence University, Taichung, Taiwan)
Hsin-Hung Wu (Department of Business Administration, National Changhua University of Education, Changhua, Taiwan) (Asia University, Taichung, Taiwan)
Yii-Ching Lee (Hung Kuang University, Shalu, Taiwan)
Chih-Hsuan Huang (School of Business Administration, Hubei University of Economics, Wuhan, China) (Hubei Enterprise Culture Research Center, Hubei University of Economics, Wuhan, China)

Journal of Health Organization and Management

ISSN: 1477-7266

Article publication date: 29 December 2022

Issue publication date: 4 April 2023




The rapid changes that the healthcare services industry is undergoing pose a challenge to obtaining accurate measurements of the delivery of medical services to patients. Current Chinese measures of patient safety culture may not adequately capture how medical staff perceives the promotion of patient safety. This study aims to construct a valid and applicable patient safety culture instrument by re-estimating the Chinese version of the Safety Attitudes Questionnaire (SAQ) with medical staff in Taiwan.


Exploratory factor analysis (EFA) was conducted on data collected from a sample of 448 medical workers at a regional teaching hospital in Taiwan, and data from 804 participants at a medical center were subjected to confirmatory factor analysis (CFA). The distribution of the questions among the dimensions was different from that in the Chinese version of the SAQ.


The authors' results confirm that 3 correlated first-order factors, including 11 items, can be used to measure collaboration and safety, stress recognition and emotional exhaustion (EE). The authors' data suggest that the cooperation mechanism, patient safety promotion, stress management and emotional management are drivers of patient safety and should be prioritized when seeking to evaluate the perceptions of hospital staff toward patient safety culture in hospitals in Taiwan.


To improve the quality and safety of patient care, the measurement scale should be revisited and modified as the industry changes over time and to take account of cultural variation. The authors restructured the current Chinese version of the SAQ developed by the Joint Commission of Taiwan (JCT) to offer more precise measures that increase the sensitivity of the measurement of the level of care in items of patient safety and that serve as a diagnostic instrument to review patient safety management.



Funding: This study was supported by Hubei Higher Education at the provincial level teaching and research project (project number: 2021550).


Tang, Y.-T., Wu, H.-H., Lee, Y.-C. and Huang, C.-H. (2023), "Evaluating the psychometric properties of the Chinese version of the Safety Attitudes Questionnaire among medical staff in Taiwan", Journal of Health Organization and Management, Vol. 37 No. 1, pp. 84-95.



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