Construct Validity and Reliability of the Korean Version of the Speaking Up about Patient Safety Questionnaire Scale

S. AHN1 and D.E. KIM2

 1. Department of Nursing, Wonkwang University, Iksan, Korea, Republic of

 2. College of Nursing and Research Institute of Nursing Science, Kyungpook University, Deagu, Korea, Republic of 

Introduction:

Speaking up is an assertive form of communication among healthcare providers, for ensuring patient safety, that has become increasingly important in healthcare. Facilitating nurses’ willingness to speak up in clinical settings can create an environment that promotes patient safety, contributing to the prevention of patient safety incidents. Despite the evident benefits, little is known about the concept of speaking up and instruments related to it in the Korean context. This study was conducted to assess the psychometric properties of the Korean-language version of Speaking Up about Patient Safety Questionnaire for nurses

METHOD:

Study Design: This study used a cross-sectional survey design, with a convenience sample to describe psychometrics of the Korean version of the Speaking Up about Patient Safety Questionnaire (KSUPS-Q).

Study Population: Survey data were gathered in the Republic of Korea using an online survey tool. A total of 314 nurses with more than 1 month of clinical experience participated in the survey.

Analysis: Exploratory factor analysis and confirmatory factor analysis were conducted to investigate the construct validity of the instrument. Convergent validity was examined using Pearson correlations. Internal consistency was tested using Cronbach’s alpha and McDonald’s omega coefficient for reliability.

RESULTS:

The most frequently reported barrier to speaking up was the fear of negative reactions (n=129, 41.1%). Additionally, approximately one-third of the participants answered that it was difficult to speak up owing to the presence of the patients or relatives (n=106, 33.8%). 

The speaking up-related climate scale consists of 11 items with two factors (‘psychological safety and encouraging environment for speaking up’ and ‘resignation toward speaking up’). CFA confirmed that the two-factor model was adequate, with an acceptable fit (comparative fit index=0.971, Tucker-Lewis index=0.962, and standardised root mean-square residual=0.050). Convergent validity was confirmed based on the correlations with the teamwork (r=0.695) and safety (r=0.696) climate domains of the Safety Attitudes Questionnaire-Korean version (SAQ-K). The speaking up-related climate scale demonstrated satisfactory internal consistency reliability (Cronbach’s alpha=0.897, omega=0.929). 

CONCLUSIONS:

The Korean-language version of Speaking Up about Patient Safety Questionnaire is a valid and reliable instrument to measure the speaking up-related behaviour and climate among nurses in Republic of Korea. To improve patient safety in the care process, it is necessary to develop an education program with assertive communication tools to facilitate speaking up in clinical settings, which in turn can prevent medical errors. 

REFERENCES:

1. Okuyama A, Wagner C, Bijnen B. Speaking up for patient safety by hospital-based health care professionals: a literature review. BMC Health Serv Res. 2014;14:1-8

2. Richard A, Pfeiffer Y, Schwappach DDL.Development and Psychometric Evaluation of the Speaking Up About Patient Safety Questionnaire. J patient Saf. 2021;17:e599-606

This work was supported by the National Research Foundation of Korea(NRF) grant funded by the Korea government(MSIT) (No. 2021R1G1A1093057).