Psychometric properties of the Georgian version of the Safety Attitudes Questionnaire: a cross-sectional study

OBJECTIVE: To study the psychometric properties of the Georgian version of the Safety Attitudes Questionnaire short version. DESIGN: Cross-sectional study. SETTING: Three Georgian hospitals. PARTICIPANTS: Personnel of participating hospitals (n=305 responses, estimated response rate 30%). INTERVENTIONS: None. PRIMARY AND SECONDARY OUTCOME MEASURES: Psychometric properties (model fit, internal consistency, construct validity, convergent and discriminant validity) of the instrument, factor structure derived from the data. RESULTS: The Georgian version of Safety Attitudes Questionnaire demonstrated acceptable construct validity and internal consistency (Cronbach’s alpha 0.61–0.91). Three factors, Teamwork Climate, Safety Climate and Working Conditions, had limited convergent and discriminant validity. Confirmatory factor analysis with the original six-factor model resulted in limited model fit (χ(2)/df=2.14, root mean square error of approximation (RMSEA)=0.06, goodness of fit index (GFI)=0.83, CFI=0.88, TLI=0.86). Exploratory factor analysis resulted in a modified four-factor model with satisfactory model fit (χ(2)/df=2.09, RMSEA=0.06, GFI=0.88, CFI=0.93, TLI=0.91). CONCLUSIONS: The Georgian version of the Safety Attitudes Questionnaire (short version) demonstrated acceptable psychometric properties, with acceptable to good internal consistency and construct validity. While the whole model had limited fit to the data, a modified factor model resulted in good model fit. Our findings suggest the dimension Working Conditions has questionable psychometric properties and should be interpreted with caution. Other two correlated dimensions Teamwork Climate and Safety Climate share considerable variance and may be merged. Overall, the instrument can provide valuable information relevant for advancement of patient safety culture in Georgian hospitals.