THE ENDOSCOPY SAFETY ATTITUDES QUESTIONNAIRE (ENDO-SAQ): VALIDATION AND RESULTS

Aims Safety culture is fundamental in healthcare. Safety attitudes, a surrogate for safety culture, have been linked to patient outcomes. We report the results of a national survey of safety attitudes in endoscopy and validation of the Endo-SAQ (Endoscopy Safety Attitudes Questionnaire).

Methods The Endo-SAQ, consisting of 6 domains and 35 question items, was disseminated online to endoscopy staff in UK and Ireland. Outcomes measures were domain scores and percentage of positive responses (PPR) per domain. Descriptive and comparative analyses were performed as well as binary logistic regression to identify predictors of positive scores. Validity and reliability of Endo-SAQ were assessed through confirmatory factor analysis, Cronbach’s alpha and composite reliability measures.

Results 453 participants completed the Endo-SAQ. All domains scores were above 70, indicating positive safety attitudes. Teamwork and safety climate scores were the highest rated across domains. Endoscopists scored higher than nursing staff in stress recognition (p=0.02) and working conditions (p=0.03). Joint Advisory Group on Gastrointestinal Endoscopy (JAG) accreditation was a positive predictor in safety climate (OR 1.923, p=0.02) and job satisfaction (OR 2.093, p=0.004) domains. Female gender was a negative predictor in safety climate (OR 0.520, p=0.01), job satisfaction (OR 0.625, p=0.047) and working conditions (OR 0.348, p<0.001) domains. Endo-SAQ met construct validity and reliability thresholds.

Table 1

Confirmatory factor analysis Goodness-of-fit (tests of model fit)	Value	Accepted threshold
Comparative Fit Index (CFI)	0.972	>0.95
Tucker-Lewis-Index (TLI)	0.97	>0.95
Standardised Root Mean Square Residual (SRMR)	0.045	<0.05
Root Mean Square Error of Approximation (RMSEA)	0.049	<0.05

Conclusions Endoscopy staff in the UK and Ireland have generally positive safety attitudes. There were significant differences between staff subtypes. There is evidence to support the validity and reliability of Endo-SAQ.

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Publication History

Article published online:
14 April 2022