Objective: To explore the psychometrics of the Bulgarian version of the Hospital Survey on Patient Safety Culture (B-HSOPSC) and its suitability for use in Bulgaria.
Design: A national web-based cross-sectional survey of the safety patient culture.
Setting: The hospitals' staffs from 28 administrative areas in the country.
Interventions: Web-based self-administered questionnaire.
Participants: Physicians and non-physicians such as nurses, midwifes, etc., working at hospitals.
Main outcome measures: Confirmatory factor analysis (CFA) was performed to assess the psychometric properties of the original US structure. Assessment of construct validity included convergent validity, discriminant validity, and nomological validity of constructs.
Results: A total of 525 valid cases were included in the analysis. The results of CFA revealed acceptable values for absolute indices and lower for the incremental index, comparative fit index. Due to the very low convergence validity, the dimension 'staffing' was removed from the model. Additionally, one item was removed from another dimension. The B-HSOPSC included 11 dimensions and 37 items.
Conclusions: The B-HSOPSC had acceptable levels of global and local fits. Its safety culture dimensions were sufficiently distinguishable and correlated with outcome variables.
Keywords: patient safety; quality management; quality measurement.
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