Development and psychometric testing of the safety climate instrument suitable for nurses handling chemotherapy drugs

Ying-Siou Lin; Bih-Shya Gau; Jyh-Chong Liang; Hai-Chiao Chen; Fuh-Yuan Shih; Yen-Chun Lin; Meei-Fang Lou

doi:10.1111/jan.15257

Development and psychometric testing of the safety climate instrument suitable for nurses handling chemotherapy drugs

J Adv Nurs. 2022 Jun;78(6):1824-1835. doi: 10.1111/jan.15257. Epub 2022 Apr 11.

Authors

Ying-Siou Lin¹, Bih-Shya Gau^{1

2}, Jyh-Chong Liang³, Hai-Chiao Chen⁴, Fuh-Yuan Shih⁵, Yen-Chun Lin², Meei-Fang Lou²

Affiliations

¹ Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan.
² School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.
³ Program of Learning Sciences and Institute for Research Excellence in Learning Sciences, National Taiwan Normal University, Taipei, Taiwan.
⁴ Department of Nursing, Chang Gung University of Science and Technology, Taoyuan City, Taiwan.
⁵ Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan.

PMID: 35404507
DOI: 10.1111/jan.15257

Abstract

Aim: To develop and test the psychometric properties of the Taiwanese safety climate instrument suitable for nurses handling chemotherapy drugs.

Design: This is an instrument development study.

Method: All four stages, including questionnaire design, expert consultation, cognitive testing and psychometric validation, were used in this study. The data were collected between August and December 2018. Nurses with experience in handling chemotherapy drugs (N = 484) at one medical centre and two regional hospitals in Taiwan completed this instrument. Data were randomly split into two groups: one group (N = 237) for exploratory factor analysis and the other (N = 247) for confirmatory factor analysis.

Results: The instruments' items were based on qualitative research, and the content validity index levels exceeded the acceptable value. An exploratory factor analysis revealed 43 items remaining in six factors, which accounted for 74.4% of variance. The result of the confirmatory factor analysis verified the acceptability of a 43-item model. The composite reliability values, Cronbach's alpha values, convergent validity and discriminant validity for each factor exceeded the acceptable value.

Conclusion: Most climate safety instruments used in the health care sector focus mainly on patient safety outcomes. Furthermore, there is no safety climate instrument for handling chemotherapy drugs, and there is a cultural difference. Through the development and validation process, we have developed a new instrument suitable for nurses handling chemotherapy drugs, which has good psychometric properties.

Impact: This instrument is valuable as its development was based on the concept of a safety climate for health care perceptions and qualitative survey findings. Hospital managers can use this instrument regularly to evaluate nurses' perceptions of the safety climate to determine the strengths and weaknesses of their workplace, thereby assisting organizational managers in proposing concrete actions.

Keywords: chemotherapy; instrument development; psychometric testing; safety climate.

MeSH terms

Factor Analysis, Statistical
Humans
Organizational Culture*
Psychometrics
Reproducibility of Results
Surveys and Questionnaires

Abstract

MeSH terms

Grants and funding