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Psychometric properties of the full and short version Nursing Home Survey on Patient Safety Culture (NHSOPSC) instrument: a cross-sectional study assessing patient safety culture in Norwegian homecare services


Objectives: Measure patient safety culture in homecare
services; test the psychometric properties of the Nursing
Home Survey on Patient Safety Culture (NHSOPSC)
instrument; and propose a short-version Homecare
Services Survey on Patient Safety Culture instrument for
use in homecare services.
Design: Cross-sectional survey with psychometric testing.
Setting Twenty- seven publicly funded homecare units in
eight municipalities (six counties) in Norway.
Participants Five-hundred and forty health personnel
working in homecare services.
Interventions Not applicable.
Primary and secondary outcome measures Primary:
Patient safety culture assessed using the NHSOPSC
instrument. Secondary: Overall perception of service users’
safety, service safety and overall care.
Methods Psychometric testing of the NHSOPSC
instrument using factor analysis and optimal test assembly
with generalised partial credit model to develop a short-
version instrument proposal.
Results Most healthcare personnel rated patient safety culture
in homecare services positively. A 19-item short-version
instrument for assessing patient safety culture had high
internal consistency, and was considered to have sufficient
concurrent and convergent validity. It explained a greater
proportion of variance (59%) than the full version (50%).
Short-version factors included safety improvement actions,
teamwork, information flow and management support.
Conclusion This study provides a first proposal for a short-
version Homecare Services Survey on Patient Safety Culture
instrument to assess patient safety culture within homecare
services. It needs further improvement, but provides a starting
point for developing an improved valid and reliable short-
version instrument as part of assessment of patient safety and
quality improvement processes
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Academic article


  • SHARE - Centre for Resilience in Healthcare / 5091
  • Research Council of Norway (RCN) / 256681




  • Petter Viksveen
  • Mette Røhne
  • Lisbet Grut
  • Kathrine Cappelen
  • Siri Wiig
  • Eline Ree


  • University of Stavanger
  • SINTEF Digital / Health Research
  • University of South-Eastern Norway



Published in

BMJ Open








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