RESUMO

OBJECTIVE: to adapt the Hospital Survey on Patient Safety Culture (HSOPSC) to the Brazilian context and validate a computer program that facilitates the collection and analysis of data in hospitals with different types of management. METHODS: methodological study developed in six hospitals in Natal-RN, Brazil; a software which allows data collection via e-mail, cloud storage and automatic data report was developed; validity was verified through confirmatory factor analysis and reliability, through consistency analysis with Cronbach's alpha. RESULTS: 863 professionals participated in the study; the adapted version presented total Cronbach's alpha of 0.92 and median of 0.69 in the 12 dimensions (90% confidence interval: 0.53;0.87); the model was fitted and showed good indexes in the confirmatory factor analysis. CONCLUSION: the results confirmed the validity and reliability of the instrument with adequate psychometric properties for the assessment of patient's safety culture in Brazilian hospitals.

Assuntos

RESUMO

OBJETIVO: adaptar o instrumento Hospital Survey on Patient Safety Culture (HSOPSC) para o contexto brasileiro e validar um programa computacional que facilite a coleta e análise dos dados em hospitais com diferentes tipos de gestão. MÉTODOS: estudo metodológico desenvolvido em seis hospitais de Natal-RN, Brasil; foi desenvolvido um software que permite coleta via e-mail, armazenamento eletrônico em "nuvem" e relatório automático dos dados; a validade foi verificada mediante análise fatorial confirmatória, e a confiabilidade, mediante análise de consistência com cálculo do alfa de Cronbach. RESULTADOS: 863 profissionais participaram do estudo; a versão adaptada apresentou alfa de Cronbach total de 0,92 e mediana de 0,69 nas 12 dimensões (intervalo de confiança de 90%: 0,53;0,87); o modelo foi ajustado e revelou bons índices na análise fatorial confirmatória. CONCLUSÃO: os resultados confirmaram validade e confiabilidade do instrumento, com adequadas propriedades psicométricas para avaliação da cultura de segurança do paciente em hospitais brasileiros.

OBJETIVO: adaptar el Hospital Survey on Patient Safety Culture (HSOPSC) al contexto brasileño y validar un programa informático que facilite la colecta y análisis de datos en hospitales con diferentes tipos de gestión. MÉTODOS: estudio metodológico de adaptación y validación en seis hospitales de Natal-RN, Brasil; se desarrolló un software que permite la colecta por correo electrónico, almacenamiento en nube e elaboración de informe automático; la validez se analizó mediante análisis factorial confirmatoria y consistencia a través del cálculo alfa de Cronbach. RESULTADOS: se obtuvo 863 respuestas; el instrumento presentó un alfa de Cronbach de 0,92 y mediana de 0,69 en las 12 dimensiones (intervalo de confianza al 90%: 0,53;0,87); el modelo se presentó ajustado y mostró buenos índices en el análisis factorial confirmatorio. CONCLUSIÓN: se confirmaron la validez y consistencia del instrumento con adecuadas propiedades psicométricas para la evaluación de la cultura de seguridad del paciente en hospitales brasileños.

OBJECTIVE: to adapt the Hospital Survey on Patient Safety Culture (HSOPSC) to the Brazilian context and validate a computer program that facilitates the collection and analysis of data in hospitals with different types of management. METHODS: methodological study developed in six hospitals in Natal-RN, Brazil; a software which allows data collection via e-mail, cloud storage and automatic data report was developed; validity was verified through confirmatory factor analysis and reliability, through consistency analysis with Cronbach's alpha. RESULTS: 863 professionals participated in the study; the adapted version presented total Cronbach's alpha of 0.92 and median of 0.69 in the 12 dimensions (90% confidence interval: 0.53;0.87); the model was fitted and showed good indexes in the confirmatory factor analysis. CONCLUSION: the results confirmed the validity and reliability of the instrument with adequate psychometric properties for the assessment of patient's safety culture in Brazilian hospitals.

Assuntos

RESUMO

Purpose To identify access barriers to physical rehabilitation for traffic accident (TA) victims with severe disability and build a theoretical model to provide guidance towards the improvement of these services. Methods Qualitative research carried out in the city of Natal (Northeast Brazil), with semi-structured interviews with 120 subjects (19 key informer health professionals and 101 TA victims) identified in a database made available by the emergency hospital. The interviews were analyzed using Alceste software, version 4.9. Results The main barriers present in the interviews were: (1) related to services: bureaucratic administrative practises, low offer of rehabilitation services, insufficient information on rehabilitation, lack of guidelines that integrate hospital and ambulatory care and (2) related to patients: financial difficulties, functional limitations, geographic distance, little information on health, association with low education levels and disbelief in the system and in rehabilitation. Conclusion The numerous access barriers were presented in a theoretical model with causes related to organizational structure, processes of care, professionals and patients. This model must be tested by health policy-makers and managers to improve the quality of physical rehabilitation and avoid unnecessary prolongation of the suffering and disability experienced by TA survivors. Implications for rehabilitation Traffic accidents (TAs) are a global health dilemma that demands integrality of preventive actions, pre-hospital and hospital care and physical rehabilitation (PR). This study lays the foundation for improving access to PR for TA survivors, an issue of quality of care that results in preventable disabilities. The words of the patients interviewed reveal the suffering of victims, which is often invisible to society and given low priority by health policies that relegate PR to a second plan ahead of prevention and urgent care. A theoretical model of the causes of the problem of access to PR was built. The identified barriers are potentially preventable through the intervention of health policy-makers, managers, regulators and rehabilitation professionals, and by encouraging the participation of patients. Addressing timely access barriers involves the expansion of the supply of services and rehabilitation professionals, regulation and standardization of referencing practises and encouraging the provision of information to patients about continuity of care and their health needs.

Assuntos