Validity and Reliability of the Turkish Version of the Short-Form Safety Climate Scale for Healthcare Institutions: A Methodological Study

Öz

The Safety Climate Scale is an essential tool for understanding employees’ shared perceptions of occupational safety but required adaptation for use in Turkish healthcare settings. The purpose of this study was to linguistically and culturally adapt the scale to ensure its validity and reliability and to measure healthcare workers’ perceptions of safety. A cross-sectional and methodological design was employed, collecting data from 421 healthcare workers in a hospital in Niğde, Türkiye. Data were gathered via face-to-face interviews and online methods using a two-part questionnaire, including socio-demographic data and the Turkish version of the scale. The analyses, which were carried out using SPSS 25.0 and AMOS 24.0, included descriptive statistics, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA). For linguistic validity, the scale was translated into Turkish and back-translated to verify semantic consistency. Expert opinions and Content Validity Index (CVI) calculations confirmed content validity, retaining all items. Four items with low factor loadings were eliminated using EFA, leaving a 36-item, five-component structure. CFA validated this structure with improved model fit. The sample consisted of 72.7% participants aged 18–44, 51.3% female, and 52.5% holding associate or bachelor’s degrees. Most participants (82%) worked in healthcare services, and 57.5% were shift workers. The scale explained 83.905% of the total variance, with a Cronbach’s Alpha of 0.98, indicating high reliability. These results confirm the scale’s validity and reliability, providing a robust tool for evaluating safety climate in Turkish healthcare institutions.

Anahtar Kelimeler

• Healthcare Institutions
• Safety Climate
• Validity and Reliability
• Scale Adaptation

Kaynakça

1. Alpar, R. (2012). Uygulamalı istatistik ve geçerlik-güvenirlik (5. baskı). Detay Yayıncılık.
2. Alpar, R. (2022). Spor sağlık ve eğitim bilimlerinden örneklerle uygulamalı istatistik ve geçerlik- güvenirlik. Detay Yayıncılık.
3. Amoadu, M., Agyare, D. F., Doe, P. F., & Abraham, S. A. (2025). Examining the impact of psychosocial safety climate on working conditions, well-being and safety of healthcare providers: A scoping review. BMC Health Services Research, 25, 90. https://doi.org/10.1186/s12913-025-12254-2
4. Barling, J., Kelloway, E. K., & Iverson, R. D. (2003). High-quality work, job satisfaction, and occupational injuries. Journal of Applied Psychology, 88(2), 276–283. https://doi.org/10.1037/0021-9010.88.2.276
5. Baumgartner, H., & Homburg, C. (1996). Applications of structural equation modeling in marketing and consumer research: A review. International Journal of Research in Marketing, 13(2), 139–161.
6. Beaton, D. E., Bombardier, C., Guillemin, F., & Ferraz, M. B. (2000). Guidelines for the process of cross-cultural adaptation of self-report measures. Spine, 25(24), 3186–3191. https://doi.org/10.1097/00007632-200012150-00014
7. Brown, T. A. (2006). Confirmatory factor analysis for applied research (1st ed.). Guilford Publications.
8. Büyüköztürk, Ş. (2002). Faktör analizi: Temel kavramlar ve ölçek geliştirmede kullanımı. Kuram ve Uygulamada Eğitim Yönetimi, 32(32), 470–483.

9. Clarke, S. (1999). Perceptions of organizational safety: Implications for the development of safety culture. Journal of Organizational Behavior, 20(2), 185–198. https://doi.org/10.1002/(SICI)1099-1379(199903)20:2<185::AID-JOB892>3.0.CO;2-C
10. Çoban, G. İ. (2006). Hastanın hemşirelik bakımını algılayışı ölçeğinin geçerlilik ve güvenilirlik çalışması [Yüksek lisans tezi, Atatürk Üniversitesi Sağlık Bilimleri Enstitüsü].
11. Davis, L. L. (1992). Instrument review: Getting the most from a panel of experts. Applied Nursing ed Research, 5(4), 194–197. https://doi.org/10.1016/S0897-1897(05)80008-4
12. Edmondson, A. (1999). Psychological safety and learning behavior in work teams. Administrative Science Quarterly, 44(2), 350–383.
13. Evroro, E. S. (2015). Item analysis of test of number operations. Asian Journal of Education Research, 3(1), 18–25.
14. Gershon, R. R. M., Karkashian, C. D., Grosch, J. W., Murphy, L. R., Escamilla-Cejudo, A., Flanagan, P. A., Bernacki, E.,
15. Kasting, C., & Martin, L. (2000). Hospital safety climate and its relationship with safe work practices and workplace exposure incidents. American Journal of Infection Control, 28(3), 211–221. https://doi.org/10.1067/MIC.2000.105288
16. Glarcher, M., Kaiser, K., Nestler, N., & Kutschar, P. (2022). Psychometric properties of the safety climate survey in Austrian acute care: Factor structure, reliability, and usability. Journal of Patient Safety, 18(3), 193–200. https://doi.org/10.1097/PTS.0000000000000888
17. Güven, R. (2012). Dünyada ve ülkemizde meslek hastalıkları. Çalışma ve Sosyal Güvenlik Bakanlığı İş Sağlığı ve Güvenliği Genel Müdürlüğü.
18. Hambleton, R. K., Merenda, P. F., & Spielberger, C. D. (Eds.). (2005). Adapting educational and psychological tests for cross-cultural assessment. Lawrence Erlbaum Associates.
19. Hessels, A. J., & Larson, E. L. (2016). Relationship between patient safety climate and standard precaution adherence: A systematic review of the literature. Journal of Hospital Infection, 92(4), 349–362. https://doi.org/10.1016/J.JHIN.2015.08.023
20. Hofmann, D. A., & Stetzer, A. (1996). A cross-level investigation of factors influencing unsafe behaviors and accidents. Personnel Psychology, 49(2), 307–339. https://doi.org/10.1111/J.1744-6570.1996.TB01802.X
21. Hooper, D., Coughlan, J., & Mullen, M. R. (2008). Structural equation modeling: Guidelines for determining model fit. Electronic Journal of Business Research Methods, 6(1), 53–60.
22. Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 1–55.
23. Karagöz, Y., & Ağbektaş, A. (2016). Yapısal eşitlik modellemesi ile yaşam memnuniyeti ölçeğinin geliştirilmesi; Sivas ili örneği. Bartın Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi, 7(13), 274–290.
24. Karagöz, Y., & Kösterilioğlu, İ. (2008). İletişim becerileri değerlendirme ölçeğinin faktör analizi metodu ile geliştirilmesi. Dumlupınar Üniversitesi Sosyal Bilimler Enstitüsü Dergisi, 21, 81–98.
25. Karasu, E. (2018). 112 acil sağlık hizmetlerinden hasta memnuniyet düzeyinin belirlenmesi ve hasta memnuniyet ölçeğinin geliştirilmesi [Yüksek lisans tezi, Selçuk Üniversitesi Sağlık Bilimleri Enstitüsü].
26. Karasu, E., & Öztürk, Y. E. (2025). Patient satisfaction in 112 emergency health services: Scale development and validation. Eurasian Journal of Emergency Medicine, 24(1), 40–49. https://doi.org/10.4274/eajem.galenos.2025.48902
27. Kline, R. B. (2005). Principles and practice of structural equation modeling (2nd ed.). Guilford Publications.
28. Lawshe, C. H. (1975). A quantitative approach to content validity. Personnel psychology, 28(4), 563–575.
29. Lin, Y. S., Lin, Y. C., & Lou, M. F. (2016). Concept analysis of safety climate in healthcare providers. Journal of Clinical Nursing, 26, 1737–1747. https://doi.org/10.1111/jocn.13641
30. Neal, A., Griffin, M. A., & Hart, P. M. (2000). The impact of organizational climate on safety climate and individual behavior. Safety Science, 34(1–3), 99–109. https://doi.org/10.1016/S0925-7535(00)00008-4
31. Noor Arzahan, I. S., Ismail, Z., & Yasin, S. M. (2022). Safety culture, safety climate, and safety performance in healthcare facilities: A systematic review. Safety Science, 147, 105624. https://doi.org/10.1016/j.ssci.2021.105624
32. Öven, V. A., & Pekdemir, D. (2005). Faktör analizi ile ofis kira değerini etkileyen parametrelerin belirlenmesi. İTÜ Dergisi, 4(2), 3–13.
33. Özata, M., & Altunkan, H. (2010). Hemşirelikte tıbbi hataya eğilim ölçeğinin geliştirilmesi ve geçerlilik güvenilirlik analizinin yapılması. 2. Uluslararası Sağlıkta Performans ve Kalite Kongresi Bildiriler kitabı (Cilt 1, ss. 415–428).
34. Özdamar, K. (2016). Eğitim, sağlık ve davranış bilimlerinde ölçek ve test geliştirme yapısal eşitlik modellemesi (1. baskı). Nisan Kitabevi.
35. Polovich, M., & Clark, P. C. (2012). Factors influencing oncology nurses’ use of hazardous drug safe-handling precautions. Oncology Nursing Forum, 39(3), E299–E309. https://doi.org/10.1188/12.ONF.E299-E309
36. Raykov, T., & Marcoulides, G. A. (2008). An introduction to applied multivariate analysis. Routledge-Taylor & Francis Group.
37. Reason, J. (2000). Human error: Models and management. BMJ, 320(7237), 768–770. https://doi.org/10.1136/BMJ.320.7237.768
38. Roberts, K. H. (1990). Some characteristics of one type of high reliability organization. Organization Science, 1(2), 160–176. https://doi.org/10.1287/ORSC.1.2.160
39. Rotenstein, L. S., Wang, H., West, C. P., Dyrbye, L. N., Trockel, M. T., Sinsky, C., & Shanafelt, T. (2024). Teamwork climate, safety climate, and physician burnout: A national, cross-sectional study. Joint Commission Journal on Quality and Patient Safety, 50(6), 458–462. https://doi.org/10.1016/j.jcjq.2024.03.007
40. Schneider, B., Ehrhart, M. G., & Macey, W. H. (2013). Organizational climate and culture. Annual Review of Psychology, 64, 361–388. https://doi.org/10.1146/ANNUREV-PSYCH-113011-143809
41. Sosyal Güvenlik Kurumu. (2024). Türkiye’de iş kazaları ve ölümler [SGK İstatistik Yıllığı 2024 verileri].
42. Tabachnick, B. G., & Fidell, L. S. (2013). Using multivariate statistics (6th ed.). Boston, MA: Allyn & Bacon/Pearson education.
43. Thompson, B. (2004). Exploratory and confirmatory factor analysis: Understanding concepts and applications (1st ed.). Washington, DC: American psychological association.
44. Todaro, N. M., Testa, F., Rizzi, F., Vizzoto, F., & Curcuruto, M. (2023). Safety climate in high safety maturity organisations: Development of a multidimensional and multilevel safety climate questionnaire. Safety Science, 166, 106231. https://doi.org/10.1016/j.ssci.2023.106231
45. Uluslararası Çalışma Örgütü. (2019). Ölümlü iş kazaları, meslek hastalıkları ve kazalar: Küresel istatistikler raporu.
46. Weick, K. E., & Sutcliffe, K. M. (2001). Managing the unexpected: Resilient performance in an age of uncertainty. Jossey-Bass.
47. Yıldız, N. N. (2008). Eğitim yöneticilerinin öğretim programları yönetimi yeterliliklerine yönelik bir ölçek geliştirme çalışması [Yayımlanmamış Yüksek Lisans Tezi, Yeditepe Üniversitesi].
48. Yurdugül, H. (2005). Ölçek geliştirme çalışmalarında kapsam geçerliliği için kapsam geçerlilik indekslerinin kullanılması. 14. Ulusal Eğitim Bilimleri Kongresi Kitabı (ss. 1–4). Denizli: Pamukkale Üniversitesi.
49. Zohar, D. (1980). Safety climate in industrial organizations: Theoretical and applied implications. Journal of Applied Psychology, 65(1), 96–102. https://doi.org/10.1037/0021-9010.65.1.96
50. Zohar, D. (2003). Safety climate: Conceptual and measurement issues. In J. C. Quick & L. E. Tetrick (Eds.), Handbook of occupational health psychology (pp. 123–142). American Psychological Association. https://doi.org/10.1037/10474-006