Journal of health research in community

Introduction & Purpose:

Methods:
This methodological study was conducted among nurses working in selected public and private hospitals in Golestan Province, Iran. Instrument development involved a structured literature search, item extraction and integration, classification of items according to  macroergonomic subsystems, development of the preliminary questionnaire, and forward–backward translation. Psychometric evaluation included face validity, content validity, construct validity using exploratory and confirmatory factor analyses, and reliability assessment using Cronbach's alpha and the test–retest method.

Results:
Of the initial 73 items, 25 items remained after validity assessment and factor analyses. The final instrument consisted of seven factors representing four work system subsystems (organization, individual, tools and technology, and physical environment), explaining 60.76% of the total variance. The Kaiser–Meyer–Olkin value was 0.821, and Bartlett's test of sphericity was statistically significant. The overall Cronbach's alpha coefficient was 0.903, while test–retest reliability coefficients ranged from 0.780 to 0.911, indicating satisfactory internal consistency and temporal stability.

Conclusion:

The developed instrument demonstrated satisfactory psychometric properties and can serve as a valid and reliable instrument for assessing patient safety climate. By adopting a macroergonomic work system perspective, the instrument enables simultaneous evaluation of organizational, individual, technological, and physical environmental factors, thereby facilitating the identification of work system weaknesses and supporting the design of system-based interventions to improve patient safety.