Psychometric evaluation of a Korean-language version of the Nursing Home Survey on Patient Safety Culture (K-NHSPSC)

Abstract

Background Patient safety culture is a foundational component of quality care in long-term care facilities. Although the Nursing Home Survey on Patient Safety Culture (NHSPSC) has been widely used and validated internationally, there has been no validated Korean version applicable to the Korean context. This study aimed to translate, culturally adapt, and validate the NHSPSC for use in Korean long-term care settings. Methods We employed a two-phase design. In Phase 1, the original NHSPSC was translated into Korean using a committee-based translation method, followed by an expert review for content validity. A panel of five experts rated the relevance and clarity of each item. Subsequently, cognitive interviews were conducted with five nursing home staff to assess item comprehension and cultural appropriateness. In Phase 2, a cross-sectional survey was administered to healthcare workers in 10 nursing homes. After applying exclusion criteria, data from 282 participants were analyzed. Internal consistency was assessed using Cronbach's alpha. Construct validity was evaluated through confirmatory factor analysis and correlations with global safety ratings. Results The Korean version of the NHSPSC retained all 12 original factors and demonstrated acceptable internal consistency. Confirmatory factor analysis supported the factorial structure of the instrument. Correlations between subscales and global safety ratings provided additional support for construct validity. Conclusions The Korean version of NHSPSC demonstrated acceptable psychometric properties and retains the original instrument's multidimensional structure. It is a reliable and valid tool for assessing patient safety culture in Korean nursing homes and can facilitate both domestic quality improvement and international benchmarking efforts.