Development and Psychometric Validation of the Geriatric Patient Safety Culture Questionnaire for Intensive Care Nurses
TL;DR
The GPSC-Q provides preliminary psychometric support for assessing ICU nurses’ knowledge, attitudes, self-reported practices, and perceptions of the work environment related to geriatric patient safety, however, support varied across subscales, with weaker findings for Work Environment.
Abstract
Background: Critically ill geriatric patients represent a unique group with specific care needs due to the physiological and pathological changes associated with aging, which make them susceptible to adverse events and complications during their stay in the Intensive Care Units. This study aimed to develop and psychometrically validate the Geriatric Patient Safety Culture Questionnaire (GPSC-Q), which assesses ICU nurses’ knowledge, attitudes, self-reported practices, and perceptions of the work environment related to the safety of critically ill geriatric patients. Method: A methodological study was conducted among 330 ICU nurses to develop and evaluate the psychometric properties of the multidimensional GPSC-Q. The psychometric evaluation included content validity, exploratory and confirmatory factor analyses, internal consistency, and convergent and discriminant validity assessments. Results: The final questionnaire comprised 43 items: 15 Knowledge, 7 Attitude, 12 Practice, and 9 Work Environment items. Exploratory factor analysis identified four, one, four, and three factors, respectively. Internal consistency coefficients were 0.902, 0.936, 0.749, and 0.721, respectively. Knowledge and Practice showed satisfactory primary CFA fit, whereas Attitude showed mixed fit, including an elevated RMSEA of 0.083. Work Environment showed weaker fit (CFI = 0.907, TLI = 0.855, RMSEA = 0.089) and lower reliability and convergent validity in two domains. The second-order CFA showed mixed fit (CFI = 0.936, TLI = 0.930, RMSEA = 0.048, SRMR = 0.070), with CFI and TLI below the prespecified criteria. Conclusions: The GPSC-Q provides preliminary psychometric support for assessing ICU nurses’ knowledge, attitudes, self-reported practices, and perceptions of the work environment related to geriatric patient safety. However, support varied across subscales, with weaker findings for Work Environment. Further refinement and validation in independent samples are needed before recommending broad application. Implications for Practice: The GPSC-Q provides a structured approach to assessing nursing and work environment dimensions relevant to geriatric patient safety in intensive care. Further validation may support its use in identifying educational priorities and informing organizational safety initiatives.