Safety Attitude and Its Predictor Individual and Organizational Variables among Nurses: A Cross-Sectional Study

  • ARAM TIRGAR Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
  • MAJID BAGHERI HOSSEINABADI School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran.
  • OMRAN AHMADI Department of Occupational Health, Tabriz University of Medical Sciences, Tabriz, Iran
  • MAHMOUD SADEGHI Infectious Diseases and Tropical Medicine Research Center, Babol University of Medical Sciences, Babol, Iran.
  • HASANALI JAFARPOOR Students Research office, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  • SEYED EHSAN SAMAEI Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
Keywords: Safety Attitude, Individual Variables, Organizational Variables, Predictor Variables, Nurses


ORIGINAL ARTICLE This study evaluated the safety attitude and determined its predictor individual and organizational variables among nurses. This cross-sectional and descriptive-analytical study was conducted on 295 nurses working in hospitals affiliated to the Babol University of Medical Sciences, northern Iran (at 6 hospitals) from Oct 2016 to May 2017. The required data was collected using two questionnaires of demographic and organizational information and Safety Attitude Questionnaire (SAQ). The data were analyzed using the SPSS Ver. 23 software. A logistic regression model (Backward: LR) was also used to investigate the effect of predictor personal and organizational factors on the studied nurses' attitude of safety. The highest and lowest scores in the dimensions of the SAQ questionnaire were respectively related to the stress recognition dimension (73.57 ± 17.93) and management perception dimension (48.79 ± 16.17). Based on the Pearson correlation, a significant correlation was established between the six dimensions of the questionnaire except for the stress recognition dimension. In addition, the most important individual-organizational factors affecting the attitude of the studied nurses included gender, training, work experience, education, and type of the ward. Since among the individual-organizational variables affecting the attitude of safety, the nurses' training can be acquired, it is recommended to hold regular safety courses along with an assessment after the training to improve the safety attitudes, and consequently, reduce the occupational accidents for nurses.


Tabibi J, Nasiripour A, Maleki M, Raessi P, Mahmmoudi M, Azimi L. Survey of employees' safety attitude in a teaching hospital Tehran 2010. Iran Occupational Health. 2011;7(4):5-0.

Stranks JW. Human factors and behavioural safety: Routledge; 2007.

Lofquist EA, Greve A, Olsson UH. Modeling attitudes and perceptions as predictors for changing safety margins during organizational change. Safety science. 2011;49(3):531-41.

Modak I, Sexton JB, Lux TR, Helmreich RL, Thomas EJ. Measuring safety culture in the ambulatory setting: the safety attitudes questionnaire—ambulatory version. Journal of general internal medicine. 2007;22(1):1-5.

Kiani F, Samavtyan H, Poorabdiyan S, Jafari E. How safety trainings decrease perceived job stress: the effects of improvement in employees attitude toward safety issues. Far East Journal of Psychology and Business. 2012;6(4):46-58.

Rundmo T, Hale AR. Managers’ attitudes towards safety and accident prevention. Safety science. 2003;41(7):557-74.

Pettker C, Thung S, Raab C, Donohue K, Copel J, Lockwood C, et al. A Comprehensive Obstetrics Patient Safety Program Improves Safety Climate and Culture. Obstetric Anesthesia Digest. 2012;32(1):40.

Zaroshani V, Sheykhi S, Amini M, Mohamadizeydi M, editors. Investigation of safety attitude among operating room staff of of educational hospital of Qazvin university of medical sciences. Selected Proceedings of Safe Community Conference in Tehran; 2009.

Lindberg L, Judd K, Snyder J. Developing a safety culture with front-line staff. Hospitals & health networks/AHA. 2008;82(9):84.

Khalesi N, Arabloo J, Khosravizadeh O, Taghizadeh S, Heyrani A, Ebrahimian A. Psychometric properties of the Persian version of the “Hospital Ethical Climate Survey”. Journal of medical ethics and history of medicine. 2014;7.

Tourani S, Khodayari Zarnaq R, Arabloo J, Esmaili A, Taghizadeh S, Khosravizadeh O. A Survey on Patient Safety Using the Farsi Version of the Safety Attitudes Questionnaire in Iran. Journal of Payavard Salamat. 2016;10(1):82-92.

Relihan E, Glynn S, Daly D, Silke B, Ryder S. Measuring and benchmarking safety culture: application of the safety attitudes questionnaire to an acute medical admissions unit. Irish journal of medical science. 2009;178(4):433.

Haynes AB, Weiser TG, Berry WR, Lipsitz SR, Breizat A-HS, Dellinger EP, et al. Changes in safety attitude and relationship to decreased postoperative morbidity and mortality following implementation of a checklist-based surgical safety intervention. Quality and Safety in Health Care. 2011;20(1):102-7.

Sexton JB, Helmreich RL, Neilands TB, Rowan K, Vella K, Boyden J, et al. The Safety Attitudes Questionnaire: psychometric properties, benchmarking data, and emerging research. BMC health services research. 2006;6(1):44.

Baker DP, Amodeo AM, Krokos KJ, Slonim A, Herrera H. Assessing teamwork attitudes in healthcare: development of the TeamSTEPPS teamwork attitudes questionnaire. Quality and Safety in Health Care. 2010:qshc. 2009.036129.

Elsous A, Akbari Sari A, Rashidian A, Aljeesh Y, Radwan M, AbuZaydeh H. A cross-sectional study to assess the patient safety culture in the Palestinian hospitals: a baseline assessment for quality improvement. JRSM open. 2016;7(12):2054270416675235.

Henning JB, Stufft CJ, Payne SC, Bergman ME, Mannan MS, Keren N. The influence of individual differences on organizational safety attitudes. Safety science. 2009;47(3):337-45.

Samaei SE, Raadabadi M, Khanjani N, Heravizadeh O, Hosseinabadi MB, Pirani S. Safety Attitudes among Nurses and Its Relation with Occupational Accidents: A Questionnaire Based Survey. International Journal of Occupational Hygiene. 2015;7(4):177-86.

Kaya S, Barsbay S, Karabulut E. The Turkish version of the safety attitudes questionnaire: psychometric properties and baseline data. Quality and Safety in Health Care. 2010:qshc. 2008.032003.

Buljac-Samardzic M, van Wijngaarden JD, Dekker–van Doorn CM. Safety culture in long-term care: a cross-sectional analysis of the Safety Attitudes Questionnaire in nursing and residential homes in the Netherlands. BMJ Qual Saf. 2015:bmjqs-2014-003397.

Wisniewski AM, Erdley WS, Singh R, Servoss TJ, Naughton BJ, Singh G. Assessment of safety attitudes in a skilled nursing facility. Geriatric Nursing. 2007;28(2):126-36.

Hong SJ. Perception of Safety Attitude and Priority and Progress of Safe Practices of Nurses in Emergency Room. International Journal of u-and e-Service, Science and Technology. 2015;8(11):125-38.

Taylor JA, Pandian R. A dissonant scale: stress recognition in the SAQ. BMC research notes. 2013;6(1):302.

Brasaite I, Kaunonen M, Martinkenas A, Suominen T. Health care professionals’ attitudes regarding patient safety: cross-sectional survey. BMC research notes. 2016;9(1):177.

Carney B, Mills P, Bagian J, Weeks W. Sex differences in operating room care giver perceptions of patient safety: a pilot study from the Veterans Health Administration Medical Team Training Program. Quality and Safety in Health Care. 2010;19(2):128-31.

Arab M, Mohammadian F, Rahmani A, Rahimi A, Omidi L, Asghari M. Safety Attitude in Operating Room’s Staff’s in selected hospitals of Tehran University of Medical Sciences in 2013. Journal of Hospital. 2014;13(3):25-33.

Colet PC, Cruz JP, Cruz CP, Al-otaibi J, Qubeilat H, Alquwez N. Patient Safety Competence of Nursing Students in Saudi Arabia: A Self-Reported Survey. International Journal of Health Sciences. 2015;9(4):418-26.

Mousavi SMH, Dargahi H, Hasibi M, Mokhtari Z, Shaham G. Evaluation of safety standards in operating rooms of Tehran University of Medical Sciences (TUMS) Hospitals in 2010. Journal of Payavard Salamat. 2011;5(2):10-7.

Abdolahzadeh F, Zamanzadeh V, Boroumand A. Studying the Relationship between Individual and Organizational Factors and Nurses' Perception of Patient Safety Culture. Journal of Caring Sciences. 2012;1(4):215-22.

Bondevik GT, Hofoss D, Husebø BS, Deilkås ECT. Patient safety culture in Norwegian nursing homes. BMC health services research. 2017;17(1):424.

Haghighi M, Zinat Motlagh K, Zinat Motlagh F, Taghdisi M. Assessment of patient safety culture among employees of healthcareproviders' hospitals in Tehran. 2014. 2014:9.

Abdou HA, Saber KM. A baseline assessment of patient safety culture among nurses at student university hospital. World Journal of Medical Sciences. 2011;6(1):17-26.

How to Cite
TIRGAR A, BAGHERI HOSSEINABADI M, AHMADI O, SADEGHI M, JAFARPOOR H, SAMAEI SE. Safety Attitude and Its Predictor Individual and Organizational Variables among Nurses: A Cross-Sectional Study. ijoh. 10(1):12-8.
Original Article(s)