Psychometric analysis and construct validation of Health Professional Education in Patient Safety Survey in the Indian context

BACKGROUND Improving patient safety (PS) is critical to optimizing healthcare delivery. There is a need to develop curricula or incorporate PS concepts in health professionals’ (HPs) education, in both theoretical and practical training. Consequently, there is a need to measure the perception of HPs regarding various PS competencies imparted to them during their training. The Health Professional Education in Patient Safety Survey (H-PEPSS) is a tool that measures HPs’ self-reported PS competence and was designed to reflect six sociocultural areas central to PS. The tool has been validated in Canada but not in India. We did a confirmatory factor analysis (CFA) and psychometric validation of the H-PEPSS in the Indian context. METHODS The sample comprised 240 HPs. We used the maximum likelihood estimation method on AMOS V20 (SPSS Inc.) to carry out a CFA of the tool. We used the normed fit index, Tucker–Lewis index, comparative fit index, standard root mean square residual, root mean square residual and root mean square error of approximation to evaluate the model fit. Internal consistency and reliability of the six factors of the model were examined using Cronbach’s alpha. Convergent validity of the model was examined using average variance extracted and composite reliability. Discriminant validity was examined using the Fornell and Larcker criterion and the heterotrait–monotrait method. RESULTS The results indicate a good fit. The H-PEPSS was found to be reliable and valid for assessing PS competencies among HPs. Comparison of the results with the results of the Canadian setting confirmed external validity. CONCLUSION The 16-item H-PEPSS has good psychometric properties for use in the Indian context. The 23-item HPEPSS was found to be reliable and valid for assessing PS.

hould birth preparedness and complication readiness (BPCR) interventions be scaled up in developing countries.

This meta-analysis aimed to put together evidence on effectiveness of birth preparedness and complication readiness (BPCR) interventions on maternal and neonatal mortality. BPCR activities cover antenatal, intranatal, postnatal and neonatal periods with the strategy to inform mothers about location of emergency services, potential occurrence of obstetric complications and signs of complications, encourage the mother to take decisions before the onset of labour and to save money needed to pay for services and, finally, be able to take decisions during an emergency or complications.1 The intervention was BPCR, which could be any individual intervention or any of the above components combined, received by pregnant women residing in developing nations. In the comparator group were women who did not receive any BPCR interventions. The primary outcomes were maternal mortality ratio (MMR) and neonatal mortality rates (NMR) while the secondary outcomes were process indicators such as use of skilled services, and hygienic practices in the home. The review included randomized controlled trials; the level of randomization was either at the individual or at the cluster level. Articles published in French or English language were considered. Major search engines were used to look for relevant articles. Finally, 14 studies were selected and the quality ascertainment was done using McMaster Quality Assessment Tool. Meta-analysis was done to combine relative risks (RR), and a random effects model was used. Data were reanalysed on the basis of the intention-to-treat principle. Combinations