Enhancing Patient Safety Education: Cross-Cultural Validation of the APSQ-III in Brazilian Healthcare Students

Background: This study aimed to adapt and validate the Attitudes to Patient Safety Questionnaire (APSQ-III) for Brazili-an Portuguese and to compare patient safety attitudes between medical and nursing students. Given the critical role of assessing safety attitudes in shaping future healthcare professionals, this research addresses a significant gap in the Brazilian educational context. Materials and Methods The cross-cultural adaptation process adhered to the guidelines of Beaton et al. (2000), encompassing trans-lation, synthesis, back-translation, and expert committee evaluation. The adapted APSQ-III was adminis-tered to a sample of 423 undergraduate students from medicine and nursing courses. Confirmatory factor analysis (CFA) was conducted to verify the factor structure, while reliability was assessed using Cronbach's alpha, McDonald's omega, and composite reliability measures. Results The CFA supported an acceptable fit for the nine-factor model with 26 items, following the exclusion of four items (χ²/df = 1.92; CFI = 0.90; TLI = 0.89; RMSEA = 0.05; SRMR = 0.07). Factor loadings ranged from 0.30 to 0.82, with satisfactory reliability indices, except for factors 4 (α = 0.47; ω = 0.48) and 9 (α = 0.54; ω = 0.54). Sig-nificant differences were discovered between medical and nursing students in four factors, and gender dif-ferences were noted in five items, highlighting the diverse perceptions of patient safety across these groups. Conclusion The Brazilian version of the APSQ-III demonstrated adequate validity and reliability for seven out of the nine original factors. It is recommended to use the scale with modifications, such as excluding factors with low reliability, to enhance its applicability. This study contributes to advancing patient safety research and education in Brazil, providing a robust tool for evaluating and improving safety attitudes among healthcare students.