Safety culture evaluation in Sarawak General Hospital: a cross-sectional study using Safety Attitude Questionnaire (SAQ)

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Globally, healthcare organizations prioritize patient safety as a key factor in quality and safety. This study aimed to investigate the patient safety culture at Sarawak General Hospital (SGH), a tertiary referral hospital in Malaysia. A cross-sectional study using the Safety Attitude Questionnaire (SAQ) was conducted at SGH from May 2022 to April 2023. The survey included 767 hospital staff members, such as doctors, nurses, pharmacists, and other clinical personnel, with a response rate of 84.2% (646 respondents). The study used Jamovi 2.3.28 for statistical analysis of the survey data. The overall mean SAQ score was 65.8 ± 15.0 with a 31.3% positive response rate. Most domain scores were higher than benchmark scores (65.7–72.2%), except for the stress recognition domain. Job satisfaction had the highest mean (71.7 ± 23.3) and positive rate (53.4%), indicating high contentment among healthcare workers. Conversely, the working condition domain had the lowest mean (52.7 ± 19.5) and positive rate (17%), reflecting dissatisfaction with staffing levels and logistical support. Overall, the patient safety culture at SGH is satisfactory, with most domain scores exceeding benchmark levels. Safety Attitude Questionnaire safety culture patient safety organization supports INTRODUCTION Patient safety refers to the proactive and systematic efforts undertaken within healthcare settings to prevent harm to patients during the provision of medical care 1 . Patient safety incidents represent significant concerns within this domain because they encompass a broad spectrum, ranging from medication errors and diagnostic errors to falls and surgical complications 2 . Each incident can compromise patient well-being and undermine trust in the healthcare system. These incidents have the potential to incur substantial costs for both patients and the healthcare system 2 . The failure to uphold patients' safety leads to a considerable escalation in the expenses of healthcare, as well as elevated levels of morbidity and mortality 3 . Throughout the years, healthcare organisations worldwide have consistently prioritised patient safety as their primary focus 4 . It is becoming a priority, and improving patient safety is heavily reliant on creating a culture that encourages and supports health workers to report errors or near misses without fear of repercussions. Since the American Institute of Medicine published "To Err Is Human" in 1999, there has been a surge in interest in patient safety research. This patient safety framework encompasses a wide range of factors including teamwork, safety climate, employee satisfaction, work environment, stress recognition, management perception, and attitude 5 , 6 . Based on previous research, it is commonly concurred that in order to enhance patient safety and elevate the standard of care, medical organisations should foster a patient safety culture 7 , 8 , 9 . The British Health and Safety Commission defined patient safety culture as the culmination of individual and collective values, attitudes, perceptions, competencies, and behavioral patterns within an organisation, which influence its dedication to, and the manner and effectiveness of, safety management 13 . Conducting safety culture assessments represents a primary strategic approach for enhancing the culture of patient safety. Hence, it is critical to assess safety culture in order to identify predictor factors that influence patient safety outcomes. A survey using safety culture assessment tools such as the Safety Attitude Questionnaire (SAQ) can help healthcare leaders understand their organisations' safety culture. The SAQ is a tool commonly used to assess various dimensions of safety culture among healthcare professionals. It has undergone comprehensive psychometric testing and has been shown to have good construct validity and internal consistency. It delves into six domains such as teamwork, safety climate, job satisfaction, stress recognition, management perceptions and working conditions 10 . By measuring these aspects, the SAQ provides valuable insights into the strengths and weaknesses of an organisation's safety culture. Healthcare institutions can utilise SAQ results to identify areas for improvement, implement targeted interventions, and cultivate a culture of safety that prioritises patient outcomes. Despite the importance of assessing patient safety culture, there is still a lack of published investigations examining the level of patient safety culture among healthcare professionals in Malaysia. Hence, it is essential to assess the level of safety culture among healthcare professionals and identify the factors associated with it. This is the first SAQ study conducted in Sarawak General Hospital (SGH) which is situated in Kuching, East Malaysia. In 2018, a hospital survey on patient safety culture was conducted in SGH, using the Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire, which found that most of the scores related to dimensions were lower than benchmark score 2 . While both the HSOPSC and SAQ aim to measure patient safety culture, the SAQ includes specific domains that are not covered by the HSOPSC, such as stress recognition, job satisfaction, and working conditions. These domains are critical for understanding the holistic environment of patient safety and staff well-being. The HSOPSC, in contrast, offers a broader range of safety culture dimensions but lacks some of the specific focus areas of the SAQ. SGH will benefit from this study's baseline data for long-term ongoing assessment and a solid foundation for additional focused actions. In most hospitals, the safety culture has to be strengthened through intervention measures because it is not yet fully formed. To effectively implement the principle of "first, do no harm" throughout the entire healthcare organisation, it is essential to fully comprehend the meaning of a safety culture and its fundamental components, emphasises the significant impact that human factors have on patient safety, stress the significance of a safety culture at every level of management, and continuously enhance teamwork and communication both within and across teams. Therefore, this study was initiated to evaluate the status of safety culture in Sarawak General Hospital using the Safety Attitude Questionnaire (SAQ). METHODS 2.1 Safety Attitude Questionnaire (SAQ) The Safety Attitudes Questionnaire (SAQ) was developed by Sexton at the University of Texas in the year 2000 11 . It was widely recognized as one of the most extensively validated instruments for assessing safety culture within healthcare settings 10 . SAQ was employed to assess individuals' sentiments regarding safety across six safety culture domains, encompassing safety climate, teamwork, stress recognition, management perception, working conditions, and job satisfaction. The survey offers international benchmarking data, facilitating the comparison of safety cultures across healthcare organisations and countries 12 . The distribution of the questionnaires based on the six domains were shown in Appendix 1. The SAQ comprises 36 items, all of which are closed-ended questions, requiring respondents to indicate their level of agreement on a 5-point Likert scale, spanning from 1 (disagree strongly) to 5 (agree strongly) 13 . Items 14 and 33–36 were not part of the scales mentioned while items 2, 11, and 36 were reverse scored. Demographic information of the respondents, including details such as age, gender, years in service, occupation, and disciplines based on the organization chart, was also collected. The department was categorised into four disciplines: maternal & child, surgical, medicine, and clinical support. The department of pediatrics, obstetrics, and gynecology were merged into the maternal & child disciplines, while the surgical disciplines encompassed the department of surgery, orthopedics, the emergency department, neurosurgery, anesthesiology, critical care, plastic surgery, otorhinolaryngology, ophthalmology, urology, pediatric surgery, and radiology. Furthermore, the medicine disciplines included the general medicine, other medical subspecialties, psychiatry, oncology, and the clinical support disciplines comprised the department of pharmacy, radiology, pathology, and rehabilitation medicine. 2.2 Study Design and Sampling A cross-sectional study using "Safety Attitude Questionnaire" was conducted in Sarawak General Hospital. Snow-balling or wide dissemination was used in this study to engage healthcare workers to participate in this survey. The data were collected from 15 May 2022 to 14 April, 2023. A self-administered questionnaire was distributed to 767 hospital staff members, including doctors, nurses, pharmacists, and other clinical personnel. The questionnaire was prepared in English, as most respondents understood English. Each respondent was allocated a duration of 10–15 minutes to complete the questionnaires, after which they were promptly collected upon completion. The participation and results were voluntary, anonymised and kept confidential. Written informed consent was obtained from all respondents. The questionnaire was successfully completed by 646 respondents. 2.3 Data analysis Descriptive statistics were used to calculate the scores of each item, while demographic data was analysed using ANOVA and paired sample t-tests. Standardised algorithms were employed to consolidate individual items in each domain into a 0–100 scale (1 = 0, 2 = 25, 3 = 50, 4 = 75 and 5 = 100). Lower scores indicate a less favorable perception on that items, while higher scores signify more favorable perceptions 14 . The mean of respondents who "agree" or "strongly agree" with a specific statement was used to calculate scores. Likewise with inquiries that are phrased negatively. The analysis did not include responses marked "not applicable" or left blank. The percentages of respondents indicating a positive attitude (≥ 75; agree slightly and agree strongly) were computed. Statistical significance is defined as a p-value of 5% or less. Logistic regression was performed to identify demographic factors that serve as predictors of positive scores in the SAQ. All the statistical analyses were performed using Jamovi version 2.3.28. This research was cross-sectional and contained no extra interventions. It was carried out in accordance with the Declaration of Helsinki's ethical principles and the Malaysian Good Clinical Practice Guideline. The study protocol was approved by the Medical Research and Ethics Committee of the National Medical Research Registry, Ministry of Health Malaysia (Approval number: NMRR-22-00409-EUW) on May 10, 2022. RESULTS 3.1 Socio-demographic characteristics of respondents The SAQ response rate was 84.2% overall (646 out of 767 distributed questionnaires). The respondents were mostly female (81.7%), and worked for 11 to 20 years (32.8%). Among the respondents, mostly (64.9%) were nurses, followed by doctors (21.4%), allied health (10.5%) and pharmacist (3.3%). Majority of the respondents were from surgical disciplines (45.5%), followed by medical (23.7%), maternal and child (18.6%), and clinical support (12.2%) ( Table 1 ) . Table 1 Demographics profile of respondents (N = 646) Demographics n (%) Gender Female 528 (81.7) Male 118 (18.3) Working Experience (Years) 21 years 113 (17.5) Occupation Doctor 138 (21.4) Nurse 419 (64.9) Pharmacist 21 (3.3) Allied Health 68 (10.5) Disciplines a Maternal & Child 120 (18.6) Medicine 153 (23.7) Surgical 294 (45.5) Clinical Support 79 (12.2) a Disciplines were categorised based on the Sarawak General Hospital organisation chart 3.2 Comparison of SAQ Domain Results Among Healthcare Professionals The average SAQ score was 65.8 ± 15.0 with 31.3% achieving positive responses (score of 75 ≥ on a 100-point scale). With a mean of 71.7 ± 20.5, job satisfaction obtained the highest rating with 53.4% positive responses. The mean score for working conditions, on the other hand, was the lowest at 52.7 ± 19.5 with 17.0% of positive responses ( Table 2 ) . A significant difference was observed among healthcare professionals in teamwork, job satisfaction, management perception, working condition and stress recognition (p < 0.05). Among healthcare professionals, doctors attained the highest mean score in teamwork (70.4±25.7), pharmacists in safety climate (70.6±20.0) and stress recognition (81.5±23.8), allied health professionals in job satisfaction (75.5±23.7), and nurses in management perception (67.6±17.8) and working conditions (55.5±18.4). In contrast, allied health professionals attained the lowest mean scores for teamwork (59.0±23.3), safety climate (66.1±20.4), and stress recognition (63.6±27.9), pharmacists in job satisfaction (60.2± 23.4), and doctors in management perception (61.4±22.3) and working condition (45.4± 21.5). Nurses garnered the highest overall SAQ mean score (66.8±13.6). Conversely, allied health professionals obtained the lowest overall SAQ mean scores (62.7±16.1) ( Table 2 ) . Table 2 Comparing SAQ Domain Results Among Healthcare Professionals Domain Overall Allied health professional Doctor Nurses Pharmacist p-value* (100 scale) n = 68 n = 138 n = 419 n = 21 Teamwork Mean ± SD 67.6 ± 20.5 59.0 ± 23.3 70.4 ± 25.7 68.1 ± 17.7 68.1 ± 20.0 0.016 Positive responses (≥75) (%) 42.9* 30.9 57.2 40.6 33.3 Safety Climate Mean ± SD 68.7 ± 18.5 66.1 ± 20.4 67.7 ± 23.1 69.4 ± 16.3 70.6 ± 20.0 0.544 Positive responses (≥75) (%) 43.0* 39.7 45.7 42.7 42.9 Job Satisfaction Mean ± SD 71.7 ± 23.3 75.5 ± 23.7 63.2 ± 28.1 74.5 ± 20.6 60.2 ± 23.4 < .001 Positive responses (≥75) (%) 53.4* 60.3 39.9 57.8 33.3 Management Perception Mean ± SD 65.8 ± 19.4 64.6 ± 20.7 61.4 ± 22.3 67.6 ± 17.8 63.0 ± 21.6 < .001 Positive responses (≥75) (%) 35.3* 27.9 29.0 38.9 28.6 Working Condition Mean ± SD 52.7 ± 19.5 51.1 ± 18.0 45.4 ± 21.5 55.5 ± 18.4 50.6 ± 20.2 0.026 Positive responses (≥75) (%) 17.0* 17.6 9.4 19.3 19.0 Stress Recognition Mean ± SD 68.3 ± 25.2 63.6 ± 27.9 81.3 ± 20.1 64.1 ± 24.7 81.5 ± 23.8 < .001 Positive responses (≥75) (%) 50.2* 42.6 73.9 42.0 81.0 Overall SAQ score Mean ± SD 65.8 ± 15.0 62.7±16.1 64.6±18.2 66.8±13.6 64.4±15.2 0.168 Positive responses (≥75) (%) 31.3* 27.9 34.8 30.8 28.6 * Percent positive scores are computed as the per cent of participants who answered ‘agree slightly’ or ‘agree strongly’ on each of the items within a scale (i.e. 4 or 5 on the original 5-point Likert scale). * Analysed using one-way ANOVA. 3.3 Comparison of SAQ Domain Results Among Disciplines A notable variation was observed among the disciplines in terms of teamwork, safety climate, unit management, hospital management, and management perception (p < 0.05). The surgical disciplines achieved the highest average scores for both teamwork (70.5±20.9) and safety climate (70.4±19.2) followed by the maternal & child discipline department excelled in job satisfaction (74.1±22.7), unit management (69.8±17.6), hospital management (68.4±17.0), management perception (69.1±16.9), and working conditions (53.9±19.8). Conversely, the clinical support discipline recorded the lowest average scores for teamwork (61.9±24.2), while the medical discipline received the lowest scores in several areas including safety climate (65.5±17.7), job satisfaction (68.4±23.8), stress recognition (65.3±24.2), unit management (63.7±19.6), hospital management (60.9±20.4), management perception (62.3±19.3), and working conditions (51.5±18.1). The maternal & child discipline garnered the highest mean score in the SAQ assessment, with a value of 67.4±12.9, whereas the medical discipline recorded the lowest overall SAQ mean scores at 62.9±14.6 ( Table 3 ) . Table 3 Comparing SAQ Domain Results Among Discipline Domain Maternal & child Surgical Medicine Clinical support p-value* n = 120 n = 294 n = 153 n = 79 Teamwork Mean ± SD 68.2 ± 18.5 70.5± 20.9 64.8 ± 18.4 61.9 ± 24.2 0.004 Positive responses (≥75) (%) 43.2 51.0 30.8 35.2 Safety Climate Mean ± SD 69.7 ± 16.4 70.4 ± 19.2 65.5 ± 17.7 67.2 ± 19.7 0.042 Positive responses (≥75) (%) 48.4 46.6 31.2 44.3 Job Satisfaction Mean ± SD 74.1 ± 22.7 72.1 ± 23.4 68.4 ± 23.8 73.0 ± 22.9 0.212 Positive responses (≥75) (%) 59.1 54.1 44.3 59.3 Stress Recognition Mean ± SD 67.8 ± 25.5 69.3 ± 25.0 65.3 ± 24.2 71.2 ± 27.3 0.291 Positive responses (≥75) (%) 50.0 51.0 43.9 59.3 Management Perception (Unit) Mean ± SD 69.8 ± 17.6 68.2 ± 20.7 63.7 ± 19.6 66.8 ± 22.1 0.047 Positive responses (≥75) (%) 47.3 45.3 33.3 40.7 Management Perception (Hospital) Mean ± SD 68.4 ± 17.0 64.3 ± 21.5 60.9 ± 20.4 65.1 ± 20.2 0.013 Positive responses (≥75) (%) 43.2 36.5 28.7 34.4 Management Perception (Overall) Mean ± SD 69.1 ± 16.9 66.3 ± 20.2 62.3 ± 19.3 65.9 ± 19.6 0.024 Positive responses (≥75) (%) 44.1 35.7 29.5 31.7 Working Condition Mean ± SD 53.9 ± 19.8 53.1 ± 20.5 51.5 ± 18.1 52.0 ± 18.1 0.719 Positive responses (≥75) (%) 19.4 18.4 14.3 13.9 Overall SAQ score Mean ± SD 67.4 ± 12.9 66.8 ± 15.6 62.9 ± 14.6 65.3 ± 14.5 0.027 Positive responses (≥75) (%) 28.5 32.0 22.8 26.8 * Per cent positive scores are computed as the per cent of participants who answered ‘agree slightly’ or ‘agree strongly’ on each of the items within a scale (i.e., 4 or 5 on the original 5-point Likert scale). * Analysed using one-way ANOVA. 3.4 Comparing SAQ Domain Results Between Selected Hospitals in Malaysia and International Benchmark In comparison to the international benchmark for inpatient care in the United States, Hospital Sultanah Bahiyah in Kedah, Sarawak General Hospital in Sarawak, and public hospital in Melaka scored notably higher mean scores across five of the six domains: teamwork, safety climate, job satisfaction, management perception, and working conditions ( Table 4 ) . Table 4 Comparing SAQ Domain Results Between Selected Hospitals in Malaysia and International Benchmark SAQ Safety Domain Setting Country Teamwork scale Safety Climate scale Job Satisfaction scale Stress Recognition scale Management Perception scale Working condition scale Overall SAQ score International Benchmark [ref:11] Mean±SD Inpatient USA 64.3±16.6 60.5±16.0 59.6±20.5 74.4±20.2 38.3±18.7 49.2±19.5 57.7±N.A* Positive responses (≥75) (%) N.A N.A N.A N.A N.A N.A N.A Sultanah Bahiyah Hospital [ref:13] Mean±SD Healthcare Malaysia 69.0±12.8 69.0±12.4 76.3±17.9 63.7±24.4 64.7±16.3 62.6±12.7 67.8±10.5 Positive responses (≥75) (%) Professionals (Kedah) 36.4 34.7 66.2 43.6 28.3 24.0 23.0 Sarawak General Hospital Mean±SD Healthcare Malaysia 67.7±20.5 68.7±18.5 71.7±23.3 68.3±25.2 65.8±19.4 52.7±19.5 65.8±15.0 Positive responses (≥75) (%) Professionals (Sarawak) 42.9 43.0 53.4 50.2 35.3 17.0 31.3 Public Hospitals and Health Clinics [ref:10] Mean±SD Pharmacist Malaysia 67.6±14.5 66.8±14.9 67.3± 19.4 73.0±20.4 62.2±14.0 54.8±17.4 65.6±11.0 Positive responses (≥75) (%) (Melaka) 38.5 33.3 46.2 58.1 29.9 15.4 20.5 * The journal does not contain data on the standard deviation. 3.5 Demographic predictors of positive scores in SAQ Following the adjustment for gender, males employed at SGH demonstrate a 1.8-fold higher probability (p = 0.021) of achieving positive scores in overall safety attitude assessments. Employees at SGH who have been employed for less than six months have a 2.7 times greater likelihood (p = 0.045) of receiving positive ratings in evaluations of the overall safety attitude score, compared to those between 5 and 10 years of working experience. Employees who have been with SGH for 11 years or longer, including those with 11 to 20 years of experience and over 21 years, exhibit a 1.9-fold higher likelihood (p = 0.045) and a 4.9-fold higher likelihood (p = < 0.001) respectively of achieving positive scores in overall safety culture assessments, than employees with 5 to 10 years of experience. Staff in surgical disciplines had a more positive attitude towards patient safety than staff in other disciplines (p-value = 0.040) ( Table 5 ) . Table 5. Demographic predictors of positive scores in SAQ Variables Adj. OR (95% CI OR) p-value Gender Male Female (Ref) 1.834 1.000 (1.096, 3.070) - 0.021 - Working experience (years) <6 months 6 – 11 months 1 – 2 years 3 – 4 years 5 – 10 years (Ref) 11 – 20 years ³21 years 2.706 1.076 1.701 1.306 1.000 1.933 4.909 (1.024, 7.152) (0.367, 3.154) (0.804, 3.600) (0.430, 3.964) - (1.220, 3.063) (2.910, 8.279) 0.045 0.893 0.165 0.638 - 0.005 <0.001 Discipline Maternal and Child Surgical Clinical Support Medicine (Ref) 1.125 1.641 0.933 1.000 (0.632, 2.001) (1.024, 2.630) (0.444, 1.962) - 0.690 0.040 0.855 - Occupation Allied health professionals Nurse (Ref) Doctor 0.703 1.000 0.917 (0.363, 1.362) - (0.537, 1.563) 0.296 - 0.749 DISCUSSION This study is the initial implementation of SAQ within SGH to evaluate the patient safety culture. Evaluating and promoting safety culture is a prerequisite step to improve patient safety 15 . The SAQ, utilised as a tool for assessing patient safety culture, enables SGH to gain a deeper understanding of the current state of patient safety culture and the associated factors by evaluating individuals' attitudes towards safety across six domains within the safety culture framework. This study found a higher overall mean score of 65.8 compared to the international benchmark of 57.7, indicating that respondents in this study generally outperformed the international standard 11 . Job satisfaction received the highest mean score (71.7±23.3) in this study, surpassing the international benchmark 11 , suggesting that most healthcare workers are content with their jobs and have positive work experiences. This is supported by a significant proportion of participants expressing positive sentiments to the statement "I like my job" (77.9%) which ranked among the highest-scoring items in the SAQ. However, working conditions received the lowest mean score (52.7±19.5) in our study, although it still scored above the international benchmark 11 . This suggests employees' dissatisfaction with aspects such as staffing levels and logistical support, as evidenced by low scores on “the staffing level in this clinical area is adequate to manage the number of patients” (26.4%) which is one of the five lowest mean scores in our SAQ. The shortage of staff, increased patient volume, and expanded clinical services contribute to heightened workload and potential risks to patient safety 10 . Despite perceived poor working conditions, a higher level of job satisfaction could be attributed to strong organisational support, in terms of recognition, career development opportunities, and interpersonal relationships. This perceived support could enhance overall job satisfaction, mitigating the negative impact of poor working conditions 16 . The study found that teamwork scores were higher among doctors compared to allied health professionals. Doctors, operating within a hierarchical system, often have significant authority and responsibility for patient care, which facilitates teamwork through close collaboration in medical decision-making and treatment planning 21 . In contrast, allied health professionals have diverse specialties and levels of autonomy, leading to challenges in achieving seamless teamwork due to differences in scope of practice and communication across various disciplines and settings 22 . The study showed higher job satisfaction among allied health professionals compared to pharmacists. Allied health professionals benefit from dynamic work environments offering continuous learning, career advancement, and exposure to diverse patient populations, fostering a sense of professional growth 22 . In contrast, pharmacists, face challenges like high workload, time pressures, and limited autonomy, potentially leading to lower job satisfaction than their allied health counterparts 23 . The observed disparity in teamwork scores between the surgical disciplines and clinical support disciplines can be attributed by task complexity. Surgical teams, often faced with high-stakes, complex procedures, require tight coordination and collaboration among team members to ensure patient safety and successful outcomes. This necessity for interdependence and clear communication fosters a strong sense of teamwork within the surgical department 24 . Conversely, clinical support roles involve more independent tasks with less reliance on team collaboration, leading to lower perceived levels of teamwork. The variance in safety climate scores between surgical and medical disciplines can be elucidated by inherent risks associated with surgical procedures. Surgical disciplines prioritise safety due to the high stakes and complexity of procedures, fostering a culture of adherence to safety protocols and heightened awareness. In contrast, medical disciplines perceive safety protocols as less central due to a greater focus on diagnostic processes and treatment plans. The higher job satisfaction, unit management, hospital management, management perception, and work conditions in the maternal & child disciplines compared to the medical disciplines can be attributed to several factors. The maternal & child disciplines typically receive more attention and resources due to its critical role in ensuring the health and well-being of mothers and infants, leading to better unit and hospital management practices. Moreover, the perception of management effectiveness and the quality of work conditions are influenced by factors such as communication, support from supervisors, and access to necessary resources, which can be better addressed in the maternal & child disciplines compared to the medical disciplines 25 . Conversely, the medical disciplines face challenges such as high patient volume, and demanding work schedules, which can contribute to lower job satisfaction and perceived management effectiveness 26 . In light of these challenges, the medical disciplines shall explore strategies to improve teamwork and safety climates. The Malaysian hospital surpassed the international benchmark in five out of six domains, except for stress recognition domain 11 , 13 . These findings likely stem from robust leadership, better communication, greater safety awareness, and improvements in infrastructure 11 . Sarawak General Hospital achieved a comparatively higher score on management perception, indicating strong leadership despite challenges like resource constraints associated with working conditions. Interestingly, the dissonant finding of the stress recognition domain aligns with an earlier study, which found that this subscale of SAQ does not fit with the overall heuristic of the instrument and is not reflective of safety climate 23 . The predictive variables identified as significantly correlated with fostering a positive patient safety culture. It is interesting to note that male gender is more likely to respond a higher SAQ score. It can be postulated that men and women interpret safety concerns in varying ways, and these distinctions are impacted by societal norms or professional backgrounds 24 . Previous research suggests that males prefer independent learning while females favour collaborative learning. Consequently, women tend to perceive competitive learning environments as inhibiting confidence and voice 25 . Furthermore, male-dominated roles within healthcare, particularly surgeons may confer a sense of authority and control over safety-related decisions, thereby contributing to higher safety attitude scores among male staff members 8 . Employees with less than 6 months working experience responded a higher rating in safety attitude, this could be attributed to their fresh perspective on the workplace, leading to increased attention to safety protocols and procedures. Additionally, new employees often feel a greater sense of responsibility to make a positive impression and comply with safety standards, potentially resulting in higher scores on safety attitude 16 . Similarly, healthcare workers who have been with SGH for 11 years or longer responded a higher positive safety attitude score. This suggests that long-term employees are likely to develop a heightened awareness of safety protocols, a stronger commitment to adhering to them, and a deeper understanding of the importance of maintaining a safe work environment. Individuals employed in surgery disciplines responded favorable patient safety attitude score compared to other disciplines. Surgery discipline specialise in surgical procedures, making them particularly prone to patient safety issues. Given the potential medicolegal consequences of errors or incidents like incorrect surgeries, they possess a heightened awareness of the significance of upholding a safe workplace environment 13 . This study has some limitations. First, a causal relationship could not be established because of the cross-sectional nature of the study. Second, snowball sampling was employed to engage respondents, which may introduce selection bias as it relies on referrals from initial participants. This approach might result in the overrepresentation of certain groups or perspectives within the sample, potentially affecting the generalisability of the findings. Finally, the use of self-administered questionnaires may introduce response bias, as participants may provide socially desirable responses or misinterpret survey items. CONCLUSION This study offers SGH an improved insight into the perceptions and cultural dynamics of healthcare professionals concerning patient safety. Overall, the patient safety culture is deemed satisfactory, with the majority of domains scores higher than the benchmark level. Certain domains and disciplines have been pinpointed as areas of weakness, offering opportunities for improvement. SGH needs to improve logistical support, including staffing level by recruiting additional personnel to accommodate the rising demands. The medical disciplines should explore strategies to improve the safety culture within the discipline. It is recommended that this survey be regularly conducted to track the advancement of patient safety culture following the implementation of targeted interventions. Declarations Acknowledgements The authors would like to thank the Director General of Health Malaysia for his permission to publish this article. Author contributions A.R.J.K., S.H.T., I.K.Y.K., Y.F.L. and H.U.N. designed the study. A.R.J.K., S.H.T., I.K.Y.K., F.C., Y.F.L. and H.U.N. analysed, interpreted the data and drafted the paper. A.R.J.K. had primary responsibility for statistical analysis and final content. All authors reviewed and approved the final paper. Conflict of interest The authors declare that they have no conflicts of interest. Data availability The dataset used and/or analysed during the current study are available from the corresponding author upon reasonable request. References Olesen, A. E., Juhl, M. H., Deilkås, E. T. & Kristensen, S. 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Safety culture perceptions of pharmacists in Malaysian hospitals and health clinics: a multicentre assessment using the Safety Attitudes Questionnaire. BMJ Open 5 , 1–9 (2015). Sexton, J. B. et al. The Safety Attitudes Questionnaire: Psychometric properties, benchmarking data, and emerging research. BMC Health Serv. Res. 6 , 1–10 (2006). Gleeson, L. L. et al. Healthcare provider perceptions of safety culture: A multi-site study using the safety attitudes questionnaire. Explor. Res. Clin. Soc. Pharm. 9 , 100228 (2023). Ismail, A. & Khalid, S. N. M. Patient safety culture and its determinants among healthcare professionals at a cluster hospital in Malaysia: A cross-sectional study. BMJ Open 12 , 1–11 (2022). Li, Y. et al. Perceptions of patient safety culture among healthcare employees in tertiary hospitals of Heilongjiang province in northern China: A cross-sectional study. Int. J. Qual. Heal. Care 30 , 618–623 (2018). Nieva, V. F. & Sorra, J. Safety culture assessment: A tool for improving patient safety in healthcare organizations. Qual. Saf. Heal. Care 12 , 17–23 (2003). Pires, M. L. Working conditions and organizational support influence on satisfaction and performance. Eur. J. Appl. Bus. Manag. Spec. Issue ICABM2018 162–186 (2018). Noyes, A. L. Navigating the Hierarchy: Communicating Power Relationships in Collaborative Health Care Groups. Manag. Commun. Q. 36 , 62–91 (2022). Sciences, A. H. Profile of Allied Health Professions in Ministry of Health Malaysia . vol. 20 (2020). Al-Jumaili, A. A. et al. Factors impacting job satisfaction among pharmacists in the Arab world: A qualitative study. Saudi Pharm. J. 31 , 578–584 (2023). Salas, E. et al. Does team training improve team performance? A meta-analysis. Hum. Factors 50 , 903–933 (2008). Dixon-Woods, M., McNicol, S. & Martin, G. Ten challenges in improving quality in healthcare: Lessons from the Health Foundation’s programme evaluations and relevant literature. BMJ Qual. Saf. 21 , 876–884 (2012). Shanafelt, T. D. et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch. Intern. Med. 172 , 1377–1385 (2012). Taylor, J. A. & Pandian, R. A dissonant scale: Stress recognition in the SAQ. BMC Res. Notes 6 , 2–7 (2013). Lee, S., Alsereidi, R. H. & Ben Romdhane, S. Gender Roles, Gender Bias, and Cultural Influences: Perceptions of Male and Female UAE Public Relations Professionals. Soc. Sci. 12 , (2023). Reynolds, F. Initial experiences of interprofessional problem-based learning: A comparison of male and female students’ views. J. Interprof. Care 17 , 35–44 (2003). Alqahtani, A. S. & Evley, R. Application of Safety Attitudes Questionnaire (SAQ) in Adult Intensive Care Units: a cross-sectional study. medRxiv 2020.07.07.20114918 (2020). Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4801909","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":345524263,"identity":"3b465520-6a0b-42bd-9e9a-b38c280b2855","order_by":0,"name":"Alex Ren Jye Kim","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA7UlEQVRIiWNgGAWjYDACdgYGxgYDIEOC+QCIlCGshRmuhS0BRPIQqYUBrBikkYGwFv5m5mOSMwq22ctH93x+daPGgoeB/fDRDfi0SBxmSzbcYHA7ceOds9usc44BHcaTlnYDrzWHeQwfPjC4nWA4I3ebcQ4bUIsEjxleLfKH+T8cBGqxN5yR88w45x8RWgwO8zA+BDqMcb5EDvPj3DYitBgeZjM2nAH0ywaJNDPm3D4JHjZCfpE73vxMsufPbXv5GcmPP+d8q5PjZz98DL/34S48wMAmAWKwEaUcBOQbGJg/EK16FIyCUTAKRhQAAFSnSJ20IPzuAAAAAElFTkSuQmCC","orcid":"","institution":"Sarawak General Hospital","correspondingAuthor":true,"prefix":"","firstName":"Alex","middleName":"Ren Jye","lastName":"Kim","suffix":""},{"id":345524264,"identity":"c5d4cd92-d977-49d7-9799-021154537265","order_by":1,"name":"Shirin Hui Tan","email":"","orcid":"","institution":"National Institutes of Health, Ministry of Health, Jalan Hospital","correspondingAuthor":false,"prefix":"","firstName":"Shirin","middleName":"Hui","lastName":"Tan","suffix":""},{"id":345524265,"identity":"0076fe9e-cf0c-4e57-a298-62e5e6532f51","order_by":2,"name":"Irene Khai Yen Kho","email":"","orcid":"","institution":"National Institutes of Health, Ministry of Health, Jalan Hospital","correspondingAuthor":false,"prefix":"","firstName":"Irene","middleName":"Khai Yen","lastName":"Kho","suffix":""},{"id":345524266,"identity":"a45c3d39-a5a4-4069-bd68-3b476574ff09","order_by":3,"name":"Farahfaiza Cuki","email":"","orcid":"","institution":"Ministry of Health, Jalan Hospital","correspondingAuthor":false,"prefix":"","firstName":"Farahfaiza","middleName":"","lastName":"Cuki","suffix":""},{"id":345524267,"identity":"5740c13e-d999-4534-ab28-a8f0a8284fec","order_by":4,"name":"Yew Fong Lee","email":"","orcid":"","institution":"Sarawak General Hospital","correspondingAuthor":false,"prefix":"","firstName":"Yew","middleName":"Fong","lastName":"Lee","suffix":""},{"id":345524268,"identity":"4e1554cd-4f13-4881-9742-3c2b5cd60f2d","order_by":5,"name":"Hie Ung Ngian","email":"","orcid":"","institution":"Sarawak General Hospital","correspondingAuthor":false,"prefix":"","firstName":"Hie","middleName":"Ung","lastName":"Ngian","suffix":""}],"badges":[],"createdAt":"2024-07-25 12:39:02","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4801909/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4801909/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":76194897,"identity":"ddc9c74b-0798-47cc-95b5-7124e51ec900","added_by":"auto","created_at":"2025-02-13 10:10:46","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1384061,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4801909/v1/a8a6ff64-7d5e-4cf6-8723-bf6797c51abb.pdf"},{"id":63490874,"identity":"a1898dd5-9dd4-41e0-82ee-e5242240ea0b","added_by":"auto","created_at":"2024-08-28 17:40:15","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":13475,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementaryAppendix102072024.docx","url":"https://assets-eu.researchsquare.com/files/rs-4801909/v1/ecd3ae2ca16b68b727227b73.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Safety culture evaluation in Sarawak General Hospital: a cross-sectional study using Safety Attitude Questionnaire (SAQ)","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003ePatient safety refers to the proactive and systematic efforts undertaken within healthcare settings to prevent harm to patients during the provision of medical care\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e. Patient safety incidents represent significant concerns within this domain because they encompass a broad spectrum, ranging from medication errors and diagnostic errors to falls and surgical complications\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e. Each incident can compromise patient well-being and undermine trust in the healthcare system. These incidents have the potential to incur substantial costs for both patients and the healthcare system\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e. The failure to uphold patients' safety leads to a considerable escalation in the expenses of healthcare, as well as elevated levels of morbidity and mortality\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThroughout the years, healthcare organisations worldwide have consistently prioritised patient safety as their primary focus\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e. It is becoming a priority, and improving patient safety is heavily reliant on creating a culture that encourages and supports health workers to report errors or near misses without fear of repercussions. Since the American Institute of Medicine published \"To Err Is Human\" in 1999, there has been a surge in interest in patient safety research. This patient safety framework encompasses a wide range of factors including teamwork, safety climate, employee satisfaction, work environment, stress recognition, management perception, and attitude\u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e,\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e. Based on previous research, it is commonly concurred that in order to enhance patient safety and elevate the standard of care, medical organisations should foster a patient safety culture\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e,\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e,\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThe British Health and Safety Commission defined patient safety culture as the culmination of individual and collective values, attitudes, perceptions, competencies, and behavioral patterns within an organisation, which influence its dedication to, and the manner and effectiveness of, safety management\u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e. Conducting safety culture assessments represents a primary strategic approach for enhancing the culture of patient safety. Hence, it is critical to assess safety culture in order to identify predictor factors that influence patient safety outcomes. A survey using safety culture assessment tools such as the Safety Attitude Questionnaire (SAQ) can help healthcare leaders understand their organisations' safety culture. The SAQ is a tool commonly used to assess various dimensions of safety culture among healthcare professionals. It has undergone comprehensive psychometric testing and has been shown to have good construct validity and internal consistency. It delves into six domains such as teamwork, safety climate, job satisfaction, stress recognition, management perceptions and working conditions\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e. By measuring these aspects, the SAQ provides valuable insights into the strengths and weaknesses of an organisation's safety culture. Healthcare institutions can utilise SAQ results to identify areas for improvement, implement targeted interventions, and cultivate a culture of safety that prioritises patient outcomes.\u003c/p\u003e \u003cp\u003eDespite the importance of assessing patient safety culture, there is still a lack of published investigations examining the level of patient safety culture among healthcare professionals in Malaysia. Hence, it is essential to assess the level of safety culture among healthcare professionals and identify the factors associated with it. This is the first SAQ study conducted in Sarawak General Hospital (SGH) which is situated in Kuching, East Malaysia. In 2018, a hospital survey on patient safety culture was conducted in SGH, using the Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire, which found that most of the scores related to dimensions were lower than benchmark score\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e. While both the HSOPSC and SAQ aim to measure patient safety culture, the SAQ includes specific domains that are not covered by the HSOPSC, such as stress recognition, job satisfaction, and working conditions. These domains are critical for understanding the holistic environment of patient safety and staff well-being. The HSOPSC, in contrast, offers a broader range of safety culture dimensions but lacks some of the specific focus areas of the SAQ. SGH will benefit from this study's baseline data for long-term ongoing assessment and a solid foundation for additional focused actions. In most hospitals, the safety culture has to be strengthened through intervention measures because it is not yet fully formed. To effectively implement the principle of \"first, do no harm\" throughout the entire healthcare organisation, it is essential to fully comprehend the meaning of a safety culture and its fundamental components, emphasises the significant impact that human factors have on patient safety, stress the significance of a safety culture at every level of management, and continuously enhance teamwork and communication both within and across teams. Therefore, this study was initiated to evaluate the status of safety culture in Sarawak General Hospital using the Safety Attitude Questionnaire (SAQ).\u003c/p\u003e"},{"header":"METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Safety Attitude Questionnaire (SAQ)\u003c/h2\u003e \u003cp\u003eThe Safety Attitudes Questionnaire (SAQ) was developed by Sexton at the University of Texas in the year 2000\u003csup\u003e11\u003c/sup\u003e. It was widely recognized as one of the most extensively validated instruments for assessing safety culture within healthcare settings\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e. SAQ was employed to assess individuals' sentiments regarding safety across six safety culture domains, encompassing safety climate, teamwork, stress recognition, management perception, working conditions, and job satisfaction. The survey offers international benchmarking data, facilitating the comparison of safety cultures across healthcare organisations and countries\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThe distribution of the questionnaires based on the six domains were shown in Appendix 1. The SAQ comprises 36 items, all of which are closed-ended questions, requiring respondents to indicate their level of agreement on a 5-point Likert scale, spanning from 1 (disagree strongly) to 5 (agree strongly)\u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e. Items 14 and 33\u0026ndash;36 were not part of the scales mentioned while items 2, 11, and 36 were reverse scored. Demographic information of the respondents, including details such as age, gender, years in service, occupation, and disciplines based on the organization chart, was also collected. The department was categorised into four disciplines: maternal \u0026amp; child, surgical, medicine, and clinical support. The department of pediatrics, obstetrics, and gynecology were merged into the maternal \u0026amp; child disciplines, while the surgical disciplines encompassed the department of surgery, orthopedics, the emergency department, neurosurgery, anesthesiology, critical care, plastic surgery, otorhinolaryngology, ophthalmology, urology, pediatric surgery, and radiology. Furthermore, the medicine disciplines included the general medicine, other medical subspecialties, psychiatry, oncology, and the clinical support disciplines comprised the department of pharmacy, radiology, pathology, and rehabilitation medicine.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Study Design and Sampling\u003c/h2\u003e \u003cp\u003eA cross-sectional study using \"Safety Attitude Questionnaire\" was conducted in Sarawak General Hospital. Snow-balling or wide dissemination was used in this study to engage healthcare workers to participate in this survey. The data were collected from 15 May 2022 to 14 April, 2023. A self-administered questionnaire was distributed to 767 hospital staff members, including doctors, nurses, pharmacists, and other clinical personnel. The questionnaire was prepared in English, as most respondents understood English. Each respondent was allocated a duration of 10\u0026ndash;15 minutes to complete the questionnaires, after which they were promptly collected upon completion. The participation and results were voluntary, anonymised and kept confidential. Written informed consent was obtained from all respondents. The questionnaire was successfully completed by 646 respondents.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Data analysis\u003c/h2\u003e \u003cp\u003eDescriptive statistics were used to calculate the scores of each item, while demographic data was analysed using ANOVA and paired sample t-tests. Standardised algorithms were employed to consolidate individual items in each domain into a 0\u0026ndash;100 scale (1\u0026thinsp;=\u0026thinsp;0, 2\u0026thinsp;=\u0026thinsp;25, 3\u0026thinsp;=\u0026thinsp;50, 4\u0026thinsp;=\u0026thinsp;75 and 5\u0026thinsp;=\u0026thinsp;100). Lower scores indicate a less favorable perception on that items, while higher scores signify more favorable perceptions\u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e. The mean of respondents who \"agree\" or \"strongly agree\" with a specific statement was used to calculate scores. Likewise with inquiries that are phrased negatively. The analysis did not include responses marked \"not applicable\" or left blank. The percentages of respondents indicating a positive attitude (\u0026ge;\u0026thinsp;75; agree slightly and agree strongly) were computed. Statistical significance is defined as a p-value of 5% or less. Logistic regression was performed to identify demographic factors that serve as predictors of positive scores in the SAQ. All the statistical analyses were performed using Jamovi version 2.3.28.\u003c/p\u003e \u003cp\u003eThis research was cross-sectional and contained no extra interventions. It was carried out in accordance with the Declaration of Helsinki's ethical principles and the Malaysian Good Clinical Practice Guideline. The study protocol was approved by the Medical Research and Ethics Committee of the National Medical Research Registry, Ministry of Health Malaysia (Approval number: NMRR-22-00409-EUW) on May 10, 2022.\u003c/p\u003e \u003c/div\u003e"},{"header":"RESULTS","content":"\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e3.1 Socio-demographic characteristics of respondents\u003c/h2\u003e \u003cp\u003eThe SAQ response rate was 84.2% overall (646 out of 767 distributed questionnaires). The respondents were mostly female (81.7%), and worked for 11 to 20 years (32.8%). Among the respondents, mostly (64.9%) were nurses, followed by doctors (21.4%), allied health (10.5%) and pharmacist (3.3%). Majority of the respondents were from surgical disciplines (45.5%), followed by medical (23.7%), maternal and child (18.6%), and clinical support (12.2%) \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDemographics profile of respondents (N\u0026thinsp;=\u0026thinsp;646)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eDemographics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e528 (81.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e118 (18.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"6\" rowspan=\"7\"\u003e \u003cp\u003e\u003cb\u003eWorking Experience (Years)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;6 months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21 (3.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u0026ndash;11 months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22 (3.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026ndash;2 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e46 (7.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3\u0026ndash;4 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21 (3.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5\u0026ndash;10 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e211 (32.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11\u0026ndash;20 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e212 (32.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;21 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e113 (17.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u003cb\u003eOccupation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDoctor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e138 (21.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNurse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e419 (64.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePharmacist\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21 (3.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAllied Health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e68 (10.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u003cb\u003eDisciplines\u003c/b\u003e\u003csup\u003e\u003cb\u003ea\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMaternal \u0026amp; Child\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e120 (18.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMedicine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e153 (23.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSurgical\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e294 (45.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eClinical Support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e79 (12.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"3\"\u003e\u003csup\u003ea\u003c/sup\u003eDisciplines were categorised based on the Sarawak General Hospital organisation chart\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e3.2 Comparison of SAQ Domain Results Among Healthcare Professionals\u003c/h2\u003e \u003cp\u003eThe average SAQ score was 65.8\u0026thinsp;\u0026plusmn;\u0026thinsp;15.0 with 31.3% achieving positive responses (score of 75\u0026thinsp;\u003cb\u003e\u0026ge;\u003c/b\u003e\u0026thinsp;on a 100-point scale). With a mean of 71.7\u0026thinsp;\u0026plusmn;\u0026thinsp;20.5, job satisfaction obtained the highest rating with 53.4% positive responses. The mean score for working conditions, on the other hand, was the lowest at 52.7\u0026thinsp;\u0026plusmn;\u0026thinsp;19.5 with 17.0% of positive responses \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003eA significant difference was observed among healthcare professionals in teamwork, job satisfaction, management perception, working condition and stress recognition (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Among healthcare professionals, doctors attained the highest mean score in teamwork (70.4\u0026plusmn;25.7), pharmacists in safety climate (70.6\u0026plusmn;20.0) and stress recognition (81.5\u0026plusmn;23.8), allied health professionals in job satisfaction (75.5\u0026plusmn;23.7), and nurses in management perception (67.6\u0026plusmn;17.8) and working conditions (55.5\u0026plusmn;18.4). In contrast, allied health professionals attained the lowest mean scores for teamwork (59.0\u0026plusmn;23.3), safety climate (66.1\u0026plusmn;20.4), and stress recognition (63.6\u0026plusmn;27.9), pharmacists in job satisfaction (60.2\u0026plusmn; 23.4), and doctors in management perception (61.4\u0026plusmn;22.3) and working condition (45.4\u0026plusmn; 21.5). Nurses garnered the highest overall SAQ mean score (66.8\u0026plusmn;13.6). Conversely, allied health professionals obtained the lowest overall SAQ mean scores (62.7\u0026plusmn;16.1) \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparing SAQ Domain Results Among Healthcare Professionals\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDomain\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOverall\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAllied health professional\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eDoctor\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNurses\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003ePharmacist\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003ep-value*\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e(100 scale)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;68\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;138\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;419\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;21\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTeamwork\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMean \u0026plusmn; SD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e67.6 \u0026plusmn; 20.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e59.0 \u0026plusmn; 23.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e70.4 \u0026plusmn; 25.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e68.1 \u0026plusmn; 17.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e68.1 \u0026plusmn; 20.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.016\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePositive responses (\u0026ge;75) (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e42.9*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e57.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e40.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e33.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSafety Climate\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMean \u0026plusmn; SD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e68.7 \u0026plusmn; 18.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e66.1 \u0026plusmn; 20.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e67.7 \u0026plusmn; 23.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e69.4 \u0026plusmn; 16.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e70.6 \u0026plusmn; 20.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.544\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePositive responses (\u0026ge;75) (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e43.0*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e45.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e42.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e42.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eJob Satisfaction\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMean \u0026plusmn; SD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e71.7 \u0026plusmn; 23.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e75.5 \u0026plusmn; 23.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e63.2 \u0026plusmn; 28.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e74.5 \u0026plusmn; 20.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e60.2 \u0026plusmn; 23.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePositive responses (\u0026ge;75) (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e53.4*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e39.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e57.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e33.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eManagement Perception\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMean \u0026plusmn; SD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e65.8 \u0026plusmn; 19.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e64.6 \u0026plusmn; 20.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e61.4 \u0026plusmn; 22.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e67.6 \u0026plusmn; 17.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e63.0 \u0026plusmn; 21.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePositive responses (\u0026ge;75) (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35.3*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e29.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e38.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e28.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWorking Condition\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMean \u0026plusmn; SD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e52.7 \u0026plusmn; 19.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e51.1 \u0026plusmn; 18.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e45.4 \u0026plusmn; 21.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e55.5 \u0026plusmn; 18.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e50.6 \u0026plusmn; 20.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.026\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePositive responses (\u0026ge;75) (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e17.0*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e19.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e19.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eStress Recognition\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMean \u0026plusmn; SD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e68.3 \u0026plusmn; 25.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e63.6 \u0026plusmn; 27.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e81.3 \u0026plusmn; 20.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e64.1 \u0026plusmn; 24.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e81.5 \u0026plusmn; 23.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePositive responses (\u0026ge;75) (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e50.2*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e73.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e42.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e81.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOverall SAQ score\u003c/b\u003e\u003c/p\u003e \u003cp\u003eMean \u0026plusmn; SD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e65.8 \u0026plusmn; 15.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e62.7\u0026plusmn;16.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e64.6\u0026plusmn;18.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e66.8\u0026plusmn;13.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e64.4\u0026plusmn;15.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.168\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePositive responses (\u0026ge;75) (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31.3*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e34.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e30.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e28.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003e* Percent positive scores are computed as the per cent of participants who answered \u0026lsquo;agree slightly\u0026rsquo; or \u0026lsquo;agree strongly\u0026rsquo; on each of the items\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003ewithin a scale (i.e. 4 or 5 on the original 5-point Likert scale).\u003c/p\u003e \u003cp\u003e* Analysed using one-way ANOVA.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e3.3 Comparison of SAQ Domain Results Among Disciplines\u003c/h2\u003e \u003cp\u003eA notable variation was observed among the disciplines in terms of teamwork, safety climate, unit management, hospital management, and management perception (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). The surgical disciplines achieved the highest average scores for both teamwork (70.5\u0026plusmn;20.9) and safety climate (70.4\u0026plusmn;19.2) followed by the maternal \u0026amp; child discipline department excelled in job satisfaction (74.1\u0026plusmn;22.7), unit management (69.8\u0026plusmn;17.6), hospital management (68.4\u0026plusmn;17.0), management perception (69.1\u0026plusmn;16.9), and working conditions (53.9\u0026plusmn;19.8). Conversely, the clinical support discipline recorded the lowest average scores for teamwork (61.9\u0026plusmn;24.2), while the medical discipline received the lowest scores in several areas including safety climate (65.5\u0026plusmn;17.7), job satisfaction (68.4\u0026plusmn;23.8), stress recognition (65.3\u0026plusmn;24.2), unit management (63.7\u0026plusmn;19.6), hospital management (60.9\u0026plusmn;20.4), management perception (62.3\u0026plusmn;19.3), and working conditions (51.5\u0026plusmn;18.1). The maternal \u0026amp; child discipline garnered the highest mean score in the SAQ assessment, with a value of 67.4\u0026plusmn;12.9, whereas the medical discipline recorded the lowest overall SAQ mean scores at 62.9\u0026plusmn;14.6 \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparing SAQ Domain Results Among Discipline\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDomain\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMaternal \u0026amp; child\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSurgical\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMedicine\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eClinical support\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep-value*\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;120\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;294\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;153\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;79\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTeamwork\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMean \u0026plusmn; SD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e68.2 \u0026plusmn; 18.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e70.5\u0026plusmn; 20.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e64.8 \u0026plusmn; 18.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e61.9 \u0026plusmn; 24.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePositive responses (\u0026ge;75) (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e43.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e51.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e35.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSafety Climate\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMean \u0026plusmn; SD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e69.7 \u0026plusmn; 16.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e70.4 \u0026plusmn; 19.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e65.5 \u0026plusmn; 17.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e67.2 \u0026plusmn; 19.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.042\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePositive responses (\u0026ge;75) (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e48.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e46.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e44.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eJob Satisfaction\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMean \u0026plusmn; SD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e74.1 \u0026plusmn; 22.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e72.1 \u0026plusmn; 23.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e68.4 \u0026plusmn; 23.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e73.0 \u0026plusmn; 22.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.212\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePositive responses (\u0026ge;75) (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e59.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e54.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e44.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e59.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eStress Recognition\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMean \u0026plusmn; SD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e67.8 \u0026plusmn; 25.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e69.3 \u0026plusmn; 25.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e65.3 \u0026plusmn; 24.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e71.2 \u0026plusmn; 27.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.291\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePositive responses (\u0026ge;75) (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e50.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e51.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e43.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e59.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eManagement Perception (Unit)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMean \u0026plusmn; SD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e69.8 \u0026plusmn; 17.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e68.2 \u0026plusmn; 20.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e63.7 \u0026plusmn; 19.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e66.8 \u0026plusmn; 22.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.047\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePositive responses (\u0026ge;75) (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e47.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e40.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eManagement Perception (Hospital)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMean \u0026plusmn; SD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e68.4 \u0026plusmn; 17.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e64.3 \u0026plusmn; 21.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e60.9 \u0026plusmn; 20.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e65.1 \u0026plusmn; 20.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.013\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePositive responses (\u0026ge;75) (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e43.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e34.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eManagement Perception (Overall)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMean \u0026plusmn; SD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e69.1 \u0026plusmn; 16.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e66.3 \u0026plusmn; 20.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e62.3 \u0026plusmn; 19.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e65.9 \u0026plusmn; 19.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.024\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePositive responses (\u0026ge;75) (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e44.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e29.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e31.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWorking Condition\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMean \u0026plusmn; SD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e53.9 \u0026plusmn; 19.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e53.1 \u0026plusmn; 20.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e51.5 \u0026plusmn; 18.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e52.0 \u0026plusmn; 18.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.719\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePositive responses (\u0026ge;75) (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOverall SAQ score\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMean \u0026plusmn; SD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e67.4 \u0026plusmn; 12.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e66.8 \u0026plusmn; 15.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e62.9 \u0026plusmn; 14.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e65.3 \u0026plusmn; 14.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.027\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePositive responses (\u0026ge;75) (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e28.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e26.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003e* Per cent positive scores are computed as the per cent of participants who answered \u0026lsquo;agree\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eslightly\u0026rsquo; or \u0026lsquo;agree strongly\u0026rsquo; on each of the items within a scale (i.e., 4 or 5 on the original\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003e5-point Likert scale).\u003c/h3\u003e\n\u003cp\u003e* Analysed using one-way ANOVA.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e3.4 Comparing SAQ Domain Results Between Selected Hospitals in Malaysia and International Benchmark\u003c/h2\u003e \u003cp\u003eIn comparison to the international benchmark for inpatient care in the United States, Hospital Sultanah Bahiyah in Kedah, Sarawak General Hospital in Sarawak, and public hospital in Melaka scored notably higher mean scores across five of the six domains: teamwork, safety climate, job satisfaction, management perception, and working conditions \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparing SAQ Domain Results Between Selected Hospitals in Malaysia and International Benchmark\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"11\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"9\" nameend=\"c11\" namest=\"c3\"\u003e \u003cp\u003eSAQ Safety Domain\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSetting\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCountry\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eTeamwork scale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eSafety Climate scale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eJob Satisfaction scale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eStress\u003c/p\u003e \u003cp\u003eRecognition scale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eManagement\u003c/p\u003e \u003cp\u003ePerception scale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eWorking condition scale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003eOverall SAQ score\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eInternational Benchmark [ref:11]\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eMean\u0026plusmn;SD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eInpatient\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eUSA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e64.3\u0026plusmn;16.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e60.5\u0026plusmn;16.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e59.6\u0026plusmn;20.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e74.4\u0026plusmn;20.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e38.3\u0026plusmn;18.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e49.2\u0026plusmn;19.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e57.7\u0026plusmn;N.A*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003ePositive responses (\u0026ge;75) (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eN.A\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eN.A\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eN.A\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eN.A\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eN.A\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eN.A\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eN.A\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSultanah Bahiyah Hospital [ref:13]\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eMean\u0026plusmn;SD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHealthcare\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMalaysia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e69.0\u0026plusmn;12.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e69.0\u0026plusmn;12.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e76.3\u0026plusmn;17.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e63.7\u0026plusmn;24.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e64.7\u0026plusmn;16.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e62.6\u0026plusmn;12.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e67.8\u0026plusmn;10.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003ePositive responses (\u0026ge;75) (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eProfessionals\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e(Kedah)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e36.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e34.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e66.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e43.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e28.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e24.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e23.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSarawak General Hospital\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eMean\u0026plusmn;SD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHealthcare\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMalaysia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e67.7\u0026plusmn;20.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e68.7\u0026plusmn;18.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e71.7\u0026plusmn;23.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e68.3\u0026plusmn;25.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e65.8\u0026plusmn;19.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e52.7\u0026plusmn;19.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e65.8\u0026plusmn;15.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003ePositive responses (\u0026ge;75) (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eProfessionals\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e(Sarawak)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e42.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e43.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e53.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e50.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e35.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e17.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e31.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePublic Hospitals and Health Clinics [ref:10]\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eMean\u0026plusmn;SD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePharmacist\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMalaysia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e67.6\u0026plusmn;14.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e66.8\u0026plusmn;14.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e67.3\u0026plusmn; 19.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e73.0\u0026plusmn;20.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e62.2\u0026plusmn;14.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e54.8\u0026plusmn;17.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e65.6\u0026plusmn;11.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003ePositive responses (\u0026ge;75) (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e(Melaka)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e38.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e33.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e46.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e58.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e29.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e15.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e20.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e* The journal does not contain data on the standard deviation.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003e3.5 Demographic predictors of positive scores in SAQ\u003c/h2\u003e \u003cp\u003eFollowing the adjustment for gender, males employed at SGH demonstrate a 1.8-fold higher probability (p\u0026thinsp;=\u0026thinsp;0.021) of achieving positive scores in overall safety attitude assessments. Employees at SGH who have been employed for less than six months have a 2.7 times greater likelihood (p\u0026thinsp;=\u0026thinsp;0.045) of receiving positive ratings in evaluations of the overall safety attitude score, compared to those between 5 and 10 years of working experience. Employees who have been with SGH for 11 years or longer, including those with 11 to 20 years of experience and over 21 years, exhibit a 1.9-fold higher likelihood (p\u0026thinsp;=\u0026thinsp;0.045) and a 4.9-fold higher likelihood (p\u0026thinsp;=\u0026thinsp;\u0026lt;\u0026thinsp;0.001) respectively of achieving positive scores in overall safety culture assessments, than employees with 5 to 10 years of experience. Staff in surgical disciplines had a more positive attitude towards patient safety than staff in other disciplines (p-value\u0026thinsp;=\u0026thinsp;0.040) \u003cb\u003e(\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e\u003cb\u003e)\u003c/b\u003e.\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eTable 5. Demographic predictors of positive scores in SAQ\u003c/strong\u003e\n\u003cdiv\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"37.666666666666664%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAdj.\u003cem\u003e\u0026nbsp;OR\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e(95% CI \u003cem\u003eOR)\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.333333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"37.666666666666664%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Male\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Female (Ref)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1.834\u003c/p\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e(1.096, 3.070)\u003c/p\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.333333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.021\u003c/p\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"37.666666666666664%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eWorking experience (years)\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;\u0026lt;6 months\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;6 \u0026ndash; 11 months\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;1 \u0026ndash; 2 years\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;3 \u0026ndash; 4 years\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;5 \u0026ndash; 10 years (Ref)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;11 \u0026ndash; 20 years\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;\u0026sup3;21 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2.706\u003c/p\u003e\n \u003cp\u003e1.076\u003c/p\u003e\n \u003cp\u003e1.701\u003c/p\u003e\n \u003cp\u003e1.306\u003c/p\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003cp\u003e1.933\u003c/p\u003e\n \u003cp\u003e4.909\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e(1.024, 7.152)\u003c/p\u003e\n \u003cp\u003e(0.367, 3.154)\u003c/p\u003e\n \u003cp\u003e(0.804, 3.600)\u003c/p\u003e\n \u003cp\u003e(0.430, 3.964)\u003c/p\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e(1.220, 3.063)\u003c/p\u003e\n \u003cp\u003e(2.910, 8.279)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.333333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.045\u003c/p\u003e\n \u003cp\u003e0.893\u003c/p\u003e\n \u003cp\u003e0.165\u003c/p\u003e\n \u003cp\u003e0.638\u003c/p\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003cp\u003e\u0026lt;0.001\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"37.666666666666664%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eDiscipline\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Maternal and Child\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Surgical\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Clinical Support\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Medicine (Ref)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1.125\u003c/p\u003e\n \u003cp\u003e1.641\u003c/p\u003e\n \u003cp\u003e0.933\u003c/p\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e(0.632, 2.001)\u003c/p\u003e\n \u003cp\u003e(1.024, 2.630)\u003c/p\u003e\n \u003cp\u003e(0.444, 1.962)\u003c/p\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.333333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.690\u003c/p\u003e\n \u003cp\u003e0.040\u003c/p\u003e\n \u003cp\u003e0.855\u003c/p\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"37.666666666666664%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eOccupation\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Allied health professionals\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Nurse (Ref)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp;Doctor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.703\u003c/p\u003e\n \u003cp\u003e1.000\u003c/p\u003e\n \u003cp\u003e0.917\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e(0.363, 1.362)\u003c/p\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e(0.537, 1.563)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.333333333333332%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e0.296\u003c/p\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003cp\u003e0.749\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThis study is the initial implementation of SAQ within SGH to evaluate the patient safety culture. Evaluating and promoting safety culture is a prerequisite step to improve patient safety\u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e. The SAQ, utilised as a tool for assessing patient safety culture, enables SGH to gain a deeper understanding of the current state of patient safety culture and the associated factors by evaluating individuals' attitudes towards safety across six domains within the safety culture framework.\u003c/p\u003e \u003cp\u003eThis study found a higher overall mean score of 65.8 compared to the international benchmark of 57.7, indicating that respondents in this study generally outperformed the international standard\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e. Job satisfaction received the highest mean score (71.7\u0026plusmn;23.3) in this study, surpassing the international benchmark\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e, suggesting that most healthcare workers are content with their jobs and have positive work experiences. This is supported by a significant proportion of participants expressing positive sentiments to the statement \"I like my job\" (77.9%) which ranked among the highest-scoring items in the SAQ. However, working conditions received the lowest mean score (52.7\u0026plusmn;19.5) in our study, although it still scored above the international benchmark\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e. This suggests employees' dissatisfaction with aspects such as staffing levels and logistical support, as evidenced by low scores on \u0026ldquo;the staffing level in this clinical area is adequate to manage the number of patients\u0026rdquo; (26.4%) which is one of the five lowest mean scores in our SAQ. The shortage of staff, increased patient volume, and expanded clinical services contribute to heightened workload and potential risks to patient safety\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e. Despite perceived poor working conditions, a higher level of job satisfaction could be attributed to strong organisational support, in terms of recognition, career development opportunities, and interpersonal relationships. This perceived support could enhance overall job satisfaction, mitigating the negative impact of poor working conditions\u003csup\u003e\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThe study found that teamwork scores were higher among doctors compared to allied health professionals. Doctors, operating within a hierarchical system, often have significant authority and responsibility for patient care, which facilitates teamwork through close collaboration in medical decision-making and treatment planning\u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e. In contrast, allied health professionals have diverse specialties and levels of autonomy, leading to challenges in achieving seamless teamwork due to differences in scope of practice and communication across various disciplines and settings\u003csup\u003e\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e. The study showed higher job satisfaction among allied health professionals compared to pharmacists. Allied health professionals benefit from dynamic work environments offering continuous learning, career advancement, and exposure to diverse patient populations, fostering a sense of professional growth\u003csup\u003e\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e. In contrast, pharmacists, face challenges like high workload, time pressures, and limited autonomy, potentially leading to lower job satisfaction than their allied health counterparts\u003csup\u003e\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThe observed disparity in teamwork scores between the surgical disciplines and clinical support disciplines can be attributed by task complexity. Surgical teams, often faced with high-stakes, complex procedures, require tight coordination and collaboration among team members to ensure patient safety and successful outcomes. This necessity for interdependence and clear communication fosters a strong sense of teamwork within the surgical department\u003csup\u003e\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e. Conversely, clinical support roles involve more independent tasks with less reliance on team collaboration, leading to lower perceived levels of teamwork. The variance in safety climate scores between surgical and medical disciplines can be elucidated by inherent risks associated with surgical procedures. Surgical disciplines prioritise safety due to the high stakes and complexity of procedures, fostering a culture of adherence to safety protocols and heightened awareness. In contrast, medical disciplines perceive safety protocols as less central due to a greater focus on diagnostic processes and treatment plans.\u003c/p\u003e \u003cp\u003eThe higher job satisfaction, unit management, hospital management, management perception, and work conditions in the maternal \u0026amp; child disciplines compared to the medical disciplines can be attributed to several factors. The maternal \u0026amp; child disciplines typically receive more attention and resources due to its critical role in ensuring the health and well-being of mothers and infants, leading to better unit and hospital management practices. Moreover, the perception of management effectiveness and the quality of work conditions are influenced by factors such as communication, support from supervisors, and access to necessary resources, which can be better addressed in the maternal \u0026amp; child disciplines compared to the medical disciplines\u003csup\u003e\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u003c/sup\u003e. Conversely, the medical disciplines face challenges such as high patient volume, and demanding work schedules, which can contribute to lower job satisfaction and perceived management effectiveness\u003csup\u003e\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u003c/sup\u003e. In light of these challenges, the medical disciplines shall explore strategies to improve teamwork and safety climates.\u003c/p\u003e \u003cp\u003eThe Malaysian hospital surpassed the international benchmark in five out of six domains, except for stress recognition domain\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e,\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e. These findings likely stem from robust leadership, better communication, greater safety awareness, and improvements in infrastructure\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e. Sarawak General Hospital achieved a comparatively higher score on management perception, indicating strong leadership despite challenges like resource constraints associated with working conditions. Interestingly, the dissonant finding of the stress recognition domain aligns with an earlier study, which found that this subscale of SAQ does not fit with the overall heuristic of the instrument and is not reflective of safety climate\u003csup\u003e\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThe predictive variables identified as significantly correlated with fostering a positive patient safety culture. It is interesting to note that male gender is more likely to respond a higher SAQ score. It can be postulated that men and women interpret safety concerns in varying ways, and these distinctions are impacted by societal norms or professional backgrounds\u003csup\u003e\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e. Previous research suggests that males prefer independent learning while females favour collaborative learning. Consequently, women tend to perceive competitive learning environments as inhibiting confidence and voice\u003csup\u003e\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u003c/sup\u003e. Furthermore, male-dominated roles within healthcare, particularly surgeons may confer a sense of authority and control over safety-related decisions, thereby contributing to higher safety attitude scores among male staff members\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eEmployees with less than 6 months working experience responded a higher rating in safety attitude, this could be attributed to their fresh perspective on the workplace, leading to increased attention to safety protocols and procedures. Additionally, new employees often feel a greater sense of responsibility to make a positive impression and comply with safety standards, potentially resulting in higher scores on safety attitude\u003csup\u003e\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e. Similarly, healthcare workers who have been with SGH for 11 years or longer responded a higher positive safety attitude score. This suggests that long-term employees are likely to develop a heightened awareness of safety protocols, a stronger commitment to adhering to them, and a deeper understanding of the importance of maintaining a safe work environment.\u003c/p\u003e \u003cp\u003eIndividuals employed in surgery disciplines responded favorable patient safety attitude score compared to other disciplines. Surgery discipline specialise in surgical procedures, making them particularly prone to patient safety issues. Given the potential medicolegal consequences of errors or incidents like incorrect surgeries, they possess a heightened awareness of the significance of upholding a safe workplace environment\u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThis study has some limitations. First, a causal relationship could not be established because of the cross-sectional nature of the study. Second, snowball sampling was employed to engage respondents, which may introduce selection bias as it relies on referrals from initial participants. This approach might result in the overrepresentation of certain groups or perspectives within the sample, potentially affecting the generalisability of the findings. Finally, the use of self-administered questionnaires may introduce response bias, as participants may provide socially desirable responses or misinterpret survey items.\u003c/p\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eThis study offers SGH an improved insight into the perceptions and cultural dynamics of healthcare professionals concerning patient safety. Overall, the patient safety culture is deemed satisfactory, with the majority of domains scores higher than the benchmark level. Certain domains and disciplines have been pinpointed as areas of weakness, offering opportunities for improvement. SGH needs to improve logistical support, including staffing level by recruiting additional personnel to accommodate the rising demands. The medical disciplines should explore strategies to improve the safety culture within the discipline. It is recommended that this survey be regularly conducted to track the advancement of patient safety culture following the implementation of targeted interventions.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u0026nbsp; \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to thank the Director General of Health Malaysia for his permission to publish this article.\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA.R.J.K., S.H.T., I.K.Y.K., Y.F.L. and H.U.N. designed the study. A.R.J.K., S.H.T., I.K.Y.K., F.C., Y.F.L. and H.U.N. analysed, interpreted the data and drafted the paper. A.R.J.K. had primary responsibility for statistical analysis and final content. All authors reviewed and approved the final paper.\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eConflict of interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no conflicts of interest.\u0026nbsp; \u0026nbsp;\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe dataset used and/or analysed during the current study are available from the corresponding author upon reasonable request.\u003cstrong\u003e\u003cbr\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eOlesen, A. E., Juhl, M. H., Deilk\u0026aring;s, E. T. \u0026amp; Kristensen, S. Review: application of the Safety Attitudes Questionnaire (SAQ) in primary care - a systematic synthesis on validity, descriptive and comparative results, and variance across organisational units. \u003cem\u003eBMC Prim. 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Application of Safety Attitudes Questionnaire (SAQ) in Adult Intensive Care Units: a cross-sectional study. \u003cem\u003emedRxiv\u003c/em\u003e 2020.07.07.20114918 (2020).\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Safety Attitude Questionnaire, safety culture, patient safety, organization supports","lastPublishedDoi":"10.21203/rs.3.rs-4801909/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4801909/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003ePatient safety involves proactive and systematic efforts within healthcare settings to prevent harm to patients during medical care. Globally, healthcare organizations prioritize patient safety as a key factor in quality and safety. This study aimed to investigate the patient safety culture at Sarawak General Hospital (SGH), a tertiary referral hospital in Malaysia. A cross-sectional study using the Safety Attitude Questionnaire (SAQ) was conducted at SGH from May 2022 to April 2023. The survey included 767 hospital staff members, such as doctors, nurses, pharmacists, and other clinical personnel, with a response rate of 84.2% (646 respondents). The study used Jamovi 2.3.28 for statistical analysis of the survey data. The overall mean SAQ score was 65.8\u0026thinsp;\u0026plusmn;\u0026thinsp;15.0 with a 31.3% positive response rate. Most domain scores were higher than benchmark scores (65.7\u0026ndash;72.2%), except for the stress recognition domain. Job satisfaction had the highest mean (71.7\u0026thinsp;\u0026plusmn;\u0026thinsp;23.3) and positive rate (53.4%), indicating high contentment among healthcare workers. Conversely, the working condition domain had the lowest mean (52.7\u0026thinsp;\u0026plusmn;\u0026thinsp;19.5) and positive rate (17%), reflecting dissatisfaction with staffing levels and logistical support. Overall, the patient safety culture at SGH is satisfactory, with most domain scores exceeding benchmark levels.\u003c/p\u003e","manuscriptTitle":"Safety culture evaluation in Sarawak General Hospital: a cross-sectional study using Safety Attitude Questionnaire (SAQ)","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-08-28 17:40:10","doi":"10.21203/rs.3.rs-4801909/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"7ac674c9-c813-48fd-9713-4a933b17476b","owner":[],"postedDate":"August 28th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-02-13T10:09:47+00:00","versionOfRecord":[],"versionCreatedAt":"2024-08-28 17:40:10","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4801909","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4801909","identity":"rs-4801909","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}