郭乃文Abdirahman Ibrahim Dualeh2026-05-062026-05-062025-06-17https://203.71.86.71/handle/123456789/9185學位別：碩士 口試委員：郭乃文; 石崇良; 林恆慶 關鍵字：Patient Safety、patient safety climate (PSC)、job satisfaction、stress recognition、work-life balance、emotional exhaustion、working conditions、teamwork、perception of managementAbstract Title of Thesis: Association between Work Environment and Patient safety climate: Perceptions Among Nurses in Somaliland Author: Abdirahman Ibrahim Dualeh Thesis advised by: Professor Nei-Wen Kuo Background: There is awareness of the association between organizational characteristics of the work environment and patient safety climate in healthcare organizations in Somaliland; however, limited research has addressed how sociodemographic characteristics and work environment influence this association. Identifying these associations could enhance patient safety, improve nurses' work conditions, and contribute to reducing medical errors and improving healthcare quality. Objectives: This study aimed to determine the association between work environment factors, with the patient safety climate from the perspective of nurses in Somaliland. Methods: The study used a cross-sectional survey design involving healthcare practitioners (nurses) working in public hospitals in Somaliland, namely Hargeisa General Hospital, Burao General Hospital, Borama Regional Hospital, and Berbera Regional Hospital, located across four different regions. A total of 235 nurses volunteered and participated in the study, which was conducted between January and March 2025. The collected data were analyzed using SPSS version 19. Descriptive statistics were computed to summarize the demographic characteristics of the participants and their scores for each dimension of the Safety Attitudes Questionnaire (SAQ). Analysis of Variance (ANOVA) was utilized to compare mean values across different groups to identify statistically significant differences. Pearson correlation was used to examine the strength of linear relationships between work environment factors, sociodemographic characteristics with patient safety climate. Additionally, Multiple Linear Regression analysis was conducted to assess the impact of various work environment factors and sociodemographic characteristics with patient safety climate, allowing for evaluation of the relative contribution of each factor while controlling for other variables. Results: A total of 235 nurses participated in the study. The Patient Safety Climate dimension recorded the highest mean score (M = 22.66), while Stress Recognition had the lowest (M = 12.16). ANOVA results showed statistically significant differences in safety climate perceptions across departments, with the Outpatient Unit scoring significantly higher than the Emergency, Maternity, and Medical Wards (p < 0.05). Pearson correlation analysis revealed strong positive associations between patient safety climate and teamwork climate (r = 0.756, p < 0.05), job satisfaction (r = 0.678, p < 0.05), and perception of management (r = 0.672, p < 0.05). Negative correlations were observed with emotional exhaustion (r = –0.229, p < 0.05) and stress recognition (r = –0.376, p < 0.05). Multiple linear regression analysis identified significant predictors of patient safety climate, including teamwork climate (B = 0.520, p < 0.05), working conditions (B = 0.191, p = 0.030), and working in the Outpatient Department (B = 1.803, p = 0.041). Specifically, nurses working in the Outpatient Unit reported patient safety climate scores that were, on average, 1.803 points higher than those working in the Medical Ward, a difference that was statistically significant (p = 0.041). The Medical Ward was used as the reference category for the departmental dummy variables, as it had the highest number of participating nurses in the study. Conclusion: This study found that teamwork, working conditions, and the department where nurses work especially the outpatient unit strongly affect nurses' perceptions of patient safety climate in public hospitals in Somaliland. Nurses in the outpatient unit reported significantly higher safety climate perceptions compared to those in the medical ward. The study also found that emotional exhaustion and stress recognition were linked to lower safety scores, indicating that hospitals should do more to help nurses manage stress and prevent burnout. Key Words: Patient safety, patient safety climate, work environment factors (teamwork, perception of management, job satisfaction, stress recognition, work-life balance, emotional exhaustion, working conditions)系所名稱：醫務管理學系碩士班thesis