Attitudes Toward Patient Safety in Operating Rooms: Cross-Cultural Adaptation and Validation of the French Version of the Operating Room Management Attitudes Questionnaire (ORMAQ)

Abstract

Background: The Operating Room Management Attitudes Questionnaire (ORMAQ) is widely used to assess operating room (OR) staff attitudes toward patient safety and teamwork across diverse contexts. However, no validated French version currently exists, limiting its use in francophone settings. This study aimed to translate and culturally adapt the ORMAQ into French and to evaluate its psychometric properties, while also reporting OR professionals’ attitudes explored during the validation process. Methods: A cross-sectional methodological study was conducted among OR professionals, including surgeons, anesthetists, anesthesia nurses, operating room nurses, and residents. The original ORMAQ was translated into French using a standardized forward–backward translation procedure and pretested with 20 OR professionals. Content and concurrent validity were examined. Reliability was assessed through internal consistency, test–retest reproducibility, and dimension-level consistency. Construct validity was examined using both exploratory and confirmatory factor analyses (CFA). Results: The overall response rate to the survey was 76.5% (n = 303). The French ORMAQ demonstrated good internal consistency, as evidenced by both Cronbach’s alpha (α = 0.842) and McDonald’s Omega (ω = 0.98). For the individual dimensions, reliability values ranged from 0.597 to 0.891 for alpha and from 0.75 to 0.89 for Omega. Test–retest analysis showed excellent reproducibility (ICC = 0.96; 95% CI: 0.92–0.98). Factor analyses supported the eight-factor structure, with the CFA confirming good model fit and meaningful item loadings across dimensions, with standardized loadings ranging from 0.40 to 0.83. Conclusions: The French version of the ORMAQ showed satisfactory psychometric properties. It represents a robust tool for assessing safety and teamwork attitudes among OR professionals in francophone countries.