# Patient Safety Culture in Hospital Settings Across Continents: A Systematic Review
## 3 Result
### General Characteristics of the Reviewed Studies  
To achieve the study's aim, this review explores key data extracted from included studies, including the use of HSOPSC Versions 1.0 and 2.0, geographical distribution across continents, hospital and respondent characteristics, and perceptions of Patient Safety Culture. By exploring these elements, the analysis will reveal regional variations and key factors influencing patient safety culture on a global scale.  
Based on Supplementary Materials and Table 2, this review involved 75 studies from intercontinental locations. Fourteen studies from Europe covered multiple countries, including Croatia, Hungary, Spain [29], Sweden [29; 30], Turkey [23; 31; 32], Slovenia [33], Italy [34],  
Figure 3: Strength of relationships between “patient safety” and organizational culture.  
Figure 2: Co-occurring terms associated with “patient safety” in research.  
Portugal [35; 36], Slovak Republic [37], Bulgaria [38], Romania [39; 40], Scotland [41], and the Netherlands [42]. Nine studies from South America encompassed countries such as Brazil [27; 43; 44; 45; 46; 47; 48], Peru [49], and Portuguese [48], with one study covering Argentina, Brazil, Chile, and Colombia [50]. Ten studies from Africa involved countries like Ethiopia [51; 52; 53; 54], Egypt [55; 56; 57; 58], Algeria [59], Morocco [60], and Ghana [61]. One study had a global focus, including Taiwan, the Netherlands, and the United States [42]. Finally, 41 studies from Asia covered a range of countries including Lebanon [62], Oman [63; 64; 65], China [25; 66; 67; 68; 69], Saudi Arabia [26; 70; 71; 72; 73; 74; 75; 76; 77], Iran [78; 79; 80; 81], Palestine [82; 83], Kuwait [84], Jordan [56; 85; 86], Taiwan [42; 87], Philippines [88], Korea [22; 89], Pakistan [90], Qatar [91], Indonesia [92; 24; 92], Vietnam [93; 94; 95], Afghanistan [96], India [28], and Indonesia [92].  
All 75 studies employed versions of the HSOPSC, either modified or translated, as their primary tool to evaluate PSC. These studies encompassed 2188 hospitals of various types, ranging from individual hospital settings to entire hospitals for national healthcare systems, such as the one examined in Sweden [30]. Most studies involved a mix of healthcare professionals. While 15 focused on nursing staff, 59 included a range of clinical and non-clinical workers. One study examined nurses and other providers separately. The studies included in this analysis were conducted from 2010 to the present year, 2024, with 22 studies conducted between 2010 and 2015, 26 between 2016 and 2020, and 27 from 2021 to 2024.  
The majority of studies aimed to evaluate healthcare workers' perceptions of PSC. Among them, some examined the validity of HSOPSC 1.0 [33; 35], while others examined the adaptation and validation of HSOPSC 2.0 [22; 23; 24; 25; 27; 28]. Additionally, certain studies focused on testing interventions [56; 92]. Nearly all studies adopted a descriptive cross-sectional design involving various hospital settings or regions. However, some studies employed mixed methods [29; 46; 76], with only one utilizing a quasi-experimental approach [56].