Document Type


Subject Area(s)

Adult; Aged; Attitude of Health Personnel; Cross-Sectional Studies; Female; Hand Hygiene; Humans; Male; Medication Errors; Middle Aged; Patient Safety; Professional-Family Relations; Surveys and Questionnaires; Young Adult


OBJECTIVES: To investigate predictors of healthcare professionals' (HCPs) attitudes towards family involvement in safety-relevant behaviours. DESIGN: A cross-sectional fractional factorial survey that assessed HCPs' attitudes towards family involvement in two error scenarios relating to hand hygiene and medication safety. Each survey comprised two randomised vignettes that described the potential error, how the family member communicated with the HCP about the error and how the HCP responded to the family member's question. SETTING: 5 teaching hospitals in London, the Midlands and York. HCPs were approached on a range of medical and surgical wards. PARTICIPANTS: 160 HCPs (73 doctors; 87 nurses) aged between 21 and 65 years (mean 37) 102 were female. OUTCOME MEASURES: HCP approval of family member's behaviour; HCP reaction to the family member; anticipated effects on the family member-HCP relationship; HCP support for being questioned about hand hygiene/medication; affective rating responses. RESULTS: HCPs supported family member's intervening (88%) but only 41% agreed this would have positive effects on the family member/HCP relationship. Across vignettes and error scenarios the strongest predictors of attitudes were how the HCP (in the scenario) responded to the family member and whether an error actually occurred. Doctors (vs nurses) provided systematically more positive affective ratings to the vignettes. CONCLUSIONS: Important predictors of HCPs' attitudes towards family members' involvement in patient safety have been highlighted. In particular, a discouraging response from HCP's decreased support for family members being involved and had strong perceived negative effects on the family member/HCP relationship.

Digital Object Identifier (DOI)


© 2022 BMJ Publishing Group Ltd. All rights reserved This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

APA Citation

Davis, R., Savvopoulou, M., Shergill, R., Shergill, S., & Schwappach, D. (2014). Predictors of healthcare professionals' attitudes towards family involvement in safety-relevant behaviours: a cross-sectional factorial survey study. BMJ Open, 4(9), e005549-e005549.