Person-centered care competence and patient safety competence in relation to patient safety culture: Mediating effects of patient safety management activities among nurses in central Vietnam

BackgroundPatient safety culture is a key determinant of healthcare quality, yet evidence remains limited on how nurses person-centered care competence and patient safety competence relate to patient safety culture through patient safety management activities, particularly in low- and middle-income settings. ObjectiveTo describe levels of person-centered care competence, patient safety competence, patient safety management activities, and patient safety culture among nurses in central Vietnam, and to examine direct and indirect relationships among these factors using a mediation model. MethodsA multicenter cross-sectional study was conducted among 1,036 nurses from five tertiary hospitals in central Vietnam (response rate 99.6%). Person-centered care competence was measured using P-CAT, patient safety competence using H-PEPSS, patient safety management activities using PSMA, and patient safety culture using HSOPSC. Descriptive statistics, Pearson correlations, and multivariable linear regression analyses were performed. Mediation effects were tested using bias-corrected bootstrapping with 5,000 resamples. ResultsMean scores indicated moderate-to-high levels of person-centered care competence (3.77{+/-}0.36), patient safety competence (4.23{+/-}0.36), and patient safety management activities (4.44{+/-}0.35), while patient safety culture was moderate (3.93{+/-}0.35). All variables were positively correlated, with the strongest association observed between person-centered care competence and patient safety culture (r=0.49, p<0.001). In adjusted regression analyses, person-centered care competence and patient safety competence were independently associated with patient safety management activities ({beta}=0.149 and {beta}=0.274; both p<0.001). Patient safety management activities were significantly associated with patient safety culture ({beta}=0.102, p<0.001). Bootstrapped mediation analyses demonstrated significant partial mediation through patient safety management activities for both person-centered care competence (indirect {beta}=0.0265, 95% confidence interval 0.0143-0.0404) and patient safety competence (indirect {beta}=0.0497, 95% confidence interval 0.0304-0.0711). ConclusionsHigher person-centered care competence and patient safety competence were associated with stronger patient safety culture, partly through increased engagement in patient safety management activities. Interventions to strengthen patient safety culture should combine competence development with organizational supports that enable reliable frontline safety practices.