Nurses’ Attitudes Toward Adverse Event Reporting Based on the Rocaes Scale: A Cross-Sectional Survey

Introduction. Patient safety is widely recognized as a priority in modern healthcare systems. Reporting adverse events is an important mechanism for identifying weaknesses in healthcare processes and improving the quality of care. Nevertheless, underreporting remains a common problem in many healthcare organizations. Nurses are closely involved in clinical care and therefore play a key role in patient safety. Their willingness to report adverse events may depend on several factors, including organizational culture, peer expectations, perceived blame, and the clarity of reporting procedures. The Reporting of Clinical Adverse Events Scale (RoCAES ) is frequently used to examine healthcare professionals’ attitudes toward reporting practices. Aim. To assess nurses’ attitudes toward adverse event reporting using the RoCAES scale. Materials and Methods. A cross-sectional study was carried out from September to November 2025 in primary healthcare organizations located in six cities of Kazakhstan. The study involved 468 practicing nurses who met the inclusion criteria and agreed to participate. Attitudes toward adverse event reporting were assessed using the 25-item RoCAES instrument, which includes five subscales: perceived blame, perceived criteria for reporting, perceptions of colleagues’ expectations, perceived benefits of reporting, and perceived clarity of reporting procedures. Data were collected anonymously using an online questionnaire. Statistical analysis was performed in IBM SPSS Statistics (version 29.0). Descriptive statistics were calculated and the internal consistency of the instrument was evaluated using Cronbach’s alpha. Results. The findings indicate differences in attitudes across the RoCAES dimensions. The highest mean score was observed for the subscale Perceptions of Colleagues’ Expectations (M = 2.43, mean score), suggesting that peer-related norms may influence reporting attitudes. Moderate values were found for Perceived Criteria for Reporting (M = 2.41) and Perceived Blame (M = 2.36). Lower mean scores were observed for Perceived Benefits of Reporting (M = 1.97) and Perceived Clarity of Reporting Procedures (M = 1.92), reflecting generally positive evaluations of these aspects. Overall, structural aspects of reporting were evaluated more positively than socio-cultural factors. Conclusion. The results suggest that nurses’ attitudes toward adverse event reporting are shaped by both structural and socio-cultural factors. While reporting procedures and perceived benefits appear to be relatively well understood, peer expectations, uncertainty regarding reporting criteria, and concerns about blame may still influence reporting behavior. Strengthening supportive professional norms and maintaining a non-punitive reporting environment may contribute to improving reporting practices in healthcare organizations.