The COVID-19 pandemic placed unprecedented pressure on healthcare systems, affecting frontline staff through long hours, psychological stress, and resource disparities. In Taiwan, the pandemic’s peak in 2021 and subsequent easing in 2022 brought changes in clinical operations and organizational dynamics. This study explores how these shifts influenced healthcare workers’ perceptions of patient safety culture over time. A cross-sectional survey was administered at a medical center in central Taiwan using the New Chinese version of the Safety Attitudes Questionnaire (New-SAQ). Valid responses were collected from 3,709 healthcare workers across two periods: 2021 (pandemic peak) and 2022 (post-peak). Data were analyzed using SPSS 22.0 for descriptive statistics, independent t-tests, ANOVA, Pearson correlation, and two-way ANOVA to assess differences and interactions across roles, time periods, and demographic variables. Patient safety culture scores showed significant improvement in 2022 compared to 2021. The highest-rated dimensions were Teamwork Climate, Job Satisfaction, and Perceptions of Management, reflecting enhanced collaboration and leadership support. However, Stress Recognition and Resilience (measured via reverse-coded emotional exhaustion) remained low, highlighting ongoing emotional burden. Nurses reported significantly lower scores in Job Satisfaction and Safety Climate compared to other professional groups. Strong interrelations were found among dimensions, particularly between Teamwork and Safety Climate (r = .781). While patient safety culture improved post-peak pandemic, specific groups—particularly nurses, women, and mid-career professionals—continue to face elevated stress and burnout risks. Healthcare organizations should prioritize leadership engagement, implement flexible work arrangements, and provide targeted resilience training to promote a safer and more supportive work environment.
Chang et al. (2026) studied this question.