The Quality in Psychiatric Care–Inpatient Staff Instrument: A Psychometric Evaluation

A Norwegian adaptation of the quality in psychiatric care - inpatient staff (QPC-IPS): psychometric evaluation and staff assessment of quality of care

BACKGROUND

The restructuring and decentralization of psychiatric services in Norway, aligning with global trends, has sparked debate on quality assurance. This study aimed to evaluate the psychometric properties of the Norwegian version of the Quality in Psychiatric Care - Inpatient Staff (QPC-IPS). Additionally, it sought to investigate the sociodemographic and work-related factors associated with staff perceptions of the quality of inpatient psychiatric care that they provide.

MATERIAL AND METHODS

The Swedish QPC-IPS, a 30-item, 6-dimension tool, was thoroughly translated for the Norwegian psychiatric care setting. A web survey, including the QPC-IPS and sociodemographic and work-related items, was distributed to the mental health staff of two Norwegian health trusts, yielding 117 responses.

RESULTS

The adapted version underwent confirmatory factor analysis, revealing a factor structure consistent with the original QPC-IPS and its versions in other languages. Staff generally reported high-quality care, with the highest for the secluded environment and the lowest for the secure environment. Positive associations were found between quality perceptions and factors, such as professional development, openness to quality assurance, and participation in quality work. Psychosocial environments and staff mental health were positively linked to quality-of-care dimensions and the staff recommendations correlated with their perception of patients' experiences of quality of care.

CONCLUSIONS

The Norwegian QPC-IPS demonstrated adequate psychometric properties, facilitating its use in assessing psychiatric care staff's perception of patients' experiences of quality of care. Insights from staff perspectives contribute to identifying areas for improvement in inpatient psychiatric care, thereby enhancing cross-cultural comparisons and theory development in this domain.

Norwegian adaptation of the Quality in Psychiatric Care - In-Patient instrument: psychometric properties and factor structure

BACKGROUND

Validated instruments measuring the quality of mental healthcare from patients' perspectives are scarce, and available instruments have been requested. One of the few instruments measuring the quality of care from a patient's perspective is the Swedish Quality in Psychiatric Care-In-Patient (QPC-IP). This cross-sectional study aimed to translate and adapt the QPC-IP instrument for a Norwegian context and assess its psychometric properties.

METHODS

The QPC-IP was translated and adapted to a Norwegian context using a translation back-translation process model. A total of 169 inpatients from specialised mental health services responded to the questionnaire. The QPC-IP comprises six dimensions: Encounter (eight items), Participation (eight items), Discharge (four items), Support (four items), Secluded Environment (three items), and Secure Environment (three items), totalling 30 items. Confirmatory factor analysis was conducted to assess the instrument's factor structure. Additionally, Cronbach's alpha was used to establish the instrument's internal consistency.

RESULTS

The results indicated that the Norwegian adaptation of the QPC-IP possesses good psychometric properties, including internal consistency, content, and construct validity, as confirmed by the confirmatory factor analysis results. The confirmatory factor analysis demonstrated an adequate fit for the six-factor structure, consistent with the original Swedish instrument.

CONCLUSIONS

The QPC-IP is a user-friendly and easily implementable tool that assesses various dimensions of the quality of inpatient mental healthcare from a patient's perspective. Moreover, the Norwegian QPC-IP holds potential for use in comparative, cross-cultural studies within mental healthcare services to monitor the quality of the provided services.

The Spanish Adaptation of the Quality in Psychiatric Care-Forensic Inpatient (QPC-FIP) Instrument: Psychometric Properties

Background/Objectives: The quality of care in forensic mental health services is a factor that significantly impacts recovery and constitutes a right of the individuals receiving treatment. However, there is a lack of instruments to assess the perceived quality of care among individuals in this setting. Quality in Psychiatric Care-Forensic Inpatient (QPC-FIP) is a Swedish instrument that measures the perception of quality care from the perspectives of patients in the forensic setting. The aim of this study was to perform a cross-cultural adaptation of the QPC-FIP instrument into Spanish and to assess its reliability and validity. Methods: For the adaptation process, a translation-backtranslation of the instrument was performed. Regarding psychometric properties, the sample consisted of 120 inpatients in the forensic setting to whom the instrument was applied. To assess temporal stability, the instrument was readministered after 10 days (n = 98). Results: The confirmatory factor analysis showed an equivalent seven-factor structure with the original version, presenting a satisfactory model fit. Regarding reliability, the Cronbach's alpha value was 0.933, and the intraclass correlation coefficient was 0.836 (95% IC: 0.742-0.896), revealing results higher than 0.70 in six of the seven factors. Conclusions: The Spanish version of the QPC-FIP instrument showed adequate validity and reliability values, indicating that is a useful tool for measuring quality in psychiatric care in the forensic context.

Quality in Psychiatric Care in the Community Mental Health Setting from the Perspective of Patients and Staff

The current paradigm of mental health care focuses on care provided in the community, increasingly moving away from hospital care models that involve considerable economic burden. Patient and staff perspectives on the quality of psychiatric care can highlight strengths and areas for improvement to ensure better care provision. The aim of this study was to describe and compare perceptions of quality of care among patients and staff in community mental health services and to determine possible relationships between these perceptions and other study variables. A comparative cross-sectional descriptive study was conducted in a sample of 200 patients and 260 staff from community psychiatric care services in the area of Barcelona (Spain). The results showed high overall levels of quality of care from patient (m = 104.35 ± 13.57) and staff (m =102.06 ± 8.80) perspectives. Patients and staff both gave high scores to Encounter and Support factors, while factors concerning patient Participation and Environment received the lowest scores. Continuous assessment of the quality of psychiatric care in the community setting is essential to ensure the highest quality of care, taking the perspectives of those involved into account.

Spanish adaptation of the quality in psychiatric care-outpatient (QPC-OP) instrument community mental health patients’ version: psychometric properties and factor structure

Background

Health systems in the field of mental health are strongly committed to community models that allow patients to be attended in their own environment. This helps them to maintain their family and social ties while trying to avoid costly hospital admissions. The patients’ perspective is a key component in the assessment of the quality of psychiatric care and can even determine their adherence to the devices where they are treated. However, there are few instruments with adequate psychometric properties for the evaluation of the quality of psychiatric care in community mental health. The Quality in Psychiatric Care – Outpatient (QPC-OP) instrument has adequate psychometric properties to assess the quality of psychiatric care from the patients’ perspective. The aim of this study was to adapt and validate the Spanish version of the QPC-OP instrument.

Methods

A translation and back-translation of the instrument was carried out. To examine its psychometric properties, the instrument was administered to 200 patients attending various community mental health services. To assess test-retest reliability, the instrument was readministered after 7-14 days (n = 98).

Results

The Confirmatory Factor Analysis revealed a structure of 8 factors identical to the original version, with an adequate model fit. The internal consistency coefficient (Cronbach’s alpha) was 0.951. The intraclass correlation coefficient was 0.764 (95% IC: 0.649 – 0.842), and higher than 0.70 in 5 of the 8 factors. Additionally, an EFA was performed and revealed that the instrument could behave in a unifactorial or four factor manner in the sample analyzed.

Conclusions

Results show that the Spanish version of the QPC-OP instrument is valid and reliable for the assessment of quality of psychiatric care in the community setting.