What determines patients' satisfaction with their mental health care and quality of life?

Validation of the client satisfaction questionnaire: a pilot psychometric analysis in Portuguese routine practice

Treatment satisfaction has been found to have good therapeu- tic results in psychotherapy, and the 18-item version of the client satisfaction questionnaire (CSQ-18) is one of the most widely used measures to evaluate it. This study sought to carry out a pilot analysis of the psychometric's properties and factorial structure, as well as validate the CSQ-18's applicability to the Portuguese population within the context of routine clinical practice. It also sought to explore the association that treatment satisfaction has with general symptoms, therapeutic alliance, and expectations at an early stage of psychotherapy. The sample comprised 98 clients who were undergoing psychotherapy in a routine practice context. All these clients completed self-reported measures for symptom assessment and therapeutic relationship, namely the clinical out- come routine evaluation-outcome measure, working alliance in- ventory, and credibility/expectancy questionnaire, in addition to the CSQ-18. The semi-confirmatory factorial analysis demon- strated that the CSQ-18 has good psychometric properties and re- vealed an association between treatment satisfaction and therapeutic alliance. The results corroborate the findings of other versions of the measure and present a good adjustment model for the semi-confirmatory factorial analysis.

Mental healthcare services satisfaction and its associated factors among patients with mental disorders on follow-up in the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia

Background

Patient mental healthcare services satisfaction is a crucial component in evaluating the effectiveness and efficiency of clinical service delivery. It can be explained as the client's reaction to various aspects of the services they receive and their subjective assessment of the healthcare facilities and healthcare givers. Despite the importance of measuring mental healthcare services satisfaction, few studies have been conducted in Ethiopia. This study aimed to assess the prevalence of mental healthcare services satisfaction among patients with mental disorders who were on follow-up at the University of Gondar Specialized Hospital, Northwest Ethiopia.

Method

An institution-based cross-sectional study was conducted from June 1, 2022 to July 21, 2022. All the study participants were interviewed on the follow-up visit consecutively. The Mental Healthcare Services Satisfaction Scale tool was used to measure patient satisfaction, and the Oslo-3 Social Support Scale and other questionnaires, such as environmental factors and clinical factors, were also screened. The data were checked for completeness, entered and coded using Epi-data version 4.6, and exported to Stata version 14 software for analysis. Bivariable logistic and multivariable regression analyses were employed to identify the factors significantly associated with satisfaction. Adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to report the result at a p-value of <0.05.

Results

A total of 402 study participants were included in this study, with a response rate of 99.7%. The proportions of male and female participants who were satisfied with the mental healthcare services were 59.29 and 40.70%, respectively. The overall mental healthcare services satisfaction was 65.46% with a 95% CI of 59.90, 70.62. Not being admitted to psychiatry [AOR: 4.94; 95% CI (1.30, 8.76)], getting their drugs in the hospital [AOR: 1.34; 95% CI (3.58, 8.74)], and having strong social support [AOR: 6.40; 95% CI (2.64, 8.28)] were significantly associated with satisfaction.

Conclusion

The prevalence of mental healthcare services satisfaction is very low; therefore, more is expected to be done to enhance the satisfaction of the patients who access these services via psychiatry clinics. Enhancing the social support of clients, making drugs available in the hospital, and improving the service received by the admitted client are necessary to increase the healthcare service satisfaction of clients on the whole. The services delivered in psychiatry units must be improved to achieve good patient satisfaction, which might be helpful for the improvement of the disorders.

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.

The Relationships between Health Professionals' Perceived Quality of Care, Family Involvement and Sense of Coherence in Community Mental Health Services

Mental health professionals have a responsibility to ensure the best possible quality of care. Family is strongly involved in the patient's everyday life. The aim of this study was to investigate the relationship between health care professionals' perception of the quality of care, attitudes of family involvement and their own sense of coherence. A descriptive quantitative study with fifty-six health professionals, completed "Quality in Psychiatric Care-Community Outpatient Psychiatric Staff", "Families' Importance in Nursing Care-health professionals' attitudes", "The Sense of Coherence Scale-13". The health professionals perceived quality as high and did not perceive the families as a burden.

Unmet Need for Mental Healthcare in a Population Sample in Sweden: A Cross-Sectional Study of Inequalities Based on Gender, Education, and Country of Birth

This cross-sectional study investigated if gender, education, and country of birth were associated with perceived need and unmet need for mental healthcare (i.e., refraining from seeking care, or perceiving care as insufficient when seeking it). Questionnaire and register data from 2008 were collected for 3987 individuals, aged 19-64 years, in a random population-based sample from western Sweden. Descriptive statistics and logistic regression analyses were used. Men were less likely to perceive a need for care than were women, even after adjusting for mental well-being. Men were also less likely to seek care and perceiving care as sufficient. People with secondary education were less likely to seek care than those with university education. There were no statistically significant differences based on country of birth. The observed gender and education-based inequalities increases our understanding of where interventions can be implemented. These inequalities in unmet need for mental healthcare should be targeted by the healthcare system.

Optimising the integration of technology-enabled solutions to enhance primary mental health care: a service mapping study

Background

Despite the widely acknowledged potential for health information technologies to improve the accessibility, quality and clinical safety of mental health care, implementation of such technologies in services is frequently unsuccessful due to varying consumer, health professional, and service-level factors. The objective of this co-design study was to use process mapping (i.e. service mapping) to illustrate the current consumer journey through primary mental health services, identify barriers to and facilitators of quality mental health care, and highlight potential points at which to integrate the technology-enabled solution to optimise the provision of care based on key service performance indicators.

Methods

Interactive, discussion-based workshops of up to six hours were conducted with representative stakeholders from each participating service, including health professionals, service managers and administrators from Open Arms – Veterans & Families Counselling Service (Sydney), a counselling service for veterans and their families, and five headspace centres in the North Coast Primary Health Network, primary youth mental health services. Service maps were drafted and refined in real time during the workshops. Through both group discussion and the use of post-it notes, participants worked together to evaluate performance indicators (e.g. safety) at each point in the consumer journey (e.g. intake) to indicate points of impact for the technology-enabled solution, reviewing and evaluating differing opinions in order to reach consensus.

Results

Participants (n=84 across participating services) created service maps illustrating the current consumer journey through the respective services and highlighting barriers to and facilitators of quality mental health care. By consensus, the technology-enabled solution as facilitated by the InnoWell Platform was noted to enable the early identification of risk, reduce or eliminate lengthy intake processes, enable routine outcome monitoring to revise treatment plans in relation to consumer response, and serve as a personal data record for consumers, driving person-centred, coordinated care.

Conclusions

Service mapping was shown to be an effective methodology to understand the consumer’s journey through a service and served to highlight how the co-designed technology-enabled solution can optimise service pathways to improve the accessibility, quality and clinical safety of care relative to key service performance indicators, facilitating the delivery of the right care.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-021-06069-0.

Correlates of Patient Satisfaction in Psychiatric Inpatient Care: A Survey Study from a Tertiary Hospital in Turkey

In the current study, a questionnaire to evaluate satisfaction levels and related factors upon discharge was completed by 100 patients receiving care for mental illness in a tertiary care hospital in Turkey. The relationships among sociodemographic variables, nonpharmacological interventions, and participants' views about the treatment course and quality of care they received were investigated. Overall satisfaction levels of participants were good. Older participants reported more positive opinions. Involuntary hospitalization, use of restraints/seclusion, or electroconvulsive therapy did not change overall satisfaction. Participants who were hospitalized for the first time were more afraid of other patients, which may imply that this population needs special care from the treatment team. Spending an adequate amount of time and providing necessary information about their treatment plan impact patients' treatment experience positively. [Journal of Psychosocial Nursing and Mental Health Services, 59(4), 38-47.].

Routine measurement of satisfaction with life and treatment aspects in mental health patients - the DIALOG scale in East London

AIMS

The DIALOG scale has been implemented as a routine patient outcome and experience measure (PROM/PREM) in a mental health trust in East London since 2017. The resulting healthcare dataset was used to estimate satisfaction with life and treatment aspects over time and factors associated with it.

METHODS

Variables available from the Trust were DIALOG items, service level, clinical and basic demographic data. Data was extracted in February 2019. Data is described using a range of descriptive statistics and looking at the subgroups: treatment stage, diagnosis, service type. Predictors for average DIALOG scores across patients was explored with clustered linear regression models. A fixed effect model was chosen to estimate the impact of clinical and service related variables on patient's average DIALOG scores over time. Sensitivity analyses with the whole data set and complete cases were carried out.

RESULTS

Of the original 18,481 DIALOG records 12, 592 were kept after data cleaning (5646 patients). The average DIALOG score was 4.8 (SD 1.0) on the 7-point scale. Average satisfaction with life aspects (PROM) was 4.65 (SD 1.1) and with treatment aspects (PREM) was 5.25 (SD 1.17). Across all 11 items, "job situation" scored lowest (mean 4.05) and "meetings with professionals" highest (mean 5.5). Satisfaction for all items increased over time (average increase 0.47). The largest increase was in "mental health" (0.94) and the smallest in "family relationships" (0.34).

CONCLUSIONS

Patients in mental healthcare services were "fairly satisfied" in both life and treatment aspects with improvements seen over time. These results will act as a benchmark for clinical services currently implementing DIALOG across the UK and inform local service developments.

Measuring the Patient Experience of Mental Health Care: A Systematic and Critical Review of Patient-Reported Experience Measures

BACKGROUND

There is growing concern about measuring patient experience with mental health care. There are currently numerous patient-reported experience measures (PREMs) available for mental health care, but there is little guidance for selecting the most suitable instruments. The objective of this systematic review was to provide an overview of the psychometric properties and the content of available PREMs.

METHODS

A comprehensive review following the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines was conducted using the MEDLINE database with no date restrictions. The content of PREMs was analyzed using an inductive qualitative approach, and the methodological quality was assessed according to Pesudovs quality criteria.

RESULTS

A total of 86 articles examining 75 PREMs and totaling 1932 items were included. Only four PREMs used statistical methods from item response theory (IRT). The 1932 items covered seven key mental health care domains: interpersonal relationships (22.6%), followed by respect and dignity (19.3%), access and care coordination (14.9%), drug therapy (14.1%), information (9.6%), psychological care (6.8%) and care environment (6.1%). Additionally, a few items focused on patient satisfaction (6.7%) rather than patient experience. No instrument covered the latent trait continuum of patient experience, as defined by the inductive qualitative approach, and the psychometric properties of the instruments were heterogeneous.

CONCLUSION

This work is a critical step in the creation of an item library to measure mental health care patient-reported experience that will be used in France to develop, validate, and standardize item banks and computerized adaptive testing (CAT) based on IRT. It will also provide internationally replicable measures that will allow direct comparisons of mental health care systems.

TRIAL REGISTRATION

NCT02491866.

Patient Views of Behavioral Health Providers in Primary Care: A Qualitative Study of 2 Southeastern Clinics

Background:

Limited research is available around patient experience of integrated behavioral health care in primary care settings.

Objective:

We sought to identify the major themes through which patients described their integrated behavioral health care experiences as a means of informing and improving clinic processes of integrated health care delivery.

Methods:

We captured viewpoints from 16 patients who experienced an integrated behavioral health care model from 2 primary care clinics and completed at least 3 visits with a behavioral health provider (BHP). Using grounded theory analyses, we coded and analyzed transcriptions for emergent themes.

Analysis:

The interview process yielded 3 major themes related to the BHP including (a) the BHPs’ clinic presence made behavioral health care more convenient and accessible, (b) BHPs worked within time and program limitations, and (c) BHPs helped with coping, wellness, and patient-care team communication.

Conclusion:

The BHPs serving in a large primary care practice and a Federally Qualified Health Center played an important role in connecting patients with behavioral health care and improving care team collaboration, both in terms of communication within the team and between the team and the patient/family.

Treating mental health crises at home: Patient satisfaction with home nursing care

WHAT IS KNOWN ON THE SUBJECT?: Most studies have focused on whether hospital admissions have been reduced by the introduction of crisis services, rather than focusing on how these services are employed. Research has also shown that home assistance decreases costs and increases the level of patient satisfaction, thereby being more efficient in terms of the cost/effectiveness ratio than is traditional hospital care. Patient satisfaction with nursing care has long been identified as a key element of quality of care; however, satisfaction with nursing care among patients and families receiving crisis resolution at home has not been studied yet. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: There is limited research on patient satisfaction with CRHTTs. This study provides new insights and data including that on relationships between patient satisfaction and the teams' attention to person-centred mental health care. The difference between this study and other studies on patient satisfaction with crisis resolution home treatment teams is that this study focused on patients' and families' satisfaction with the nursing care provided by crisis resolution home treatment teams rather than with the general service provided. This study is the first of its kind with such a focus. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This research has both academic and clinical implications. Patients' and their families' satisfaction with nursing care is an integral aspect for evaluating mental health services, and this is especially important regarding services provided by crisis resolution home treatment teams because such teams are currently being introduced in countries such as Spain. Closely examining patients and families' satisfaction with nursing care can also foster improvements in current practices. Nurses in crisis teams might need to focus on equalizing power relations, which the data gathered in this study suggests is most important to patient satisfaction. ABSTRACT: Introduction Crisis resolution home treatment teams (CRHTT) provide short-term, intensive home treatment to people experiencing mental health crises. Patient satisfaction has long been identified as a key element of quality of care; however, satisfaction with nursing care as part of this service has not been studied yet. Aim To assess patients' and their families' satisfaction with the nursing care provided through a home care program offered by a hospital in Catalonia which administers person-centred care. Method A mixed methods research design was conducted. A cross-sectional study including quantitative survey data and qualitative interview data with a phenomenological focus was conducted. Results Twenty interviews were conducted. Patients and relatives reported high satisfaction that seems to be related to the person-centred nature of the care. Discussion The findings provide new insights, including how home treatment tends to equalize power relations between nurses and patients/the patient's family members, and how nurses increase sensitivity when focusing on service users' needs and priorities, leading to high patient and family satisfaction. Implications for practice This research has both academic and clinical implications. It highlights what mental health patients and their families value most about home care and interactions with nurses, and also drives improvements in current practices.

Treatment Modalities and Perceived Effectiveness of Treatment Among Adults With Depression

Patient-reported outcomes of mental health treatment, such as perceived effectiveness, are important. They indicate whether treatment is perceived to reduce symptoms and minimize psychiatric disability. Outpatient treatment for depression typically includes medication or counseling, either alone or in combination. This study examines the relationship between treatment modality and perceived effectiveness of treatment. Using a sample of adults who received outpatient treatment for depression from the 2015-2016 National Survey on Drug Use and Health (N = 4169), logistic regressions estimated the odds of rating treatment as effective among persons who received medication only, counseling only, and a combination of medication and counseling. There were no differences in perceived effectiveness between counseling only and medication only. However, receiving both was associated with greater odds of rating treatment as effective. Poor self-rated health and severe mental illness were associated with lower perceived effectiveness of medication. Those with substance use problems had lower odds of rating counseling and both counseling and medication as effective. A combined treatment for depression may be perceived as better than single-modality treatment. Therefore, there might be benefits to increasing access to both forms of treatment for persons less likely to rate either single modality as effective.

Perceived Patient Satisfaction and Associated Factors among Psychiatric Patients Who Attend Their Treatment at Outpatient Psychiatry Clinic, Jimma University Medical Center, Southwest Ethiopia, Jimma, 2019

Background

In health care, patient satisfaction is an attitudinal response and a pillar for quality assurance, but there is reluctance to measure it among mentally ill patients. Satisfied patients become more compliant. However, no study was done in this study area before. Therefore, this study was conducted to determine the magnitude of perceived patient satisfaction and associated factor at Jimma University Medical Center, outpatient psychiatry clinic.

Methods

Cross-sectional study design was conducted, and systematic random sampling technique was used to get study participants. The 24-item Mental Health Service Satisfaction Scale (a validated tool in Ethiopia) was used to assess patient satisfaction. Data was entered using Epi-data 3.1 and exported to the Statistical Package for the Social Sciences 22.0 for analysis. Linear regression analysis (P < 0.05) was used to identify the association between the outcome and independent variable.

Result

414 respondents participated in the study with response rate of 98%. The overall percentage of patient satisfaction was 50.3% (95% CI 48.4%-51.2%). Being male (β = -0.651, 95% CI (-0.969, -0.332)), having secondary and above educational status (β = -0.651, 95% CI (-0.969, -0.332)), having secondary and above educational status (β = -0.651, 95% CI (-0.969, -0.332)), having secondary and above educational status (β = -0.651, 95% CI (-0.969, -0.332)), having secondary and above educational status (β = -0.651, 95% CI (-0.969, -0.332)), having secondary and above educational status (β = -0.651, 95% CI (-0.969, -0.332)), having secondary and above educational status (β = -0.651, 95% CI (-0.969, -0.332)), having secondary and above educational status (β = -0.651, 95% CI (-0.969, -0.332)), having secondary and above educational status (β = -0.651, 95% CI (-0.969, -0.332)), having secondary and above educational status (Conclusion and Recommendation. This study found that half of the study participants are satisfied with the service. Distance from the hospital, current substance use, waiting time, and having good social support were identified as modifiable factors that can be improved through working with stakeholders to increase patient satisfaction.

Factors Associated with Patient Satisfaction of Community Mental Health Services: A Multilevel Approach

Community care is increasingly the mainstay of mental healthcare provision in many countries and patient satisfaction is an important barometer of quality of patient care. This paper explores the key factors associated with patient satisfaction with community mental health services in England and then compares providers' performance on patient satisfaction. Our analysis is based on patient-level responses from the community mental health survey, which is run annually by the Care Quality Commission (CQC) for the years 2010 to 2013. We perform a repeated cross-section analysis, identifying factors associated with patient satisfaction via a multi-level ordered probit model, including both patient- and provider-level variables. We identify hospital-specific effects via empirical Bayes estimation. Our analysis identifies a number of novel results. First, patient characteristics such as older age, being employed, and being able to work, are associated with higher satisfaction, while being female is associated with lower satisfaction. Service contact length, time since last visit, condition severity and admission to a mental health institution, are all associated with lower satisfaction. Second, treatment type affects satisfaction, with patients receiving talking therapies or being prescribed medications being more satisfied. Third, care continuity and involvement, as proxied by having a care plan, is associated with higher satisfaction. Fourth, seeing a health professional closer to the community improves satisfaction, with patients seeing a community-psychiatric nurse, a social worker or a mental-health support worker being more satisfied. Finally, our study identifies the need for service integration, with patients experiencing financial, accommodation, or physical health needs being less satisfied. At a provider level, we find a negative association between the percentage of occupied beds and satisfaction. We further identify significant provider-specific effects after accounting for observable differences in patient and provider characteristics which suggests significant differences in provider quality of care.

Satisfaction with health and community services among homeless and formerly homeless individuals in Quebec, Canada

User satisfaction is a crucial quality indicator in health service provision. Few studies have measured user satisfaction among homeless and formerly homeless individuals, despite the high prevalence of mental health disorders (MHD) in this population. The purpose of this study was to assess overall satisfaction among 455 homeless and formerly homeless individuals who were receiving health and community services, and to identify factors associated with user satisfaction. Data collection occurred between January and September 2017. Study participants were 18 years old or over, with experience of homelessness in the current or recent past. They completed a questionnaire eliciting socio-demographic information, and data on residential history, service use and satisfaction and health profiles. Multivariate linear analysis was performed on overall satisfaction with health and community services in the previous 12 months. Independent variables were organised as predisposing, enabling and needs factors based on the Gelberg-Andersen Behavioral Model. The mean satisfaction score was 4.11 (minimum: 1; maximum: 5). Variables associated with greater user satisfaction included: older age, residence in permanent housing, common MHD (e.g., depression, anxiety), having a family physician, having a case manager, strong social network, good quality of life and, marginally, male sex and having substance use disorders (SUD). By contrast, frequent users of public ambulatory health services were the most dissatisfied. User satisfaction was more strongly associated with enabling factors. Strategies for improving satisfaction include: promoting more tailored primary care programmes (including family physician) adapted to the needs of this population, better integrating primary care with specialised services including SUD integrated treatment and enhancing continuity of care through the reinforcement of case management services. Further efforts aimed at increasing access to permanent housing with supports, and eliciting more active involvement by relatives and friends may also improve user satisfaction with services, and reduce unnecessary service use.

Residents' Perceptions of Quality in Supported Housing for People with Psychiatric Disabilities

The residents' perspective of the quality of housing support for people with psychiatric disabilities living in congregate supported housing has been studied and a comparison has been made with the findings from those from a previous study in ordinary housing with outreach support. One-hundred and seventy-eight residents from 27 supported housing facilities in eight Swedish municipalities completed the Quality of Psychiatric Care-Housing (QPC-H) instrument. The highest quality ratings were found for: Secluded Environment, Encounter and Support, while Participation, Housing Specific and Secure Environment were rated at lower levels. Despite relatively high ratings, a majority of items did not attain the 80% cutoff point deemed as defining satisfactory quality of service. The residents in ordinary housing with outreach support rated higher levels for the majority of the QPC-H dimensions in comparison with those in supported housing. A conclusion is that the quality of care in supported housing facilities has a number of deficiencies that need to be addressed. Supported housing is generally rated as having a lower quality of care than in ordinary housing with outreach support. Suggestions for the content of staff training are made based on the results.

Comparative assessment of quality of life of patients with schizophrenia attending a community psychiatric centre and a psychiatric hospital

BACKGROUND

Over the past few decades, there has been an emphasis on the de-institutionalisation of psychiatric care with a focus on community care. With Quality of Life (QoL) as an outcome measure, this study compared the QoL of patients with schizophrenia attending a psychiatric hospital and a community psychiatric centre.

DESIGN

This was a cross-sectional study in two psychiatric facilities.

METHODS

Data were obtained through a socio-demographic and clinical questionnaire; the QoL was assessed with the WHOQOL-BREF and patient satisfaction with care with CPOSS. Total and domain scores of WHOQOL-BREF for each group were calculated and compared with each other and other group characteristics. Diagnosis of schizophrenia was based on ICD-10.

RESULTS

Participants from the two centres did not differ significantly on any of the socio-demographic characteristics measured. Similarly, there was no significant difference in their overall mean WHOQOL-BREF scores as well as the mean WHOQOL-BREF of domain scores. However, the married and females from both centres significantly had higher mean WHOQOL-BREF scores than their male counterparts. Patients in remission for more than two years or those on a single type of medication (either oral or depot preparation) from both centres significantly had higher mean WHOQOL-BREF score compared with those who had less than two years of remission or on both oral and depot preparations.

CONCLUSION

Overall QoL of patients managed at the two centres was comparable, with similar socio-demographic as well as clinical variables influencing QoL. This suggests that patients with schizophrenia can be well managed at community psychiatric centres.

FUNDING

None declared.

Assessing health service satisfaction among users with substance use disorders within the municipalities in Norway

BACKGROUND

The purpose of this study was to assess what is associated with health service satisfaction among adults with a substance use disorder receiving services provided within different municipalities in Norway. An additional aim was to examine demographic and municipality characteristics, mental health, and types of substance use associated with health service satisfaction.

METHOD

A cross-sectional partial explorative study was executed in 2017 among 491 service users with substance use disorders from 20 randomly selected municipalities. The sample consisted of 70% males. The sample majority were single and unemployed, and their main sources of healthcare were the general practitioner (78%), The Norwegian Labor and Welfare Administration (72%), and addiction counsellors (62%).

RESULTS

Overall satisfaction was negatively associated with age, size of municipality, Global Severity Index (GSI) and illicit substance use during the last 12 months. Satisfaction with practical help, such as housing, economy, work and education, was negatively associated with GSI and positively associated with onset of first alcohol intoxication. Satisfaction with personnel was positively associated with onset of first alcohol intoxication and negatively associated with municipality size, GSI and illicit use the last 12 months. The results showed that more than half of the respondents (54%) to a large or great extent were satisfied with the overall services provided. The services they were less satisfied with were related to housing, economy, getting started with exercise and establishing a social network.

CONCLUSION

The results show areas associated with satisfaction and domains where the municipalities can improve their services to meet the users' needs and increase service satisfaction.

Satisfaction with care in a Brazilian psychiatric inpatient unit: differences in perceptions among patients according to type of health insurance

INTRODUCTION

User satisfaction assessment in mental health services is an important indicator of treatment quality. The objective of this study was to evaluate treatment satisfaction in a sample of inpatients with mental disorders and the associations between levels of satisfaction and clinical/sociodemographic variables.

METHODS

This exploratory study investigated 227 psychiatric inpatients who answered the Patient Satisfaction with Mental Health Services Scale (SATIS-BR) and the Perception of Change Scale (EMP). SATIS scores were analyzed according to associations with clinical and sociodemographic data. Pearson correlations were used to correlate SATIS scores with other variables.

RESULTS

We found a high degree of satisfaction with care at the psychiatric inpatient unit assessed. In general, patients rated maximum satisfaction for most items. The highest satisfaction scores were associated with patients receiving treatment through the Brazilian Unified Health System (SUS) and with less education. SATIS showed a moderate positive correlation with EMP. The worst evaluated dimension was physical facilities and comfort of the ward.

CONCLUSION

Patients treated via SUS may be more satisfied than patients with private health insurance when treated in the same facility. The evaluation of treatment satisfaction can be used to reorganize services at psychiatric inpatient units.

Mandated Treatment and Its Impact on Therapeutic Process and Outcome Factors

Court-mandated treatments imply a dual role for therapy providers not only of caring for, but also of having control over, involuntary clients. The impact of legal coercion on the therapeutic relationship and feelings of stigma is widely regarded as negative and detrimental for treatment outcomes. This point of view stands in contrast to advocates of the perspective that involuntary treatment can ameliorate social functioning and thus promote a better quality of life. Regarding other outcome measures, there is evidence that offender treatment is effective and leads to reduced recidivism in criminal behavior. This narrative review provides an overview of research assessing the effects of mandatory treatment on therapeutic process and outcome factors. We conclude that legal mandatory treatment does not have to necessarily result in perceived coercion and reduced satisfaction with treatment and that a caring and authoritative treatment style aids a favorable therapeutic alliance, motivation, and therapy outcomes.

Satisfaction and Needs in Serious Mental Illness and Autism Spectrum Disorder: The REHABase Psychosocial Rehabilitation Project

OBJECTIVE

The REHABase project is a French observational, prospective, and multicenter cohort study of serious mental illness and autism spectrum disorder (ASD), launched in 2016 for a planned minimum duration of 15 years. The aim is to characterize the care and quality-of-life needs of participants. This article presents initial results from data collection.

METHODS

Psychosocial, cognitive, and functional data were collected at baseline, annually, and after rehabilitation care. Data from the baseline evaluation on diagnoses, medications, well-being, insight, life satisfaction, and care needs are presented. The clinical profiles of REHABase participants with serious mental illness or ASD were assessed in relation to their level of satisfaction with life and well-being in nine life dimensions and their needs, according to their stage of recovery in a five-stage model.

RESULTS

Baseline data were collected for 1,397 participants between January 2016 and August 2018. Main diagnoses were schizophrenia spectrum disorder (49%); ASD (13%); and personality (12%), bipolar (9%), and major depressive (6%) disorders. More than 50% of participants reported needs for care or interventions in four of nine dimensions: employment, cognitive functioning, symptom management, and interpersonal relationships. Nearly half of participants were not in the active stages of recovery (stages 4 and 5), and even those considered to have reached the final stage continued to require help in several areas.

CONCLUSIONS

Most participants had already received psychiatric care for several years, and most remained dissatisfied with their social and emotional life and their psychological well-being.

Patient-reported outcome measures in community mental health teams: pragmatic evaluation of PHQ-9, GAD-7 and SWEMWBS

Aims and methodWe evaluated routine use, acceptability and response rates for the Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder Scale (GAD-7) and Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS) within adult community mental health teams. Measures were repeated 3 months later. Professionals recorded the setting, refusal rates and cluster diagnosis. RESULTS: A total of 245 patients completed 674 measures, demonstrating good initial return rates (81%), excellent scale completion (98-99%) and infrequent refusal/unsuitability (11%). Only 32 (13%) returned follow-up measures. Significant improvements occurred in functioning (P = 0.01), PHQ-9 (P = 0.02) and GAD-7 (P = 0.003) scores (Cohen's d = 0.52-0.77) but not in SWEMWBS (P = 0.91) scores. Supercluster A had higher initial PHQ-9 and GAD-7 scores (P < 0.001) and lower SWEMWBS scores (P = 0.003) than supercluster B. Supercluster C showed the greatest functional impairment (P = 0.003).Clinical implicationsPHQ-9 and GAD-7 appear acceptable as patient-reported outcome measures in community mental health team. SWEMWBS seems insensitive to change. National outcome programmes should ensure good follow-up rates.Declaration of interestNone.

Psychotherapy in Jordan: An Investigation of the Host and Syrian Refugee Community's Perspectives

Little is known about patient satisfaction, bias, stigma, and the effects of psychotherapy within the Kingdom of Jordan or the Arab world in general. The purpose of this study was to explore the perceptions of both the Jordanian host and refugee community members from the psychotherapeutic services offered at various mental health care settings in Jordan. A sample of 100 patients who received psychosocial expert interventions was recruited between October and December 2017 in Amman, Jordan. Participants were either from the host or Syrian refugee community or contacted through multiple organizations working in the mental health field. The Patient Satisfaction Questionnaire, which consists of four subscales covering 1) patient satisfaction, 2) bias toward therapy, 3) effects of therapy, and 4) stigma, was administered. As a means of investigation and exploration, descriptive statistics of participant responses are displayed. Results revealed overall high rates of satisfaction with provided services and perceived benefits of psychotherapeutic interventions. However, respondents showed ambivalence regarding bias and stigma. Subsample analyses indicated no significant differences between both communities. These findings give an understanding of perceptions surrounding psychotherapy in Jordan and some insights on therapeutic processes that may be useful for clinical applications and future research.

Acceptance and treatment effects of an internet-delivered cognitive-behavioral intervention for family caregivers of people with dementia: A randomized-controlled trial

OBJECTIVES

The study evaluated the efficacy of an internet-delivered cognitive-behavioral intervention for caregivers of people with dementia and examined acceptance of program characteristics.

METHOD

Thirty-nine caregivers (M _age  = 62.11 ± 9.67, 78.4% female) were enrolled in a 2 × 3 randomized-controlled trial (RCT) that compared an intervention and wait-list control group. A cognitive-behavioral intervention program was adapted for delivery via an internet platform. Participants exchanged eight weekly messages with a therapist.

RESULTS

Treatment satisfaction and acceptance of the program were high. Well-being increased over the intervention duration and intervention group participants were better able to cope with the anticipated death of the care recipient and utilized more psychosocial resources after the intervention ended. Effects were not maintained until follow-up and there were no treatment effects for depression and burden of care.

CONCLUSIONS

Internet-delivered cognitive-behavioral interventions are suitable for caregivers. A larger RCT needs to investigate possible combinations of classic and internet-delivered programs and confirm efficacy.

Patients' satisfaction with hospital health care: Identifying indicators for people with severe mental disorder

BACKGROUND

Patients' perception of psychiatric healthcare is a critical indicator in measuring service quality. The aim of the study was to determine patient's level of satisfaction with the quality of health care delivered at the inpatient departments, and to identify the service quality factors that were important to patients.

METHOD

The Satisfaction with Psychiatry Care Questionnaire-22 was administered to 125 consecutive inpatients with schizophrenia or schizoaffective disorder in a stable condition. Sociodemographic and background variables, illness and symptom severity, insight, social anhedonia, self-esteem, perceived social support, and satisfaction with quality of life were collected.

RESULTS

Although the participants generally expressed satisfaction with the inpatient services, they indicated that the weakest aspects of the service were in the domains of 'personal experience', 'information' and 'activity'. Women were significantly more dissatisfied than men with 'staff', 'care', and by general satisfaction. Multiple regression analysis revealed that satisfaction with hospital health care was associated with five indicators: insight, satisfaction with physical health, self-efficacy, family support, and social anhedonia.

CONCLUSION

Personality related factors rather than psychopathological symptoms were associated with a satisfaction with care of admitted patients with severe mental illness. These factors could be targets for interventions aimed to improve treatment and hospital services.

A typology of satisfaction with mental health services based on Andersen's behavioral model

OBJECTIVE

Patients with mental disorders (MDs) form a highly heterogeneous group, whose satisfaction with mental health services (MHS) may vary according to different variables. Identifying patient subgroups with similar levels of satisfaction may help identify variables that contribute to satisfaction or dissatisfaction with services. This study established a typology of patient satisfaction with MHS that revealed variables specific to each group.

METHODS

The study included 325 patients with MDs across four health service networks offering integrated and diversified services. Data were collected using five standardized instruments, and participant medical records. A conceptual framework was developed, based on Andersen's Behavioral Model, which integrates socio-demographic, clinical, needs-related and service use variables. Using cluster analysis, a typology of patient satisfaction was created.

RESULTS

Analyses yielded four patient clusters: two where levels of satisfaction were relatively high and two with lower levels of satisfaction (range 3.74-4.37). Greater care continuity and higher income related to greater patient satisfaction; whereas co-occurring MDs and substance use disorders (SUD), as well as more numerous and severe needs, characterized dissatisfied patients who were frequent users of MHS.

CONCLUSIONS

Results highlight the need for continuity of care and adequate socio-economic conditions for increasing patient satisfaction with MHS. Lower levels of satisfaction among patients with common MDs and SUDs suggest the importance of addressing their specific needs to enhance satisfaction and MH recovery.

Patient satisfaction with mental health services based on Andersen's Behavioral Model

OBJECTIVE

The purpose of this article was to assess the satisfaction of adult patients who received mental health services (MHS) in healthcare networks staffed by multidisciplinary professionals and offering a range of MHS, and to identify variables associated with patient satisfaction.

METHODS

This cross-sectional study included 325 patients with mental disorders (MDs) among 4 Quebec health service networks. Data were collected using 9 standardized instruments and participant medical records. A 3-factor conceptual framework (predisposing, enabling, and needs-related factors) based on Andersen's Behavioral Model was used, integrating sociodemographic, clinical, needs-related, service utilization, social support, and quality-of-life (QOL) variables. An adjusted multiple linear regression model was performed.

RESULTS

The global mean score for patient satisfaction was 4.11 (minimum: 2.0; maximum: 5.0). Among the enabling factors, continuity of care, having a case manager, and help received from services were positively associated with patient satisfaction, whereas being hospitalized was negatively associated. Among the needs-related factors, the number of needs was negatively associated with satisfaction.

CONCLUSIONS

Findings demonstrated higher levels of satisfaction among patients who received good continuity of care and well-managed, frequent services in relation to their needs. Dissatisfaction was higher for patients with serious unmet needs or those hospitalized, which underlines the importance of taking these particular variables into account in the interest of improving MHS delivery and patient recovery.

Patient Satisfaction, Self-Rated Health Status, and Health Confidence: An Assessment of the Utility of Single-Item Questions

This study examined if known predictors of patient satisfaction would still be significant when single items are used. Approximately 5000 elderly persons were randomly sampled from 65 000 households in West Texas. Single-item questions about patient satisfaction, self-rated overall health status, self-rated mental health, and health confidence were analyzed by chi-square tests and logistic regressions. Slightly more than 12% of the participants were not satisfied or barely satisfied with health care received. Those who reported higher health confidence, lower self-rated overall health, having emotional problems, or who were men were less likely to be satisfied with health care. A simple survey tool based on single-item questions identified by the current study might be useful for monitoring patient satisfaction, self-rated health, and health confidence in primary care settings and hence might assist management in capturing the basic picture for improving health care quality.

Views and experience of communication when receiving a serious mental health diagnosis: satisfaction levels, communication preferences, and acceptability of the SPIKES protocol

BACKGROUND

There is limited research investigating how information about a mental health diagnosis is discussed and received.

AIMS

To measure community-based service users' satisfaction and preferences toward receiving news of a serious mental health diagnosis and to assess the acceptability of a diagnostic communication protocol (SPIKES: Setting; Perception; Invitation; Knowledge; Empathy; Summarizing).

METHOD

A survey was conducted with 101 participants.

RESULTS

Participants rated the methods clinicians use to facilitate diagnostic discussions are highly important; however, they were not wholly satisfied with their experience. Higher satisfaction was reported if participants were provided with information in a face-to-face meeting (p < 0.001), and if they received supplementary support at the time of diagnosis from additional health professionals rather than only a sole practitioner (p < 0.001). The SPIKES protocol was rated as highly acceptable, with Empathy being rated as the most important feature.

CONCLUSIONS

This research indicates there were specific areas of communication practices which can be improved within mental health service provision, as a gap existed between participants' desire for support and their experience. Strategies outlined in the SPIKES protocol, and others such as addressing stigma concerns, may prove useful in development of clinician training and service improvement.

The Psychiatric Patient as a Health Resource Consumer: Costs Associated with Electroconvulsive Therapy

BACKGROUND

Clinical practice protocols should consider both the psychological criteria related to a patient's satisfaction as a consumer of health services and the economic criteria to allocate resources efficiently. An electroconvulsive therapy (ECT) program was implemented in our hospital to treat psychiatric patients. The main objective of this study was to determine the cost associated with the ECT sessions implemented in our hospital between 2008 and 2014. A secondary objective was to calculate the cost of sessions that were considered ineffective, defined as those sessions in which electrical convulsion did not reach the preset threshold duration, in order to identify possible ways of saving money and improving satisfaction among psychiatric patients receiving ECT.

METHODS

A descriptive analysis of the direct health costs related to ECT from the perspective of the public health system between 2008 and 2014 was performed using a retrospective chart review. All of the costs are in euros (2011) and were discounted at a rate of 3%. Based on the base case, a sensitivity analysis of the changes of those variables showing the greatest uncertainty was performed.

RESULTS

Seventy-six patients received 853 sessions of ECT. The cumulative cost of these sessions was €1409528.63, and 92.9% of this cost corresponded to the hospital stay. A total of €420732.57 (29.8%) was inefficiently spent on 269 ineffective sessions. A sensitivity analysis of the economic data showed stable results to changes in the variables of uncertainty.

CONCLUSION

The efficiency of ECT in the context outlined here could be increased by discerning a way to shorten the associated hospital stay and by reducing the number of ineffective sessions performed.

Satisfaction and associated factors of outpatient psychiatric service consumers in Ethiopia

PURPOSE

The purpose of this study was to assess the level of patient satisfaction and associated factors with psychiatric outpatient services in Ethiopia.

PATIENTS AND METHODS

A cross-sectional study was performed from May 2015 to June 2015. A total of 454 participants selected by systematic random sampling were included in this study. Pretested and interviewer-administered questionnaire was used to collect the data. Patient satisfaction was measured using Charleston Psychiatric Outpatient Satisfaction Scale, and other validated tools were used to assess the associated variables. Multivariate logistic regressions with 95% confidence interval (CI) were used to assess the strength, and P-value <0.05 was used to indicate significance of association.

RESULTS

A total of 441 respondents were enrolled, with a response rate of 97.1% and magnitude of satisfaction of 61.2%. Being male (adjusted odds ratio [AOR] =0.612, 95% CI: 0.39, 0.94), being widowed (AOR =0.13, 95% CI: 0.05, 0.36), urban residence (AOR =0.49, 95% CI: 0.31, 0.78), diagnosed with schizophrenia (AOR =0.48, 95% CI: 0.28, 0.81), unfavorable attitude (AOR =0.49, 95% CI: 0.28, 0.86), and poor social functioning (AOR =0.52, 95% CI: 0.34, 0.80) were significantly associated with satisfaction.

CONCLUSION

More than one-third of psychiatric service consumers were dissatisfied with the service they received. Integrating patients to their own treatment plan and regular service evaluation are important to improve satisfaction.

Can we have routine measurement of patient satisfaction in acute psychiatric settings? A cross sectional study

Patient satisfaction is considered an important indicator of the quality of care in psychiatric services. Its importance has been widely studied, but the literature identifies methodological problems deriving from samples with low response rates and exclusion criteria which would seem to imply a kind of exclusion in the evaluations of less compliant patients. The aim of this study is to test a methodology to assess patient satisfaction with the quality of care received at an acute psychiatric ward in terms of its application in daily routine. In this cross sectional survey inpatients were given the Rome Opinion Questionnaire (ROQ). Our patients, involuntary patients included, with a 92.3% participation rate (47 patients out of 51), returned a mean general satisfaction score of 7.7/9. This response rate is higher than that reported in most previously published studies, which shows that a good level of both voluntary and involuntary patient participation may be achieved when an appropriate methodological approach is adopted. Not acknowledging patient satisfaction reduces the possibility of more effective caring actions. Measuring patient satisfaction, through use of short questionnaires, should become a routine in daily practice.

Associations of Quality of Life with Service Satisfaction in Psychotic Patients: A Meta-Analysis

BACKGROUND

Quality of life (QoL) has gained increasing attention as a desired outcome of psychosocial treatments targeting psychotic patients. Yet, the relationship between the patients' satisfaction with services and QoL has not been clearly established, perhaps due to the multidimensionality of the QoL concept and the variability in its assessment.

AIM

This is the first systematic meta-analysis of all available evidence assessing the relationship between QoL and service satisfaction.

METHODS

In all, 19 studies reporting data of 21 independent samples (N = 5,337) were included in the present meta-analysis. In moderator analyses, effects of age, sex, diagnoses (schizophrenia vs. other psychoses), treatment context (inpatients vs. outpatients), study design (cross-sectional vs. longitudinal), and QoL domain (subjective vs. health-related) were examined.

RESULTS

Analyses revealed a highly significant medium-sized effect (r = .30, p < .001) for the associations of QoL and service satisfaction. Effect sizes were significantly stronger for subjective than health-related quality of life (r = .35 vs. r = .14, respectively). Moreover, associations with subjective QoL remained largely robust when accounting for moderating variables, although there was a trend of stronger associations for outpatients compared to inpatients. In contrast, effect sizes for health-related QoL were small and only observable for samples with longitudinal designs.

CONCLUSION

Associations between QoL and service satisfaction appear to be robust but are differentiated in regard to QoL domain. Our findings suggest that agents responsible for service design and implementation need to take the patients' perception of the service adequacy for achieving QoL enhancement into account.

Use of the distress thermometer to evaluate symptoms, outcome and satisfaction in a specialist psycho-oncology service

OBJECTIVE

The National Institute for Health and Care Excellence recommends the use of structured tools to improve holistic care for patients with cancer. The Distress Thermometer and Problem Checklist (DT) is commonly used for screening in physical health settings. However, it has not been integrated into the clinical pathway within specialist psycho-oncology services. We used the DT to examine the broad clinical effectiveness of psycho-oncology intervention and to ascertain factors from the DT linked to an improved outcome. We also evaluated patients' satisfaction with their care.

METHOD

We asked 111 adult outpatients referred to York Psycho-Oncology Service to complete the DT at their first appointment. Individuals offered a period of psycho-oncology care re-rated their emotional distress, problems and service satisfaction on the DT at discharge.

RESULTS

Median distress scores decreased significantly (from 6 to 4, Wilcoxon's z = -4.83, P < .001) indicating a large clinical effect size (Cohen's d = 1.22). Frequency of emotional problems (anxiety, depression and anger) fell significantly by 15-24% despite no significant change in patients' physical health or practical problems. Number of emotional problems was the best predictor of distress at discharge (beta = 0.468, P = .002). Satisfaction was high and correlated with lower distress scores (r = -0.42, P = .005) and fewer emotional problems (r = -0.31, P = .04) at discharge but not with number of appointments attended. Qualitative thematic analysis showed patients particularly value supportive listening and advice on coping strategies from professionals independent of their physical care.

CONCLUSION

The DT is an acceptable and useful tool for enhancing the delivery of structured psycho-oncology care. It may also provide evidence to support the effectiveness of specialist psycho-oncology interventions.

Gender and the relative importance of mental health satisfaction domains

Consumer-reported satisfaction data is a tool used for measuring and targeting areas for quality improvement in mental healthcare. In this study, we investigated the relationship between gender and the relative importance of mental health service satisfaction domains to overall satisfaction, in addition to gender differences in satisfaction across domains. People receiving mental health services (1765 males and 1950 females) completed questionnaires regarding their overall service satisfaction and satisfaction along six domains: Access to Services, Quality and Appropriateness, Participation in Treatment Planning, Outcome of Services, Social Connectedness, and Functioning. While all were important to overall satisfaction across genders, women reported slightly higher overall satisfaction. Linear regression analyses were used to determine the relative importance of these subscales to overall satisfaction for each gender. While the correlations between each subscale and overall satisfaction were significant for both, gender was found to moderate the relationship between some subscales and overall satisfaction. Although predictive of overall service satisfaction across the sample, we found Functioning, Outcome of Services, Social Connectedness, and Access to Services were relatively more important to overall satisfaction for men than women. Consistent feedback of results and improved access to services may be particularly effective for engaging both men and women in treatment.

Patient reports of the outcomes of treatment: a structured review of approaches

Patient reports or ratings are essential for measuring the quality of patient care. Measures designed for this purpose tend to focus on the processes and structures of care rather than the outcomes of it. The latter is arguably the most valid indicator of the quality of care patients receive. Typically this information is gathered by probing patient satisfaction with treatment as part of an investigation of satisfaction with hospital care. More recently patient ratings of the outcome of treatment have been obtained to measure treatment efficacy in clinical trials. However, a more direct approach is to ask patients to assess the benefit of treatment on their current health status. We performed a structured literature review on patient reported satisfaction with outcomes of treatment and direct patient assessments of the same. The purpose of this was to identify suitable candidate questions for a short instrument to tap patient evaluations of in-patient hospital interventions. Articles were included if they dealt with patient satisfaction or patient assessment of the outcomes of treatment. Articles were excluded if they dealt more generally with patient satisfaction with care. We identified 169 papers, 79 were included in the review. The findings of this review suggest that there are a number of benefits of directly asking patients to assess the outcome of hospital treatment. Importantly this approach reflects outcomes relevant to the patient and is also more likely to reflect patient report in routine clinical practice. There is also evidence that such approaches have face validity and construct validity. The problems associated with this approach (i.e. response bias), are those common to patient reported outcome surveys, but employing appropriate strategies can minimize them. Furthermore, employing a simple set of questions that asks patients to assess the outcomes of treatment they receive can be time and resource efficient in comparison to administering lengthy measures. This approach could be tested for potential generic use as an evaluative measure for patients in hospital settings.

Validation of the Chinese version of Perception of Care in an acute psychiatric ward in Hong Kong

INTRODUCTION

This study aimed to validate and culturally adapt the Perception of Care (PoC) for patients receiving acute psychiatric inpatient services in Hong Kong.

METHODS

The PoC was translated and culturally adapted into a written Chinese version (C-PoC). Subjects completed C-PoC, Chinese version of Admission Experience Survey (C-AES) and World Health Organization Quality of Life Measure (WHOQOL-BREF). They were then rated by assessors with Brief Psychiatric Rating Scale (BPRS), Hamilton Rating Scale for Depression, Hamilton Rating Scale for Anxiety and Extrapyramidal Symptom Rating Scale. Explorative factor analysis and correlation between C-PoC, WHOQOL-BREF and C-AES served as the theoretical basis of construct validity. Multivariate analysis was used to identify predictors of satisfaction.

RESULTS

The C-PoC has a four-factor structure that resembles the original scale with demonstrating satisfactory construct validity and test-re-test reliability. Psychiatric symptom ratings did not predict any satisfaction ratings. Extrapyramidal symptoms predicted poorer satisfaction. Younger patients with affective diagnoses had better satisfaction.

DISCUSSION

The C-PoC is a psychometrically sound translation of the original scale. The current study paves the way for further studies among Chinese-speaking communities on the determinants and implications of patients' satisfaction by offering a psychometrically sound and yet concise instrument.

Patient satisfaction with psychiatric outpatient care in a university hospital setting

OBJECTIVES

To measure patient satisfaction with psychiatric outpatient care in a university hospital setting. We wished to ascertain whether there was an association between increased patient satisfaction and background factors such as demographic details, diagnosis and patient preference for outpatient treatment in a hospital or a community setting.

METHODS

We conducted a cross-sectional survey of individuals' satisfaction levels with their outpatient treatment. Outpatients were invited to complete the Client Satisfaction Questionnaire-8 (CSQ-8), a well validated self-report instrument, along with some additional questions on their attitudes to the service.

RESULTS

One hundred and sixty-two respondents had a mean total CSQ-8 score of 26.7 (s.d. = 4.6) indicating a moderate to high level of satisfaction with outpatient care. Ninety percent of patients were satisfied with their psychiatric outpatient care. There were no significant sociodemographic or clinical associations with satisfaction levels identified. Sixty one percent of patients were in favour of retaining outpatient care in the university hospital.

CONCLUSIONS

This study demonstrates high satisfaction levels with psychiatric outpatient care in a university hospital setting. The majority of patients expressed a preference for maintaining outpatient care in the general hospital setting, rather than transferring to a stand-alone mental health facility in a suburban setting.

Is perceived patient involvement in mental health care associated with satisfaction and empowerment?

BACKGROUND

Patients increasingly assume active roles in their mental health care. While there is a growing interest in patient involvement and patient-reported outcomes, there is insufficient research on the outcomes of patient involvement.

OBJECTIVE

The research questions in this study are as follows: 'To what extent is perceived patient involvement associated with satisfaction and empowerment?'; 'What is the nature of the relationship between satisfaction and empowerment?'; and 'To what extent are background variables associated with satisfaction and empowerment?'. We assumed that a higher degree of patient involvement is associated with higher satisfaction and empowerment scores and that satisfaction and empowerment are positively associated.

DESIGN, SETTING AND PARTICIPANTS

Data were gathered using surveys of 111 patients of 36 multidisciplinary care networks for persons with serious and persistent mental illness.

MAIN VARIABLES STUDIED AND MAIN OUTCOME MEASURES

Demographic characteristics, patient involvement and satisfaction were measured using a new questionnaire. Empowerment was assessed using the Dutch Empowerment Scale. Descriptive, univariate (Pearson's r and independent-samples t-tests), multivariate (hierarchical forced entry regression) and mixed-model analyses were conducted.

RESULTS

The hypotheses of positive associations between patient involvement, satisfaction and empowerment are confirmed. The demographics are not significantly related to satisfaction or empowerment, except for gender. Men reported higher empowerment scores than did women.

DISCUSSION AND CONCLUSIONS

Making patient involvement a reality is more than just an ethical imperative. It provides an opportunity to enhance patient-reported outcomes such as satisfaction and empowerment. Future research should focus on the nature of the association between satisfaction and empowerment.

The patient's view of quality in psychiatric outpatient care

The influence of demographic characteristics on patients' ratings of the quality of psychiatric outpatient care has been given little attention in research. The aim of the present study is to elucidate the quality of psychiatric care among outpatients and investigate demographic and clinical factors associated with the way in which this quality is perceived. A sample of 1340 outpatients from 15 general adult psychiatric clinics in Sweden completed the quality in psychiatric care-out-patient (QPC-OP), with a response rate of 71%. The patients' highest ratings were for Encounter; the lowest were for discharge. Most notably, quality of care was rated higher by women, older people, those with a partner, those with a lower educational level and those who were gainfully employed. In regard to visits to the clinic, higher quality of care was associated with shorter waiting time, better information and fewer professions encounters. Older people and those gainfully employed reported better mental health. Thus the QPC-OP was associated with both demographic and clinical factors. In particular, 'wanting to come back to the clinic' was the single strongest predictor of quality.

Treatment satisfaction, perceived treatment effectiveness, and dropout among older users of mental health services

OBJECTIVES

To examine the rates and correlates of treatment satisfaction, perceived treatment effectiveness, and dropout among older users of mental health services.

METHOD

We used data from the Canadian Community Health Survey-Mental Health and Well-Being (CCHS-1.2), which includes 12,792 individuals aged ≥55 years. The average age of these participants was 67 years and 53.2% were female. We examined the rates of treatment satisfaction, perceived treatment effectiveness, and dropout for those who had used mental health services in the past year, and used logistic regression to examine the correlates of these outcomes.

RESULTS

Of the older adults included in the CCHS-1.2, 664 (5.3%) had used mental health services in the past year. The majority of these were satisfied with services (88.5%) and perceived treatment to be effective (83.6%), which is likely why only 15.5% dropped out in the past year. In logistic regression models, social support was significantly and positively related to both treatment satisfaction and perceived effectiveness. Perceived treatment effectiveness was the only variable related to dropout, with lower levels of perceived effectiveness associated with greater odds of dropping out of treatment.

CONCLUSIONS

Results from this study indicate that older adults have very good self-reported treatment outcomes. The modest influence of individual characteristics on treatment outcomes suggests the potential importance of contextual characteristics.

Racial differences in satisfaction with mental health services among victims of intimate partner violence

Research on mental health among victims of intimate partner violence (IPV) has often ignored racial minorities. As the US population has become more racially diverse, the dearth of research on racial minorities' experience with current mental health systems makes it challenging for service providers and practitioners to serve them adequately. This study hypothesized that satisfaction with mental health services would be different across race in both the general population and among IPV victims. This study used the Collaborative Psychiatric Epidemiology Surveys. Logistic regression analyses were conducted. The study results revealed racial differences in satisfaction only in the IPV group. Race had effects on perceived helpfulness among IPV victims. Asian victims of IPV were more likely to perceive mental health services as helpful than any other race groups. Financial security had a positive effect both on subjective satisfaction and perceived helpfulness among IPV victims.

Consumer participation in service evaluation and quality improvement: key ingredients for a system to deliver national indicators

OBJECTIVES

The aim of this paper is to describe the fundamental components of a system to ensure consumer participation in mental health service evaluation and quality improvement.

CONCLUSIONS

The seven fundamental components identified provide the basis for a system to deliver national indicators for consumer participation in quality improvement under the National Health Performance domain of "responsiveness to consumers". The MH-CoPES Framework satisfies these criteria and may be drawn upon as the basis for developing local systems for consumer participation in quality improvement within mental health services.

Dual diagnosis clients' treatment satisfaction - a systematic review

BACKGROUND

The aim of this systematic review is to synthesize existing evidence about treatment satisfaction among clients with substance misuse and mental health co-morbidity (dual diagnoses, DD).

METHODS

We examined satisfaction with treatment received, variations in satisfaction levels by type of treatment intervention and by diagnosis (i.e. DD clients vs. single diagnosis clients), and the influence of factors other than treatment type on satisfaction. Peer-reviewed studies published in English since 1970 were identified by searching electronic databases using pre-defined search strings.

RESULTS

Across the 27 studies that met inclusion criteria, high average satisfaction scores were found. In most studies, integrated DD treatment yielded greater client satisfaction than standard treatment without explicit DD focus. In standard treatment without DD focus, DD clients tended to be less satisfied than single diagnosis clients. Whilst the evidence base on client and treatment variables related to satisfaction is small, it suggested client demographics and symptom severity to be unrelated to treatment satisfaction. However, satisfaction tended to be linked to other treatment process and outcome variables. Findings are limited in that many studies had very small sample sizes, did not use validated satisfaction instruments and may not have controlled for potential confounders. A framework for further research in this important area is discussed.

CONCLUSIONS

High satisfaction levels with current treatment provision, especially among those in integrated treatment, should enhance therapeutic optimism among practitioners dealing with DD clients.

Promoting wellness and recovery for persons with serious mental illness: a program evaluation

This retrospective descriptive correlational study evaluated treatment satisfaction and the quality of life (QOL) of consumers with serious mental illness participating in a community mental health program that combined illness management and recovery strategies with a group appointment model. The Wellness Enhancement and Recovery Program (WERP) was evaluated to determine satisfaction with services and QOL of consumers over 3 years. Findings from the data analyses indicated that consumers in WERP were satisfied with treatment services and had a fair to good QOL. Satisfaction and QOL were moderately correlated.

Examining satisfaction with live-in foreign home care in Israel from the perspectives of care recipients, their family members, and their foreign home care workers

OBJECTIVES

This pilot study evaluates satisfaction with foreign home care arrangement from the perspectives of older adults, their family members, and their foreign home care workers.

METHODS

A matched cross-sectional sample of 148 family members and foreign home care workers and 90 older care recipients completed a satisfaction survey in the years 2007-2008.

RESULTS

Foreign home care workers' satisfaction was directly associated with family members' and care recipients' satisfaction. In addition, the well-being of older care recipients and foreign home care workers was directly associated with their satisfaction with this arrangement. Finally, there was an inverse association between care recipients' cognitive functioning and family members' satisfaction.

CONCLUSIONS

This study demonstrates the complex associations between the various stakeholders involved in this caregiving arrangement. It is possible that better working conditions would result in improved satisfaction with services of all parties involved.