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Migchels C, van den Brink W, Zerrouk A, Matthys F, De Ruysscher C, Vanderplasschen W, Crunelle CL. Psychometric evaluation of the Dutch version of the patient-reported experience measure for addiction treatment (PREMAT-NL). Drug Alcohol Rev 2024. [PMID: 39256987 DOI: 10.1111/dar.13939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 08/07/2024] [Accepted: 08/16/2024] [Indexed: 09/12/2024]
Abstract
INTRODUCTION Patient-centred care has become increasingly important in health care. Patient-reported experience measures (PREM) are used to measure patient experiences in health care, but the availability of psychometrically validated PREMs is limited. The Patient Reported Experience Measure in Addiction Treatment (PREMAT) is a PREM developed with extensive service user input to assess the experiences of people in residential addiction treatment services. In this study we aimed to evaluate the psychometric properties of the Dutch translation of the PREMAT, the PREMAT-NL. METHODS Ninety-three participants completed the PREMAT-NL approximately 45 days after starting addiction treatment as part of a naturalistic prospective multi-centre study in Belgium. We examined the factorial structure using principal component analysis with Promax oblique rotation and assessed the internal consistencies of the subscales and total score using Cronbach's α. Additionally, we explored the relationship of PREMAT-NL scores with demographic and clinical variables. RESULTS The PREMAT-NL had a four-factor structure, with good internal consistencies of the subscales (Cronbach's α >0.70) and excellent internal consistency of the total score (Cronbach's α = 0.94). The PREMAT-NL total score was negatively skewed, and four score categories were proposed based on z-scores. PREMAT-NL scores correlated weakly with the type of treatment centre (r = 0.21, p < 0.05) and with previously received treatment for addiction (r = -0.25, p < 0.05). DISCUSSION AND CONCLUSIONS Although the factor structure and thus the appropriate use of subscales need further investigation, the findings of this study support the use of the PREMAT-NL total score as a valid and reliable PREM to evaluate residential addiction treatment services.
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Affiliation(s)
- Charlotte Migchels
- Department of Psychiatry, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Wim van den Brink
- Department of Psychiatry, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Amine Zerrouk
- Department of Special Needs Education, Ghent University, Ghent, Belgium
| | - Frieda Matthys
- Department of Psychiatry, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | | | | | - Cleo L Crunelle
- Department of Psychiatry, Vrije Universiteit Brussel, Universitair Ziekenhuis Brussel, Brussels, Belgium
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Iversen HH, Haugum M, Ellingsen-Dalskau LH, Bjertnaes O. Reliability and validity of the Patient Experiences Questionnaire for Interdisciplinary Treatment for Substance Dependence - Continuous Electronic Measurement (PEQ-ITSD - CEM). BMC Health Serv Res 2024; 24:26. [PMID: 38178069 PMCID: PMC10768463 DOI: 10.1186/s12913-023-10506-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 12/20/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Inpatient experiences with interdisciplinary treatment for substance dependence and mental health care are measured using continuous electronic measurements in Norway. Major changes in data collection from cross-sectional surveys to continuous measurements necessitated the revalidation of the instrument. The main purpose of the present study was to determine the psychometric properties of the Patient Experiences Questionnaire for Interdisciplinary Treatment for Substance Dependence - Continuous Electronic Measurement (PEQ-ITSD - CEM). We also aimed to develop a short version of this tool, since completing the original version can be burdensome for some patients. METHODS The study included adult inpatients (aged ≥ 16 years) who received substance-dependence treatment at 102 different sections in Norway during 2020-2022 (n = 2,850). Factor structure and item performance were assessed. A short version was developed based on the psychometric testing results that included item response theory analysis. RESULTS The PEQ-ITSD - CEM comprised three empirically based scales with good internal consistency, reliability and validity, which covers treatment and personnel (14 items), milieu (6 items) and outcome (5 items). The results supported a seven-item short version, with three items selected for the treatment and personnel scale, two items for the milieu scale and two items for the outcome scale. CONCLUSIONS The PEQ-ITSD - CEM can be recommended for future assessments of patient experiences with interdisciplinary treatment for substance dependence in Norway and in other countries with similar healthcare systems. This short-form version can be applied when respondent burden is a crucial issue.
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Affiliation(s)
| | - Mona Haugum
- Norwegian Institute of Public Health, PO Box 222 Skoyen, Oslo, 0213, Norway
| | | | - Oyvind Bjertnaes
- Norwegian Institute of Public Health, PO Box 222 Skoyen, Oslo, 0213, Norway
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van der Sterren AE, Nathan S, Rawstorne P, Yarbakhsh E, Gough C, Bowles D. Involvement of people who use alcohol and other drug services in the development of patient-reported measures of experience: A scoping review. Health Expect 2023; 26:2151-2163. [PMID: 37515528 PMCID: PMC10632652 DOI: 10.1111/hex.13829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 06/17/2023] [Accepted: 07/14/2023] [Indexed: 07/31/2023] Open
Abstract
INTRODUCTION Patient-reported measures that assess satisfaction and experience are increasingly utilised in healthcare sectors, including the alcohol and other drug (AOD) sector. This scoping review identifies how and to what extent people accessing AOD services have been involved in the development of satisfaction and experience measures to date. METHODS PubMed, EMBASE, CINAHL, Scopus, ProQuest, Google and Google Scholar were searched. Included papers described the development and/or implementation of a multiple-item measure of patient-reported experience or satisfaction specifically for people accessing AOD treatment and/or harm reduction programmes. If there was more than one paper, key papers were chosen that described each measure. The method of development, including service user involvement, was assessed against a framework generated for this review. Two reviewers were involved at each stage. RESULTS Thirty measures-23 satisfaction and 7 experience-were identified. Sixteen measures reported some level of involvement by people accessing AOD services in their development, although, for most measures, at a relatively low level. This involvement increased over the time span of the review becoming more frequent in later years. Only four measures were developed for use in harm reduction-specific settings, and fewer than half reported undertaking analysis of underlying scale structure and constructs. CONCLUSION Several gaps could be addressed to enhance the measurement of patient-centred care in the AOD sector, including: developing experience measures for use in harm reduction settings and across various AOD settings in a service system; improved reporting of psychometric properties of these measures and increasing commitment to the meaningful involvement of AOD service users in measure development. PATIENT OR PUBLIC CONTRIBUTION This scoping review is part of a broader codesign project that involves a partnership between the peak organisation for AOD services and the peer-based AOD consumer organisation in the Australian Capital Territory, Australia. These organisations are working closely together to engage with AOD service users, service providers and policy makers in this codesign project. As such, the Executive Director of the peer-based AOD consumer organisation is involved as a co-author of this scoping review.
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Affiliation(s)
- Anke E. van der Sterren
- Alcohol Tobacco and Other Drug Association ACT (ATODA)CanberraAustralian Capital TerritoryAustralia
- School of Population HealthUNSW SydneySydneyNew South WalesAustralia
| | - Sally Nathan
- School of Population HealthUNSW SydneySydneyNew South WalesAustralia
| | - Patrick Rawstorne
- School of Population HealthUNSW SydneySydneyNew South WalesAustralia
| | - Elisabeth Yarbakhsh
- Alcohol Tobacco and Other Drug Association ACT (ATODA)CanberraAustralian Capital TerritoryAustralia
| | - Chris Gough
- Canberra Alliance for Harm Minimisation and Advocacy (CAHMA)CanberraAustralian Capital TerritoryAustralia
| | - Devin Bowles
- Alcohol Tobacco and Other Drug Association ACT (ATODA)CanberraAustralian Capital TerritoryAustralia
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Silva MMDJ, Santos CBD, Clapis MJ. Elaboração e validação de construto da Escala de Risco de Depressão na Gravidez. Rev Bras Enferm 2023. [DOI: 10.1590/0034-7167-2022-0306pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
RESUMO Objetivos: elaborar e analisar as propriedades psicométricas da Escala de Risco de Depressão na Gravidez. Métodos: pesquisa metodológica, em seis etapas: definição empírica do modelo teórico; elaboração dos itens da escala com revisão da literatura; consulta a cinco especialistas profissionais de saúde e 15 gestantes; validação de conteúdo com seis especialistas; pré-teste-validação semântica com 24 gestantes; definição da estrutura fatorial da escala com 350 gestantes; estudo piloto com 100 gestantes, totalizando 489 gestantes e 11 especialistas. Os dados foram analisados pela análise de conteúdo, análise fatorial exploratória, análise multitraço-multimétodo e consistência interna. Resultados: 68 fatores de risco foram identificados para formulação dos itens. A versão final da escala foi composta por 24 itens em cinco domínios. A escala demonstrou validade de conteúdo, semântica, de construto e fidedignidade satisfatória. Conclusões: a escala mostrou-se válida em conteúdo e semântica, com estrutura fatorial definida segundo modelo teórico adotado e propriedades psicométricas satisfatórias.
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Silva MMDJ, Santos CBD, Clapis MJ. Construct elaboration and validity of the Pregnancy Depression Risk Scale. Rev Bras Enferm 2023; 76:e20220306. [PMID: 36888797 PMCID: PMC9987458 DOI: 10.1590/0034-7167-2022-0306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 10/01/2022] [Indexed: 03/08/2023] Open
Abstract
OBJECTIVES to elaborate and analyze the Pregnancy Depression Risk Scale psychometric properties. METHODS methodological research, in six steps: theoretical model empirical definition; elaboration of scale items with literature review; consultation with five professional health experts and 15 pregnant women; content validity with six experts; pre-test-semantic validity with 24 pregnant women; scale factor structure definition with 350 pregnant women; pilot study with 100 pregnant women, totaling 489 pregnant women and 11 experts. Data were analyzed by content analysis, exploratory factor analysis, multitrait-multimethod analysis and internal consistency. RESULTS sixty-eight risk factors were identified for item formulation. The final version of the scale consisted of 24 items in five domains. The scale demonstrated satisfactory construct content, semantic, validity and reliability. CONCLUSIONS the scale proved to be valid in terms of content and semantics, with a factor structure defined according to the adopted theoretical model and satisfactory psychometric properties.
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Haberstroh C, Weider S, Flemmen G, Loe H, Andersson HW, Hallgren M, Mosti MP. The effect of high-intensity interval training on cognitive function in patients with substance use disorder: Study protocol for a two-armed randomized controlled trial. Front Sports Act Living 2022; 4:954561. [PMID: 36570498 PMCID: PMC9780390 DOI: 10.3389/fspor.2022.954561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 11/21/2022] [Indexed: 12/13/2022] Open
Abstract
Introduction Substance use disorder (SUD) is characterized by cognitive impairment, especially executive dysfunction. Executive function is recognized as an important determinant of treatment outcome as it is associated with dropout rate, attendance to therapy and potential relapse after treatment termination. Physical activity can have beneficial effects on cognitive function, but there is still a lack of knowledge regarding potential benefits of aerobic exercise for executive function in SUD treatment. The aim of this study is to examine the effect of aerobic high-intensity interval training (HIIT) on cognitive function and the subsequent effect on treatment outcome in patients with SUD. Methods and analysis This study is a randomized controlled trial, including men and women ≥18 years with diagnosed SUD by ICD-10. The patients will be recruited from the department for inpatient treatment at Blue Cross - Lade Addiction Treatment Center, Trondheim, Norway. Participants will be randomized 1:1 into either HIIT (3x/week) + treatment as usual (TAU), or TAU alone. Study outcomes will be assessed at baseline, after eight weeks of intervention, and at 3- and 12-months follow-up. The primary outcome is to compare the change in executive function (via altered BRIEF-A score, Behavior Rating Inventory of Executive Function-Adult) measured between the two study groups after eight weeks. Secondary outcomes include mapping of cognitive function in different subgroups (e.g. type of substance, age, fitness level), collecting self-reported information about quality of life, craving, sleep quality, etc., as well as assessing compliance to TAU and long-term treatment outcome. Ethics and dissemination The project was approved by the Regional Ethical Committee and will be performed in accordance with this protocol and the Declaration of Helsinki. Written informed consent will be obtained from all participants prior to inclusion. This project will explore a novel approach to how exercise can be applied in SUD treatment, beyond the well-known effects on physical health. We expect to achieve new knowledge in regard to what extent HIIT can improve cognitive abilities and subsequent treatment outcome in SUD. Trial registration number https://www.clinicaltrials.gov/NCT05324085.
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Affiliation(s)
- Carolin Haberstroh
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St Olavs University Hospital, Trondheim, Norway,Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway,Correspondence: Carolin Haberstroh Mats Peder Mosti
| | - Siri Weider
- Department of Psychology, Faculty of Social and Educational Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Grete Flemmen
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St Olavs University Hospital, Trondheim, Norway,Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Henrik Loe
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St Olavs University Hospital, Trondheim, Norway
| | - Helle Wessel Andersson
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St Olavs University Hospital, Trondheim, Norway
| | - Mats Hallgren
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Mats Peder Mosti
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St Olavs University Hospital, Trondheim, Norway,Correspondence: Carolin Haberstroh Mats Peder Mosti
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Iversen HH, Haugum M, Bjertnaes O. Reliability and validity of the Psychiatric Inpatient Patient Experience Questionnaire - Continuous Electronic Measurement (PIPEQ-CEM). BMC Health Serv Res 2022; 22:897. [PMID: 35821137 PMCID: PMC9275271 DOI: 10.1186/s12913-022-08307-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 07/07/2022] [Indexed: 12/04/2022] Open
Abstract
Background The increasing emphasis on patient-centred care has accelerated the demand for high-quality assessment instruments, but the development and application of measures of the quality of care provided for mental health have lagged behind other areas of medicine. The main objective of this study was to determine the psychometric properties of the Psychiatric Inpatient Patient Experience Questionnaire – Continuous Electronic Measurement (PIPEQ-CEM), which consists of large-scale measurements from a Norwegian population. The change from cross-sectional surveys to continuous measurements necessitated further validation of the instrument. The secondary objective was to develop a short version of the PIPEQ-CEM. Methods The data included responses from the first year of continuous measurement, and included adult inpatients (age ≥ 18 years) who received specialized mental healthcare from 191 different sections in Norway (n = 3,249). Missing data, ceiling effects, factor structure and internal consistency levels were assessed. The short scale was developed by exploring missing items, ceiling effects, results from exploratory factor analysis (EFA) and item performance from item response theory (IRT) analyses. Results Psychometric testing supported previous results and illustrated that the PIPEQ-CEM comprises three empirically based scales with good internal consistency, reliability and validity, and covers structure and facilities, patient-centred interactions, and outcomes. A seven-item short form was developed, which provides an efficient approach for brief yet comprehensive measurements that can be applied in the future. Conclusion The PIPEQ-CEM can be recommended for use in future national surveys that assess patient experience with inpatient psychiatric care in Norway and in other countries with similar healthcare systems. The short form can be applied where respondent burden and cognitive load are crucial issues. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08307-5.
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Affiliation(s)
| | - Mona Haugum
- Norwegian Institute of Public Health, PO Box 222 Skoyen, Oslo, 0213, Norway
| | - Oyvind Bjertnaes
- Norwegian Institute of Public Health, PO Box 222 Skoyen, Oslo, 0213, Norway
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Myers B, Koch JR, Johnson K, Harker N. Factors associated with patient-reported experiences and outcomes of substance use disorder treatment in Cape Town, South Africa. Addict Sci Clin Pract 2022; 17:8. [PMID: 35109915 PMCID: PMC8812030 DOI: 10.1186/s13722-022-00289-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 01/18/2022] [Indexed: 12/15/2022] Open
Abstract
Background Interventions are needed to improve the quality of South Africa’s substance use disorder (SUD) treatment system. This study aimed to identify factors associated with patient-reported suboptimal access, quality, and outcomes of SUD treatment to guide the design of targeted quality improvement initiatives. Method We analysed clinical record and patient survey data routinely collected by SUD services in the Western Cape Province, South Africa. The sample included 1097 treatment episodes, representing 32% of all episodes in 2019. Using multivariate logistic regression, we modelled socio-demographic, substance use and treatment correlates of patient-reported suboptimal access to, quality and outcomes of SUD treatment. Results Overall, 37.9% of patients reported substantial difficulties in accessing treatment, 28.8% reported suboptimal quality treatment, and 31.1% reported suboptimal SUD outcomes. The odds of reporting poor access were elevated for patients identifying as Black/African, in residential treatment, with comorbid mental health problems, and longer histories of substance use. Length of substance use, comorbid mental health problems, and prior SUD treatment were associated with greater likelihood of reporting suboptimal quality treatment. Patients with comorbid mental health problems, polysubstance use, who did not complete treatment, and who perceived treatment to be of poor quality were more likely to report suboptimal outcomes. Conclusion This study is among the first to use patient-reported experiences and outcome measures to identify targets for SUD treatment improvement. Findings suggest substantial room to improve South African SUD treatment services, with targeted efforts needed to reduce disparities in outcomes for patients of Black/African descent, for those with comorbid mental health problems, and for patients who have chronic substance use difficulties. Interventions to enhance the relevance, appropriateness, and acceptability of SUD services for these patient sub-groups are needed to improve system performance.
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Affiliation(s)
- Bronwyn Myers
- Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, WA, 6102, Australia. .,Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa. .,Division of Addiction Psychiatry, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
| | - J Randy Koch
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Kim Johnson
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Nadine Harker
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa.,School of Public Health, University of Cape Town, Cape Town, South Africa
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de Bienassis K, Kristensen S, Hewlett E, Roe D, Mainz J, Klazinga N. Patient-reported indicators in mental health care: towards international standards among members of the OECD. Int J Qual Health Care 2021; 34:ii7–ii12. [PMID: 33693897 DOI: 10.1093/intqhc/mzab020] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 01/25/2021] [Accepted: 03/05/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Achieving people-centred health care systems requires new and innovative strategies to capture information about whether, and to what degree, health care is successful in improving health from the perspective of the patient. Patient-reported outcome measures (PROMs) and Patient-reported experience measures (PREMs) can bring some of these new insights, and are increasingly used in research, clinical care, and policymaking. METHODS This paper reflects the ongoing discussions and findings of the OECD PaRIS Working Group on Patient-reported Indicators for Mental Health Care. RESULTS The OECD has been measuring quality of care for mental health conditions over the last 14 years through the Health Care Quality and Outcomes (HCQO) program; nonetheless, information on how persons with mental health problems value the services they receive, and impact of the services, remains limited. As of 2018, a survey from the OECD showed that only five of the twelve countries surveyed (Australia, Israel, Netherlands, Sweden, United Kingdom) reported PROMs and PREMs collection on a regular basis in mental health settings. The paper details some of the challenges specific to the collection and use of PROMs and PREMs in mental health care, and examples from countries which have implemented comprehensive programmes to gather information about PROMs and PREMs for individuals receiving mental health services. CONCLUSIONS Given the health and economic impact of mental ill-health across all OECD countries, there is significant value to being able to assess the quality and outcomes of care in this area using internationally-comparable measures. Continued international harmonisation of PROMs and PREMs for mental health through international coordination is a key way to facilitate the sharing of national experiences, promote the use of PROMs and PREMs, and create meaningful indicators for national and international benchmarking.
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Affiliation(s)
| | - Solvejg Kristensen
- Psychiatry, Aalborg University Hospital, Moelleparkvej 10, Aalborg 9000, Denmark
| | - Emily Hewlett
- Health Division, OECD, 2 Rue Andre Pascal, Paris 75016, France
| | - David Roe
- Department of Community Mental Health, University of Haifa, Abba Khoushy Ave 199, Haifa 3498838, Israel
| | - Jan Mainz
- Department South, Psychiatry Region Nordjylland, Moelleparkvej 10, Aalborg 9000, Denmark
| | - Niek Klazinga
- Health Division, OECD, 2 Rue Andre Pascal, Paris 75016, France
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Andersson HW, Nordfjærn T. Factors associated with quality of life trajectories among inpatients treated for alcohol use disorders: A prospective cohort study. Addict Behav Rep 2020; 12:100285. [PMID: 32637561 PMCID: PMC7330870 DOI: 10.1016/j.abrep.2020.100285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 05/12/2020] [Accepted: 05/15/2020] [Indexed: 12/05/2022] Open
Abstract
AIMS The main study purpose was to investigate patient- and treatment-related factors associated with overall quality of life (OQOL) trajectories during and after inpatient alcohol use disorder (AUD) treatment. DESIGN A large-scale prospective multicenter cohort study of patients with different substance use disorder (SUD) types who were consecutively admitted for inpatient SUD treatment. Data were obtained at treatment entry (T1), discharge (T2), three months after discharge (T3), and one year after discharge (T4). The inclusion criterion was that the patient be dependent solely on alcohol. OQOL data were collected at all four time points. Independent variables included demographics, mental distress, psychiatric disorders, substance use, treatment history, and patient satisfaction. RESULTS Among the 611 patients available, 236 met the AUD inclusion criterion and completed T1 assessments. A linear mixed model showed substantial co-occurrence between higher mental distress and lower OQOL. Higher patient satisfaction with inpatient treatment (T2) was associated with higher trajectories of OQOL, whereas abstinence (T3) was not. There was a substantial increase in OQOL from T1 to T2, which then remained stable during the last two assessment time points. CONCLUSIONS Routine OQOL screening at treatment entry, and targeting mental distress both during and after inpatient treatment, may be associated with improved OQOL among individuals with AUD. Further research should investigate inpatient treatment factors that contribute to OQOL improvement and those that moderate the relationship between patient satisfaction and OQOL.
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Affiliation(s)
- Helle Wessel Andersson
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olavs University Hospital, Trondheim, Norway
| | - Trond Nordfjærn
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olavs University Hospital, Trondheim, Norway
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
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Iversen HH, Bjertnaes O, Helland Y, Skrivarhaug T. The Adolescent Patient Experiences of Diabetes Care Questionnaire (APEQ-DC): Reliability and Validity in a Study Based on Data from the Norwegian Childhood Diabetes Registry. PATIENT-RELATED OUTCOME MEASURES 2019; 10:405-416. [PMID: 31920415 PMCID: PMC6938190 DOI: 10.2147/prom.s232166] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 12/13/2019] [Indexed: 12/31/2022]
Abstract
Purpose Patient-reported experiences are a key source of information on quality in health care. Most patient experience surveys only include adults’ assessments including parent or proxy surveys in child health care settings. The aim of this study was to determine the psychometric properties of the Adolescent Patient Experiences of Diabetes Care Questionnaire, a new instrument developed to measure adolescent experiences of paediatric diabetes care at hospital outpatient departments in Norway. Patients and Methods The questionnaire was developed based on a literature review, qualitative interviews with adolescents, expert-group consultations, pretesting of the questionnaire and a pilot study. The pilot study involved adolescents aged 12–17 years with type 1 diabetes, sampled from the four largest paediatric outpatient departments in Norway. We assessed the levels of missing data, ceiling effects, factor structure, internal consistency, item discriminant validity and construct validity. Results The pilot study included responses from 335 (54%) patients. Low proportions of missing or “not applicable” responses were found for 17 of the 19 items, and 14 of these 19 items were below the ceiling-effect criterion. Five indicators were identified: consultation, information on food and physical activity/exercise, nurse contact, doctor contact and outcome. All except one indicator met the criterion of 0.7 for Cronbach’s alpha. Each of the single items had a stronger correlation with its hypothesized indicator than with any of the other indicators. The construct validity of the instrument was supported by 38 out of 45 significant associations. Conclusion The content validity of the instrument was secured by a rigorous development process. Psychometric testing produced good evidence for data quality, internal consistency and construct validity. Further research is needed to assess the usefulness of the Adolescent Patient Experiences of Diabetes Care Questionnaire as a basis for quality indicators.
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Affiliation(s)
- Hilde Hestad Iversen
- Division of Health Services, Norwegian Institute of Public Health, Oslo N-0403, Norway
| | - Oyvind Bjertnaes
- Division of Health Services, Norwegian Institute of Public Health, Oslo N-0403, Norway
| | - Ylva Helland
- Division of Health Services, Norwegian Institute of Public Health, Oslo N-0403, Norway
| | - Torild Skrivarhaug
- Division of Paediatric and Adolescent Medicine, The Norwegian Childhood Diabetes Registry, Oslo University Hospital, Oslo N-0424, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo N-0318, Norway
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Patient experiences with a transitional, low-threshold clinic for the treatment of substance use disorder: A qualitative study of a bridge clinic. J Subst Abuse Treat 2019; 107:1-7. [DOI: 10.1016/j.jsat.2019.09.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 08/29/2019] [Accepted: 09/09/2019] [Indexed: 12/21/2022]
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Bull C, Byrnes J, Hettiarachchi R, Downes M. A systematic review of the validity and reliability of patient-reported experience measures. Health Serv Res 2019; 54:1023-1035. [PMID: 31218671 PMCID: PMC6736915 DOI: 10.1111/1475-6773.13187] [Citation(s) in RCA: 123] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To identify patient-reported experience measures (PREMs), assess their validity and reliability, and assess any bias in the study design of PREM validity and reliability testing. DATA SOURCES/STUDY SETTING Articles reporting on PREM development and testing sourced from MEDLINE, CINAHL and Scopus databases up to March 13, 2018. STUDY DESIGN Systematic review. DATA COLLECTION/EXTRACTION METHODS Critical appraisal of PREM study design was undertaken using the Appraisal tool for Cross-Sectional Studies (AXIS). Critical appraisal of PREM validity and reliability was undertaken using a revised version of the COSMIN checklist. PRINCIPAL FINDINGS Eighty-eight PREMs were identified, spanning across four main health care contexts. PREM validity and reliability was supported by appropriate study designs. Internal consistency (n = 58, 65.2 percent), structural validity (n = 49, 55.1 percent), and content validity (n = 34, 38.2 percent) were the most frequently reported validity and reliability tests. CONCLUSIONS Careful consideration should be given when selecting PREMs, particularly as seven of the 10 validity and reliability criteria were not undertaken in ≥50 percent of the PREMs. Testing PREM responsiveness should be prioritized for the application of PREMs where the end user is measuring change over time. Assessing measurement error/agreement of PREMs is important to understand the clinical relevancy of PREM scores used in a health care evaluation capacity.
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Affiliation(s)
- Claudia Bull
- Centre for Applied Health Economics (CAHE)Griffith UniversityBrisbaneQueenslandAustralia
- Menzies Health Institute Queensland (MHIQ)BrisbaneQueenslandAustralia
| | - Joshua Byrnes
- Centre for Applied Health Economics (CAHE)Griffith UniversityBrisbaneQueenslandAustralia
- Menzies Health Institute Queensland (MHIQ)BrisbaneQueenslandAustralia
| | - Ruvini Hettiarachchi
- Centre for Applied Health Economics (CAHE)Griffith UniversityBrisbaneQueenslandAustralia
- Menzies Health Institute Queensland (MHIQ)BrisbaneQueenslandAustralia
| | - Martin Downes
- Centre for Applied Health Economics (CAHE)Griffith UniversityBrisbaneQueenslandAustralia
- Menzies Health Institute Queensland (MHIQ)BrisbaneQueenslandAustralia
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Homaei S, Banazadeh N, Roaei F, Ziaaddini H. Development and Psychometric Assessment of the Methadone Therapy Experiences Questionnaire among Patients under Treatment. ADDICTION & HEALTH 2019; 11:183-191. [PMID: 31839916 PMCID: PMC6904980 DOI: 10.22122/ahj.v11i3.241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 04/28/2019] [Indexed: 12/04/2022]
Abstract
BACKGROUND Patient experiences play an important role in the quality of health care and gathering patients' experiences is common as part of quality measurement in health care. The present study was carried out with the aim of developing and psychometric analysis of the methadone therapy experiences questionnaire among patients under treatment with methadone. METHODS This cross-sectional study was performed in 2018 and 200 patients referred to the addiction treatment clinics in Kerman, Iran, participated in this study. The convenient sampling method was employed. The validity was assessed using the opinions of 50 individuals similar to the target population and 8 experts. In addition, the Cronbach's alpha coefficient was utilized to examine the test-retest reliability. Data were analyzed using descriptive and inferential statistics in the SPSS software. FINDINGS The face validity of the questionnaire was acceptable in the present study and the values for content validity were higher than 0.79, indicating the appropriate content validity of the questionnaire [content validity index (CVI) = 0.82 and content validity ratio (CVR) = 0.83]. Moreover, the results confirmed the reliability or reproducibility of the questionnaire (Cronbach's alpha = 0.83). CONCLUSION The methadone therapy experiences questionnaire was of a good validity and reliability among the patients. In the clinical area, the psychiatrists, psychologists, authorities, and staff in addiction treatment clinics can identify the quality of treatment and its strengths and weaknesses using this questionnaire.
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Affiliation(s)
- Saeideh Homaei
- Department of Psychiatry, School of Medicine AND Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Nabi Banazadeh
- Department of Psychiatry, School of Medicine AND Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Farzaneh Roaei
- Department of Psychiatry, School of Medicine AND Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Hassan Ziaaddini
- Department of Psychiatry, School of Medicine AND Neuroscience Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
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15
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Haugum M, Iversen HH, Helgeland J, Lindahl AK, Bjertnaes O. Patient experiences with interdisciplinary treatment for substance dependence: an assessment of quality indicators based on two national surveys in Norway. Patient Prefer Adherence 2019; 13:453-464. [PMID: 31118584 PMCID: PMC6498953 DOI: 10.2147/ppa.s194925] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 03/12/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose: The quality of health care is often measured using quality indicators, which can be utilized to compare the performance of health-care providers. Conducting comparisons in a meaningful and fair way requires the quality indicators to be adjusted for patient characteristics and other individual-level factors. The aims of the study were to develop and test a case-mix adjustment model for quality indicators based on patient-experience surveys among inpatients receiving interdisciplinary treatment for substance dependence, and to establish whether the quality indicators discriminate between health care providers. Patients and methods: Data were collected through two national surveys involving inpatients receiving residential treatment in Norway in 2013 and 2014. The same questionnaire was used in both surveys, and comprised three patient-experience scales. The scales are reported as national quality indicators, and associations between the scales and patient characteristics were tested through multilevel modeling to establish a case-mix model. The intraclass correlation coefficient was computed to assess the amount of variation at the hospital-trust level. Results: The intraclass correlation coefficient for the patient-reported experience scales varied from 2.3% for "treatment and personnel" to 8.1% for "milieu". Multivariate multilevel regression analyses showed that alcohol reported as the most frequently used substance, gender and age were significantly associated with two of the three scales. The length of stay at the institution, pressure to be admitted for treatment, and self-perceived health were significantly related to all three scales. Explained variance at the individual level was approximately 7% for all three scales. Conclusion: This study identified several important case-mix variables for the patient-based quality indicators and systematic variations at the hospital-trust level. Future research should assess the association between patient-based quality indicators and other quality indicators, and the predictive validity of patient-experience indicators based on on-site measurements.
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Affiliation(s)
- Mona Haugum
- Division of Health Services, Norwegian Institute of Public Health, Oslo, Norway
- Department of Health Management and Health Economics, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Correspondence: Mona HaugumDivision of Health Services, Norwegian Institute of Public Health, PO Box 222 Skoyen, Oslo0213, NorwayTel +4 792 457 560Email
| | | | - Jon Helgeland
- Division of Health Services, Norwegian Institute of Public Health, Oslo, Norway
| | - Anne Karin Lindahl
- Department of Health Management and Health Economics, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Surgery, Akershus University Hospital, Lorenskog, Norway
| | - Oyvind Bjertnaes
- Division of Health Services, Norwegian Institute of Public Health, Oslo, Norway
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Iversen HH, Helland Y, Bjertnaes O, Skrivarhaug T. Parent experiences of diabetes care questionnaire (PEQ-DC): reliability and validity following a national survey in Norway. BMC Health Serv Res 2018; 18:774. [PMID: 30314486 PMCID: PMC6186125 DOI: 10.1186/s12913-018-3591-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 10/01/2018] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Patient experiences are acknowledged as an important aspect of health care quality but no validated instruments have been identified for the measurement of either parent or patient experiences with outpatient paediatric diabetes care. The aim of the current study was to assess the psychometric properties of a new instrument developed to measure parent experiences of paediatric diabetes care at hospital outpatient departments in Norway. METHODS The development of the questionnaire was based on a literature review of existing questionnaires, qualitative interviews with both parents and children/adolescents, expert-group consultations, pretesting of the questionnaire and a pilot study. The national pilot study included parents of 2606 children/adolescents aged 0-17 years with Type 1 Diabetes registered in The Norwegian Childhood Diabetes Registry, a nationwide, population-based registry. Levels of missing data, ceiling effects, factor structure, internal consistency, item discriminant validity and construct validity were assessed. RESULTS A total of 2606 patients were included in the survey, but 80 were excluded due to incorrect addresses. 1399 (55%) parents responded to the questionnaire. Low levels of missing or "not applicable" responses were found for 31 of the 35 items (< 10%), and 27 of 35 items were below the ceiling-effect criterion. Psychometric testing and theoretical considerations identified six scales: Consultation (six items), organisation (five items), equipment (three items), nurse contact (four items), doctor contact (four items) and outcome (five items). All six scales met the 0.7 criterion for Cronbach's alpha (range: 0.71-0.90). As expected, each item had a higher correlation with its hypothesised scale than with any of the other five scales. The construct validity of the Parent Experiences of Diabetes Care Questionnaire (PEQ-DC) was supported by 17 out of 18 associations with variables expected to be related to parent experiences. CONCLUSION The psychometric testing of the PEQ-DC showed good evidence for data quality, internal consistency and construct validity. The instrument includes important aspects of diabetes care at paediatric outpatient departments from the perspective of the parent. The content validity of the PEQ-DC was secured by a rigorous development process, and the instrument was tested following a national survey in Norway, securing generalisability across Norway.
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Affiliation(s)
| | - Ylva Helland
- Norwegian Directorate of Health, PO Box 7000, N-0130 Oslo, Norway
| | - Oyvind Bjertnaes
- Norwegian Institute of Public Health, PO Box 4404, Nydalen, N-0403 Oslo, Norway
| | - Torild Skrivarhaug
- Division of Paediatric and Adolescent Medicine, The Norwegian Childhood Diabetes Registry, Oslo University Hospital, PO Box 4956, Nydalen, N-0424 Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, N-0318 Oslo, Norway
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Andersson HW, Otterholt E, Gråwe RW. Patient satisfaction with treatments and outcomes in residential addiction institutions. NORDIC STUDIES ON ALCOHOL AND DRUGS 2017; 34:375-384. [PMID: 32934499 PMCID: PMC7450857 DOI: 10.1177/1455072517718456] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 05/16/2017] [Indexed: 11/16/2022] Open
Abstract
Aim: The objective of the present study was to investigate associations between patients’ satisfaction with different domains of inpatient substance use treatment and their perceived treatment outcome. The primary purpose was to identify domains of treatment satisfaction most strongly associated with a positive treatment outcome. Design: Data were based on a survey among 188 patients with alcohol and/or illicit substance use disorders completing a three–six-month inpatient stay at one of two public clinics in Central Norway. The survey was carried out shortly before discharge. The 15-item questionnaire covered ratings of staff and programme factors, and services received for medical and mental problems and ancillary services. The outcome score was based on items measuring perceived substance use improvements and benefit of treatment. Results: A significant proportion of patients were dissatisfied with the support provided for housing, financial issues and employment. Confidence in staff competence was the domain of treatment satisfaction most strongly associated with the outcome score. Furthermore, patients were more likely to report a positive outcome when they were actively involved in the treatment, as indicated by satisfaction with opportunities to affect treatment plans. Conclusion: Our results suggest that patient-experienced improvements are connected to confidence in staff competence and user involvement. The findings may be interpreted as supporting a collaborative relationship between patients and counsellors.
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Affiliation(s)
| | | | - Rolf W Gråwe
- St. Olav's University Hospital, Trondheim, Norway
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Ignatyev Y, Timm J, Heinze M, Indefrey S, von Peter S. Development and Preliminary Validation of the Scale for Evaluation of Psychiatric Integrative and Continuous Care-Patient's Version. Front Psychiatry 2017; 8:162. [PMID: 28912735 PMCID: PMC5583144 DOI: 10.3389/fpsyt.2017.00162] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Accepted: 08/14/2017] [Indexed: 11/13/2022] Open
Abstract
This pilot study aimed to evaluate and examine an instrument that integrates relevant aspects of cross-sectoral (in- and outpatients) mental health care, is simply to use and shows satisfactory psychometric properties. The development of the scale comprised literature research, held 14 focus groups and 12 interviews with patients and health care providers, item-pool generation, content validation by a scientific expert panel, and face validation by 90 patients. The preliminary scale was tested on 385 patients across seven German hospitals with cross-sectoral mental health care (CSMHC) as part of their treatment program. Psychometric properties of the scale were evaluated using genuine and transformed data scoring. To check reliability and postdictive validity of the scale, Cronbach's α coefficient and multivariable linear regression were used. This development process led to the development of an 18-item scale called the "Scale for Evaluation of Psychiatric Integrative and Continuous Care (SEPICC)" with a two-point and five-point response options. The scale consists of two sections. The first section assesses the presence or absence of patients' experiences with various CSMHC' relevant components such as home treatment, flexibility of treatments' switching, case management, continuity of care, cross-sectoral therapeutic groups, and multidisciplinary teams. The second section evaluates the patients' opinions about these relevant components. Using raw and transformed scoring resulted into comparable results. However, data distribution using transformed scoring showed a smaller deviation from normality. For the overall scale, the Cronbach's α coefficient was 0.82. Self-reported experiences with relevant components of the CSMHC were positively associated with the patients approval of these components. In conclusion, the new scale provides a good starting point for further validation. It can be used as a tool to evaluate CSMHC. Methodologically, using transformed data scoring appeared to be preferable because of a smaller deviation from normality and a higher reliability measured by Cronbach's α.
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Affiliation(s)
- Yuriy Ignatyev
- Department of Psychiatry, Psychotherapy and Psychosomatics, Immanuel Klinik, Brandenburg Medical School Theodor Fontane, Rüdersdorf, Germany
| | - Jürgen Timm
- Biometry Section, Competence Center for Clinical Trials, University of Bremen, Bremen, Germany
| | - Martin Heinze
- Department of Psychiatry, Psychotherapy and Psychosomatics, Immanuel Klinik, Brandenburg Medical School Theodor Fontane, Rüdersdorf, Germany
| | - Sonja Indefrey
- Department of Psychiatry and Psychotherapy, Charité University Medicine Berlin, Berlin, Germany
| | - Sebastian von Peter
- Department of Psychiatry and Psychotherapy, Charité University Medicine Berlin, Berlin, Germany
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