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      VOICE: Developing a new measure of service users’ perceptions of inpatient care, using a participatory methodology

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          Abstract

          Background

          Service users express dissatisfaction with inpatient care and their concerns revolve around staff interactions, involvement in treatment decisions, the availability of activities and safety. Traditionally, satisfaction with acute care has been assessed using measures designed by clinicians or academics.

          Aims

          To develop a patient-reported outcome measure of perceptions of acute care. An innovative participatory methodology was used to involve services users throughout the research process.

          Method

          A total of 397 participants were recruited for the study. Focus groups of service users were convened to discuss their experiences and views of acute care. Service user researchers constructed a measure from the qualitative data, which was validated by expert panels of service users and tested for its psychometric properties.

          Results

          Views on Inpatient Care (VOICE) is easy to understand and complete and therefore is suitable for use by service users while in hospital. The 19-item measure has good validity and internal and test–retest reliability. Service users who have been compulsorily admitted have significantly worse perceptions of the inpatient environment.

          Conclusions

          A participatory methodology has been used to generate a self-report questionnaire measuring service users’ perceptions of acute care. VOICE encompasses the issues that service users consider most important and has strong psychometric properties.

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          Most cited references41

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          Coefficient alpha and the internal structure of tests

          Psychometrika, 16(3), 297-334
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            A concordance correlation coefficient to evaluate reproducibility.

            L Lin (1989)
            A new reproducibility index is developed and studied. This index is the correlation between the two readings that fall on the 45 degree line through the origin. It is simple to use and possesses desirable properties. The statistical properties of this estimate can be satisfactorily evaluated using an inverse hyperbolic tangent transformation. A Monte Carlo experiment with 5,000 runs was performed to confirm the estimate's validity. An application using actual data is given.
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              Patient satisfaction: a valid concept?

              Over the past 10 yr consumer satisfaction has gained widespread recognition as a measure of quality in many public sector services. This has become manifest in the NHS in the call by the 1983 NHS Management inquiry to ascertain how well the service is being delivered at local level by obtaining the experience and perceptions of patients and the community. Patient satisfaction is now deemed an important outcome measure for health services; however, this professed utility rests on a number of implicit assumptions about the nature and meaning of expressions of 'satisfaction'. Through a review of past research findings this paper suggests that patients may have a complex set of important and relevant beliefs which cannot be embodied in terms of expressions of satisfaction. Consequently, many satisfaction surveys provide only an illusion of consumerism producing results which tend only to endorse the status quo. For service providers to meaningfully ascertain the experience and perceptions of patients and the community then research must first be conducted to identify the ways and terms in which those patients perceive and evaluate that service.
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                Author and article information

                Journal
                J Ment Health
                J Ment Health
                JMH
                Journal of Mental Health (Abingdon, England)
                Informa Healthcare
                0963-8237
                1360-0567
                February 2012
                18 January 2012
                : 21
                : 1
                : 57-71
                Affiliations
                [1] 1Health Service and Population Department
                [2] 2Psychology Department, Institute of Psychiatry, Kings College London , London, UK
                [3] 3Salomons, Canterbury Christ Church University , Kent, UK
                Author notes
                Correspondence: Jo Evans, Health Service and Population Department, Institute of Psychiatry, Kings College London, SURE PO34, De Crespigny Park, London SE5 8AF, UK. Tel: +0207 848 5147. E-mail: joanne.m.evans@ 123456kcl.ac.uk

                *Joint first author

                Article
                10.3109/09638237.2011.629240
                4018995
                22257131
                d93aeb6d-520c-4b91-b875-59c84fb3d413
                © 2012 Informa UK, Ltd.

                This is an open-access article distributed under the terms of the CC-BY-NC-ND 3.0 License which permits users to download and share the article for non-commercial purposes, so long as the article is reproduced in the whole without changes, and provided the original source is credited.

                History
                : 29 June 2013
                : 18 December 2013
                Categories
                Original Article

                Clinical Psychology & Psychiatry
                service users’ perceptions,participatory methodology,service user involvement,acute care,inpatient services

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