Developing a measure of mental health service satisfaction for use in low income countries: a mixed methods study

Abstract

BackgroundService satisfaction is integral to quality of care and measures are therefore considered important indicators of quality. Patient’s responses to their experiences of using services are under-researched in the context of mental healthcare in low income countries. Our aim was to use mixed methods to develop a new measure of satisfaction for use among consumers of the new models of mental healthcare which are currently being scaled-up.MethodsWe used qualitative methods to explore the concept of service satisfaction. On the basis of these findings, we developed a new ‘Mental health service satisfaction scale’ (MHSSS v0.0) by adapting existing measures of service satisfaction. We evaluated psychometric properties of the new measure, among a sample of service users with severe mental disorder (SMD) (n = 200) and caregivers (n = 200). Following expert review, a modified version of the measure was developed (MHSSS v1.0) and psychometric properties were examined with data from a second independent sample (n = 150 service users with SMD and n = 150 caregivers).ResultsFactors identified in analysis of the first quantitative sample coincide with core concepts of service satisfaction as reported in the literature and were reflected in the key themes which emerged from our qualitative study: interpersonal factors, efficacy, communication, technical competency and adequacy of facilities. There was generally consensus among caregivers and service users regarding dimensions of satisfaction. However there was evidence of some differences in prioritization. Revisions made to version 0.0 of the Mental Health Service Satisfaction Scale (MHSSS) led to an improved instrument, with excellent internal consistency, convergent validity and factor loadings indicative of a uni-dimensional construct.ConclusionsOur findings suggest that conceptions of service satisfaction among people accessing a service for SMD are broadly similar with those established in the literature. Our findings indicate that the MHSSS might be a useful candidate for inclusion in the new toolkit of measures needed to facilitate monitoring of service satisfaction which will be crucial to quality improvement.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-2126-2) contains supplementary material, which is available to authorized users.

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

“…(i) Mental Health Service Satisfaction Scale (MHSSS), which was written in English and then translated and validated in Amharic (Cronbach's α = 0:92) [27] 2 Psychiatry Journal (ii) Oslo Social Support Scale (OSSS)-it is a three-item scale with Cronbach alpha of 0.75 and has a range value of 3-14, further categorized as follows: "poor support," 3-8; "moderate support," 9-11; and "strong support," 12-14 [28] (iii) Clinical Decision-Making Involvement assessment tool-it is a tool that is used to assess the decisionmaking style of a physician on patient treatment with Cronbach alpha of 0.79, which has three parts [29] (iv) Clinical Global Impressions-Severity (CGI-S)-it is a seven-item scale with Cronbach alpha of 0.78, which is used to assess the level of clinical severity of psychiatric disorders on the basis of clinician experience in judging the level of illness like 0 = not assessed; 1 = normal, not at all ill; 2 = borderline mentally ill; 3 = mildly ill; 4 = moderately ill; 5 = markedly ill; 6 = severely ill; and 7 = extremely ill [30] (v) The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST-3.0) was adopted to assess the current status on alcohol, cigarettes, and khat and cannabis use of the participants. It was developed by WHO to detect psychoactive substance use and related problems in primary care patients with Cronbach alpha of 0.73 [31] 2.7.…”

“…Health institutions that periodically performed service patient satisfaction level showed high-quality assurance and efficiency of care through decreasing referrals and readmissions, and their patients were more compliant, cooperative, and interested to be involved actively in their treatment regimen; promptness of follow-up and continuity of outpatient care; good treatment response, and in addition, they addressed reliability of services through providing services in a consistent and dependable manner and decrease burnout of the health-care providers [22][23][24][25][26][27].…”

Patient satisfaction and associated factors among psychiatry outpatients of St Paulo’s Hospital, Ethiopia

“…8 Poor patient satisfaction with mental healthcare causes reduced compliance with treatment, which may lead ultimately to poor health outcomes. [9][10][11][12] Providing long-term mental healthcare for people with mental disorders that meets their expectations is one of the major challenges for mental health facilities. 13 Despite the large burden of mental disorders, less attention has been paid to these conditions in lower-and middleincome countries.…”

Evaluation of family caregiver satisfaction with a mental health inpatient service

“…[5][6][7] Besides the fact that services lack resources, there is also the possibility of reproduction of some negative characteristics of the psychiatric hospital context (institutionalism, segregation, abandonment) in the substitute services, justifying the need for supervision through evaluation of the quality of care. 8 The World Health Organization (WHO) 6 The importance of an adequate evaluation of the quality of care is related to a greater approval of the treatment provided and reduction of both dropout rates [9][10][11][12] and number of hospitalizations. 13,14 In this way, the evaluation of services must be a continuous activity, carried out periodically.…”