Mayston Rosie, Habtamu Kassahun, Medhin Girmay, Alem Atalay, Fekadu Abebaw, Habtamu Alehegn, Prince Martin, Hanlon Charlotte
King's College London, Institute of Psychiatry, Psychology and Neuroscience, Centre for Global Mental Health, London, UK.
Addis Ababa University, School of Psychology, Addis Ababa, Ethiopia.
BMC Health Serv Res. 2017 Mar 9;17(1):183. doi: 10.1186/s12913-017-2126-2.
Service 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.
We 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).
Factors 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.
Our 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.
服务满意度是医疗质量的重要组成部分，因此被视为质量的重要指标。在低收入国家的精神卫生保健背景下，患者对其使用服务体验的反应研究不足。我们的目的是采用混合方法开发一种新的满意度测量工具，供目前正在扩大规模的新型精神卫生保健模式的消费者使用。
我们采用定性方法探索服务满意度的概念。基于这些发现，我们通过改编现有的服务满意度测量工具，开发了一种新的“精神卫生服务满意度量表”（MHSSS v0.0）。我们在患有严重精神障碍（SMD）的服务使用者样本（n = 200）和照顾者样本（n = 200）中评估了该新测量工具的心理测量特性。经过专家评审，开发了该测量工具的修订版（MHSSS v1.0），并使用来自第二个独立样本（n = 150名患有SMD的服务使用者和n = 150名照顾者）的数据检查了心理测量特性。
对第一个定量样本的分析中确定的因素与文献中报道的服务满意度核心概念一致，并反映在我们定性研究中出现的关键主题中：人际因素、效能、沟通、技术能力和设施充足性。照顾者和服务使用者在满意度维度上总体上达成了共识。然而，有证据表明在优先级上存在一些差异。对精神卫生服务满意度量表（MHSSS）0.0版的修订产生了一个改进的工具，具有出色的内部一致性、收敛效度和表明单维结构的因子载荷。
我们的研究结果表明，使用SMD服务的人群中服务满意度的概念与文献中确立的概念大致相似。我们的研究结果表明，MHSSS可能是纳入促进服务满意度监测所需新测量工具包的一个有用候选工具，这对质量改进至关重要。
