Kotsis Konstantinos, Mitropoulou Andromachi, Tzotzi Alexandra, Marchionatti Lauro Estivalete, Hoffmann Mauricio Scopel, Schafer Julia Luiza, Casella Caio B, Simioni André, Papanikolaou Katerina, Basta Maria, Serdari Aspasia, Koumoula Anastasia, Salum Giovanni Abrahão
Child and Adolescent Mental Health Initiative (CAMHI), Stavros Niarchos Foundation & Child Mind Institute, Greece.
Department of Psychiatry, Community CAMHS, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.
medRxiv. 2024 Jul 5:2024.07.05.24309986. doi: 10.1101/2024.07.05.24309986.
Health systems need tools to assess patient's experience of service, but existing tools lack reliability and validity assessment. Our aim is to investigate the factor structure, reliability, validity, item parameters and interpretability of the parent version of the Experience of Service Questionnaire (ESQ) for practical use in Greece.
A total of 265 caregivers that were using mental health services in Greece participated in this study as part of the Nationwide cross-sectional survey from the Child and Adolescent Mental Health Initiative (CAMHI). Confirmatory Factor Analysis was used to test factor structure. Reliability of all models were measured with omega coefficients. Tobit regression analysis was used to test for convergent and discriminant validity with specifically designed questions. Item parameters were assessed via Item Response Theory. Interpretability was assessed by means of IRT-based scores.
We found that ESQ is best represented and scored as a unidimensional construct, given potential subscales would not have enough reliability apart from a general factor. Convergent and discriminant validity was demonstrated, as caregivers who perceived that their child benefited from the received mental health care had 6.50 higher summed scores (SMD=1.14, p<0.001); while those who believed that their child needed additional help had 5.08 lower summed scores on the ESQ (SMD=-0.89, p<0.001). Average z-scores provided five meaningful categories of services, in terms of user satisfaction, compared to the national average.
Our study presents evidence for the reliability and validity of the ESQ and provides recommendations for its practical use in Greece. ESQ can be used to measure experience of service and might help drive improvements in service delivery in the Greek mental health sector.
卫生系统需要工具来评估患者的服务体验，但现有工具缺乏可靠性和有效性评估。我们的目的是调查服务体验问卷（ESQ）母版的因子结构、可靠性、有效性、项目参数和可解释性，以便在希腊实际使用。
作为儿童和青少年心理健康倡议（CAMHI）全国横断面调查的一部分，共有265名在希腊使用心理健康服务的护理人员参与了本研究。采用验证性因子分析来检验因子结构。所有模型的可靠性用欧米伽系数来衡量。使用托比特回归分析，通过专门设计的问题来检验收敛效度和区分效度。通过项目反应理论评估项目参数。通过基于IRT的分数评估可解释性。
我们发现，鉴于除一般因子外潜在的子量表可靠性不足，ESQ最好表示为单维结构并进行评分。收敛效度和区分效度得到了证明，因为认为其孩子从所接受的心理健康护理中受益的护理人员的总分高6.50（标准化均值差=1.14，p<0.001）；而那些认为其孩子需要额外帮助的护理人员在ESQ上的总分低5.08（标准化均值差=-0.89，p<0.001）。与全国平均水平相比，平均z分数提供了五类关于用户满意度的有意义的服务类别。
我们的研究提供了ESQ可靠性和有效性的证据，并为其在希腊的实际使用提供了建议。ESQ可用于衡量服务体验，并可能有助于推动希腊心理健康部门服务提供的改善。
