To Örebro University

Aim and objectives: Describe patients' and family members' perceptions of family support from nurses and other mental healthcare professionals, and quality of care in community mental healthcare service. Further, compare the perceptions of patients and family members.

Background: While patients value family involvement, family members feel unprepared and lack the necessary skills to be supportive. Since healthcare professionals predominantly focus on patients, they may fail to understand the complex needs of families. Family perceived support and quality of community mental health care may vary across patients and family members.

Design and methods: Cross-sectional study with patients suffering from mental illness and family members in community mental healthcare services in Norway. Altogether 86 participants, of whom 33 patients and 33 family members had a family relationship-paired samples. Participants filled in the translated version of the Iceland Family Perceived Support Questionnaire (FPSQ-N) and Quality in Psychiatric Care-Community Out-Patient (QPC-COP) and Community Out-Patient Next of Kin (QPC-COPNK). STROBE checklist was used.

Results: Family members scored family perceived support and quality of community mental health care lower than patients. Family members feel the loss of support. Patient and family members found the Patient-healthcare professionals' relationship to be of high quality, while family members gave low score to being respected and invited to take part in care by nurses and other mental healthcare professionals.

Conclusion: Family members' unmet need of support highlights the need for nurses and other community mental healthcare professionals to assess complex family needs and to intervene. Barriers to collaboration exist, and family members need to be respected and invited into community mental health care. Relevance to clinical practice Contributes knowledge of how to meet the family's needs and provides a basis for further care and treatment development in similar contexts nationally and internationally.

The aim of this study is to explore families' perceptions of everyday life when living with a young adult suffering from mental illness. Findings include: 1) Families balance between letting go and enabling the young adult to become independent while remaining close to help him/her complete education, work and have a social life. 2) Young adults try to deal with symptoms of mental illness by themselves and not be a burden, although longing for family members to understand them and the situation. 3) Healthcare professionals still hold back information although young adults have consented to giving family members insight.

The aim of this study was to evaluate the usefulness of Family-Centered Support Conversations (FCSC) offered in community mental health care in Norway to young adults and their families experiencing mental illness. The FCSC is a family nursing intervention based on the Calgary Family Assessment and Intervention Models and the Illness Beliefs Model and is focused on how family members can be supportive to each other, how to identify strengths and resources of the family, and how to share and reflect on the experiences of everyday life together while living with mental illness. Interviews were conducted with young adults and their family members in Norway who had received the FCSC intervention and were analyzed using phenomenography. Two descriptive categories were identified: "Facilitating the sharing of reflections about everyday life" and "Possibility of change in everyday life." The family nursing conversations about family structure and function in the context of mental illness allowed families to find new meanings and possibilities in everyday life. Health care professionals can play an important role in facilitating a safe environment for young adults and their families to talk openly about the experience of living with and managing mental illness.

AIM: To describe the impact of mental health on the ability to function optimally among older adults experiencing mental health issues.

DESIGN: This study had a descriptive qualitative design.

METHODS: Six older females with a Hospital Anxiety and Depression Scale (HADS) score of ≥8 on either of the subscales (depression or anxiety) participated in individual interviews. All data were analysed using a phenomenological approach influenced by Giorgi.

RESULTS: The phenomenological analysis led to a structured synthesis comprising the following three themes: (a) life situations affecting mental health, (b) consequences of mental health in everyday life and (c) strategies for maintaining mental health.

The residents' perspective of the quality of housing support for people with psychiatric disabilities living in congregate supported housing has been studied and a comparison has been made with the findings from those from a previous study in ordinary housing with outreach support. One-hundred and seventy-eight residents from 27 supported housing facilities in eight Swedish municipalities completed the Quality of Psychiatric Care-Housing (QPC-H) instrument. The highest quality ratings were found for: Secluded Environment, Encounter and Support, while Participation, Housing Specific and Secure Environment were rated at lower levels. Despite relatively high ratings, a majority of items did not attain the 80% cutoff point deemed as defining satisfactory quality of service. The residents in ordinary housing with outreach support rated higher levels for the majority of the QPC-H dimensions in comparison with those in supported housing. A conclusion is that the quality of care in supported housing facilities has a number of deficiencies that need to be addressed. Supported housing is generally rated as having a lower quality of care than in ordinary housing with outreach support. Suggestions for the content of staff training are made based on the results.

Quality in Psychiatric Care-Forensic Inpatient Staff (QPC-FIPS) is an instrument of Swedish origin validated to measure the perception of the quality of mental health care provided by forensic psychiatry professionals. The aim of this study was to cross-culturally adapt the QPC-FIPS instrument and to evaluate the psychometric properties of the Spanish version of the instrument. A psychometric study was carried out. For validity, content validity, convergent validity and construct validity were included. For reliability, the analysis of internal consistency and temporal stability was included. The sample consisted of 153 mental health professionals from four Forensic Psychiatry units. The adapted Spanish version of the QPC-FIPS scale was configured with the same number of items and dimensions as the original. The psychometric properties, in terms of temporal stability and internal consistency, were adequate and the factor structure, such as the homogeneity of the dimensions of the Spanish version of the QPC-FIPS, was equivalent to the original Swedish version. We found that the QPC_FIPS-Spanish is a valid, reliable and easy-to-apply instrument for assessing the self-perception of professionals regarding the care they provide.

Background: Sensory reactivity in people with autism spectrum conditions (ASC) has been found to differ in comparison to reactivity in people without ASC. In this study sensory experiences of high-functioning individuals with ASC were explored and described.

Method: Interview data from 15 participants with a diagnosis of ASC were analysed by content analysis.

Results: Seven aspects of sensory experiences were identified: Being hyper- and hypo-reactive, reacting to general overload, having strong stimuli preferences, managing attentiveness to stimuli, managing sensory/motor stimuli, and dealing with consequences of sensory reactions in daily life.

Conclusions: The categorisation of sensory reactivity in this study can guide clinicians on how to pose questions about sensory issues to individuals with ASC. The assessment of spectrum-specific sensory experiences in high-functioning ASC and their association with other social and nonsocial features of ASC are goals for further research.

Sensory experiences in Asperger syndrome (AS) or high-functioning autism (HFA) were explored by qualitative content analysis of autobiographical texts by persons with AS/HFA. Predetermined categories of hyper- and hyposensitivity were applied to texts. Hypersensitivity consists of strong reactions and heightened apprehension in reaction to external stimuli, sometimes together with overfocused or unselective attention. It was common in vision, hearing, and touch. In contrast, hyposensitivity was frequent in reaction to internal and body stimuli such as interoception, proprioception, and pain. It consists of less registration, discrimination, and recognition of stimuli as well as cravings for specific stimuli. Awareness of the strong impact of sensitivity is essential for creating good environments and encounters in the context of psychiatric and other health care.

Background: Unusual reactions to sensory stimuli are experienced by 90-95% of people with an autism spectrum condition (ASC). Self-reported sensory reactivity in ASC has mainly been measured with generic questionnaires developed and validated on data from the general population. Interest in sensory reactivity in ASC increased after the inclusion of hyper- and hypo-reactivity together with unusual sensory interest as diagnostic markers of ASC in the DSM-5.

Aims: To develop and pilot validate a self-report questionnaire designed from first-hand descriptions of the target group of adults diagnosed with high functioning ASC. Psychometric properties of the questionnaire were evaluated on a sample of participants with ASC diagnoses (N = 71) and a random sample from the general population (N = 162).

Results: The Sensory Reactivity in Autism Spectrum (SR-AS is intended to be used as a screening tool in diagnostic processes with adults and for support in adapting compensating strategies and environmental adjustments. The internal consistency was high for both the SR-AS and its subscales. The total scale Cronbach's alpha was 0.96 and the subscales alphas were 0.80. Confirmatory factor analysis (CFA) showed best fit for a four-factor model of inter-correlated factors: hyper and hypo-reactivity, strong sensory interest and a sensory/motor factor. The questionnaire discriminated well between ASC-diagnosed participants and participants from the general population.

Conclusions: The SR-AS displayed good internal consistency and discriminatory power and promising factorial validity.

We identified clusters of atypical sensory functioning adults with ASC by hierarchical cluster analysis. A new scale for commonly self-reported sensory reactivity was used as a measure. In a low frequency group (n = 37), all subscale scores were relatively low, in particular atypical sensory/motor reactivity. In the intermediate group (n = 17) hyperreactivity, sensory interests and sensory/motor issues were significantly elevated in relation to the first group, but not hyporeactivity. In a high frequency subgroup (n = 17) all subscale scores were significantly elevated and co-occurrence of hyper- and hyporeactivity was evident. In a population sample, a cluster of low scorers (n = 136) and high scorers relative to the other cluster (n = 26) was found. Identification of atypical sensory reactivity is important for targeting support.

Patient perspectives on the quality of care received are fundamental to mental health care. This study aimed to investigate the association between patient-reported mental health care quality, perceived coercion, and various demographic, clinical, and ward-related factors. Using a cross-sectional design, data were collected from 169 patients in Norwegian mental health wards using the quality in psychiatric care-inpatient (QPC-IP) instrument and experienced coercion scale (ECS). The analysis revealed a consistent pattern in which patients with higher perceived coercion consistently rated lower quality on all QPC-IP dimensions. The significant findings of the multiple regression models further supported this association. Beyond coercion, the factors influencing quality ratings include self-reported treatment results, participation in treatment planning, and knowledge of complaint procedures. Emphasizing the pivotal role of coercion in enhancing mental health care quality, these findings contribute to a nuanced understanding of patient experiences and underscore the importance of patient participation in mental health care improvement efforts.

BACKGROUND: Becoming critically ill represents not just a great upheaval for the patient in question, but also for the patient's closest family. In recent years, there has been a change in how the quality of the public health service is measured. There is currently a focus on how patients and their families perceive the quality of treatment and care. It can be challenging for patients to evaluate their stay in an intensive care unit (ICU) due to illness and treatment. Earlier studies show that the perceptions of the family and the patient may concur. It is important, therefore, to ascertain the family's level of satisfaction with the ICU stay. The aim of the study was to describe how the family evaluate their satisfaction with the ICU stay. A further aim was to identify which demographic variables were associated with differences in family satisfaction.

METHOD: The study had a cross-sectional design. A sample of 57 family members in two ICUs in Norway completed the questionnaire: Family satisfaction in the intensive care unit 24 (FS-ICU 24). Statistical analysis was conducted using the Mann-Whitney U test (U), Kruskal Wallis, Spearman rho and a performance-importance plot.

RESULTS: The results showed that families were very satisfied with a considerable portion of the ICU stay. Families were less satisfied with the information they received and the decision-making processes than with the nursing and care performed during the ICU stay. The results revealed that two demographic variables - relation to the patient and patient survival - significantly affected family satisfaction.

CONCLUSION: Although families were very satisfied with the ICU stay, several areas were identified as having potential for improvement. The results showed that some of the family demographic variables were significant for family satisfaction. The findings are clinically relevant since the results can strengthen intensive care nurses' knowledge when meeting the family of the intensive care patient.

BACKGROUND: Cervical cancer is a global disease and it is well established that cervical cancer is caused by human papillomavirus (HPV). In Sweden self-sampling for HPV is now used as a complement to sampling performed by a midwife. However, there is a lack of knowledge on how older women perceive the self-sampling compared to the sampling performed by a midwife. Therefore, the aim of the study was to describe how women, aged 64 years and older, perceived the process of self-sampling and sampling performed by a midwife for HPV-testing.

METHODS: Eighteen women were included in a qualitative interview study, and a phenomenographic approach was used for the analysis of the interviews.

RESULTS: Three descriptive categories emerged: Confidence in sampling, Facilitating participation and Being informed. Within the categories, eight conceptions emerged describing the variation relating to how the women perceived the process of self-sampling and sampling performed by a midwife.

CONCLUSIONS: Women in this study describe confidence in self-sampling for HPV-testing and that the self-sampling was saving time and money, both for themselves and for society. Information in relation to an HPV-positive test result is of importance and it must be kept in mind that women affected by HPV may feel guilt and shame, which health care professionals should pay attention to. This knowledge can be used in education of health care staff.

Background: There has been an increasing demand for emergency medical services (EMS), and a growing number of patients are not conveyed; i.e., they are referred to levels of care other than ambulance conveyance to the emergency department. Patient safety issues have been raised regarding the ability of EMS to decide not to convey patients. To improve non-conveyance guidelines, information is needed about patients who are not conveyed by EMS. Therefore, the purpose of this study was to describe and compare the proportion and characteristics of non-conveyed EMS patients, together with assignment data.

Methods: A descriptive and comparative consecutive cohort design was undertaken. The decision of whether to convey patients was made by EMS according to a region-specific non-conveyance guideline. Non-conveyed patients' medical record data were prospectively gathered from February 2016 to January 2017. Analyses was conducted using the chi-squared test, two-sample t test, proportion test and Mann-Whitneys U-test.

Results: Out of the 23,250 patients served during the study period, 2691 (12%) were not conveyed. For non-conveyed adults, the most commonly used Emergency Signs and Symptoms (ESS) codes were unspecific symptoms/malaise, abdomen/flank/groin pain, and breathing difficulties. For non-conveyed children, the most common ESS codes were breathing difficulties and fever of unclear origin. Most of the non-conveyed patients had normal vital signs. Half of all patients with a designated non-conveyance level of care were referred to self-care. There were statistically significant differences between men and women.

Conclusions: Fewer patients were non-conveyed in the studied region compared to national and international non-conveyance rates. The differences seen between men and women were not of clinical significance. Follow-up studies are needed to understand what effect patient outcome so that guidelines might improve.

BACKGROUND: The decision to not convey patients has become common in emergency medical services worldwide. A substantial proportion (12-51%) of the patients seen by emergency medical services are not conveyed by those services. The practice of non-conveyance is a result of the increasing and changing demands on the acute care system. Research focusing on the outcomes of the decision by emergency medical services to not convey patients is needed.

AIM: The aim was to describe outcomes (emergency department visits, admission to in-hospital intensive care units and mortality, all within seven days) and their association with the variables (sex, age, day of week, time of day, emergency signs and symptoms codes, triage level colour, and destination) for non-conveyed patients.

METHODS: This was a prospective analytical study with consecutive inclusion of all patients not conveyed by emergency medical services. Patients were included between February 2016 and January 2017. The study was conducted in Region Örebro county, Sweden. The region consists of both rural and urban areas and has a population of approximately 295,000. The region had three ambulance departments that received approximately 30,000 assignments per year.

RESULTS: The result showed that no patient received intensive care, and 18 (0.7%) patients died within seven days after the non-conveyance decision. Older age was associated with a higher risk of hospitalisation and death within seven days after a non-conveyance decision.

CONCLUSIONS: Based on the results of this one-year follow-up study, few patients compared to previous studies were admitted to the hospital, received intensive care or died within seven days. This study contributes insights that can be used to improve non-conveyance guidelines and minimise the risk of patient harm.

AIMS AND OBJECTIVES: To explore ambulance nurses' (ANs) experiences of non-conveying patients to alternate levels of care.

BACKGROUND: Increases in ambulance utilisation and in the number of patients seeking ambulance care who do not require medical supervision or treatment during transport have led to increased nonconveyance (NC) and referral to other levels of care.

DESIGN: A qualitative interview study was conducted using an inductive research approach.

METHODS: The study was conducted in a region in the middle of Sweden during 2016-2017. Twenty nurses were recruited from the ambulance departments in the region. A conventional content analysis was used to analyse the interviews. The study followed the COREQ checklist.

RESULTS: The ANs experienced NC as a complex and difficult task that carried a large amount of responsibility. They wanted to be professional, spend time with the patient and find the best solution for him or her. These needs conflicted with the ANs' desire to be available for assignments with a higher priority. The ANs could feel frustrated when they perceived that ambulance resources were being misused and when it was difficult to follow the NC guidelines.

CONCLUSION: If ANs are expected to nonconvey patients seeking ambulance care, they need a formal mandate, knowledge and access to primary health care.

RELEVANCE TO CLINICAL PRACTICE: This study provides new knowledge regarding the work situation of ANs in relation to NC. These findings can guide future research and can be used by policymakers and ambulance organisations to highlight areas that need to evolve to improve patient care.

PURPOSE: To describe how patients receiving cancer treatment perceive quality of care in the oncological outpatient settings.

METHOD: A strategic sample of 20 adult patients with cancer treated in four oncological outpatient settings in four hospitals in Sweden participated in the study. Participants were interviewed using a semi-structured interview guide with open-ended questions. The interviews were audio-recorded, and the transcripts were analysed using a phenomenographic approach.

RESULTS: Three descriptive categories emerged from the data: The patient's care is designed to meet individual needs, The patient's dignity is respected, and The patient feels safe and secure with the care. Overall, quality of care in the oncological outpatient setting is perceived as something positive and described in normative terms by the participants.

CONCLUSION: The results emphasises that in order to achieve quality of care it is important to the patients that they are able to meet with the same well-educated, professional, caring and sensible health care professionals every time.

Ensamhet ses som en riskfaktor för att utveckla fysisk och mental ohälsa. I Sverige uppskattas var tionde äldre vuxen besväras av ensamhet och psykisk ohälsa. I denna fenomenologiskt inspirerade studie har 19 äldre personer mellan 66-94 år intervjuats om varför de är ensamma och hur de upplever ensamheten, detta innan de deltog i ett äldre kollo sommaren 2017.

Målgruppen för äldre kollot var äldre personer som upplever att de är ensamma och har ett begränsat socialt umgänge och som inte har möjlighet att själva att ta initiativ till att delta i olika aktiviteter och bryta ensamheten.

Syftet med studien var att få kunskap om varför informanterna upplevde ensamhet samt hur de beskrev sina erfarenheter av att vara ensamma innan de deltog i äldre kollot.

Informanterna angav flera orsaker till sin ensamhet och det som framkom i resultaten var bl.a. att det var svårare att få kontakt med andra personer på äldre dar, vänner och bekanta har dött och vänskapsrelationer som de haft tidigare har varit svåra att behålla. Många av informanterna var anhörigvårdare till sin make/maka, några hade nyligen flyttat, de hade sämre ekonomi och att de inte kunde förflytta sig lika flexibelt som tidigare då de inte hade en bil att tillgå. När det gäller upplevelsen om ensamhet utryckte många informanter att de kände sig väldigt ensamma trots att de hade ett aktivt socialt liv. De saknade meningsfulla relationer, någon som de kunde vända sig till i förtroende och utveckla en nära vänskapsrelation med. De upplevde behovet av att tillhöra något eller behovet av en förändring i vardagen.

Many older adults with complex illnesses are today cared for by their next of kin in their own homes and are often sent between different caregivers in public healthcare. Mobile Geriatric Teams (MGTs) are a healthcare initiative for older adults with extensive care needs living at home, coordinated between hospital, primary, and municipal care. The study aims to describe how next of kin experience care efforts from an MGT for their older adult family members. The study has a descriptive qualitative design and uses a phenomenographic approach. Fourteen next of kin to older adult family members who receive efforts from an MGT were interviewed. Two descriptive categories reflecting their experiences emerged: Professional care and No longer having the main responsibility. The study shows that the participants valued that the staff was very competent, that the physician made home visits and could make quick decisions, and that treatments were given at home. They feel that they receive support and experience security and that a burden is lifted from them. Our study shows that through the MGT, next of kin become involved in the care and are relieved of the burden of responsibility of caring for their older family member.

Several municipalities in Sweden organize senior summer camps where older adults can meet and where loneliness and social isolation can be mitigated. Few studies, however, examine how the older adults themselves describe the experience in retrospect and how it might have influenced their daily lives after the stay. This study aims to fill this gap by examining how older adults who participated in a senior summer camp experience the impact the stay has had on their lives. The study has a descriptive qualitative design that uses a phenomenographic approach to explore the variations in the older adults' conceptions of how their participation at the senior summer camp may have affected them. Nineteen older adults aged between 66 and 94 years were interviewed. Three descriptive categories emerge: "Mitigating loneliness," 'Developing as a person' and 'Gaining inspiration.' The study shows that the older adults experience that the stay at the summer camp has had lasting effects on their quality of life. The sense of community at the camp helped them break the experience of loneliness, they improved their self-confidence and gained a positive attitude to life, that it is worth living and that there is much left to experience, regardless of their age.

Loneliness is seen as a risk factor for decreased physical and mental health. Swedish studies have shown that every ten older adults experience severe anxiety and 15 percent are often bothered by loneliness. According to Swedish law all older adults should have an active and meaningful life in community with others. Thus, loneliness among older people has become an important concern in Sweden. Within municipalities various projects are taking place to decrease loneliness among older adults, but these projects are often poorly evaluated. Therefore, knowledge of interventions to decrease loneliness among older adults is essential. From a larger phenomenological inspired study based on interviews with 19 older adults (4 men and 15 women) who had been attending a summer camp, this presentation will bring attention to the reason that these older adults were applying for this experience. Thus, the aim in this part of the study was to explore why they were feeling lonely and considered themselves in need of attending a summer camp and also how they experience loneliness. Often, anxiety and illness are associated with loneliness, but our analysis showed a complex picture of why the interviewees were feeling lonely. Furthermore their experience of loneliness was due not only to an absence of other people to socialize with, but also with the quality of the relationship. This study makes an important contribution in understanding loneliness at older ages and identifies factors that might lead to loneliness among older adults.

The aim of the present study was explore why the informants were feeling lonely and considered themselves to be in need of attending a senior summer camp, and how the informants were experiencing loneliness before they went to the senior summer camp. Interviews was made with nineteen older adult people (15 women and 4 men). A phenomenological inspired approach was used for the analysis of the interviews. Eight themes resulted: Hard to make new friends, Other circumstances making it hard to be social, Feel very lonely even if they lead rich social lives, Loss of loved ones, Do not want to do things alone, Friends make a difference, Do not feel lonely but need a change and Loneliness occurs at certain times. Through this analysis, we have gain insights to better understand loneliness as a multifaceted phenomenon that is asso-ciated with both personal circumstances and social situations. Many of the informants experienced being very lonely, even if they lead rich social lives. The experience of loneliness was connected to not having anyone they can turn to in confidence or to share experiences with and the need to belong to something or the need of a change in everyday life.

Patient-perceived quality of inpatient/outpatient psychiatric care remains under-researched. A cross-sectional survey with purposive sampling comprising 567 inpatients and 549 outpatients was conducted among eight psychiatric care facilities in Taiwan to examine the factors influencing patient-perceived care quality. Inpatients and outpatients perceived moderate quality of care, where "Encounter" was reported as the highest dimension. Inpatients perceived "Secure environment" as the lowest; outpatients rated "Discharge/Referring" as the lowest. Hospital region and customer loyalty were significantly associated with patient-perceived care quality. Other significant factors were also identified: inpatient employment, perceived mental health and treatment effects, understanding diagnosis, previous treatment, and visited by appointment.

Accessible summary: This paper describes Swedish outpatients' perception of the quality of psychiatric care they received. A large number of patients (1340) from 15 outpatient clinics participated in the study. A newly developed and tested questionnaire, the Quality in Psychiatric Care Out-Patient, was used. The patients' highest ratings were for Encounter (staffpatient interaction), the lowest were for Discharge. Most notably, quality of care was rated higher by women, older people, those with a partner, those with a lower educational level and those who were gainfully employed. In relation to the visit to the clinic, higher quality of care was associated with shorter waiting time, better information and meeting with fewer professions. Older people and those gainfully employed reported better mental health. The longer the waiting time and the greater the number of professions met, the poorer mental health was reported. The conclusion was that although a majority of the patients rated the quality of outpatient care as high, aspects of it remain unsatisfactory. The Quality in Psychiatric Care Out-Patient offers an easy way to assess patients' perception of the quality of care they receive as an outpatient and has a useful role to play in quality-assurance evaluations. Abstract The influence of demographic characteristics on patients' ratings of the quality of psychiatric outpatient care has been given little attention in research. The aim of the present study is to elucidate the quality of psychiatric care among outpatients and investigate demographic and clinical factors associated with the way in which this quality is perceived. A sample of 1340 outpatients from 15 general adult psychiatric clinics in Sweden completed the Quality in Psychiatric Care Out-Patient (QPCOP), with a response rate of 71%. The patients' highest ratings were for Encounter; the lowest were for Discharge. Most notably, quality of care was rated higher by women, older people, those with a partner, those with a lower educational level and those who were gainfully employed. In regard to visits to the clinic, higher quality of care was associated with shorter waiting time, better information and fewer professions encounters. Older people and those gainfully employed reported better mental health. Thus the QPCOP was associated with both demographic and clinical factors. In particular, wanting to come back to the clinic was the single strongest predictor of quality.

Background/aims: The aim of the present study was to test the psychometric properties and dimensionality of the instrument Quality in Psychiatric Care - Daily Activities (QPC-DA) and to briefly describe the day centre attendees' perception of the quality at community-based day centre services.

Methods: A sample of 218 attendees from 14 community-based day centre services in seven municipalities in Sweden participated in the study.

Results: Confirmatory factor analysis revealed that the QPC-DA consists of six dimensions and has a factor structure that to a large extent corresponds to that found in other studies of quality in psychiatric care settings, such as inpatient, outpatient, forensic inpatient, and housing support for people with psychiatric disabilities. The internal consistency of the factors was satisfactory and thus the QPC-DA showed adequate psychometric properties. The attendees' ratings of quality of community-based day centre services were generally high. The highest rating was for the encounter dimension and the lowest for the participation and the secluded environment dimensions, indicating areas for improvement.

Conclusion/significance: The QPC-DA includes important aspects of the attendees' assessment of quality of community-based day centre services and offers a simple and inexpensive way to evaluate quality from their perspective.

Background/Aims: Community-based day centres in Sweden are well-established arenas for psychiatric rehabilitation, but little is known of the attendees' perception of the quality of the service provided. The aim of the study was thus to describe and investigate the quality of the services in community-based day centre for people with psychiatric disabilities.

Methods: A sample of 218 attendees in 14 community-based day centre services in Sweden completed the Quality in Psychiatric Care - Daily Activities (QPC-DA).

Results: The results showed that people with psychiatric disabilities perceived the quality of community-based day centre services as high. Most notably, quality of service was rated higher by those with lower educational level, had waited shorter time to attend the centre, and had better mental and physical health. However, particularly aspects of a secluded environment and participation (information) may be areas with potential for improvement.

Conclusion/Significance: From an occupational science perspective, the results adhere to the importance of occupational balance, with periods of rest/privacy during the time at the centre.

Objective: The aims of this study were to adapt and evaluate the psychometric properties and factor structure of the Danish version of the Quality in Psychiatric Care-Forensic In-Patient (QPC-FIP) questionnaire.

Methods: A sample of 139 inpatients from 25 wards in Denmark who received care during 5 weeks in March and April 2012 participated in the study by completing the QPC-FIP instrument.

Results: Confirmatory factor analysis revealed that the factor structure of the Danish version was equivalent to that of the original Swedish QPC-FIP. The results indicate that the concept of quality of care expressed in the QPC-FIP is equivalent among forensic inpatients in nationally different healthcare systems and cultural contexts.

Conclusion: The Danish version of QPC-FIP is a reliable and valid measurement instrument recommended for use in evaluating quality of care in forensic inpatient care.

Community-based day centers in Sweden are well-established arenas for psychiatric rehabilitation. Little is, however, known of the attendees’ perception of the quality of the service provided. Therefore, the aim of the study was to describe and investigate the quality of community-based day center services for people with psychiatric disabilities. A sample of 218 attendees (44% females) between 18 and 71 years old in 14 community-based day center services in Sweden completed the quality in psychiatric care–daily activities (QPC-DA) instrument. The results showed that people with psychiatric disabilities perceived the quality of community-based day center services as high and 87% perceived the overall quality as satisfactory. The highest ratings were found in encounter followed by support, daily activity-specific, secure environment, participation, and the lowest quality was found in secluded environment dimensions of the QPC-DA. Most notably, quality of service was rated higher by those with lower educational level, had waited shorter time to attend the center, and had better mental and physical health. However, particularly aspects of a secluded environment and participation (information) may be areas with potential for improvement. In conclusion, the results adhere to the importance of occupational balance, with periods of rest/privacy during the time at the center.

Purpose - The purpose of this paper is to test the psychometric properties and dimensionality of the instrument Quality in Psychiatric Care-Housing (QPC-H) and briefly describe the residents' perception of quality of housing support. Design/methodology/approach - A sample of 174 residents from 22 housing support services in nine Swedish municipalities participated in the study. Confirmatory factor analysis (CFA) revealed that the QPC-H consisted of six dimensions and had a factor structure largely corresponding to that found among other instruments in the Quality in Psychiatric Care (QPC) family of instruments. Findings - CFA revealed that the QPC-H consisted of six dimensions and had a factor structure largely corresponding to that found among other instruments in the QPC family of instruments. The internal consistency of the factors was acceptable except in the case of secure and secluded environment, probably due to few numbers of items. With this exception, the QPC-H shows adequate psychometric properties. Social implications - The residents' ratings of quality of housing service were generally high; the highest rating was for secluded environment and the lowest for participation. This dimension would thus seem to indicate an important area for improvement. Originality/value - The QPC-H includes important aspects of residents' assessment of quality of housing service and offers a simple and inexpensive way to evaluate housing support services from the residents' perspective.

There is a need for an internationally standardized and psychometrically tested instrument to measure the perceptions of staff members on the quality of forensic inpatient care provided. The aim of the present study was to adapt the Swedish instrument Quality of Psychiatric Care-Forensic In-Patient Staff (QPC-FIPS) to the Danish context and to evaluate its psychometric properties and factor structure in this context. All permanently employed staff members at all 27 forensic inpatient wards in Denmark were invited to answer the Danish version of the QPC-FIPS. In total, 641 staff members participated, resulting in a response rate of 80%. The Danish version of the QPCFIPS showed adequate psychometric properties and excellent goodness of fit of the hypothesised factor structure. Hence, the Danish QPC-FIPS is an excellent instrument for evaluating quality of forensic inpatient care both in clinical practice and in cross-cultural research. The members of staff generally reported that the care provided to patients was of high quality. The quality of the forensic-specific dimension was rated the highest, followed by the support, secluded environment, encounter, discharge and participation. The quality of the secure environment dimension was perceived to be the worst. The QPC-FIPS includes important aspects of staff members’ assessments of quality of care and offers a simple and inexpensive way to evaluate psychiatric forensic inpatient care. The QPC-FIPS can be used together with the Quality of Psychiatric Care-Forensic In-Patient (QPC-FIP) instrument, which covers the same items and dimensions as the QPC-FIPS, to identify patients’ and staff members’ views on quality of care and to improve the quality of forensic psychiatric care and benchmarking.

Objective: To investigate the relationship between perceived mental health service provision and quality of life (QoL) as perceived by patients in psychiatric outpatient care.

Methods: A total of 373 adult patients registered at 15 psychiatric outpatient clinics in three regions in central and southern Sweden were included in the study. Survey data were collected using a questionnaire on mental health service provision, symptom severity, recovery, clinical diagnosis, sociodemographics (serving as independent variables) and QoL (serving as the dependent variable). Three aspects of mental health service provision were used: patients’ perceived quality of care, perceived staff-patient interaction, and patient reported psychiatric treatments. Structural equation modelling was used to model the relationship among the variables.

Results: Variables in mental health service provision showed few direct associations with patients’ perceived QoL. Instead, the associations of mental health service provision on QoL were mainly mediated through symptom severity and recovery. These relationships were retained after adjusting for sociodemographic variables and clinical diagnoses. The final model achieved excellent goodness of fit (χ2 = 49.502, p = 0.230, RMSEA = 0.020, CFI = 0.997 and a SRMR = 0.024).

Conclusion: This study shows that mental health service provision is associated with patients’ perceived QoL; however, this association is mostly indirect and mediated by reduced symptom severity and increased recovery. This finding can help inform the design of future interventions to enhance service provision to improve patients’ QoL.

PURPOSE: This study evaluates the dimensionality and differential item functioning of SCL-9S, a short version of the Symptom Checklist-90-R (SCL-90-R), on patients in psychiatric care.

MATERIAL AND METHODS: Based on the factor structure of the Swedish standardization and validation of the SCL-90-R, a nine-item index (SCL-9S) was developed consisting of the items most indicative for each of the nine subscales in SCL-90-R. Rasch analysis was used to evaluate the SCL-9S on a sample of 668 psychiatric outpatients and 167 inpatients across four Swedish regions.

RESULTS: The evaluation revealed that the SCL-9S was unidimensional, the items represented different levels of severity across a general psychological distress dimension, and the scale showed equity (no differential items functioning) across gender and patient groups.

CONCLUSION: The SCL-9S is a fast, structurally valid, and reliable tool for screening general psychological distress among men and women in psychiatric in- and outpatient services, and in combination with other instruments, it will be useful in epidemiological studies.

The study describes and compares perceived quality of care among patients and staff using the Quality in Psychiatric Care–Forensic In-Patient and the Quality in Psychiatric Care–Forensic In-Patient Staff questionnaires. The questionnaires are both based on the perception of the quality of the forensic psychiatric care given to the patients, but the wording is adjusted to fit patients or staff. The study sample consisted of 66 patients and 202 staff members from 12 forensic units in Sweden. Using multiple regression analyses to adjust for demographic variables, it was found that patients perceived the quality of support and secluded environment lower than did staff, whereas staff had lower perceptions than patients of the quality of secure environment. The combination of these questionnaires provides new possibilities for assessing the quality of forensic psychiatric care and evaluating interventions, important factors in the management and planning of forensic care.

Measuring the quality of care received by patients of mental health services is necessary to determine the effectiveness of prevention programs and mental health treatment. This study translated the original Swedish Quality in Psychiatric Care-Outpatient (QPC-OP) instrument to Brazilian Portuguese, adapted it to the context of Brazilian psychosocial care centers (CAPS), and evaluated its psychometric properties. The instrument was translated and back-translated by two independent professional translators. A seven-person expert group of professionals and 31 psychiatric outpatients verified the content validity of the Brazilian Portuguese QPC-OP, which then was completed by 253 outpatients from 16 CAPS in São Paulo, Brazil. Confirmatory factor analysis revealed adequate goodness of fit for the factor structure corresponding to the original Swedish version, except for the discharge dimension. Three additional items added in the Brazilian Portuguese QPC-OP formed a separate factor. The internal consistency of the entire scale was excellent but low in some dimensions. In conclusion, the translation and cultural adaptation of the Brazilian Portuguese QPC-OP was satisfactory, and the psychometric evaluation demonstrated that the concept of quality of mental health care is similarly understood in the Brazilian and Swedish cultural context. Thus, the Brazilian Portuguese QPC-OP is a useful instrument for assessing the quality of care in the Brazilian CAPS context and will be useful in quality assurance and in cross-cultural research addressing quality of mental health care from the patient's perspective.

Aim: The aim of the present study was to adapt and evaluate the psychometric properties and factor structure of the Indonesian version of the Quality in Psychiatric Care - Inpatient (QPC-IP) instrument.

Methods: The QPC-IP is based on a definition of quality of care from the patient's perspective; it consists of 30 items covering six factors. A sample of 150 inpatients at general psychiatric wards in Indonesia completed the QPC-IP questionnaire.

Results: Confirmatory factor analysis revealed that the factor structure of the Indonesian version was equivalent to that of the original Swedish QPC-IP, with the exception of the secluded environment factor. The results thus demonstrate that the concept of quality of care expressed in the QPC-IP is to a large extent equivalent among inpatients in fundamentally different health care systems and cultural contexts. Internal consistency for the full QPC-IP was adequate, but poor for the separate factors.

Conclusion: The Indonesian QPC-IP is a useful instrument for evaluating psychiatric inpatient care, and thus contributes to health care improvement in the field of psychiatry.

AIM: The aim of the present study was to evaluate the psychometric properties and factor structure of the Indonesian version of the Quality of Psychiatric Care - Inpatient Staff (QPC-IPS) instrument.

METHODS: A sample of 192 permanently employed members of staff at two general psychiatric wards in Indonesia completed the QPC-IPS, which consists of 30 items covering six dimensions of quality.

RESULTS: Confirmatory factor analysis revealed that the factor structure of the Indonesian version was equivalent to that proposed from the original Swedish QPC-IPS. Internal consistency for the full QPC-IPS was adequate, but poor for some of the factors. The results thus demonstrate that the concept of quality of care expressed in the QPC-IPS is to a large extent equivalent among staff in fundamentally different health care systems and cultural contexts.

CONCLUSION: The Indonesian QPC-IPS is a useful instrument for evaluating staff perception of psychiatric inpatient care in Indonesia, and thus contributes to health care improvement in the field of psychiatry. The QPC-IPS can be used together with the Quality of Psychiatric Care- In-Patient (QPC-IP) instrument, which is completed by the inpatients themselves, to improve the quality of psychiatric inpatient care and national as well as international benchmarking.

AIMS AND OBJECTIVES: To explore how mental healthcare professionals' experience and evaluate the use of Family-Centred Support Conversation Intervention.

BACKGROUND: Mental health professionals working in the community mental health service provide treatment, care and support to young adults suffering from mental illness. Young adults suffering from mental illness are dependent on other family members and live close to the family. The Family-Centred Support Conversation promotes healing and alleviates the suffering of the family.

DESIGN AND METHODS: A qualitative explorative design was used. Individual interviews with health professionals (n = 13) were conducted in Norway and analysed using a phenomenographic approach. The COREQ checklist was used.

RESULTS: Three descriptive categories emerged: A new tool in the toolbox, the family as a conversational partner and Implementing the intervention, with seven conceptions. The mental health professionals had no previous routine for family support. The conversations helped them to structure the involvement of family members. Having the family as a conversational partner together with the patients was considered both somewhat new and rewarding but also challenging. The mental health professionals described a need to adjust the intervention.

CONCLUSIONS: The Family-Centred Support Conversation was described as a complement to care, as usual, structuring the involvement of families. The knowledge exchange between the families and the mental health professionals may create a context of changing beliefs, strengths and resources.

RELEVANCE TO CLINICAL PRACTICE: Clinical practice is challenged to work on establishing a mindset; whereby, the family is regarded as a resource with important skills and life experience. The family should be offered individualised support and follow-up, and FCSC may be a relevant intervention.

Mental health professionals have a responsibility to ensure the best possible quality of care. Family is strongly involved in the patient's everyday life. The aim of this study was to investigate the relationship between health care professionals' perception of the quality of care, attitudes of family involvement and their own sense of coherence. A descriptive quantitative study with fifty-six health professionals, completed "Quality in Psychiatric Care-Community Outpatient Psychiatric Staff", "Families' Importance in Nursing Care-health professionals' attitudes", "The Sense of Coherence Scale-13". The health professionals perceived quality as high and did not perceive the families as a burden.